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Social and cultural differences between the United States and the United Kingdom mean that positive results from US prevention programmes may not translate to the United Kingdom. The Strengthening Families Programme 10-14 (SFP10-14) has been evaluated in a large Phase III randomized controlled trial in rural Iowa in the United States and shown to be effective for delaying alcohol and drug initiation. This paper reports the first stage of the adaptation and evaluation of the SFP10-14 for the United Kingdom through a process of cultural accommodation of the SFP10-14 materials and format. Themes that emerged in nominal group and focus group research with young people and their parents indicated that changes to the US SFP10-14 materials needed to consider language, narrators, realism, acceptability of exercises/games, perceived religiosity and ethnic representativeness. However, not all changes reflected straightforward cultural differences, as adaptations were also required to improve the quality and to update the material, indicating that cultural accommodation does not necessarily imply cultural diversity. [ABSTRACT FROM AUTHOR]

School drug education is seen by governments as an ideal prevention strategy because it offers the potential to stop use by the next generation. Australian schools expanded drug education substantially during the 1960s in response to rising use by young people, and in 1970 the first national drug education programme was launched. In the mid-1990s the level and quality of drug education increased noticeably. Unfortunately, subsequent national initiatives have failed to capitalise on the gains made during this period. Some good quality, independent research, such as the Gatehouse Project and the School Health and Alcohol Harm Reduction Project (SHAHRP), has been conducted in Australia. However, national-level momentum is being lost, because there is little commitment to the development of evidence-based mass programmes. In this climate drug education has become vulnerable to short-term decision-making that emphasises palatable, policy-driven outcomes and focuses on strategies designed to bolster the legitimacy of these goals. So is Australia 'fair dinkum' about drug education in schools? There is a history of innovation, and past programmes have left behind pockets of expertise, but the challenge is to invest continuously in methods with evidence of success, rather than settle for cyclical programmes driven by the political and moral palliatives of the day. To do less is to fail the young people of Australia. [Midford R. Is Australia 'fair dinkum' about drug education in schools? Drug Alcohol Rev 2007;26:421 - 427] [ABSTRACT FROM AUTHOR]

Objectives. We examined disparities in age-related patterns of marijuana initiation in 2 culturally distinct American Indian reservation communities (from the Northern Plains and the Southwest) compared with a national sample. Methods. We used discrete-time survival models to estimate age-related risk for initiation with data from 2 population-based studies: the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project and the baseline National Comorbidity Survey. Results. Among respondents who were born before 1960, peak risk for marijuana initiation in all samples was at age 18 years, and risk was greatest in the national sample. Among those who were born later than 1960, risk peaked at age 16 years and was highest in the American Indian samples. Males were at increased risk compared with females, especially in the older cohort and the Southwest tribal sample. Conclusions. Findings of disproportionate risk for marijuana initiation among younger members of the tribal samples raise concerns that American Indian reservation youths may be increasingly vulnerable to drug use and its concomitants, which suggests a need for more aggressive prevention efforts in these communities. (Am J Public Health. 2007;97:1311-1318.) [ABSTRACT FROM AUTHOR]

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]

Parent drug education is considered a key aspect of drug prevention. Effective communication acts as protective factor for drug misuse in young people. This study is a Participatory Action Research study of Drugsbridge, a drug education programme that has an emphasis on facilitating intergenerational communication about drugs between parents and unrelated young people. The programme was designed on principles of best practice in parent drug education: the provision of balanced information; the development of communication skills and the merging of parents' and young people's drug education. Qualitative multi-methods were used to ascertain parents' (n = 6) and young people's (n = 11) perspectives and experiences of the programme. The research found that it was valuable to have parents and unrelated young people attend the programme together. Being unrelated removed some of the obstacles within family communication and enabled more open and honest, two-way communication between the generations. Parents developed a more balanced perspective of drugs and young people; and young people were empowered to discuss their own experiences and perspectives. The research, and its limitations, as well as suggestions for further research are discussed. [ABSTRACT FROM AUTHOR]

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]

Prevention researchers and school personnel lack a common understanding concerning the opportunities and burdens of school-based drug prevention research. In this article, we review issues related to researching substance abuse prevention programs in school settings, and assess challenges related to recruitment, communication, research design, surveying, and ensuring program fidelity. We conclude that before any school is enrolled, there must be a mutual understanding as to the nature and extent of the study's requirements and what adjustments a school will have to make to support a successful collaboration. Further, researchers must understand that schools' responsibilities for preparing students to perform well on academic and standardized tests will always overshadow the value they place on participating in studies to evaluate the effectiveness of prevention curricula. [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]

This article presents data from four groups of rural Key Informants--Community leaders, educators, health care providers and justice/law enforcement officials--to understand the nonmedical use and misuse of prescription drugs. Seventy key informants were purposively selected from two counties in Appalachian Kentucky. Key informants indicated that the nonmedical use of prescription drugs is complex and has historical roots. Two pathways, or entry points, into the nonmedical use and misuse of prescription drugs were identified: physical pain and recreational use. Data show trends with regard to drug use patterns, drug use education, involvement with the criminal justice system and the role of economics in the prescription drug use problem. Key Informants underscored a common theme that the rural prescription drug problem was fueled by a cultural acceptance of drug misuse. Recommendations are presented for services and research. [ABSTRACT FROM AUTHOR]

"The Doubles," funded by the National Institute on Drug Abuse, is a seven-episode series of media tools designed to teach third- and fourth-grade students about the science of drug addiction. The program's curriculum was delivered through a set of DVDs, interactive CD-ROMs, workbooks, or an Internet Site. Results indicate that although the interventions were successful in teaching students about the biological bases of substance abuse, they had little effect on student attitudes. Implications for future studies are discussed. [ABSTRACT FROM AUTHOR]

Abstract: This study compares the provision of HIV testing in a nationally representative sample of correctional agencies and community-based substance abuse treatment programs and identifies the internal organizational-level correlates of HIV testing in both organizations. Data are derived from the Criminal Justice Drug Abuse Treatment Studies'' National Criminal Justice Treatment Practices Survey. Using an organizational diffusion theoretical framework [Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: The Free Press], the impact of Centralization of Power, Complexity, Formalization, Interconnectedness, Organizational Resources, and Organizational Size on HIV testing was examined in correctional agencies and treatment programs. Although there were no significant differences in the provision of HIV testing among correctional agencies (49%) and treatment programs (50%), the internal organizational-level correlates were more predictive of HIV testing in correctional agencies. Specifically, all dimensions, with the exception of Formalization, were related to the provision of HIV testing in correctional agencies. Implications for correctional agencies and community treatment to adopt HIV testing are discussed. [Copyright &y& Elsevier]

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]

Abstract: Aims: Methods for the training and fidelity monitoring of behavioral interventions in multi-site addictions research are reviewed, including five published studies and seven ongoing studies sponsored by the National Institute on Drug Abuse-funded Clinical Trials Network. Methods: Methods are categorized and reviewed consistent with a technology model of treatment delivery. Topics include: therapist selection, training, certification, and supervision; selection, training, and certification of supervisors; scales and processes used for monitoring of the quality of treatment; and processes followed to provide new training for replacement staff once trials have begun. Results: The review reveals both a wide array of procedures and emerging standards for multi-site trials. Methodological weakness was observed with respect to limited empirical support for many adherence scales, little or no evaluation of supervisory processes, and no evaluation of re-training practices. Conclusions: Methods used in multi-site trials are important not only to ensure validity of those trials, but also to inform the wider dissemination of empirically based treatment into community agencies. Studies examining noted weaknesses are needed. Training and fidelity models that delegate responsibility to participating sites appear most relevant for establishing best practices for dissemination of behavioral interventions. The effectiveness of these distributed training and supervision models should be subjected to empirical study at a level of rigor comparable to the evaluation of their corresponding treatments. [Copyright &y& Elsevier]

This article questions whether inhalants should continue to be excluded from school-based drug education curricula in Australia. It argues that rationales provided for such a policy in Victoria are, in the main, not supported by recent research. The Australian evidence-base about drug education makes it difficult to predict the outcomes of providing young people with education about any form of drug use, not just inhalants. Nonetheless, a strong case may be made (particularly in disadvantaged communities) for policy change on this issue. [ABSTRACT FROM AUTHOR]

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]

The present paper reports on a study of the efficacy of drugs education delivered to children aged 7 to 11 years through a carefully sequenced high-fidelity programme of classroom based curriculum enrichment activities supported by visiting drug education specialist educators. The programme was designed to map onto the national curriculum requirements of British primary schools and was framed within the conceptual boundaries provided by a 'healthy lifestyles approach'. The programme operated through a spiral curriculum with each year of the programme building on the alms and objectives of preceding years. The overarching aim was to enable children to develop an increasingly sophisticated cognitive framework through which they would be empowered to make informed choices about being safe, healthy and drug-free. 240 children between 3+ and 10+ years of age, were assessed for knowledge and understanding of targeted healthy lifestyles issues prior to and at two points subsequent to the interventions. Children were drawn in approximately equal numbers from nursery classes through to year 6 across 14 schools in one large urban Authority in the North of England. The Authority had adopted a drugs prevention and education programme delivered by a National Charity and supported by teachers and parents. This paper reports on the data from a defined age segment of the total sample. Outcomes indicated that the intervention with subsequent teacher support in-class affected positively children's knowledge of how stay healthy and the likely impact of drugs, alcohol and smoking on the maintenance of health and well-being. However, it became clear that yr6 pupils in particular were overtly conscious of the likely future impact of older pupils on their ability to stay drug free on transferring to Secondary school. This study indicates that whilst interventions at primary school level can achieve valued objectives at the level of knowledge and understanding, the maintenance of these acquired dispositions into adolescence is unlikely in the absence of continuing programmes of education and support on a long-term basis. Interpreting what 10 year olds say, such programmes should enable individual children to acquire strategies of personal empowerment and support their intention to adopt a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Substance abuse is a major problem encountered by social workers in all settings. This study investigated the impact of a post- master's program in the treatment of substance-abusing clients on the domains of "Attitudes and Values," "Knowledge and Skills," and "Behaviors" of its graduates. Overall, 91 percent of respondents found the program to be professionally beneficial to them. Significant increases were shown on all items in the Knowledge and Skills Scale and the - Behavior Scale. Among the greatest changes reflected in the Attitudes and Values Scale were increases in respondents' desire to add substance-abusing clients to their caseloads, their belief for good recovery prognosis, and their comfort level in being considered a substance abuse specialist. The results of this study indicate that completion of a comprehensive, long-term substance abuse training program not only increases clinicians' knowledge about substance abuse issues, but also impacts positively on their attitudes and behavior toward substance-abusing clients. [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]

The article discusses inquiry-based active learning and real-world relevance as means by which teachers can increase student involvement and interest in complex scientific concepts. He introduces a teaching module on the impact of drug abuse on the nervous system as a highly relevant topic for adolescents and a logical topic for teaching neuroscience, biology, psychology, health, chemistry, and math. Also, it has the added advantage of emphasizing the harmful effects of drug use.

This brief comment on Anderson and Baumberg's (2006) review of alcohol in Europe looks at this report from an Irish perspective, with a view to assessing its impact on the alcohol policy debate which has been a feature of Irish society over the past decade. It is argued that the review's empirical data and their accompanying policy recommendations are already broadly familiar to Irish stakeholders in the alcohol policy process, but that the provenance of this report---which has been prepared for the European Commission—creates further potential to tip the balance of Irish alcohol policy in the public health direction espoused by its authors. [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]

This study examined the short-term effects of a web-based alcohol misuse and harm prevention course (College Alc) among incoming freshmen at a California public university. Analysis results indicated that at the end of the fall semester, students randomly assigned to College Alc (n = 173) had a higher level of alcohol-related knowledge and less positive attitudes toward alcohol use than students in the control group (n = 197). Students assigned to College Alc also reported a somewhat higher level of intentions to use strategies to minimize alcohol-related harm. College Alc did not have and effects on other targeted psychosocial factors (e.g., alcohol expectancies), alcohol use and heavy drinking, and alcohol-related problems. Observed effect sites were generally small, suggesting that College Alc may have no effect on students' risk for alcohol misuse and related harm. [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]

Young adults' 3,4-methylenedyoxymethamphetamine (MDMA) use is a national public health concern. Although research on the epidemiology of MDMA use has increased, inquiry into intervention and treatment is needed. The authors examine results from an epidemiological investigation from a clinical perspective and provide suggestions for clinicians working with MDMA users. [ABSTRACT FROM AUTHOR]

This investigation was designed to examine prescription drug-related content and learning objectives in Drug Abuse Resistance Education (D.A.R.E.) for upper elementary and middle schools. Specific prescription-drug topics and context associated with content and objectives were coded. The coding system for topics included 126 topics organized within 14 categories. A two-dimensional coding system for context identified Use versus Abuse and Explicit versus Implicit references to prescription drugs. Results indicated that content and objectives found in D.A.R.E. represent a very narrow breadth of prescription drug topics. Moreover, all prescription-drug related content and objectives were presented in an Abuse-Implicit context. Although some educational material in D.A.R.E. modules potentially is related to prescription drugs, none of the content or objectives explicitly identify drugs discussed as prescription drugs. If elementary and middle schools rely on D.A.R.E. modules to teach students about drug abuse, students are likely to be under-informed about prescription drug risks. [ABSTRACT FROM AUTHOR]

Several studies have highlighted risk factors that cause HIV vulnerability among injection drug users (IDUs); these studies in turn have prompted public health officials to take action to minimize these risks. We sought to evaluate the potential association between binge drug use and HIV seroconversion and, subsequently, risk factors associated with binge drug use among a cohort of IDUs. To do this, we performed analyses of (1) associations with HIV seroconversion and (2) associations with binge drug use among participants enrolled in the Vancouver Injection Drug Users Study (VIDUS), a prospective cohort of IDU. Because serial measures for each individual were available, we undertook a time-updated Cox regression analysis to detect associations with HIV incidence and variables potentially associated with binge drug use were evaluated by using generalized estimating equations (GEE). Overall, 1548 IDU were enrolled into the VIDUS cohort between May 1996 and May 2003. There were 1013 individuals who were HIV seronegative at enrollment and had at least one follow-up visit; 125 (12%) became HIV positive during the study period for a cumulative incidence rate of 14% at 64 months after enrollment. In the final multivariate model, binge drug use [Adjusted Hazards Ratio: 1.61 (CI: 1.12, 2.31)] was independently associated with HIV seroconversion. In subanalyses, when we evaluated associations with binge drug use in GEE analyses, borrowing [Odds Ratio (OR): 153 (CI: 1.33-1.76)] and lending [OR: 1.73 (CI: 1.50-1.98)] syringes, sex trade work [OR: 1.14 (CI: 1.01-1.29)], frequent cocaine [OR: 2.34 (CI: 2.11-2.60)] and heroin [OR: 1.29 (CI: 1.17-1.43)] injection were independently associated with binge drug use and methadone [OR: 0.80 (CI: 0.71-0.89)] was protective against binge drug use. Our study identified an independent association between binge drug use and HIV incidence and demonstrated several high-risk drug practices associated with bingeing. Given the unaddressed public health risks associated with bingeing, a public health response protocol must be developed to minimize the personal and public health risks associated with the binge use of drugs. [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]

Study Objectives. To enhance physician and patient awareness of polypharmacy; to decrease the risks, drug costs, and waste resulting from polypharmacy; and to make the business case for reducing misuse, overuse, and underuse of drugs by reducing polypharmacy. Design. Longitudinal, time series cohort. Setting. Outpatient, managed care, integrated delivery system. Patients. A total of 195,971 patients who received health care from the Henry Ford Medical Group and had health insurance coverage from the Health Alliance Plan. Measurements and Main Results. Two identical interventions separated by 1 year were conducted in patients at high risk of harm from polypharmacy based on five categories of high-risk drug combinations (referred to as polypharmacy events). Six months of pharmacy claims data were reviewed before and after each intervention to identify these patients. The intervention program consisted of clinical pharmacists performing drug therapy reviews, educating physicians and patients about drug safety and polypharmacy, and working with physicians and patients to correct polypharmacy problems. Prescription cost/member/month, number of prescriptions/member/month, and rates of polypharmacy events/1000 members were measured before and after each of the two interventions. After the first intervention, the overall rate of polypharmacy events decreased from 29.01 to 9.43/1000 patients (67.5% reduction). The number of prescriptions/member/month decreased from 4.6 to 2.2 (52.2% reduction), prescription cost/member/month decreased from $222 to $113 (49.1% reduction), and overall institution drug cost was reduced by $4.8 million. Six months after the second intervention, the overall rate of polypharmacy events was reduced from 27.99 to 17.07/1000 (39% reduction), the number of prescriptions/member/month decreased from 4.5 to 4.0 (11.1% reduction), and prescription cost/member/month decreased from $264 to $239 (9.5% reduction). Overall institution drug costs were reduced by $1.3 million. Sustained effects were seen for all measures of polypharmacy (p=0.001). Conclusions. These interventions reduced drug costs and numbers of prescriptions in a managed care cohort of patients at high risk for adverse drug events due to polypharmacy. By providing clinical information, decision support, patient self-management support, and care delivery redesign some of the problems resulting from polypharmacy can be solved. [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]

The article focuses on drug abuse in the youths of Australia. Generally drug education is one instrument used by governments in schools to help limit the negative short and long- term affects of drug-use on the individuals and also the community at large. This article links the curriculum's content to the views shaped by ethical fear, which tries to inform that the drug use is solely an individual problem. It also examines some of the social aspects of one such program, the harm reduction approach of the drug education syllabus in New South Wales. choices. It places a deficit model by means of which the youth are constructed as incorrigibly unfit and inadequate in their understanding of drugs. The psychological empathetics of drug use focus on individual deficiencies and the establishment of healthy models. Though, the individualizing nature of drug education response neglects to take into the account the cultural, structural, and environmental factors of drug-use, the youth drug use exists within its own set of values, roles and interactions.

Comments on the application of social cognitive theory to enhance the effectiveness of alcohol and drug education programs. Triadic reciprocity between behavior, personal factors and environment; Primary determinants of the theory including knowledge of health risks and benefits of healthy practices; Significance of intervention studies for the application of the theory.

Abstract: This paper examines the drug-related decisions of a previously under researched group of children; those in their pre-teen and early teenage years. Based on a prospective study of 92 ‘at risk’ children, it explores the reasons which they gave for their use or non-use of illegal drugs. The accounts of those who used drugs on a regular or occasional basis are strongly supportive of the importance of personal choice, emphasising the role of enjoyment and boredom as the main motivating factors. The reasons given for not using drugs included a lack of interest in the activity, fear of the effects of the drug and a concern that drug taking would compromise other valued activities or pursuits. The anticipated reaction of parents, and the extent to which they had internalised parental values on drugs, also appeared to act as an important restraint for some of the children. While there is a vital role for drug education in seeking to influence children''s drug-related decisions, the study''s conclusions also emphasise the significance of parents in this regard. The fact that the overwhelming majority of the children reported using drugs because they enjoyed them or because they were bored also suggests that the provision of alternative activities should be central to any preventive strategy. [Copyright &y& Elsevier]

Abstract: In this paper we estimate the risk of becoming cannabis dependent within 24 months after first use of cannabis and examine subgroup variation in this risk. The study estimates are based on the National Household Survey on Drug Abuse conducted during 2000–2001, with a representative sample of U.S. residents ages 12 and older (n =114,241). A total of 3352 respondents were found to have used cannabis for the first time within a span of up to 24 months prior to assessment. An estimated 3.9% of these recent-onset users developed a cannabis dependence syndrome during the interval since first use (median interval duration ∼12 months). Excess risk of cannabis dependence was found for those with cannabis onset before late-adolescence, those with family income less than US$ 20,000, and those who had used three or more drugs before the first use of cannabis (i.e., tobacco, alcohol, and other drugs). While these findings generally support previous study results, this study''s focus on recent-onset users more closely approximates prospective and longitudinal research on the incidence (risk) of becoming cannabis dependent soon after onset of cannabis use, removing the influence of users with long-sustained or persistent cannabis dependence developed years ago. [Copyright &y& Elsevier]

Abstract This study examines ethnic differences in relationships between a large number of risk factors and adolescent binge drinking with data collected from 14 to 17 year olds who participated in the 1999 National Household Survey on Drug Abuse (NHSDA). Logistic regression analyses were conducted to determine whether 39 risk factors in community, family, school, and peer-individual domains were differentially associated with past-30-day binge drinking among youth in ethnic minority groups (black, Hispanic and Asian) relative to whites. Forty-three percent (17) of the risk factors examined were differentially associated with binge drinking in at least one of the ethnic groups relative to whites. Most of these risk factors were more strongly associated with binge drinking among white adolescents than Hispanic and black youth, but not Asians. The direction of the relationships between these risk factors and binge drinking, however, was usually the same for whites and ethnic minority groups. A multivariate prediction model indicated that risk factors in the community, family, school, and peer-individual domains accounted for 27% of the variance in binge drinking for white adolescents, 22% for Hispanics, 10% for blacks, and 39% for Asians. These findings suggest that research is needed to identify additional risk factors that are associated with binge drinking among adolescents, particularly blacks, Hispanics and possibly other ethnic minority groups. [ABSTRACT FROM AUTHOR]

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]

BACKGROUND:: Studies of the prevalence of DSM-IV alcohol use disorders (AUDs) in general population samples of adolescents and adults are rare. Comparisons of the prevalence of alcohol abuse and dependence in adolescent surveys with the prevalence in adult general population surveys are confounded by differences in survey design and measurement, thereby reducing their validity. The purpose of the present study was to examine the effects of age, sex, race/ethnicity, and drinking status on the prevalence of DSM-IV alcohol abuse and dependence (including diagnostic orphans) and associated diagnostic criteria among adolescents and adults aged 12-65 years in a single representative sample of the US population.METHODS:: This study was based on data from the 2001 National Household Survey on Drug Abuse public use file. Of the 55,561 subjects in the survey, 33,576 (60.5%) reported alcohol use in the past year and provided information on DSM-IV AUD criteria. DSM-IV AUD criteria were assessed by questions related to specific symptoms occurring during the past 12 months.RESULTS:: Overall, the most prevalent criteria of DSM-IV alcohol dependence were “tolerance” and “time spent obtaining alcohol, drinking, or getting over its effects.” The most prevalent criterion of DSM-IV alcohol abuse was “hazardous use.” The prevalence of alcohol abuse only and of dependence with and without abuse was highest among respondents aged 18-23 years, followed by respondents aged 12-17 years, and lowest among respondents aged 50 years and older. Among subgroups of current and heavier drinkers, differences between adolescents and young adults were less pronounced, especially among females. For each age group, the prevalence of alcohol abuse only was greater than the prevalence of dependence (with or without abuse). The abuse-to-dependence ratios also were generally consistent across age groups and slightly higher among males (2.1:1.0) than females (1.6:1.0).CONCLUSIONS:: The higher prevalence for some dependence criteria among adolescents and young adults as measured in the present study may blur the distinction between symptom reports associated with the normative development of drinking patterns and clinically relevant aspects of DSM-IV alcohol dependence. [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]

This study compared the perceptions of head athletic trainers (HATS) from NCAA member Divisions I, II, and III regarding current athletic department drug education policies in their institutions. A Web-based questionnaire collected responses from 353 HATS. Drug education programs focused more on providing information about the negative consequences of drugs than changing the attitudes and behaviors of students in relation to drug use. More Division I and II schools offered comprehensive ATOD education programs to their athletes compared to Division III schools; however, the majority of these programs were not scheduled on a regular basis. HATS in all divisions reported that the abuse of alcohol and other drugs by student athletes during and after athletic and social events was a significant concern and indicated the importance of scheduling drug education programs closer to such events. Majority of HATS did not view participating in the drug education programs as part of their professional duties; however, they expressed an interest to increase their involvement in these activities. [ABSTRACT FROM AUTHOR]

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

We live in a drug-using society and therefore children need access to good drug education so that they can learn to live safely in our society. There is a wealth of advice, information and guidance available to help us deliver good drug education. Drug education is best taught through the PSHE curriculum but the science curriculum also has an important part to play. [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]