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Background: Cannabis use is a global public health issue associated with increased risks of developing mental health disorders, especially in young people. We aimed to investigate the relationships between cannabis exposure and risks of receiving mental illness diagnoses or treatment as outcomes. Methods: A population based, retrospective, open cohort study using patients recorded in 'IQVIA medical research data', a UK primary care database. Read codes were used to confirm patients with recorded exposure to cannabis use who were matched up to two unexposed patients. We examined the risk of developing three categories of mental ill health: depression, anxiety or serious mental illness (SMI). Results: At study entry, the exposed cohort had an increased likelihood of having experienced mental ill health [odds ratio (OR) 4.13; 95% confidence interval (CI) 3.99–4.27] and mental ill health-related prescription (OR 2.95; 95% CI 2.86–3.05) compared to the unexposed group. During the study period we found that exposure to cannabis was associated with an increased risk of developing any mental disorder [adjusted hazard ratio (aHR) 2.73; 95% CI 2.59–2.88], also noted when examining by subtype of disorder: anxiety (aHR 2.46; 95% CI 2.29–2.64), depression (aHR 2.34; 95% CI 2.20–2.49) and SMI (aHR 6.41; 95% CI 5.42–7.57). These results remained robust in sensitivity analyses. Conclusion: These findings point to the potential need for a public health approach to the management of people misusing cannabis. However, there is a gross under-recording of cannabis use in GP records, as seen by the prevalence of recorded cannabis exposure substantially lower than self-reported survey records. [ABSTRACT FROM AUTHOR]

Aims: To explore reasons why individuals who prefer to use heroin by routes other than injection have abstained from injecting despite entrenched heroin use. Methods: A cross-sectional interview using structured and semi-structured questions was carried out with 40 non-injecting heroin users (20 former injectors and 20 who had never injected) recruited at two Community Drug Team sites in Birmingham, UK. Results: The most endorsed reason for non-injection was worry about appearance. Additional reasons included identity issues and stigmatized status of injecting. 'Never injectors' were younger (p

Twenty of the 24 drug users receiving prescribed injectable methadone from a citywide drug treatment service agreed to participate in a semi-structured interview about their drug use and treatment. Participants reported that they were originally prescribed injectable methadone to replace street purchases because they could not tolerate oral methadone or because of an inability to stop injecting. The experience of injectable methadone was reported as having led to significant improvements in drug use and life stability and reductions in risk behavior, but several participants compared injectable methadone unfavorably to injectable heroin, either in the form of street heroin or prescribed diamorphine. Although a number of the respondents reported sufficient stability to contemplate employment and relationships, few spoke about abstinence as a viable goal in the short-term and many participants reported considerable ambivalence about the experience of receiving injectable methadone prescriptions.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.06.005 Byline: Alex Copello (a)(b), Emmie Williamson (c), Jim Orford (a)(b), Ed Day (a)(d) Keywords: Addiction; Substance abuse treatment; Social environment; Intervention; Social influences Abstract: This paper reports on the implementation and preliminary evaluation of Social Behaviour and Network Therapy (SBNT) within drug treatment services. SBNT was initially developed and evaluated as part of a trial for alcohol treatment in the UK (UKATT). For the study reported in this paper SBNT was adapted for application with drug users. Therapists (N =20) from community drug services in Birmingham, UK, were trained to deliver the intervention. Training methods were supported by a treatment manual and included a two-day workshop followed by video supervision and monitoring. Following training therapists were asked to implement the treatment within the services in which they worked. Twelve of the therapists that were trained delivered SBNT to 24 clients within the study period of 8 months. Baseline and 3-month follow-up measures were administered using both quantitative and qualitative methods. This paper reports the quantitative results including drug use, levels of dependence, drug users' social network variables and family environment. Results suggest that it was feasible to train a number of therapists to deliver SBNT, and preliminary outcome results are encouraging. Further evaluation is needed in order to continue developing this promising social intervention. Author Affiliation: (a) Substance Misuse Services, Birmingham and Solihull Mental Health NHS Trust, UK (b) School of Psychology, The University of Birmingham, Edgbaston, Birmingham B15 2TT, UK (c) Department of Clinical Psychology, Bristol University, Bristol, UK (d) Academic Department of Psychiatry, The University of Birmingham, UK

Research has highlighted the benefits of professional substance misuse treatment workers facilitating their clients' involvement in 12-step self-help groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). This study used a cross-sectional survey design to explore the attitudes of substance misuse treatment stall' working in the English West Midlands region toward AA and NA and the 12-step philosophy. A total of 346 treatment workers responded (71%). Fewer than 10% used the 12-step model in their treatment work, and only a third fell that their clients were generally suited to AA or NA. Fewer than half (46%) said that they were likely to recommend that their clients attend a self-help group meeting. Staff with nursing qualifications were more likely to have a positive attitude toward AA/NA than their nonnursing colleagues, and there was a statistically significant association between the level of reported spirituality of the workers and the likelihood of them recommending to clients that they attend AA or NA meetings. These results highlight differences in the role of AA/NA within the substance misuse treatment system in the United Kingdom and that in the United States: possible explanations are discussed. Keywords: Substance use disorders: Staff attitudes: Alcoholics anonymous; Narcotics anonymous: 12-Step treatment

Keywords * substance abuse * alcohol and alcoholism * health promotion These keywords are based on the subject headings from the British Nursing Index. This article has been subject to [...]