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Drug Problems (drug + problem)
Selected AbstractsThe MOST Project: Economic and Social Transformations Connected with the International Drug ProblemINTERNATIONAL SOCIAL SCIENCE JOURNAL, Issue 169 2001Article first published online: 16 DEC 200 [source] Addiction research centres and the nurturing of creativity: The Swiss Institute for the Prevention of Alcohol and Drug Problems.ADDICTION, Issue 5 2009future, present ABSTRACT The aim of this paper is to offer an account of the history, the current status and the future of substance use research at the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA). Although founded originally by the temperance movement in 1901, its policy has shifted over time towards one which accepts an alcohol-consuming culture made up of self-determined but well-informed consumers, while still supporting those who choose to live an abstinent life. In the beginning, SIPA was involved primarily in collecting alcohol-related information and making it available to professionals and the general public. From the late 1960s SIPA began conducting its own research projects; by the mid-1970s it had set up its own in-house research department. In 2001, SIPA was appointed a World Health Organization (WHO) Collaborating Centre for Substance Abuse, Research, Prevention and Documentation. As a private non-governmental organization, most of its funding comes from external research commissions. SIPA participates in a variety of international projects [e.g. Gender Alcohol and Culture: An International Study (GenACIS), European School Survey Project on Alcohol and Drugs (ESPAD) and Health Behaviour in School-aged Children (HBSC)] and contributes to numerous national research projects dealing with substance use. It has also forged close links with more than 50 other research institutions in Switzerland and world-wide. Thanks to its work over the last 30 years, SIPA has become a chief port of call for alcohol use research in Switzerland. In the future, SIPA will continue to monitor substance use, while stepping up its prevention research activities and ensuring that it is able to react more promptly to emerging phenomena. [source] Personality and psychopathology in an impulsive aggressive college sampleAGGRESSIVE BEHAVIOR, Issue 1 2006Laura E. Helfritz Abstract Certain personality traits have been associated with impulsive aggression in both college and community samples, primarily irritability, anger/hostility, and impulsivity. The literature regarding the psychopathology associated with impulsive aggression is relatively sparse and strongly emphasizes DSM-IV-TR [APA, 2000] Axis II personality disorders, although some comorbidity with Axis I clinical disorders has been reported. The current study compares impulsive aggressive (IA) college students with their non-aggressive peers on several self-report measures of personality and psychopathology. Personality results were as predicted, with IAs scoring higher than controls on measures of impulsivity and aggression. Additionally, the Psychopathic Personality Inventory (PPI), which was given for exploratory purposes, revealed a unique pattern of psychopathic traits in impulsive aggression that contained key differences from the callous-unemotional profile seen in premeditated aggression. Contrary to our hypothesis that a specific pattern of psychopathology (personality disorders, bipolar disorder, and adult attention deficit hyperactivity disorder) would emerge for impulsive aggression, IAs scored significantly higher than controls on nearly every clinical scale of the Personality Assessment Inventory (PAI; Somatic Complaints, Anxiety, Anxiety-Related Disorders, Depression, Mania, Schizophrenia, Borderline Features, Antisocial Features, Alcohol Problems, and Drug Problems), indicating a global elevation of psychopathology. In conclusion, while the personality traits and behaviors that characterize impulsive aggression are relatively consistent across individuals, its associated psychopathology is unexpectedly variable. Aggr. Behav. 00:1,10, 2005. © 2005 Wiley-Liss, Inc. [source] 1985 and all that: The establishment of Australia's Drug StrategyDRUG AND ALCOHOL REVIEW, Issue 2 2009NEAL BLEWETT Abstract A national drug summit in the mid-1980s played a pivotal role in the establishment of Australia's National Drug Strategy. It transformed the delivery of drug policies in Australia and gave us the instruments to understand our drug problem, namely national Centres of Excellence, including the National Drug Research Institute. This paper examines how a ,bundle of compromises' came together in the political context of the mid-1980s to give rise to, for the first time, a cooperative national campaign that continues to drive Australia's drug strategy today.[Blewett N. 1985 and all that: The establishment of Australia's Drug Strategy. Drug Alcohol Rev 2009;28:96,98] [source] The drug situation in Thailand: the role of government and the policeDRUG AND ALCOHOL REVIEW, Issue 1 2000Dr. SUTHAM CHEURPRAKOBKIT Abstract Thailand has long dealt with the drug problem and has used several strategies to control it, including promulgating and amending drug laws, implementing drug suppression and prevention policies, cooperating with international organizations and, more recently, developing treatment facilities. Although Thailand has recently received positive results regarding reducing the opium cultivation area in the Golden Triangle and in arresting some major drug-trafficking individuals, three important issues still remain: (1) the continuation of using Thailand's advanced transportation system for the movement of illicit drug activities, (2) the rapid increase of amphetamine use among teenagers and (3) the Thai police officers' lack of concern about the drug problem and insufficient knowledge about drug laws. The article concludes that the Thai government must emphasize drug prevention strategies and the interception of illicit transported drugs and motivate its police officers to more fully enforce drug laws. In addition, more research is needed to measure the effectiveness of the drug prevention strategies and treatment programs. [source] Drug use and perceived treatment need among newly sentenced prisoners in England and WalesADDICTION, Issue 2 2009Duncan Stewart ABSTRACT Aims To investigate pre-custody levels of drug use among newly sentenced prisoners and factors associated with perceived drug treatment need. Design, setting and participants A sample of 1457 prisoners was recruited to a general purpose longitudinal survey of convicted prisoners starting a new sentence. Measurements Data were collected by structured interviews on reception to prison. Measures were taken of illicit drug use, drug treatment history, current treatment needs, psychological health and a range of social problems. Findings Life-time use of heroin, crack cocaine, cocaine powder, amphetamines or cannabis was reported by 79% of prisoners. Cannabis was the drug reported most commonly, but approximately a third had used heroin or crack cocaine during the year before custody. Nearly half of recent drug users reported wanting help or support with a drug problem during their sentence. Dependence on heroin and cocaine, previous drug treatment, employment, accommodation and psychological health problems were all associated positively with perceived treatment need. Conclusions The prevalence of pre-custody drug use among this sample of newly sentenced prisoners was high. Because treatment need was associated with a range of drug, health and social factors, assessment and referral to appropriate interventions should occur as soon as possible on reception. Treatment should be coordinated with other services and support. [source] The relative efficacy of two levels of a primary care intervention for family members affected by the addiction problem of a close relative: a randomized trialADDICTION, Issue 1 2009Alex Copello ABSTRACT Objectives A randomized trial to compare two levels of an intervention (full versus brief) for use by primary health-care professionals with family members affected by the problematic drug or alcohol use of a close relative. Design A prospective cluster randomized comparative trial of the two interventions. Setting A total of 136 primary care practices in two study areas within the West Midlands and the South West regions of England. Participants A total of 143 family members affected by the alcohol or drug problem of a relative were recruited into the study by primary health-care professionals. All recruited family members were seen on at least one occasion by the professional delivering the intervention and 129 (90 %) were followed-up at 12 weeks. Main outcome measures Two validated and standardized self-completion questionnaires measuring physical and psychological symptoms of stress (Symptom Rating Test) and behavioural coping (Coping Questionnaire) experienced by the family members. It was predicted that the full intervention would show increased reduction in both symptoms and coping when compared to the brief intervention. Results The primary analysis adjusted for clustering, baseline symptoms and stratifying variables (location and professional group) showed that there were no significant differences between the two trial arms. The symptom score at follow-up was 0.23 [95% confidence interval (CI): ,3.65, +4.06] higher in the full intervention arm than in the brief intervention arm, and the coping score at follow-up was 0.12 (95% CI: ,5.12, +5.36) higher in the full intervention arm than in the brief intervention arm. Conclusions A well-constructed self-help manual delivered by a primary care professional may be as effective for family members as several face-to-face sessions with the professional. [source] Methamphetamine precursor regulation: are we controlling or diverting the drug problem?ADDICTION, Issue 4 2008REBECCA MCKETIN No abstract is available for this article. [source] Twelve-Step Groups, Attributions of Blame for Personal Sadness, Psychological Well-Being, and the Moderating Role of Gender,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 3 2000J. B. Kingree Two studies investigated links among 12-step group participation, gender, attributions of blame for personal sadness, and psychological well-being. Study I used a correlational design to examine these links cross-sectionally among substance abusers who identified alcohol as their primary drug problem. Study 2 used an experimental design to examine prospective links among these variables for substance abusers who were also adult children of alcoholics. Females engaged in more blame than did males, and personal blame was negatively related to psychological well-being in Studies 1 and 2. Most significantly, 12-step group participation was associated with lower personal blame among females but not among males across both studies. These results indicate that 12-step groups can reduce personal blame among females who have substance abuse problems. [source] The size and mix of government spending on illicit drug policy in AustraliaDRUG AND ALCOHOL REVIEW, Issue 4 2008TIMOTHY J. MOORE Abstract Aim. To estimate how much governments in Australia spend on reducing and dealing with illicit drug problems. Methods. Government documents and supplementary information sources were used to estimate drug-related expenditure for the financial year 2002,03, in Australian dollars. Public sector expenditure on reducing drug problems (,proactive expenditure') was classified into four policy functions: prevention, treatment, harm reduction and enforcement. Expenditure related to the consequences of drug use (,reactive expenditure') was included as a separate category. Results. Spending by Australian governments in financial year 2002,03 on all drug-related activities was estimated to be $3.2 billion. Proactive expenditure was estimated to be $1.3 billion, comprising 55% on enforcement, 23% on prevention, 17% on treatment, 3% on harm reduction and 1% on activities that span several of these functions. Expenditure on dealing with the consequences of drug use was estimated to be $1.9 billion, with the majority the result of crime-related consequences. Conclusion. Several insights result from estimating these expenditures. First, law enforcement is the largest drug policy component, with Australian governments also spending significant amounts on treatment and prevention programmes. Secondly, apart from the prevention component, Australia's drug policy mix is strikingly similar to recent international estimates. Finally, expenditures associated with dealing with the consequences of illicit drugs are large and important for assessing drug-related public sector expenditure. [source] ASIA PACIFIC COLUMN: New challenges and opportunities in managing substance abuse in MalaysiaDRUG AND ALCOHOL REVIEW, Issue 5 2006MAHMUD MAZLAN MD Abstract Until recently, Malaysia has lagged behind in the treatment of drug addiction and related disorders, despite experiencing severe drug problems. By the end of 2004, 234 000 heroin users or heroin-dependent individuals had been registered in the official government registry, but other estimates exceed 500 000 for heroin abusers in the country. Amphetamine-type stimulant abuse is also increasing and of considerable public and government concern. Among the population of drug users, HIV and other infectious diseases rates are very high. In the Western Pacific regions, Malaysia has the second highest HIV prevalence (after Vietnam) among adult populations (0.62%) and the highest proportion of HIV cases resulting from injection drug use (76.3%). Drug use and related disorders exert a heavy burden on the country's health care and legal systems. Historically, drug abusers were rehabilitated involuntarily in correctional, rather than health-care, facilities. This primarily criminal treatment approach had limited effectiveness which led to widespread public dissatisfaction and the recent introduction of medical treatments for addiction. Naltrexone was introduced in 1999; buprenorphine was introduced in 2001 and methadone in 2003. Agonist maintenance programmes were embraced rapidly by the medical community in Malaysia. Currently, over 30 000 opiate-dependent patients are treated with agonist maintenance treatments by more than 500 medical practitioners in Malaysia. Despite these recent advances, treatments for amphetamine-type stimulant abuse or dependence are underdeveloped, and diversion of agonist medications is an emerging concern. [source] Childhood adversity in alcohol- and drug-dependent women presenting to out-patient treatmentDRUG AND ALCOHOL REVIEW, Issue 4 2001RAINE BERRY Abstract Eighty alcohol- and/or drug-dependent women who were consecutive admissions to a representative out-patient alcohol and drug service in Christchurch were interviewed with the aim of establishing the extent of exposure to childhood adversity including childhood sexual, physical and emotional abuse and parental problems. The results show that a sizeable percentage of the women came from backgrounds characterized by parental conflict and alcohol and drug problems. Within their first 15 years 51% were subjected to sexual abuse involving attempted or completed oral, anal or vaginal intercourse and 39% were exposed regularly to physical abuse perpetrated by their parents or main parental figures. Over half reported experiencing emotional abuse rated as being ,very distressing' and two-thirds had been exposed to ,very distressing' parental problems. The main implication for clinical practice arising from the results of this study is the need for the development of a broader approach to alcohol and drug service provision. In order to achieve positive treatment outcomes, alcohol and drug services may need to routinely screen and plan treatment for childhood adversity and associated problems in all clients presenting for alcohol and drug treatment. [source] Commentaries on the NSW Drug Summit: The treatment of drug problemsDRUG AND ALCOHOL REVIEW, Issue 2 2000GILBERT WHITTON No abstract is available for this article. [source] Prediction of twelve-month service disengagement from an early intervention in psychosis serviceEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2007Mark Turner Abstract Aim: The aim is to examine disengagement in an early psychosis treatment service and contrast clinical and demographic variables of patients who disengage against those who do not. Methods: Those with termination of treatment, despite therapeutic need within 12 months of entry (disengagers) (n = 57; 24.6%), were compared with those who remained in treatment at 12 months (n = 175) on a range of clinical and demographic variables collected at admission. After testing the difference between proportions, data analysis was conducted using methods of logistic regression. Results: Alcohol and/or cannabis abuse/dependence, initial diagnosisother than mood disorder, long duration of untreated psychosis, lower Positive and Negative Syndrome Scale total symptoms, and lower insight at referral accounted for 27% of variance in patient ,disengagement' within 12 months. Conclusion: A significant proportion of patients with first episode psychosis disengage from treatment within 12 months. Despite a number of factors being associated with disengagement, prediction using admission factors was poor. Early Intervention in Psychosis Services would benefit from increased attention to alcohol and drug problems, trying to reduce the duration of untreated psychosis, improving psychiatric symptoms and increasing insight in all patients to decrease service disengagement. [source] Seeing America,diary of a drug-focused study tour made in 1967ADDICTION, Issue 6 2010Griffith Edwards ABSTRACT In 1965 the British government was forced to admit that the country had an escalating heroin problem, with the supply coming mainly from prescribing by private practitioners. Within the official responses to what was seen at that time as a very worrying public health situation was the decision to fund the setting-up of the Addiction Research Unit (ARU) at the Institute of Psychiatry, London. The US National Institute of Mental Health (NIMH) generously sponsored a study tour for the nominated director of the ARU shortly before the opening of the British research centre. Extensive contemporaneous diary notes of a visit included contact with administrators, researchers, clinicians, parish priests, narcotic agents and addicts themselves. From a mass of often conflicting advice, some insights could be derived. In particular, these included the need for an awareness of any country's way of dealing with drug problems as a dynamic, multi-factorial total system,a holistic ,national response'. A further conclusion was to see policy itself as a complex subject for analysis: drug policy should be as much an issue for research as drug taking. Besides these broad conclusions, the experience provided many specific leads to development of a British addiction research programme, and fostered professional friendships of immeasurable worth. [source] Heroin-assisted treatment in Switzerland: a case study in policy changeADDICTION, Issue 1 2010Ambros Uchtenhagen ABSTRACT Background Switzerland introduced a pragmatic national drug policy when the former conservative abstinence-orientated politics proved unable to cope with an escalating number of users and related negative consequences for public health and public order. The high visibility of ,needle parks' and the size of the acquired immune deficiency disorder (AIDS) epidemic called for a new approach and for national leadership. Aims To describe the intentions, the process and the results of setting up the new treatment approach of prescribing heroin to treatment resistant heroin addicts, as an example of drug policy change. Materials and Methods A systematic collection of relevant documents is analysed and used as evidence for describing the process of policy change. Results Measures to reduce the negative consequences of continued use and to prevent the spread of AIDS were started mainly by private initiatives and soon taken up officially in the ,four-pillar' drug policy (including harm reduction, prevention, treatment and law enforcement). Medical prescription of heroin to chronic, treatment-resistant heroin addicts was one of the innovations, based on extensive scientific and political preparation. Detailed documentation and evaluation, ample communication of results, adaptations made on the basis of results and extensive public debate helped to consolidate the new policy and heroin-assisted treatment, in spite of its limitations as an observational cohort study. All necessary steps were taken to proceed from a scientific experiment to a routine procedure. Discussion Comparable policy changes have been observed in a few other countries, such as The Netherlands and Germany, based on the Swiss experience, with equally positive results of heroin-assisted treatment. These experiments were designed as randomised controlled trials, comparing intravenous heroin against oral methadone, thereby demonstrating the specific value of pharmaceutical diamorphine for maintenance treatment in opiate dependence. The positive impact of policy change and the positive outcomes of heroin-assisted treatment were acknowledged increasingly nationally and internationally, but made it difficult to continue the process of adapting policy to new challenges, due to the low visibility of present drug problems and to changing political priorities. Conclusion A major change in drug policy was effectively realised under typical conditions of a federalist country with a longstanding tradition of democratic consensus building. Facilitating factors were the size and visibility of the heroin problem, the rise of the Aids epidemic, and a pragmatic attitude of tolerating private initiatives opening the way to official policy change. [source] Ten years after the United Nations General Assembly Special Session (UNGASS): assessing drug problems, policies and reform proposalsADDICTION, Issue 4 2009Peter Reuter ABSTRACT In 1998 the United Nations General Assembly Special Session resolved that governments would reduce drug production and consumption greatly within 10 years. With that period now elapsed, there is an interest in reviewing how successful this was and considering how drug policy could be improved. The demand for drugs in the world has stabilized mainly as a result of the interaction of epidemic forces, culture and economic development. Supply has become more concentrated and the menu of drugs has changed surprisingly slowly. Drug policy is shifting to a more explicitly tolerant configuration in Europe and a few other countries, but retains its ferocity in most of the world. The most prominent innovations under discussion have limited potential effects (heroin maintenance), have as yet been unproductive of policy interventions (,addiction is a brain disease') or have no political appeal (legalization). The option with the most scope is increased effort at diverting arrested drug users out of criminal justice systems. No prevention, treatment or enforcement strategies have demonstrated an ability to substantially affect the extent of drug use and addiction. The best that government interventions can do is to reduce the damaging consequences of drug use and drug control. More attention should be given to reductions in the intensity of drug enforcement, which has many unintended adverse consequences and yields few of the claimed gains. [source] Prevalence and socio-demographic correlates of drug use among adolescents: results from the Mexican Adolescent Mental Health SurveyADDICTION, Issue 8 2007Corina Benjet ABSTRACT Aims To estimate the life-time and 12-month prevalence of illicit drug use among Mexican adolescents, the age of onset of first drug use and the socio-demographic correlates. Method A multi-stage probability survey of adolescents aged 12,17 years residing in the Mexico City Metropolitan Area was carried out in 2005. Adolescents were administered the computer-assisted adolescent version of the World Mental Health Composite International Diagnostic Interview by trained lay interviewers in their homes. The response rate was 71% (n = 3005). Descriptive and logistic regression analyses were performed considering the multi-stage and weighted sample design of the survey. Findings Of the adolescents, 5.2% have ever tried illicit drugs, 2.9% in the last 12 months. The most frequently used drugs are marijuana, followed by tranquilizers/stimulants. The median age of first use is 14 years. Correlates of life-time drug use are older age, having dropped out of school, parental drug problems, low religiosity and low parental monitoring. Conclusions While drug use among Mexican adolescents is lower than among adolescents from other developed countries, its increasing prevalence with age and the narrowing male/female ratio calls for firm public health actions, particularly prevention strategies. [source] In 12-step groups, helping helps the helperADDICTION, Issue 8 2004Sarah E. Zemore ABSTRACT Aims The helper therapy principle suggests that, within mutual-help groups, those who help others help themselves. The current study examines whether clients in treatment for alcohol and drug problems benefit from helping others, and how helping relates to 12-step involvement. Design Longitudinal treatment outcome. Participants An ethnically diverse community sample of 279 alcohol- and/or drug-dependent individuals (162 males, 117 females) was recruited through advertisement and treatment referral from Northern California Bay Area communities. Participants were treated at one of four day-treatment programs. Measurements A helping checklist measured the amount of time participants spent, during treatment, helping others by sharing experiences, explaining how to get help and giving advice on housing and employment. Measures of 12-step involvement and substance use outcomes were administered at baseline and a 6 month follow-up. Findings Helping and 12-step involvement emerged as important and related predictors of treatment outcomes. In the general sample, total abstinence at follow-up was strongly and positively predicted by 12-step involvement at follow-up, but not by helping during treatment; still, helping positively predicted subsequent 12-step involvement. Among individuals still drinking at follow-up, helping during treatment predicted a lower probability of binge drinking, whereas effects for 12-step involvement proved inconsistent. Conclusions Findings support the helper therapy principle and clarify the process of 12-step affiliation. [source] Developmental Considerations for Substance Use Interventions From Middle School Through CollegeALCOHOLISM, Issue 3 2005Elizabeth J. D'Amico This article summarizes a symposium organized by Dr. Elizabeth D'Amico and presented at the 2004 Annual Meeting of the Research Society on Alcoholism in Vancouver, Canada. The four presentations illustrate the importance of creating substance use interventions that are developmentally appropriate for youth. They represent innovative approaches to working with preteens, teenagers, and young adults. Dr. D'Amico's paper describes her research on the development of a voluntary brief intervention targeting alcohol use among middle school students. Findings indicated that by using school and community input, she was able to obtain a diverse a sample of youth across grades, sex, ethnicity, and substance use status. Dr. Ellickson's paper describes her research on Project ALERT, a school-based prevention program for middle school youth. Her findings indicate that Project ALERT worked for students at all levels of risk (low, moderate, and high) and for all students combined. Dr. Wagner's Teen Intervention Project was a randomized clinical trial to test the efficacy of a standardized Student Assistance Program for treating middle and high school students with alcohol and other drug problems. The study provided a unique opportunity to begin to examine how development may impact response to an alcohol or other drug intervention. Dr. Turrisi's paper examined processes underlying the nature of the effects of a parent intervention on college student drinking tendencies. Findings suggested that the parent intervention seems to have its impact on student drinking by reducing the influence of negative communications and decreasing the susceptibility of influences from closest friends. Dr. Kim Fromme provided concluding remarks. [source] A 5-Year Prospective Evaluation of DSM-IV Alcohol Dependence With and Without a Physiological ComponentALCOHOLISM, Issue 5 2003M. A. Schuckit Background: The DSM-III-R removed tolerance and withdrawal as required elements for a diagnosis of alcohol dependence. Although this practice was continued in DSM-IV, the more recent manual asked clinicians to note whether physiological aspects of withdrawal (tolerance and withdrawal) had ever been experienced. Few studies have determined the prognostic meaning of a history of a physiological component to DSM-IV alcohol dependence. Methods: Face-to-face structured interviews were used to evaluate the course of alcohol, drug, and psychiatric problems during the subsequent 5 years for 1094 alcohol-dependent men and women. These subjects had been classified into subgroups at the time of initial interview regarding evidence of tolerance or withdrawal, and all evaluations were based on DSM-IV criteria. At baseline, the application of DSM-IV diagnostic guidelines resulted in 649 (59.3%) individuals having a history of an alcohol withdrawal syndrome, with or without tolerance (group 1); 391 (35.7%) with histories of tolerance but not withdrawal (group 2); and 54 (4.9%) with no lifetime histories of tolerance or withdrawal (group 3). Results: During the 5-year follow-up, both the broad (group 1 plus 2 versus group 3) and narrow (group 1 versus group 2 plus group 3) definitions of physiological dependence were associated with more alcohol and drug problems. However, for most items, this differential primarily reflected differences between groups 1 and 3, with a less impressive effect by group 2. Although no group differences were noted for the rate of independent major depressive episodes, substance-induced depressions did differentiate among groups, a finding also most closely related to the distinction between groups 1 and 3. Conclusions: These data support the prognostic importance of noting the presence of a physiological component in alcohol dependence and indicate the potential relevance of limiting the definition of a physiological component to withdrawal. [source] The Addiction Severity Index at 25: Origins, Contributions and TransitionsTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 2 2006A. Thomas McLellan PhD The Addiction Severity Index (ASI) is a multidimensional interview used to measure the substance use, health, and social problems of those with alcohol and other drug problems, both at admission to treatment and subsequently at follow-up contacts. This article first discusses the conceptual and practical importance of the ASI's multi-dimensional approach to measuring addiction severity, as illustrated by two case presentations. The second section of the paper reviews how this measurement approach has led to some important findings regarding the prediction and measurement of addiction treatment effectiveness. The third section describes the historical and practical considerations that have changed the instrument over time, details the problems with the instrument, and describes our efforts to correct those problems with the ASI-6. Finally, some recent ASI data collected from over 8,400 patients admitted to a nationally representative sample of U.S. addiction treatment programs are presented. [source] Integrating Project ASSERT: A Screening, Intervention, and Referral to Treatment Program for Unhealthy Alcohol and Drug Use Into an Urban Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 8 2010Gail D'Onofrio MD ACADEMIC EMERGENCY MEDICINE 2010; 17:903,911 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, The objective was to evaluate the effects of Project Alcohol and Substance Abuse Services Education and Referral to Treatment (ASSERT), an emergency department (ED)-based screening, brief intervention, and referral to treatment program for unhealthy alcohol and other drug use. Methods:, Health promotion advocates (HPAs) screened ED patients for alcohol and/or drug problems 7 days a week using questions embedded in a general health questionnaire. Patients with unhealthy drinking and/or drug use received a brief negotiation interview (BNI), with the goal of reducing alcohol/drug use and/or accepting a referral to a specialized treatment facility (STF), depending on severity of use. Patients referred to an STF were followed up at 1 month by phone or contact with the STF to determine referral completion and enrollment into the treatment program. Results:, Over a 5-year period (December 1999 through December 2004), 22,534 adult ED patients were screened. A total of 10,246 (45.5%) reported alcohol consumption in the past 30 days, of whom 5,533 (54%) exceeded the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines for low-risk drinking. Use of at least one illicit drug was reported by 3,530 patients (15.7%). Over one-fourth of screened patients received BNIs (6,266, or 27.8%). Of these, 3,968 (63%) were referred to an STF. Eighty-three percent of patients were followed at 1 month, and 2,159 (65%) had enrolled in a program. Patients who received a direct admission to an STF were 30 times more likely to enroll than those who were indirectly referred (odds ratio = 30.71; 95% confidence interval = 18.48 to 51.04). After 3 years, funding for Project ASSERT was fully incorporated into the ED budget. Conclusions:, Project ASSERT has been successfully integrated into an urban ED. A direct, facilitated referral for patients with alcohol and other drug problems results in a high rate of enrollment in treatment programs. [source] Ordnungspolitik auf illegalen Märkten: Der Drogen- und WaffenmarktPERSPEKTIVEN DER WIRTSCHAFTSPOLITIK, Issue 1 2002Hanno Beck In this paper, the economic structure of illegal markets with special reference to the markets for illegal drugs and arms is analyzed. Analytical tools of System Dynamics are employed to emphasize the dynamic aspects of these markets. The results of our analysis enable us to evaluate state intervention in the illegal markets for drugs and arms. It seems possible to mitigate the drugs problem by supplying drugs to heavily addicted people on the basis of health care measures. However, a similar policy seems not to exist for the illegal arms trade. This shows that each illegal market requires a deeper understanding before it can be fought effectively. [source] | ||||||||||||||||