ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01854.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThis article is an enquiry into the current status of alcohol in Maltese culture. The responses of society to alcoholism depend on the way members of the community perceive the problems incurred by the use and abuse of a dependence producing substance like alcohol. These perceptions and subsequent responses are very much influenced by prevailing attitudes and beliefs. Malta is a melting point of cultures. This factor, together with a high density population and Malta's geopolitical strategic position, combine to make Malta a tolerant society. There is a laissez‐faire response to alcoholism, at least partly due to the present inability to identify the need to take appropriate measures. The police force, medical profession and politicians still do not feel the responsibility or the need to provide effective laws and regulations, specialized treatment services or educative programmes on alcohol‐related issues. A systematic enquiry is needed urgently to determine the severity and degree of the problems posed by alcohol abuse among the Maltese. Such an enquiry should be followed by a well planned national policy which includes local approaches and interventions. Finally, these interventions must be evaluated frequently and developed to achieve better results in the fut

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01855.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Peter Ellemann‐Jensen died after the preparation, but prior to the publication, of this article. At the time of his death he was a member of the Department of Economics, Odense University, Denmark, Remarks in response to specific points suggested fry anonymous referees have been added in the form of footnotes because we believe that Peter Ellemann‐Jensen would have readily acknowledged those points. A few more extensive suggestions, which would have required rewriting portions of the orignal text, could not be taken fully into account.AbstractThis article may be read as a comment on and extension to the recent survey of studies of the social costs of smoking in this journal by Markandya&Pearce (1989), covering some aspects of the literature not included in that survey. Inevitably, there is a considerable amount of overlap with the material in several of the listed references, including the Markandya&Pearce (1989) survey. The article argues that the published studies based on the incidence approach to the costs of smoking, even on their own terms and accepting the stated assumptions, are erroneous, yielding cost estimates that are too high. In the appendix a simple model of the use of taxation to correct for informational error concerning a risky good is presen

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01856.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractFormal and informal social control in shaping individual behaviors toward the use of alcohol and other drugs is discussed. Emphasis is placed on formal social control as it occurs in two major institutions. The state, which embodies the political and legal structures of the society is discussed in terms of the social control of some of the consequences of drinking, such as public drunkenness, alcoholism, operating vehicles with specific blood alcohol levels, and crime and alcohol use. The medical institution's involvement in alcohol and drug control is discussed in terms of the physician's role in diagnosing alcohol and drug dependent individuals. Two contemporary cases, those of pregnant addicts and alcohol‐related organ transplant patients, illustrate the significant interactions between the responses of the political and medical institutions, and the broader influences that help shape these response

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01857.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThis study compares the responses of opiate addicts at a London drug treatment centre to two outpatient methadone‐based detoxification programmes. These involved either a fixed (non‐negotiable) dose reduction schedule or a flexible, negotiable withdrawal schedule. In the negotiable condition, subjects were less likely to complete the detoxification programme and the mean reduction in dose achieved by the subjects in the negotiable condition was less than that in the fixed group. There was no difference between groups in programme retention at 6 weeks though subjects who remained in treatment in the negotiable group tended to extend their detoxification period beyond this point. The overall response of subjects in both groups was unsatisfactory. Only 13% of the subjects initially allocated to detoxification or 28% of those who actually started detoxification completed treatment; urine screening showed that heroin abuse was a continuing problem during treatment. The implications of these results for detoxification and drug treatment services are discus

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01858.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractNaltrexone and placebo as adjuvant treatment of opioid dependence were compared in a double‐blind, controlled clinical trial in 50 heroin addicts. The overall efficacy was assessed by the degree of treatment acceptance, percentage of relapse in heroin consumption, presence of side effects, and overall retention on naltrexone. A total of 50 patients of both sexes, aged from 18 to 30 years, who fulfilled DSM‐III‐R criteria for opioid dependence were included in the study. All patients completed detoxification with clonidine on an in‐patient basis for 2 weeks and subsequently, on an out‐patient basis, received oral naltrexone (350 mg per week) for a month. At the beginning of the second month patients were randomly allocated to treatment with naltrexone (28 patients) or placebo (22 patients) until a 6‐month treatment period in a double‐blind fashion had been completed. During the study period (1 year) all patients followed the same therapeutic schedule. Patients in both groups were comparable in terms of socio‐demographic data and toxicological history. The efficacy of naltrexone was not superior to that of placebo as there were no significant differences in acceptance of treatment, retention rates, opioid and other drug consumption, drug compliance

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01859.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractCombined data from nine double‐blind placebo‐controlled trials (total n=813), showed a smoking quit rate with clonidine that was significantly greater than with placebo. Further analysis suggested a potentiating influence of individual behavior therapy, and it appeared that clonidine may be more helpful for female than male smokers. Future trials are needed to determine long‐term efficacy, and to clarify the effects of gender, other subject characteristics and various treatment conditions on the usefulness of clonidine as a smoking cessatio

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01860.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractThe extent of substance use and problems among adolescent ‘street’ and homeless populations is largely undocumented. This study describes the prevalence of drug use among a sample of 145 adolescent street youth interviewed during February and March 1990 in Toronto, Canada, and compares these data to those derived from other adolescent street and mainstream populati

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01861.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractInformation was abstracted from the hospital notes of 144 doctors who had received treatment for drug and alcohol dependency. These problems affect those in every speciality, and at all degrees of seniority. Over half came into treatment following medical referral. Social morbidity was an important contributory reason for seeking help. The mean age at presentation was 43.1 years; the mean duration of problematic use prior to this was 6.4 years for drug misusers and 6.7 years for alcohol misusers. Alcohol was the current problem for 41.6% and drug misuse for 26.4%; 31.3% were misusing both alcohol and drugs at presentation. Of the 83 subjects who were misusing drugs, only four had ever used blackmarket supplies. Psychotropic agents are readily available to doctors, but the consequences of this are not addressed. Those who develop dependency suffer a delay of years before reaching help.

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01862.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

AbstractSeventy‐two pathological gambling patients were followed‐up after treatment in a combined alcohol, substance abuse and compulsive gambling treatment program. The Addiction Severity Index (modified for use with pathological gamblers) was used to evaluate the effectiveness of treatment. Patients reduced their intake of alcohol, other drugs and their gambling as well as improved in legal, family/social, and psychological functioning. There was a trend for improvement in medical condition and no net change in employment functioning. The study supports the idea that combined treatment is an effective way of dealing with patients whose gambling problems are discovered when they enter treatment for another addiction, as well as for patients whose initial complaints include pathological gambling, with or without additional probl

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1991.tb01863.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY