ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02689.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In this specially commissionedBJAseries experienced clinicians will be giving their personal and frontline views as to how the practical business of treating people with substance problems is best handled.AbstractThe creation of a network of nearly 100 community drug teams (CDTs) across the UK stands as the most significant expansion to occur within drug services during the 1980s. Key characteristics include the narrowly defined geographical focus, the community emphasis, the multi‐disciplinary composition and the promotion of generic contribution through ‘consultancy’—as with Community Alcohol Teams. Subsequent adaptations have extended from the base of the CDT with outreach strategies and harm‐minimization techniques. However, the extent of collaboration from generic colleagues (especially general practitioners) has been initially poor and is only slowly improving. An unplanned abandonment of the original consultancy role for the CDT is widely evident, as CDT workers have become more actively involved in the delivery of care—either directly or on a ‘shared care’ basis. It is proposed that separate consideration should be given to short‐ and long‐term development strategies, including re‐examination of the target populations, staffing composition, and methods of work through consultancy and/or dir

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02690.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe authors reviewed the diagnostic methodology in 14 studies that examined the prevalence of coexisting psychiatric disorders in substance abusers. There was widespread variation among the studies in the timing of patient interviews, the nature of the interviews themselves, and abstinence criteria required before another psychiatric disorder could be diagnosed. These differences were reflected in some of the study results. The authors describe how variations in methodology can affect the diagnoses patients receive. They also suggest more specific abstinence criteria, based on the substances of abuse and the specific disorders being diagnosed.

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02691.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThis article sets out the provisions of S.2 (1)–(3) of the Homicide Act 1957 and the judicial interpretations placed thereon and relates the importance of this section to the offence of murder and considers the province of the expert in regard to the Act and the difficulties encountered when experts interpret the words ‘disease’ and ‘injury’. This is illustrated in relation to a recent Murder case where the Defendant had taken LSD and cannabis voluntarily, and deals with the question as to whether construction of the Act involves any assumption that permament injury and non‐self‐induced injury are necessary ingredients to bring the defendant within provisions of S.2 (1), i.e. abnormality of mind induced by injury substantially impairing mental responsibility. Similarities are suggested between persons suffering from hallucinations, due to delirium tremens, severe concussion cases and LSD trip cases, and the question is posed as to whether it would be logical to say that temporary injury to the brain by poisoning has occurred in situations where there is a motiveless and bizarre killing following ingestion of large quantities of alc

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02692.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractReduced body weight due to smoking may be an important factor inhibiting smoking cessation and promoting relapse after cessation in some smokers. It is popularly believed that smoking decreases body weight by suppressing appetite. However, cross‐sectional studies show that, despite their lower body weights, smokers do not eat less than non‐smokers or ex‐smokers and, in fact, tend to eat slightly more. Similarly, laboratory studies show no acute effects of smoking or nicotine intake via other means on caloric intake in smokers, although intake of non‐smokers may be reduced after nicotine. In contrast, longitudinal studies show that eating consistently increases in the first weeks after stopping smoking, but may recede to pre‐cessation levels with longer‐term abstinence, while resumption of smoking after cessation is accompanied by a reduction in eating. A similar pattern of results is seen for self‐reported hunger and some, but not all, constituents of diet. Thus, there appear to be no acute or chronic effects of smoking on eating in smokers maintaining regular smoking, but changes in eating are observed concomitant with changes in smoking status (i.e. cessation or relapse). Although tolerance to anorectic effects of nicotine is one potential explanation, these findings may be more parsimoniously explained by viewing changes in eating due to smoking as secondary to an alteration in the set point around which body weight is regulated. According to this notion, cessation is accompanied by increased eating only until a new, higher body weight set point is reached, while relapse (and perhaps initiation of smoking) decreases eating only until a lower set point is reached. Implications of these findings and a set point explanation for them

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02693.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThis paper reports on the substance use of 612 gay and bisexual men who participated in an HIV risk reduction project. Use/non‐use, level of substance use, and reported frequency of use prior to sexual activity were examined in relation to number of sexual fanners, sexual activities, HIV antibody test seeking behaviour and known HIV status. The use of substances among the study cohort appear to be higher than in a comparable heterosexual male group. An association was found between substance use, and both number of sexual partners and sexual activities. However, no significant difference was found in substance use between men participating in protected versus unprotected anal sex. Similarly, no significant difference was found in the reported frequency of substance use prior to sex by those participating in protected and unprotected anal intercourse. Greater drug use was reported among those who were known to be HIV antibody pisitive. These findings raise issues for further research. The high use of alcohol and drugs by gay and bisexual men may pose significant health risks for this group of me

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02694.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractA Guttman stages of drug use model was confirmed for Australian youth in this systematic household survey of 13–17‐year‐olds in Perth (n = 1093). The same model held for both sexes and all ages although the model was more efficient for the older youth. General drug use prevalence, expansion of drug repertoire and frequency of use all increased with age. Multiple drug use was prevalent. Marijuana use was not a necessary stage for the progression to other illicit drug use as 29% of current users of other illicit drugs reported never using marijuana. The hazard rate for use of marijuana or other illicit drugs, if one was a current tobacco smoker, was high. Alcohol and tobacco were implicated as important‘gateway’ drugs though hazard rates showed tobacco to be the more important of the two. Implications of the study are that delaying or eliminating the onset of tobacco use are important goals of prevention programmes and that multiple drug use should be recognised and addressed in health education programmes

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02695.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractAs part of a larger survey of health‐related behaviours, 2239 15–16‐year‐olds in Wales provided information on their use of eight different types of drugs. Key findings indicate that just over a fifth of this age group report to having tried drugs at some time, while a tenth say they have done so within the past month. The most frequently reported substances were marijuana, solvents and glue, and psilocybin. Few of the young people reported multiple or regular drug use. The prevalence of drug use was higher for pupils from single parent families, and more boys than girls reported using psilocybin. The reliability and validity of self‐report data are discussed, and the implications of the findings for health education programmes c

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02696.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe prevalence of injecting drug use in Glasgow during 1989 was derived using log‐linear analysis to model the relationship between unnamed identifier information obtained from Strathclyde Police, the Scottish HIV‐test Reporting Scheme and Treatment Agencies. Whereas previous attempts have required, although rarely demonstrated, independence between samples, the method adopted here did not necessitate this assumption. The best model resulted from taking the dependency between the HIV‐test and treatment samples into account, and yielded an estimate of 9424 (95% confidence interval ± 2460), which represents 11–19 per 1000 population aged 15–55 in Glasgow. The estimated male:female ratio was 2.64:1 and the modal injecting drug user (IDU) aged 20–24. While there are no indicators that prevalence has begun to decline, the extent of the hidden population suggests that around 1 in 7 were receiving some form of treatment for drug use. Available evidence suggests that buprenorphine, temazepam and amphetamines, rather than heroin, are the most commonly injected drugs. These findings should facilitate assessment of the service requirements of this group, and provide a basis from which the number of IDUs infected with HIV and the number likely to progress to AIDS can b

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02697.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractA 30‐item motivation scale and a locus of control scale were given to 165 heroin users within the first 2 days of a new attempt to withdraw from heroin. Factor analysis of the motivation items revealed three factors, the largest of which was labelled ‘private affairs motivation’ (factor one), and accounted for 26.5% of the variance. A significant positive correlation was found between scores on this factor and the I sub‐scale for locus of control. The other two factors were labelled ‘external constraints’ (7.2% of the variance) and ‘negative effects of heroin use’ (6.6% of the variance). There was a tendency for subjects attending community drug teams to have lower scores on these factors than those attending other types of agencies, especially inpatient detoxification wards. Further research is required to examine the relationship between the different motivations to withdraw from heroin and other important variables such as wit

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1992.tb02698.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY