ISSN:0965-2140    

DOI:10.1080/09652149542292

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractYoung people have been targeted as a potentially vulnerable population for the spread of HIV. The influence of alcohol on sexual behaviour is pan of popular knowledge. More recently, studies have attempted to illuminate the relationship between alcohol use and sexual risk‐taking in relation to HIV transmission. In our review of the literature three important points are highlighted for researchers in this area. First, methodological problems make establishing any relationship extremely difficult. Secondly, the concept of sexual risk‐taking has to be developed to include acknowledgement of the context in which sex takes place rather than defining risk only in terms of sexual acts. Finally, populations of gay men and men who have sex with men and lesbians are sufficiently different from heterosexuals, with regard to the influence of alcohol on sexual behaviour, to make generalizations about one population inappropriate for the ot

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1995.9033192.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThis paper describes the Community Epidemiology Laboratory (CEL) of the Alcohol Research Group, a project focusing on the epidemiology of alcohol problems and community responses to those problems. Since 1980, a series of probability surveys have been conducted in the general population and in a wide range of health and social service agencies in a northern California county. The agency‐based samples have included all agencies or representative samples of each system (alcohol treatment, drug treatment, mental health treatment, emergency rooms, primary health care, criminal justice and welfare) with probability samples of clients interviewed at intake. These studies have addressed questions regarding (I) the burden and epidemiologic description of alcohol problems in a community; (2) the relationship of alcohol to other health and social problems; (3) the influence of social policy on the constitution of services and care of individuals; and (4) health services issues of access and pathways to treatment. The project is designed for comparable analysis of studies with special focus on women and ethnic minorities. This paper provides an overview of the CEL, including its major research questions, overall design, sampling principles, methodological issues and measures. It highlights the main findings and discusses the limitations and advantages of such methodologies for further understanding alcohol problems in a communit

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1995.9033293.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractA representative sample of patients in hospital emergency rooms (ERs) in a Northern California county (n = 3731) were compared with a household probability sample of those living in the same county (n = 2101). The injured in the ER sample were more likely to be black and under 30 than those in the general population sample who reported an injury during the last year which was treated in the ER. ER injured were more likely to be abstainers than injured in the general population and among drinkers, they were also more likely to report social consequences of drinking, but were no more likely to report experiences associated with alcohol dependence. Similar differences were found between the injured and the non‐injured in the two samples, with the injured more likely to be male, younger, never married and to report heavy drinking, drunkenness, social consequences of drinking and alcohol dependence experiences. The data suggest that associations of alcohol and injury found in representative samples of the ER population may be generalizable to the injured in the general population from which these patients come, with differences which do exist most likely attributable to characteristics associated with emergency room usag

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1995.9033434.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThis paper examines the association between DSM‐III‐R alcohol dependence, psychological distress and the frequency of drug use in a sample of 219 men and 162 women consecutively admitted to nine alcohol treatment programs in a Northern California county. Results show that psychological distress is higher among men who are more severely dependent on alcohol and among those who have lower education; women who are less alcohol dependent and women who are younger have higher scores in psychological distress than other women. With regard to drug use, about 65% of the men and 64% of the women report using a drug other than alcohol at least once a week during the 12 months prior to admission into treatment. Among both men and women, the drugs most frequently used are crack/cocaine, marijuana and methamphetamine. Among men, regression analysis shows that drug use is associated with being younger. Among women results show that the predictors of drug use are being younger, being unemployed, having a higher income, being a heavier drinker and having fewer symptoms of alcohol dependence. These results show a complex pattern of association across alcohol dependence, drug use and psychological distress. Knowledge of this pattern is necessary for tailoring effective clinical interventions to clients with different kinds of comorbid

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1995.9033515.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractUse of general population surveys in addition to institutional samples is critical to disentangling the relationship between criminal behavior and alcohol problems or use of illicit drugs. Local area studies can be useful but generalizability of their results is seldom studied. Data from recent US national (n = 2058) and county (n = 3069) general population surveys are used to examine the role of alcohol problem and drug use history in predicting self‐reported criminal behavior, arrest and conviction within a logistic regression framework. In the national and county surveys controlling for age, gender, income, marital status, employment, education, race and drug use, lifetime drinking problems significantly predicted current criminal behavior (odds ratios 1.3 and 1.5, respectively) with slightly stronger relationships noted in equivalent models predicting arrest (odds ratios 1.7 and 1.8) and conviction (odds ratios 1.7 and 1.6). Relationships between alcohol, drugs and criminal behavior/justice variables are discussed. Parallels between US and county results suggest that findings from intensive, articulated analyses of community‐level population and institutional surveys may be cautiously generalized beyond their geographic lo

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1995.9033616.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractAlthough problem drinkers are over‐represented in psychiatric treatment populations throughout the United States, it is unclear whether this is primarily due to difficulties in differentially diagnosing alcohol and mental problems and to high rates of comorbidity, or to factors unique to help‐seeking for alcohol problems. This article examines the role that alcohol problems play in treatment entry to inpatient and outpatient mental health agencies, considering the potential roles of a drinking problem both as a condition perceived by the sufferer to require a psychiatrist's help, and as a source of social disruption that activates others to encourage mental health treatment. Analysis focuses on comparing samples of newly admitted patients in a community mental health system and untreated individuals with high levels of psychiatric symptoms living in the same community. Experiencing the adverse social consequences of a drinking problem, holding the belief that drinking has caused one's psychological problems, and having prior experiences in mental health treatment for a drinking problem are factors found to be positively associated with psychiatric admissions, while heavier drinking and dependence symptoms are not. Further analysis of events precipitating psychiatric admission suggests that an important role for the mental health system vis à vis alcohol problems is to contain social disruptions attributable to problem drinking in the community. Alcohol‐related psychiatric admissions are found to have more frequently involved public disruptions, to have elicited police or court referrals, and to have more often resulted in the client's going to a locked hospital ward, as opposed to a mental health outpatient

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1995.9033757.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractGeneral population survey estimates of the overall prevalence of problem drinking and drug use in a community are biased by the exclusion of non‐household populations. Estimates based on compiling prevalences in community institutions may also be biased due to over‐counting of users of more than one institution. This paper examines prevalence estimates derived from probability samples of problem drinkers in the general population and within alcohol treatment, drug treatment, mental health, criminal justice and welfare agencies in a single US county. Data sets are merged and weighted to reflect a community sample of institutions, and a 1 7% subset of cases is identified within the institutional samples that are not living in housing units typically included in general population sampling frames. The difference in prevalences of problem drinking in the household and non‐household populations is found to be large: 11% and 48%, respectively. Even greater differences are found between estimates of unprescribed weekly drug use (6% and 47%, respectively) and combined problem drinking and weekly drug use (2% and 27%, respectively). This suggests that confining samples to the household population can systematically under‐represent the prevalence of problem drinking and drug use. A second source of bias in prevalences is characteristic of studies using records from multiple institutions. When duplication of service use in the five agency samples is considered, it becomes apparent that prevalences may be biased upward due to over‐counting of multiple serv

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1995.9033918.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractNicotine gum is an important adjunct for smoking cessation for many smokers, and long‐term use of nicotine gum will occur in a small percentage of patients. To date, no method of cessation in long‐term users has been studied in a randomized trial. We enrolled 26 subjects at the Mayo Clinic site of the Lung Health Study who had used nicotine gum for more than 6 months to participate in a trial where subjects were randomly assigned to: (1) abrupt cessation, (2) taper with placebo gum, or (3) taper with active gum. At the end of the 6‐week trial, the percentage of subjects abstinent from gum use and not smoking was not different among the three groups: 66.7% for the abrupt cessation group, 71.4% for the taper with placebo gum group and 60% for the taper with active gum group. One subject in the taper with placebo gum group relapsed to smoking during the trial but was abstinent from smoking again at long‐term follow‐up. Long‐term follow‐up (median 284 days) showed 65% of subjects were abstinent from all nicotine products. Motivated subjects can stop long‐term nicotine gum use without relapse to gum use or smoking by either abrupt cessation or

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1995.9034079.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractDuring the 1980s Motivational Interviewing emerged as one of the memes of the addictions field. This occurred despite the lack of scientific evidence supporting its utility. In this paper findings of a controlled trial of a brief motivational intervention with illicit drug users (n = 122) attending a methadone clinic are reported. Clients who met the study's inclusion criteria were randomly allocated to either a motivational (experimental, n = 57) or educational (control, n = 65) procedure. Over the 6‐month follow‐up period the motivational subjects demonstrated a greater, immediate, commitment to abstention, reported more positive expected outcomes for abstention, reported fewer opiate‐related problems, were initially more contemplative of change, complied with the methadone programme longer and relapsed less quickly than the control group. There was, however, no difference in terms of the severity of reported opiate dependence and the control group fared better on reported self‐efficacy. It was concluded that motivational interventions of the type investigated are useful adjuncts to methadone pro

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1995.90341510.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY