Pub Date : 2020-01-13DOI: 10.1108/dat-07-2019-0028
Aleksi Hupli
European studies have shown lower prevalence rates of prescription stimulant use for cognitive enhancement, especially among student populations, compared to North America. This difference requires more cross-country research of the various factors involved. To find out whether other parts of the globe are witnessing similar increases in extra-medical stimulant use, and how this might relate to cognitive enhancement, requires empirical study of local contexts. This paper aims to argue that the academic and public discussion on cognitive enhancement should consider the specific country context of drug policy and research and rethink which drugs are included under the term cognitive enhancement drugs.,This paper offers a general review and a sociological country comparison between the Netherlands and Finland, focusing not only on prescription stimulants used to treat attention deficit hyperactivity disorder but also illicit amphetamines among young adults and methylphenidate use among Dutch and Finnish participants of the Global Drug Survey. This paper emphasises sociocultural perspectives and the importance of context in cognitive enhancement in general as the line between therapeutic and enhancement use can often be blurred. Data is drawn from global, European and national sources, including the International Narcotics Control Board, European Monitoring Centre for Drugs and Drug Addiction and Global Drug Survey.,There are hardly any national empirical studies done on cognitive enhancement drug use in Finland. On the other hand, there have been studies in the Netherlands showcasing that the use of prescription stimulants and other drugs for enhancement purposes is something that is happening among young people, albeit yet in a relatively small scale. Illicit and licit stimulant use and drug policy action in relation to cognitive enhancement drugs in the two countries varies, emphasising the importance of country context.,Given that cross-country research is scarce, this general review provides one of the first glimpses into cognitive enhancement drug use by comparing the country context and research in Finland, where the phenomenon has not been studied, with the Netherlands, where the topic has received more research and public attention. Further research areas are suggested.
{"title":"Cognitive enhancement with licit and illicit stimulants in the Netherlands and Finland: what is the evidence?","authors":"Aleksi Hupli","doi":"10.1108/dat-07-2019-0028","DOIUrl":"https://doi.org/10.1108/dat-07-2019-0028","url":null,"abstract":"European studies have shown lower prevalence rates of prescription stimulant use for cognitive enhancement, especially among student populations, compared to North America. This difference requires more cross-country research of the various factors involved. To find out whether other parts of the globe are witnessing similar increases in extra-medical stimulant use, and how this might relate to cognitive enhancement, requires empirical study of local contexts. This paper aims to argue that the academic and public discussion on cognitive enhancement should consider the specific country context of drug policy and research and rethink which drugs are included under the term cognitive enhancement drugs.,This paper offers a general review and a sociological country comparison between the Netherlands and Finland, focusing not only on prescription stimulants used to treat attention deficit hyperactivity disorder but also illicit amphetamines among young adults and methylphenidate use among Dutch and Finnish participants of the Global Drug Survey. This paper emphasises sociocultural perspectives and the importance of context in cognitive enhancement in general as the line between therapeutic and enhancement use can often be blurred. Data is drawn from global, European and national sources, including the International Narcotics Control Board, European Monitoring Centre for Drugs and Drug Addiction and Global Drug Survey.,There are hardly any national empirical studies done on cognitive enhancement drug use in Finland. On the other hand, there have been studies in the Netherlands showcasing that the use of prescription stimulants and other drugs for enhancement purposes is something that is happening among young people, albeit yet in a relatively small scale. Illicit and licit stimulant use and drug policy action in relation to cognitive enhancement drugs in the two countries varies, emphasising the importance of country context.,Given that cross-country research is scarce, this general review provides one of the first glimpses into cognitive enhancement drug use by comparing the country context and research in Finland, where the phenomenon has not been studied, with the Netherlands, where the topic has received more research and public attention. Further research areas are suggested.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-07-2019-0028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41516132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-11DOI: 10.1108/dat-07-2019-0032
A. Sigalas
Purpose This paper aims to focus on a meta-analysis of an applied integrative model of clinical practice at community level in a third-sector organisation. The psychotherapeutic work was exclusively aimed at those who struggled with their abstinence from their substance use. Design/methodology/approach The model adapted to the needs of those who accessed the service, combined culturally sensitive psychoanalytic, systemic and relational frameworks. Findings The analysis reflects how such a multi-dimensional approach may be used to address the experience of self-destructiveness in the context of inferiorisation. This paper also presents some statistical information as well as three case vignettes. Originality/value The analysis reflects how such a multi-dimensional approach may be used to address the experience of self-destructiveness in the context of inferiorisation.
{"title":"Working with addiction: an intercultural-integrative approach to substance dependency during a seven-year delivery of a psychotherapy service in North London","authors":"A. Sigalas","doi":"10.1108/dat-07-2019-0032","DOIUrl":"https://doi.org/10.1108/dat-07-2019-0032","url":null,"abstract":"\u0000Purpose\u0000This paper aims to focus on a meta-analysis of an applied integrative model of clinical practice at community level in a third-sector organisation. The psychotherapeutic work was exclusively aimed at those who struggled with their abstinence from their substance use.\u0000\u0000\u0000Design/methodology/approach\u0000The model adapted to the needs of those who accessed the service, combined culturally sensitive psychoanalytic, systemic and relational frameworks.\u0000\u0000\u0000Findings\u0000The analysis reflects how such a multi-dimensional approach may be used to address the experience of self-destructiveness in the context of inferiorisation. This paper also presents some statistical information as well as three case vignettes.\u0000\u0000\u0000Originality/value\u0000The analysis reflects how such a multi-dimensional approach may be used to address the experience of self-destructiveness in the context of inferiorisation.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-07-2019-0032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47433096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-10DOI: 10.1108/dat-07-2019-0033
Ediomo-ubong E. Nelson, I. Obot
The purpose of this paper is to discuss priorities for effective responses to illicit drugs in West Africa in a changing international policy environment.,The paper analyzes published research, technical papers and reports on drug use and policy responses in West Africa and opines on priorities for drug policy in the region within the post-United Nations General Assembly Special Session (UNGASS) 2016 policy environment.,Drug use and related harms continue to increase in West African countries despite efforts to reduce drug trafficking and use through legal prohibition. The UNGASS 2016 outcome document enables flexibility in policy interpretation and implementation, which provides an opportunity for governments to prioritize national needs in drug policy. West African countries should prioritize and support research and data collection, prevention, treatment and harm reduction and sustainable livelihoods.,The paper emphasizes the need for West African countries to seize the opportunity created by the ineffectiveness and weakening of the prohibition regime as well as new treaty flexibility following UNGASS 2016 to reform drug policies to prioritize regional and national needs.
{"title":"Beyond prohibition: responses to illicit drugs in West Africa in an evolving policy context","authors":"Ediomo-ubong E. Nelson, I. Obot","doi":"10.1108/dat-07-2019-0033","DOIUrl":"https://doi.org/10.1108/dat-07-2019-0033","url":null,"abstract":"The purpose of this paper is to discuss priorities for effective responses to illicit drugs in West Africa in a changing international policy environment.,The paper analyzes published research, technical papers and reports on drug use and policy responses in West Africa and opines on priorities for drug policy in the region within the post-United Nations General Assembly Special Session (UNGASS) 2016 policy environment.,Drug use and related harms continue to increase in West African countries despite efforts to reduce drug trafficking and use through legal prohibition. The UNGASS 2016 outcome document enables flexibility in policy interpretation and implementation, which provides an opportunity for governments to prioritize national needs in drug policy. West African countries should prioritize and support research and data collection, prevention, treatment and harm reduction and sustainable livelihoods.,The paper emphasizes the need for West African countries to seize the opportunity created by the ineffectiveness and weakening of the prohibition regime as well as new treaty flexibility following UNGASS 2016 to reform drug policies to prioritize regional and national needs.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-07-2019-0033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45570387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-31DOI: 10.1108/dat-06-2019-0027
A. U. Madukwe, A. Klein
The purpose of this paper is to assess participants’ perception that tramadol enhances physical work performance and acts as a pain relief.,The participants were 30 (18 male and 12 female) tramadol-using emerging adults, aged 16–27 years, selected through respondent-driven sampling. The majority of the participants were university students, whereas others had completed senior secondary education. The study adopted a qualitative design. Qualitative data were analysed using thematic analyses.,In general, respondents perceived and used tramadol for pain relief and physical work performance enhancement. The result showed that sex, employment status and daily dosage were not associated with respondents’ perception of tramadol as a pain-relieving medication. In contrast, sex and employment status were associated with participants’ perception of tramadol as a physical work performance enhancement medication, but daily dosage was not.,Some users refused to participate because they were afraid of being exposed to law enforcement.,Male and female emerging adults are involved in non-medical use of tramadol. Prevention and intervention programs to reduce or stop this behaviour are needed, especially in the rural communities.,The result showed that users were mostly from poor homes, whose parents could not afford university education and who were not qualified to get good government paying jobs. So, the use of tramadol became necessary for them to make more money from the kind of jobs they did. Reduction of the cost of university education and provision of regular jobs for this population are some of the measures recommended to counter non-medical use of tramadol by this population.,This is the first study in South-eastern Nigeria that focused on the non-medical use of tramadol among emerging adults, using a qualitative design.
{"title":"Tramadol as a pain relieving and physical work performance enhancement medication","authors":"A. U. Madukwe, A. Klein","doi":"10.1108/dat-06-2019-0027","DOIUrl":"https://doi.org/10.1108/dat-06-2019-0027","url":null,"abstract":"The purpose of this paper is to assess participants’ perception that tramadol enhances physical work performance and acts as a pain relief.,The participants were 30 (18 male and 12 female) tramadol-using emerging adults, aged 16–27 years, selected through respondent-driven sampling. The majority of the participants were university students, whereas others had completed senior secondary education. The study adopted a qualitative design. Qualitative data were analysed using thematic analyses.,In general, respondents perceived and used tramadol for pain relief and physical work performance enhancement. The result showed that sex, employment status and daily dosage were not associated with respondents’ perception of tramadol as a pain-relieving medication. In contrast, sex and employment status were associated with participants’ perception of tramadol as a physical work performance enhancement medication, but daily dosage was not.,Some users refused to participate because they were afraid of being exposed to law enforcement.,Male and female emerging adults are involved in non-medical use of tramadol. Prevention and intervention programs to reduce or stop this behaviour are needed, especially in the rural communities.,The result showed that users were mostly from poor homes, whose parents could not afford university education and who were not qualified to get good government paying jobs. So, the use of tramadol became necessary for them to make more money from the kind of jobs they did. Reduction of the cost of university education and provision of regular jobs for this population are some of the measures recommended to counter non-medical use of tramadol by this population.,This is the first study in South-eastern Nigeria that focused on the non-medical use of tramadol among emerging adults, using a qualitative design.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-06-2019-0027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48501019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-25DOI: 10.1108/dat-06-2019-0023
Benjamin Petruželka
The purpose of this paper is to improve the understanding of the relationship between region-specific regulations of medications used in the manufacture of illegal drugs and illegal drug markets.,This paper examines a case study of the relationship between the regulation of medications containing pseudoephedrine in Czechia and neighbouring countries and the illegal drug market for methamphetamine in Czechia between 2006 and 2018. The description of this case is based on a review of the literature and a review of publicly available data sources.,The tightening of the regulation of medications containing pseudoephedrine in the Czech Republic led, in the years under study, to a gradual decrease in the number of packages sold and simultaneously to the illegal import of such medications from neighbouring countries with less strict regulations. At the same time, shifts in the drug market could be observed: the internationalisation of previously primarily domestic supply chains, the increased involvement of Vietnamese organised crime groups, the emergence of large-scale methamphetamine labs and a shift in production to countries with less strict regulations. The subsequent application of stricter controls in neighbouring countries was accompanied by further shifts in supply chains and increased imports from non-European countries.,The tightening of regulations of medications within a single country or single region might lead to significant and undesirable changes in drug markets and supply chains.,This paper provides a novel case study of the development of region-specific regulations of medications and their influence on illegal drug markets and supply chains in the Czech Republic and in the European context.
{"title":"The relationship between the regulation of licit medications containing pseudoephedrine and the illicit methamphetamine market in Czechia and neighbouring countries","authors":"Benjamin Petruželka","doi":"10.1108/dat-06-2019-0023","DOIUrl":"https://doi.org/10.1108/dat-06-2019-0023","url":null,"abstract":"The purpose of this paper is to improve the understanding of the relationship between region-specific regulations of medications used in the manufacture of illegal drugs and illegal drug markets.,This paper examines a case study of the relationship between the regulation of medications containing pseudoephedrine in Czechia and neighbouring countries and the illegal drug market for methamphetamine in Czechia between 2006 and 2018. The description of this case is based on a review of the literature and a review of publicly available data sources.,The tightening of the regulation of medications containing pseudoephedrine in the Czech Republic led, in the years under study, to a gradual decrease in the number of packages sold and simultaneously to the illegal import of such medications from neighbouring countries with less strict regulations. At the same time, shifts in the drug market could be observed: the internationalisation of previously primarily domestic supply chains, the increased involvement of Vietnamese organised crime groups, the emergence of large-scale methamphetamine labs and a shift in production to countries with less strict regulations. The subsequent application of stricter controls in neighbouring countries was accompanied by further shifts in supply chains and increased imports from non-European countries.,The tightening of regulations of medications within a single country or single region might lead to significant and undesirable changes in drug markets and supply chains.,This paper provides a novel case study of the development of region-specific regulations of medications and their influence on illegal drug markets and supply chains in the Czech Republic and in the European context.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-06-2019-0023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49050942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-16DOI: 10.1108/dat-08-2019-0036
Aysel Sultan, Bernd Werse
The purpose of this paper is to explore prevalence, contexts and motives for the use of various benzodiazepines, sedatives and opioids among injection drug users in Frankfurt’s open drug scene.,The paper uses quantitative data from ten waves of the bi-annual open drug scene survey carried out within the frames of the Frankfurt local drug monitoring system (MoSyD) and an additional sample of qualitative interviews to highlight the individual user perspectives as well as professional insights.,The results suggest that the prescription drugs act as “support drugs” when the drugs of choice are not available or affordable. Patterns of use also show that by acting to manage withdrawal symptoms, insomnia and relieving stress, prescription drugs also contribute to maintaining daily functionality.,The paper contributes to the discussion on the motives and functions of prescription drug use in an urban open drug scene.
{"title":"Motivations for prescription drug use in a marginalised open drug scene","authors":"Aysel Sultan, Bernd Werse","doi":"10.1108/dat-08-2019-0036","DOIUrl":"https://doi.org/10.1108/dat-08-2019-0036","url":null,"abstract":"The purpose of this paper is to explore prevalence, contexts and motives for the use of various benzodiazepines, sedatives and opioids among injection drug users in Frankfurt’s open drug scene.,The paper uses quantitative data from ten waves of the bi-annual open drug scene survey carried out within the frames of the Frankfurt local drug monitoring system (MoSyD) and an additional sample of qualitative interviews to highlight the individual user perspectives as well as professional insights.,The results suggest that the prescription drugs act as “support drugs” when the drugs of choice are not available or affordable. Patterns of use also show that by acting to manage withdrawal symptoms, insomnia and relieving stress, prescription drugs also contribute to maintaining daily functionality.,The paper contributes to the discussion on the motives and functions of prescription drug use in an urban open drug scene.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-08-2019-0036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49165853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-21DOI: 10.1108/DAT-02-2019-0009
G. Benson, A. McPherson, J. McCallum, N. Roberts
Purpose The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency department. Design/methodology/approach A retrospective cohort study that included all patients referred to the acute addiction liaison nursing service over one calendar month (n=400, 1–30 April 2016) was undertaken. Bivariate and multivariate modelling identified the significant variables that supported the prediction of severe alcohol withdrawal syndrome (SAWS) in the cohort population. Findings The Glasgow Modified Alcohol Withdrawal Scale (GMAWS), hours since last drink, fast alcohol screening test (FAST) and systolic blood pressure correctly identified 89 per cent of patients who developed SAWS and 84 per cent of patients that did not. Increasing each component by a score of one is associated with an increase in the odds of SAWS by a factor of 2.76 (95% CI 2.21, 3.45), 1.31 (95% CI 1.24, 1.37), 1.30 (95% CI 1.08, 1.57) and 1.22 (95% CI 1.10, 1.34), respectively. Research limitations/implications The research was conducted in a single healthcare system that had a high prevalence of alcohol dependence syndrome (ADS). Second, the developed risk stratification tool was unable to guarantee no risk and lastly, the FAST score previously aligned to severe ADS may have influenced the patients highest GMAWS score. Practical implications The tool could help redesign the care pathway for patients who attend the emergency department at risk of SAWS and link low risk patients with community alcohol services better equipped to deal with their physical and psychological needs short and long term supporting engagement, abstinence and prolongation of life. Originality/value The tool could help redesign the care pathway for emergency department patients at low risk of SAWS and link them with community alcohol services better equipped to deal with their physical and psychological needs, short and long term, supporting engagement, abstinence and prolongation of life.
目的建立酒精戒断综合征风险分层工具，为急诊科低危患者安全出院提供支持。设计/方法/方法进行了一项回顾性队列研究，纳入了所有在一个月内转诊到急性成瘾联络护理服务的患者(n=400, 2016年4月1日至30日)。双变量和多变量模型确定了支持在队列人群中预测严重酒精戒断综合征(SAWS)的重要变量。格拉斯哥改良酒精戒断量表(GMAWS)、最后一次饮酒后的几个小时、快速酒精筛查试验(fast)和收缩压正确地识别出89%的患有SAWS的患者和84%的未患SAWS的患者。每增加1分，SAWS的发生率分别增加2.76 (95% CI 2.21, 3.45)、1.31 (95% CI 1.24, 1.37)、1.30 (95% CI 1.08, 1.57)和1.22 (95% CI 1.10, 1.34)。研究局限性/意义本研究是在一个酒精依赖综合征(ADS)高发的单一医疗保健系统中进行的。其次，开发的风险分层工具无法保证无风险，最后，FAST评分先前与严重ADS一致可能影响患者的最高GMAWS评分。实际意义该工具有助于重新设计急诊科有SAWS风险的患者的护理途径，并将低风险患者与社区酒精服务联系起来，更好地满足他们的生理和心理需求，短期和长期支持参与、戒酒和延长生命。独创性/价值该工具可以帮助重新设计急诊科低风险患者的护理途径，并将他们与社区酒精服务联系起来，这些服务能够更好地满足他们的短期和长期生理和心理需求，支持参与、戒酒和延长生命。
{"title":"Development of an alcohol withdrawal risk stratification tool based on patients referred to an addiction liaison nursing service in Glasgow","authors":"G. Benson, A. McPherson, J. McCallum, N. Roberts","doi":"10.1108/DAT-02-2019-0009","DOIUrl":"https://doi.org/10.1108/DAT-02-2019-0009","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to develop an alcohol withdrawal syndrome risk stratification tool that could support the safe discharge of low risk patients from the emergency department.\u0000\u0000\u0000Design/methodology/approach\u0000A retrospective cohort study that included all patients referred to the acute addiction liaison nursing service over one calendar month (n=400, 1–30 April 2016) was undertaken. Bivariate and multivariate modelling identified the significant variables that supported the prediction of severe alcohol withdrawal syndrome (SAWS) in the cohort population.\u0000\u0000\u0000Findings\u0000The Glasgow Modified Alcohol Withdrawal Scale (GMAWS), hours since last drink, fast alcohol screening test (FAST) and systolic blood pressure correctly identified 89 per cent of patients who developed SAWS and 84 per cent of patients that did not. Increasing each component by a score of one is associated with an increase in the odds of SAWS by a factor of 2.76 (95% CI 2.21, 3.45), 1.31 (95% CI 1.24, 1.37), 1.30 (95% CI 1.08, 1.57) and 1.22 (95% CI 1.10, 1.34), respectively.\u0000\u0000\u0000Research limitations/implications\u0000The research was conducted in a single healthcare system that had a high prevalence of alcohol dependence syndrome (ADS). Second, the developed risk stratification tool was unable to guarantee no risk and lastly, the FAST score previously aligned to severe ADS may have influenced the patients highest GMAWS score.\u0000\u0000\u0000Practical implications\u0000The tool could help redesign the care pathway for patients who attend the emergency department at risk of SAWS and link low risk patients with community alcohol services better equipped to deal with their physical and psychological needs short and long term supporting engagement, abstinence and prolongation of life.\u0000\u0000\u0000Originality/value\u0000The tool could help redesign the care pathway for emergency department patients at low risk of SAWS and link them with community alcohol services better equipped to deal with their physical and psychological needs, short and long term, supporting engagement, abstinence and prolongation of life.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-02-2019-0009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47084549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-21DOI: 10.1108/DAT-10-2018-0051
G. Benson, N. Roberts, J. McCallum, A. McPherson
Purpose The purpose of this paper is to identify published literature from a general hospital setting that may highlight variables implicated in the development of severe alcohol withdrawal syndrome (SAWS) in patients who have alcohol dependence syndrome (ADS). Design/methodology/approach A systematic literature review was carried out using the electronic databases: MEDLINE, Medline in Process, Cinahl, Embase and PsycINFO from 1989 to 2017. The focus of this search was on English language studies of individuals over 16 years admitted to general hospital with ADS, delirium tremens (DTs), alcohol-related seizure (ARS) or alcohol withdrawal syndrome (AWS). Findings Of the 205 studies screened, eight met the criteria for inclusion. Six studies were quantitative retrospective cohort and two were retrospective case-control. Six studies investigated risk factors associated with DTs, one examined SAWS and one alcohol kindling. Descriptive analysis was performed to summarise the empirical evidence from studies were 22 statistically significant risk factors were found; including the reason for admission to hospital, daily alcohol consumption, previous DTs and prior ARS. The last two factors mentioned appeared in two studies. Research limitations/implications Further research should consider the quality and completeness of the alcohol history data and competence of staff generating the data in retrospective studies. Originality/value The paper suggests that the factors linked to SAWS development from the literature may not fully explain why some individuals who have ADS develop SAWS, and others do not.
目的本文的目的是识别来自综合医院环境的已发表文献，这些文献可能会突出与酒精依赖综合征（ADS）患者严重酒精戒断综合征（SAWS）发展有关的变量。设计/方法/方法使用电子数据库进行系统的文献综述：MEDLINE、MEDLINE in Process，Cinahl，Embase和PsycINFO从1989年到2017年。本次搜索的重点是对16岁以上因ADS、震颤性谵妄（DT）、酒精相关癫痫（ARS）或酒精戒断综合征（AWS）而入住综合医院的患者的英语语言研究。在筛选的205项研究中，有8项符合入选标准。6项研究为定量回顾性队列研究，2项为回顾性病例对照研究。六项研究调查了与DTs相关的危险因素，一项研究了SAWS和一项酒精点燃。进行描述性分析，总结研究的经验证据，发现22个具有统计学意义的风险因素；包括入院原因、每日饮酒量、既往DTs和既往ARS。最后提到的两个因素出现在两项研究中。研究局限性/含义进一步的研究应考虑酒精史数据的质量和完整性，以及在回顾性研究中生成数据的工作人员的能力。原创性/价值本文认为，文献中与SAWS发展相关的因素可能无法完全解释为什么一些患有ADS的人会发展为SAWS，而另一些人则没有。
{"title":"Severe alcohol withdrawal syndrome: review of the literature","authors":"G. Benson, N. Roberts, J. McCallum, A. McPherson","doi":"10.1108/DAT-10-2018-0051","DOIUrl":"https://doi.org/10.1108/DAT-10-2018-0051","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to identify published literature from a general hospital setting that may highlight variables implicated in the development of severe alcohol withdrawal syndrome (SAWS) in patients who have alcohol dependence syndrome (ADS).\u0000\u0000\u0000Design/methodology/approach\u0000A systematic literature review was carried out using the electronic databases: MEDLINE, Medline in Process, Cinahl, Embase and PsycINFO from 1989 to 2017. The focus of this search was on English language studies of individuals over 16 years admitted to general hospital with ADS, delirium tremens (DTs), alcohol-related seizure (ARS) or alcohol withdrawal syndrome (AWS).\u0000\u0000\u0000Findings\u0000Of the 205 studies screened, eight met the criteria for inclusion. Six studies were quantitative retrospective cohort and two were retrospective case-control. Six studies investigated risk factors associated with DTs, one examined SAWS and one alcohol kindling. Descriptive analysis was performed to summarise the empirical evidence from studies were 22 statistically significant risk factors were found; including the reason for admission to hospital, daily alcohol consumption, previous DTs and prior ARS. The last two factors mentioned appeared in two studies.\u0000\u0000\u0000Research limitations/implications\u0000Further research should consider the quality and completeness of the alcohol history data and competence of staff generating the data in retrospective studies.\u0000\u0000\u0000Originality/value\u0000The paper suggests that the factors linked to SAWS development from the literature may not fully explain why some individuals who have ADS develop SAWS, and others do not.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-10-2018-0051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45255150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-23Epub Date: 2019-03-06DOI: 10.1108/dat-10-2018-0061
Mark A Prince, Tiffany Jenzer, Whitney Brown, Eleftherios M Hetelekides, Rachel A Mumm, R Lorraine Collins
Purpose –: Cannabis use among young adults is increasing, despite being associated with several negative consequences. Protective behavioral strategies (PBSs) are a potential mechanism of behavior change for reducing substance use, yet PBS use for cannabis is not well understood. The purpose of this paper is to further define and measure the PBS construct for cannabis.
Design/methodology/approach –: A community sample of cannabis users (n = 54) participated in eight focus groups discussing the use of PBSs. Participants completed surveys regarding demographics, cannabis use habits and cannabis problems. The authors also administered an existing measure of cannabis PBS and asked them to generate new or unique protective strategies that they had used or had heard of others using.
Findings –: Thematic analysis of qualitative focus group data provided information about cannabis users' reasons for regulating cannabis use (e.g. health or legal problems, interpersonal) as well as strategies to moderate cannabis use or attenuate their risk for experiencing adverse consequences (e.g. distraction, existential/spiritual strategies). Analyses of quantitative survey data revealed that use of PBSs was negatively correlated with cannabis outcomes. Perceived helpfulness of strategies was an important predictor of decreased cannabis use and adverse consequences.
Research limitations/implications –: Findings expand the understanding of the definition and measurement of strategies for regulating cannabis use and reducing related risk of experiencing adverse consequences.
Originality/value –: This is the first study to examine cannabis-related PBS using both qualitative and quantitative methods, which provide insights into the definition of PBS and for future refinements of PBS measurement.
{"title":"Examining cannabis protective behavioral strategy use using multiple methods.","authors":"Mark A Prince, Tiffany Jenzer, Whitney Brown, Eleftherios M Hetelekides, Rachel A Mumm, R Lorraine Collins","doi":"10.1108/dat-10-2018-0061","DOIUrl":"https://doi.org/10.1108/dat-10-2018-0061","url":null,"abstract":"<p><strong>Purpose –: </strong>Cannabis use among young adults is increasing, despite being associated with several negative consequences. Protective behavioral strategies (PBSs) are a potential mechanism of behavior change for reducing substance use, yet PBS use for cannabis is not well understood. The purpose of this paper is to further define and measure the PBS construct for cannabis.</p><p><strong>Design/methodology/approach –: </strong>A community sample of cannabis users (n = 54) participated in eight focus groups discussing the use of PBSs. Participants completed surveys regarding demographics, cannabis use habits and cannabis problems. The authors also administered an existing measure of cannabis PBS and asked them to generate new or unique protective strategies that they had used or had heard of others using.</p><p><strong>Findings –: </strong>Thematic analysis of qualitative focus group data provided information about cannabis users' reasons for regulating cannabis use (e.g. health or legal problems, interpersonal) as well as strategies to moderate cannabis use or attenuate their risk for experiencing adverse consequences (e.g. distraction, existential/spiritual strategies). Analyses of quantitative survey data revealed that use of PBSs was negatively correlated with cannabis outcomes. Perceived helpfulness of strategies was an important predictor of decreased cannabis use and adverse consequences.</p><p><strong>Research limitations/implications –: </strong>Findings expand the understanding of the definition and measurement of strategies for regulating cannabis use and reducing related risk of experiencing adverse consequences.</p><p><strong>Originality/value –: </strong>This is the first study to examine cannabis-related PBS using both qualitative and quantitative methods, which provide insights into the definition of PBS and for future refinements of PBS measurement.</p>","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-10-2018-0061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39265556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-23DOI: 10.1108/dat-05-2019-0017
E. Day, Sabrina Kirberg, N. Metrebian
Purpose Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use disorders. This effect is present whether or not the individual attends professional treatment services, but the two process can have a synergistic effect. Limited information exists about the extent to which people attending UK specialist treatment services also attend AA/NA and their views about such attendance. The paper aims to discuss these issues. Design/methodology/approach A cross-sectional survey of 200 consecutive attendees at the specialist treatment service in an English region was conducted between January and April 2018. A measure of past attendance and affiliation with AA/NA (AAAS) and a scale designed to quantify future readiness to attend (Survey of Readiness for Alcoholics Anonymous Participation) were administered and anonymously linked to data supplied to the National Drug Treatment Monitoring Service (NDTMS). Findings A minority of the sample had ever attended an AA meeting (31 per cent, n=59) or an NA meeting (41 per cent, n=79), and only 14 per cent (n=27) and 24 per cent (n=45) had attended an AA or NA meeting, respectively, in the past year. Only two variables significantly predicted level of readiness to attend AA or NA in a regression model: attended more AA/NA meetings in the past (ß=0.149, p=0.036) and previous level of participation (AAAS score) (ß=0.409, p < 0.001). Practical implications A significant proportion of attendees of a specialist drug and alcohol treatment service had never attended AA/NA, despite many positive views about their potential benefits. Given the established benefits of attending AA/NA meetings and participating in the AA or NA fellowship, these results suggest that professional treatment services should do more to explain the process and challenge preconceived ideas about how they operate. Originality/value The authors are not aware of any published research that captures the rates of attendance of and participation in both AA and NA groups in a UK-based community treatment sample. These results may therefore provide a baseline for evaluating the impact of interventions to increase attendance/participation, and also provide some insight into the potential barriers to attendance in this population.
目的参加嗜酒者匿名会(AA)或麻醉品匿名会(NA)并加入该协会对有酒精或药物使用障碍的人有潜在的好处。无论个人是否参加专业治疗服务，这种影响都存在，但这两个过程可以产生协同效应。关于参加英国专业治疗服务的人参加AA/NA的程度以及他们对这种出席的看法的信息有限。本文旨在探讨这些问题。设计/方法/方法在2018年1月至4月期间，对英国某地区专业治疗服务的200名连续参与者进行了横断面调查。对过去参加AA/NA (AAAS)的人数和隶属关系进行了测量，并设计了一个量表来量化未来参加的准备情况(匿名参与酗酒者准备情况调查)，并匿名地与提供给国家药物治疗监测服务(NDTMS)的数据相关联。少数样本曾经参加过嗜酒者互诫会(31%，n=59)或嗜酒者互诫会(41%，n=79)，在过去一年中分别只有14% (n=27)和24% (n=45)参加过嗜酒者互诫会或嗜酒者互诫会。在回归模型中，只有两个变量显著预测参加AA或NA的准备水平:过去参加过更多的AA/NA会议(ß=0.149, p=0.036)和以前的参与水平(AAAS评分)(ß=0.409, p < 0.001)。尽管许多人对戒毒和戒酒专家治疗服务的潜在益处持积极看法，但很大一部分戒毒和戒酒专家从未参加过戒毒和戒酒协会。鉴于参加AA/NA会议和参加AA或NA奖学金的既定好处，这些结果表明，专业治疗服务应该做更多的工作来解释这一过程，并挑战对其运作方式的先入为主的看法。原创性/价值作者不知道有任何已发表的研究记录了英国社区治疗样本中AA和NA小组的出勤率和参与率。因此，这些结果可能为评估提高出勤率/参与率的干预措施的影响提供基线，并为这一人群出勤的潜在障碍提供一些见解。
{"title":"Affiliation to alcoholics anonymous or narcotics anonymous among patients attending an English specialist addiction service","authors":"E. Day, Sabrina Kirberg, N. Metrebian","doi":"10.1108/dat-05-2019-0017","DOIUrl":"https://doi.org/10.1108/dat-05-2019-0017","url":null,"abstract":"\u0000Purpose\u0000Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use disorders. This effect is present whether or not the individual attends professional treatment services, but the two process can have a synergistic effect. Limited information exists about the extent to which people attending UK specialist treatment services also attend AA/NA and their views about such attendance. The paper aims to discuss these issues.\u0000\u0000\u0000Design/methodology/approach\u0000A cross-sectional survey of 200 consecutive attendees at the specialist treatment service in an English region was conducted between January and April 2018. A measure of past attendance and affiliation with AA/NA (AAAS) and a scale designed to quantify future readiness to attend (Survey of Readiness for Alcoholics Anonymous Participation) were administered and anonymously linked to data supplied to the National Drug Treatment Monitoring Service (NDTMS).\u0000\u0000\u0000Findings\u0000A minority of the sample had ever attended an AA meeting (31 per cent, n=59) or an NA meeting (41 per cent, n=79), and only 14 per cent (n=27) and 24 per cent (n=45) had attended an AA or NA meeting, respectively, in the past year. Only two variables significantly predicted level of readiness to attend AA or NA in a regression model: attended more AA/NA meetings in the past (ß=0.149, p=0.036) and previous level of participation (AAAS score) (ß=0.409, p < 0.001).\u0000\u0000\u0000Practical implications\u0000A significant proportion of attendees of a specialist drug and alcohol treatment service had never attended AA/NA, despite many positive views about their potential benefits. Given the established benefits of attending AA/NA meetings and participating in the AA or NA fellowship, these results suggest that professional treatment services should do more to explain the process and challenge preconceived ideas about how they operate.\u0000\u0000\u0000Originality/value\u0000The authors are not aware of any published research that captures the rates of attendance of and participation in both AA and NA groups in a UK-based community treatment sample. These results may therefore provide a baseline for evaluating the impact of interventions to increase attendance/participation, and also provide some insight into the potential barriers to attendance in this population.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/dat-05-2019-0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42645124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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