Showing papers in "Addiction Research in 1997"
TL;DR: In this paper, the authors developed and validated the Exercise Dependence Questionnaire (EDQ), which consisted of 29 items and eight factors; interference with social / family / work life, positive reward, withdrawal symptoms, exercise for weight control, insight into problem, Exercise for social reasons, exercisefor health reasons and stereotyped behaviour.
Abstract: The aim of the present study was to develop and validate the Exercise Dependence Questionnaire (EDQ). 86 statements, derived from semi structured questionnaires, were used to develop a self report rating scale which was completed by 449 subjects who exercised for more than 4 hours a week. Factor analysis was used and items not loading onto any factors (<0.6), that loaded onto more than one factor or intercorrelated greater than 0.6 were rejected from the analysis. The final EDQ consisted of 29 items and eight factors; interference with social / family / work life, positive reward, withdrawal symptoms, exercise for weight control, insight into problem, exercise for social reasons, exercise for health reasons and stereotyped behaviour. These factors were shown to have good internal reliability. The questionnaire was then partially validated against the Eating Attitudes Test, the Profile of Mood States factors; depression, anxiety, fatigue and vigour, perceptions of control over behaviour and characteristics...
240 citations
TL;DR: Exercise addiction is an area of great speculation with only limited evidence for its existence as discussed by the authors, despite a growing body of such literature, there have been few empirical reports and very few case studies.
Abstract: Exercise addiction is an area of great speculation with only limited evidence for its existence. Despite a growing body of such literature, there have been few empirical reports and very few case s...
153 citations
TL;DR: It is suggested, on the evidence of interviews with drug dealers at different levels of the drug distribution chain that less adulteration/dilution actually occurs than previously thought and that when it does happen 'on the street' it is of ...
Abstract: The notion that street drugs have been adulterated/diluted by all sorts of dangerous substances such as Vim, Ajax, ground-glass, brick-dust and even rat-poison is a common one. Moreover, it is in fact a practice believed to be true by those involved with the researching of drug issues, the treatment and rehabilitation of drug users, the policing of drug users and the educating of drug users (if. Coomber 1996) as well as by the users themselves. As this paper will show it is also thought to happen and be perpetrated by those who are deemed to be responsible for such adulteration/dilution, the dealers themselves. This however does not accord with the forensic evidence, or, as are the concerns of this paper with the practice or experience of individual drug dealers. This paper suggests, on the evidence of interviews with drug dealers at different levels of the drug distribution chain that less adulteration/dilution actually occurs than previously thought and that when it does happen 'on the street' it is of ...
65 citations
TL;DR: An argument is presented for shifting the main focus of the alcohol policy debate away from aggregate level of consumption as the key determinant of alcohol problems in favour of a sharper focus on the reduction of harm and of high risk drinking.
Abstract: An argument is presented for shifting the main focus of the alcohol policy debate away from aggregate level of consumption as the key determinant of alcohol problems in favour of a sharper focus on the reduction of harm and of high risk drinking. This argument is developed by highlighting the advantages of the latter approach in relation to: (i) the ability to distinguish between low risk and harmful consumption of alcohol (ii) the ability to predict which drinkers are most likely to experience harmful consequences of drinking (iii) the acceptability of policy objectives to government and industry, and (iv) the acceptability of prevention strategies to the general public. It is suggested that this focused approach to the measurement and reduction of alcohol related harm is more likely to achieve tangible success in the policy arena than one which is overtly predicated upon the need to reduce total population consumption of alcohol.
55 citations
TL;DR: The findings of the paper question common assertions that street drugs are 'dirty' drugs full of dangerous and unknown quantities, as well as the logic of why such practices should be thought to exist.
Abstract: The purpose of this paper is to throw some light on the adulteration and dilution of illicit drugs, heroin, cocaine, amphetamine and ecstasy in particular. The findings of the paper question common assertions that street drugs are 'dirty' drugs full of dangerous and unknown quantities such as brick-dust, Vim, Ajax (domestic cleaning agents), rat-poison and even ground glass, as well as the logic of why such practices should be thought to exist. Common adulterants and diluents (diluting agents) are outlined and discussed and an understanding of them as essentially rational and relatively safe not unpredictable and life-threatening is put forward. It is further suggested that far less adulteration than is frequently believed to take place actually does so.
43 citations
TL;DR: In this article, a survey of 665 grade ten students in Ontario, examined the factor structure of measures of life strain and coping responses and their effects on cigarette, alcohol, and cannabis use among adolescents.
Abstract: While stress is recognized as an important factor in relation to the mental health of adolescents, few previous studies have identified the sources of stress, particularly those considered to be life strains. The study reported here, based on a survey of 665 grade ten students in Ontario, examines the factor structure of measures of life strain and coping responses and their effects on cigarette, alcohol, and cannabis use among adolescents. Four factors of life strain, imbedded in the life situations of youth, and five factors of coping response are identified. The effects of life strain on cigarette, alcohol, and cannabis use are modest when taking into account coping response factors and social influence variables. The factor Aggression Strain had the strongest effects on substance use, compared to other life strain factors–Social Strain, Family Strain, and School Strain.
41 citations
TL;DR: T theoretical aspects of one particular type of snowball sampling are described: snowballing with random nominee selection and the characteristics of the resulting study group of opiate addicts outside the treatment system are described together with different kinds of bias that may affect the representativeness of the study group.
Abstract: Sampling opiate addicts outside the treatment system (hidden population) is considered difficult because there is no appropriate sampling frame. Several methods to achieve some form of random selection have been reviewed by earlier authors. One of these is 'snowballing' or snowball sampling. This term, however, covers various methods based on the central concept of locating new respondents through introductions from initial contact persons. In this publication theoretical aspects of one particular type of snowball sampling are described: snowballing with random nominee selection. Experiences with applying this type of snowballing in a medium sized Dutch city will be reported. The characteristics of the resulting study group of opiate addicts outside the treatment system are described together with different kinds of bias that may affect the representativeness of the study group.
41 citations
TL;DR: The results identify a minority of “hard” drug users and a majority of users of other drugs in prison; 68% used Cannabis, 25% Amphetamine and 10% Heroin, closely comparable to drug use in the community.
Abstract: This study examines the use of drugs in a Welsh prison within the context of drug use in the community as a whole. It involves a survey of custodial and non-custodial drug use among male inmates in...
38 citations
TL;DR: In a representative U.S. sample of 18,352 current drinkers, past-year alcohol- or other drug-related fighting and suicide attempt/ideation both showed strong positive bivariate associations with volume of alcohol intake, proportion of drinking days resulting in intoxication (the intoxication index) and past- year drug use, especially multiple drug use.
Abstract: In a representative U.S. sample of 18,352 current drinkers 18 years of age and over, past-year alcohol- or other drug-related fighting and suicide attempt/ideation both showed strong positive bivariate associations with volume of alcohol intake, proportion of drinking days resulting in intoxication (the intoxication index) and past-year drug use, especially multiple drug use. After adjusting for potential confounders in a series of multiple logistic regression models, average daily ethanol intake retained a significant positive association with the odds of alcohol- and other drug-related fighting, as did the intoxication index–except among drinkers who used marijuana only (i.e., no other drugs). The odds of this outcome also were increased by use of simulants or cocaine only, use of multiple drugs and use of marijuana–the latter primarily among women. The odds of past-year suicide attempt/ideation were positively associated with the intoxication index but were not significantly associated with average dai...
35 citations
TL;DR: Significantly fewer opiate addicts were still injecting at follow-up, and those who were injecting were doing so less often, and measures of both physical and psychological health showed significant improvements over the first month of methadone treatment.
Abstract: Data are presented on benefits observed in the immediate post-recruitment phase of outpatient treatment of opiate addicts with oral methadone. On re-interview by independent researchers at one-month, levels of drug use had reduced, with weekly intake of heroin reducing to a fifth, and of cocaine to a quarter (with significant reductions in both frequency of use and in amounts used per occasion). Significantly fewer opiate addicts were still injecting at follow-up, and those who were injecting were doing so less often. Measures of both physical and psychological health showed significant improvements over the first month of methadone treatment. A trend of reduction in involvement in acquisitive crime was also found. The finding of such wide-spread benefits so early within methadone treatment is encouraging in view of the recent increased provision of methadone programmes in the UK. However, the early acquisition of such benefits should prompt more rigorous study of the extent to which these changes are ass...
35 citations
TL;DR: It is argued that the widening of brief intervention to include severely dependent drinkers and the discussion of any health behaviours or concern expressed by the patient might best be achieved by adopting an intervention framework based on the principles of patient-centred medicine.
Abstract: Brief alcohol intervention is moving with apparent ease from demonstration outcome research to clinical practice. With benefits to public health in mind, nurses and doctors are being encouraged to give advice to all patients drinking above recommended limits. This paper critically examines the impact of this strategy on practitioners and their patients. It is argued that, firstly, practitioners might not be entirely satisfied with the evidence about effectiveness. Secondly, they might have difficulty interpreting the evidence about harmful consumption when talking to patients, particularly those without alcohol-related problems. Thirdly, the recommended framework for intervention, advice-giving, is potentially flawed. A number of possible solutions to these difficulties are raised for discussion. These include the widening of brief intervention to include severely dependent drinkers and the discussion of any health behaviours or concern expressed by the patient. These changes might best be achieved by adopting an intervention framework based on the principles of patient-centred medicine.
TL;DR: There were statistically significant increases in the number and proportion of amphetamine users attending the service and in the duration of contact with the treatment group, and statistically significant reductions in the quantity and frequency of illicit amphetamine use, benzodiazepine use, money spent on drugs, injecting, needle sharing and track marks.
Abstract: The study evaluated prescribing dexamphetamine for injecting primary amphetamine users. Subjects were prescribed dexamphetamine, up to 40mg daily, dispensed up to six times weekly. The treatment group were those 63 clients who had been prescribed dexamphetamine and fulfilled the study criteria. The control group comprised all 25 clients who fulfilled the same criteria but who had attended the service before dexamphetamine prescribing began. Three questions were addressed: does prescribing amphetamine attract high risk users, does it retain them in contact with the service and does it change behaviour. There were statistically significant increases in the number and proportion of amphetamine users attending the service and in the duration of contact with the treatment group. There were statistically significant reductions in the quantity and frequency of illicit amphetamine use, benzodiazepine use, money spent on drugs, injecting, needle sharing and track marks among the treatment group. Dexamphetamine pre...
TL;DR: The gateway theory may actually be counterproductive if we consider that in non-temperance cultures that manage alcohol succesl'ully, alcohol is generally introduced to young people at an early age as mentioned in this paper.
Abstract: The “gateway” theory of drug use holds that exposure to “entry” drugs–notable alcohol, cigarettes, and mari-juana-reliably predicts deeper and more severe drug involvements. U.S. drug czar Barry McCaffrey has incorporated the gateway theory as an integral part of the country's drug policy. However, although most heavier drug users undoubtedly were once lighter drug users, this association does not establish a causal connection. Few young people progress from lighter to heavier drug use; in fact, the dominant trend is for young people to reduce illicit drug use and to stabilize drinking with maturity. The gateway theory may actually be counterproductive if we consider that in non-temperance cultures that manage alcohol succesl'ully, alcohol is generally introduced to young people at an early age. Other evidence suggests that moderate-drinking and drug-using young people. even when such behavior is illegal, are better off psychologically and are more likely to make a succesful transition to adulthood than a...
TL;DR: In this paper, the authors investigated factors explaining variance in beliefs among addiction-treatment providers regarding the etiology of addiction and found that spiritual thinking, professional-group affiliation, gender, attendance in AA, certification status, and alcohol/drug consumption were each significant factors in explaining variance of addiction beliefs.
Abstract: Factors explaining variance in beliefs among addiction-treatment providers regarding the etiology of addiction were investigated (n = 295). An 18-item Addiction Belief Scale (ABS) assessed strength of belief in the disease versus the free-will models of addiction (α=. 91). Scores on an eight-item Spiritual Belief Scale assessing spiritual thinking based on Alcoholics Anonymous (AA) philosophy (α =. 92), the Multidimensional Health Locus of Control scales, and demographic questions were used to predict scores on the ABS. These variables accounted for 62 percent of the variance in addiction beliefs. Spiritual thinking explained 41 percent of the variance. Spiritual thinking, professional-group affiliation, gender, attendance in AA, certification status, and alcohol/drug consumption are each significant in explaining variance in addiction beliefs.
TL;DR: This study sought to investigate the link between crack-cocaine use and HIV transmission in a small group of incarcerated Alabama women jailed for illicit drug use or drug-related crimes.
Abstract: Although the crack-cocaine 'epidemic' has been well documented in the USA, little is known about its prevalence in the rural south. Crime statistics, anecdotal evidence and drug treatment reports indicate that crack-cocaine use has emerged as a significant social phenomenon in Alabama. The increase in pediatric and heterosexually-transmitted HIV/AIDS among African-Americans in Alabama suggests that the increase in crack-cocaine use and HIV/AIDS may be linked. This study sought to investigate the link between crack-cocaine use and HIV transmission in a small group of incarcerated Alabama women jailed for illicit drug use or drug-related crimes. The study was organized into focus group interviews consisting of three to six women (total eighteen), who discussed the topics of drug use, initiation and distribution, sexual activity, condom use and social networks in audiotaped sessions. The ratio of African-American to Caucasian women was 3:1, with ages ranging from to eighteen to fifty-three years. The use of ...
TL;DR: Between 1990 and 1994, the mean number of years injected and age at first injection increased significantly and the average age of new injectors increased from an average of 17.7 years during 1967-1989 to 21.5 years during 1990-94.
Abstract: Previous research indicates that wide scale heroin injecting began in Glasgow in the early 1980s and that by 1990 there were about 8,500 (mainly poly-drug) injectors. Data on year of, and age at, first injection, obtained from 1,425 current injectors in non-treatment settings between 1990 and 1994 are used to address three issues: 1) what was the incidence of drug injecting from, the first reported year of injection, 1967 to 1994, 2) is it possible to predict 1994 period prevalence and 3) how do changes in age at first injection, duration of injecting and age at interview relate to incidence and outcidence rates? Between 1990 and 1994, the mean number of years injected (6.9 to 8.8 years) and age at first injection (17.4 to 18.9 years) increased significantly. The average age of new injectors increased from an average of 17.7 years during 1967-1989 to 21.5 years during 1990-94. These findings could be explained by outcidence outstripping incidence, resulting in decreasing prevalence. Although further work ...
TL;DR: The aim of this research into the social contextual use of nitrites was to provide qualitative data to assist with policy-making decisions and to inform the development of preventative and harm minimisation interventions.
Abstract: This paper examines the self-reported effects of alkyl nitrite use. The aim of this research into the social contextual use of nitrites was to provide qualitative data to assist with policy-making ...
TL;DR: After one year of weekly 30 minute lessons, the children who had received Project Charlie had a greater knowledge of the effects of medicinal, social and illicit drugs and were more secure in their ability to resist peer pressure to commit anti-social acts.
Abstract: A drug education programme, developed in the USA, for primary aged children was evaluated. Pupils attending an inner-London junior school were randomly assigned to receive Project Charlie (n = 65) or to the control group (n = 55). After one year of weekly 30 minute lessons, the children who had received Project Charlie had a greater knowledge of the effects of medicinal, social and illicit drugs. They could generate both more and higher quality solutions to hypothetical social dilemmas and were more secure in their ability to resist peer pressure to commit anti-social acts. However, Project Charlie children did not have significantly higher self-esteem than the control children, nor did the two groups differ in their intentions to use drugs, or their reported current use.
TL;DR: In this article, the associations between sports involvement and alcohol use were examined using data from the Ontario Health Survey, and two hypotheses were tested: 1) drinkers are physically more active than non-drinkers, because the former are more likely to be young, male, or single; and 2) among drinkers, frequency of sports participation decreases with increasing frequency of drinking.
Abstract: This study examines the associations between sports involvement and alcohol use. Research on drinking and recreational sports has shown inconsistent findings concerning the associations between sports participation and drinking. While some have found a negative relation between sports and drinking, others found the associations to be non-significant. Unfortunately, many studies have overlooked the effects of age, sex, and marital status on sports participation and alcohol use. Using data from the Ontario Health Survey, two hypotheses are tested: 1) drinkers are physically more active than non-drinkers, because the former are more likely to be young, male, or single; and 2) among drinkers, frequency of sports participation decreases with increasing frequency of drinking. Multivariate analyses results (MCA) show some support for the first hypothesis, but not for the second. Although drinking is an important predictor for sports involvement, there seems to be a curvilinear association between sports particip...
TL;DR: Indigenous workers were employed to conduct a community survey of crack cocaine use in Trafford, Manchester, and to discover attitudes to drug services, which revealed increasing use, and considerable personal and social problems caused by crack use.
Abstract: Indigenous workers were employed to conduct a community survey of crack cocaine use in Trafford, Manchester, and to discover attitudes to drug services. This revealed increasing use, and considerable personal and social problems caused by crack use. Users did not consider services useful, even though 30% were already attending drug services for help with coexistent opiate dependence. Three groups are considered: those in touch with services, those worried about their use but not seeking help, and those who are not worried about their use. Many of those reporting the worst crack-related problems were already attending services. Specific strategies are proposed for dealing with each of these groups. Peer-education has an important role in encouraging safer cocaine use.
TL;DR: There was evidence that respondents negatively stigmatised drug misusers and this tendency was greater the longer the respondent had been a community pharmacist, but those providing services to drug mis Users had more positive attitudes towards persons with HIV and drug mis users when compared to non-providers.
Abstract: This study investigated community pharmacists' attitudes, knowledge and involvement in service provision to drug misusers. A postal questionnaire was sent to all community pharmacies in two central London Family Health Service Authorities (N = 285). A 54% response rate was obtained. Over one half were involved in dispensing controlled drugs and selling sterile injecting equipment and 13% involved in needle exchange. However, there was evidence that respondents negatively stigmatised drug misusers and this tendency was greater the longer the respondent had been a community pharmacist, but those providing services to drug misusers had more positive attitudes towards persons with HIV and drug misusers when compared to non-providers. Service provision was positively associated with confidence in one's knowledge about HIV and drug misuse with regard to counselling clients. Issues surrounding professional training are discussed.
TL;DR: In this paper, a conceptual framework was developed based on the dimensions purposiveness, hedonism, time, reductionism, attribution of addiction and contradictoriness, and a typology of conversations was then identified on the basis of judges rating profiles on these six dimensions.
Abstract: In the first stage of the study. five-hundred and forty-eight minimally structured 15 minute conversations were conducted with drug users in South Ayrshire, Glasgow. Lothian and Newcastle upon Tyne. Conversations were cued by a single question (“So what are you using at the moment?”) and took their own course thereafter. Each conversation was tape recorded and each tape recording was transcribed by a typist. A conceptual framework was developed based on the dimensions purposiveness, hedonism. generalisability. time, reductionism. attribution of addiction and contradictoriness. A typology of conversations was then identified on the basis of judges rating profiles on these six dimensions. Pilot studies of the reliability of the coding system showed high levels of replicability for this system between three judges. (r : range. 77 to. 90). The second stage of the study then examined the ways in which each of these types of drug conversation emerged in particular settings or with particular client groups. Note...
TL;DR: An historical perspective is sketched out for contemporary problems in disentangling the relationship between culpability and susceptibility in alcohol dependence by examining the formulation of medical and moral models of habitual drunkenness during the nineteenth century.
Abstract: Chronic alcohol misuse is an intractable problem for contemporary medicine. This paper explores some of the origins of this intractability, by examining the formulation of medical and moral models of habitual drunkenness during the nineteenth century. Its objective is to sketch out an historical perspective for contemporary problems in disentangling the relationship between culpability and susceptibility in alcohol dependence.Notes1. I deliberately do not deal with the impact of the temperance movement on medical models of alcoholism during this period. Porter (1984), Thompson (1988) and Berridge (1990) provide very helpful accounts. A classic survey of the growth of the Temperance cause in the United States may be found in Gusfield (1963). Heather and Robertson (1984) also note the close interlinkage of disease concepts of alcoholism and the emergence of medical models. Their discussion of the growth of the inebriate asylum is particularly useful in the context of this paper (see Heather and Robertson, 1...
TL;DR: In this paper, a plausible physiological mechanism has been put forward to explain "carbohydrate addiction" and this meshes with the folk psychology of dieting, but the evidence for the physiological basis of "drug addictions" is weak compared to drug addictions.
Abstract: Sugar and other carbohydrates are among the things to which it is claimed people can become addicted. A plausible physiological mechanism has been put forward to explain 'carbohydrate addiction' and this meshes with the folk psychology of dieting. Review shows evidence for the physiological basis of 'carbohydrate addiction' to be weak compared to drug addictions. If 'carbohydrate addiction' is a genuine phenomena then it is probably a habitual dependence based on strong reinforcement, like gambling, rather than a substance-based one.
TL;DR: This article tested the hypothesis that adult children of alcoholics would cope with anger arousal by displaying a relatively more pronounced anger-in coping style than non-ACOA controls, and found that adults with higher anger arousal exhibited a more pronounced coping style.
Abstract: This study tested the hypothesis that adult children of alcoholics (ACOAs) would cope with anger arousal by displaying a relatively more pronounced anger-in coping style than non-ACOA controls. The...
TL;DR: In this paper, the influence of interpersonal relationships and the social environment on injection risk behavior was explored in a study of the lifestyles of amphetamine users in the North-West of England.
Abstract: The influences of interpersonal relationships and the social environment on injection risk behaviour are explored in this paper. Data from a study of the lifestyles of amphetamine users in the North-West of England are used to reveal the relationships between social interactions and risk. Differences were found in the factors implicated in the two aspects of sharing. Passing on used injection equipment was largely influenced by social factors. Accepting equipment from others was associated with perceptions of dependence and the use of needle-exchanges. Implications for theory are suggested and the difficulties of intervention noted.
TL;DR: Black market heroin may now be obtained in either the form of salt (hydrochloride) or the separated base, with the salt form being most suitable for injecting, whilst many of the base forms are either used by ‘chasing’ or are chemically transformed to the salt before injection.
Abstract: Heroin isn't just heroin anymore. Over the last two decades, there has been diversification in the forms and ‘brands’ of heroin which exist in both the domestic as well as international marketplaces. Closer examination reveals important differences between these ‘brands’. Black market heroin may now be obtained in either the form of salt (hydrochloride) or the separated base. Importantly, the different forms have different suitabilities for use by injection or by ‘chasing the dragon’, with the salt form being most suitable for injecting, whilst many of the base forms are either used by ‘chasing’ or are chemically transformed to the salt before injection. Country of origin and obvious physical characteristics such as colour are strong predictors of ‘salt’ or ‘base’ status. When consideration is given to the more recent technique of chasing the dragon, a new interpretation can be attached to some of the other drugs found in samples of black market heroin (often described as ‘impurities’). New data have iden...
TL;DR: Empirical investigation into hazardous drinking should be supplemented by ethnographical investigation to determine the extent to which the phenomenon is culturally normal.
Abstract: A study of the drinking behaviour of medical students from 13 medical schools in the UK was conducted by means of a self-completion questionnaire. Data from 1277 students are presented here (response rate 67%). 23% of male students and 10% of female students reported drinking more than the recommended sensible limits in a typical week. There were significant differences in the drinking behaviour of female students in the different years of medical school. ‘Hazardous drinking’ is associated with the absence of religiosity, regular exercise, sensation seeking, extraversion and psychoticism. Epidemiological investigation into hazardous drinking should be supplemented by ethnographical investigation to determine the extent to which the phenomenon is culturally normal.
TL;DR: The results suggested that risk status was related not only to whether or not the individual currently smoked but also to characteristics of their smoking behaviour and smoking related beliefs.
Abstract: Epidemiological research has identified parental, sibling and peer group smoking as risk factors for adolescent smoking. In contrast, psychological research has emphasised the importance of smoking related beliefs. The present study aimed to integrate these literatures. Four hundred and twenty nine 16-19 year olds from educational, training and employment centres completed a questionnaire about their risk factors, smoking related beliefs and smoking behaviour and were categorised as either low, medium or high risk on the basis of their risk score. The results suggested that risk status was related not only to whether or not the individual currently smoked but also to characteristics of their smoking behaviour and smoking related beliefs such as whether they had ever tried smoking, the amount smoked, their identity as a smoker, smoking self efficacy, smoking related behavioural intentions and beliefs about the costs and benefits of smoking. However, the relationship between risk and beliefs was not always ...
TL;DR: (1997).
Abstract: (1997). Estimating Local Opioid Addict Mortality. Addiction Research: Vol. 4, No. 4, pp. 321-327.