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Showing 1 - 200 of 1589 Journals sorted alphabetically
Abacus     Hybrid Journal   (Followers: 12, SJR: 0.48, h-index: 22)
About Campus     Hybrid Journal   (Followers: 5)
Academic Emergency Medicine     Hybrid Journal   (Followers: 65, SJR: 1.385, h-index: 91)
Accounting & Finance     Hybrid Journal   (Followers: 47, SJR: 0.547, h-index: 30)
ACEP NOW     Free   (Followers: 1)
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 52, SJR: 1.02, h-index: 88)
Acta Archaeologica     Hybrid Journal   (Followers: 164, SJR: 0.101, h-index: 9)
Acta Geologica Sinica (English Edition)     Hybrid Journal   (Followers: 3, SJR: 0.552, h-index: 41)
Acta Neurologica Scandinavica     Hybrid Journal   (Followers: 5, SJR: 1.203, h-index: 74)
Acta Obstetricia et Gynecologica Scandinavica     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 81)
Acta Ophthalmologica     Hybrid Journal   (Followers: 6, SJR: 0.112, h-index: 1)
Acta Paediatrica     Hybrid Journal   (Followers: 56, SJR: 0.794, h-index: 88)
Acta Physiologica     Hybrid Journal   (Followers: 6, SJR: 1.69, h-index: 88)
Acta Polymerica     Hybrid Journal   (Followers: 9)
Acta Psychiatrica Scandinavica     Hybrid Journal   (Followers: 35, SJR: 2.518, h-index: 113)
Acta Zoologica     Hybrid Journal   (Followers: 7, SJR: 0.459, h-index: 29)
Acute Medicine & Surgery     Hybrid Journal   (Followers: 4)
Addiction     Hybrid Journal   (Followers: 35, SJR: 2.086, h-index: 143)
Addiction Biology     Hybrid Journal   (Followers: 14, SJR: 2.091, h-index: 57)
Adultspan J.     Hybrid Journal   (SJR: 0.127, h-index: 4)
Advanced Energy Materials     Hybrid Journal   (Followers: 27, SJR: 6.411, h-index: 86)
Advanced Engineering Materials     Hybrid Journal   (Followers: 26, SJR: 0.81, h-index: 81)
Advanced Functional Materials     Hybrid Journal   (Followers: 51, SJR: 5.21, h-index: 203)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 14, SJR: 0.232, h-index: 7)
Advanced Materials     Hybrid Journal   (Followers: 267, SJR: 9.021, h-index: 345)
Advanced Materials Interfaces     Hybrid Journal   (Followers: 6, SJR: 1.177, h-index: 10)
Advanced Optical Materials     Hybrid Journal   (Followers: 7, SJR: 2.488, h-index: 21)
Advanced Science     Open Access   (Followers: 5)
Advanced Synthesis & Catalysis     Hybrid Journal   (Followers: 17, SJR: 2.729, h-index: 121)
Advances in Polymer Technology     Hybrid Journal   (Followers: 13, SJR: 0.344, h-index: 31)
Africa Confidential     Hybrid Journal   (Followers: 21)
Africa Research Bulletin: Economic, Financial and Technical Series     Hybrid Journal   (Followers: 13)
Africa Research Bulletin: Political, Social and Cultural Series     Hybrid Journal   (Followers: 10)
African Development Review     Hybrid Journal   (Followers: 33, SJR: 0.275, h-index: 17)
African J. of Ecology     Hybrid Journal   (Followers: 16, SJR: 0.477, h-index: 39)
Aggressive Behavior     Hybrid Journal   (Followers: 15, SJR: 1.391, h-index: 66)
Aging Cell     Open Access   (Followers: 11, SJR: 4.374, h-index: 95)
Agribusiness : an Intl. J.     Hybrid Journal   (Followers: 3, SJR: 0.627, h-index: 14)
Agricultural and Forest Entomology     Hybrid Journal   (Followers: 16, SJR: 0.925, h-index: 43)
Agricultural Economics     Hybrid Journal   (Followers: 45, SJR: 1.099, h-index: 51)
AIChE J.     Hybrid Journal   (Followers: 32, SJR: 1.122, h-index: 120)
Alcoholism and Drug Abuse Weekly     Hybrid Journal   (Followers: 7)
Alcoholism Clinical and Experimental Research     Hybrid Journal   (Followers: 7, SJR: 1.416, h-index: 125)
Alimentary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 33, SJR: 2.833, h-index: 138)
Alimentary Pharmacology & Therapeutics Symposium Series     Hybrid Journal   (Followers: 3)
Allergy     Hybrid Journal   (Followers: 51, SJR: 3.048, h-index: 129)
Alternatives to the High Cost of Litigation     Hybrid Journal   (Followers: 3)
American Anthropologist     Hybrid Journal   (Followers: 148, SJR: 0.951, h-index: 61)
American Business Law J.     Hybrid Journal   (Followers: 24, SJR: 0.205, h-index: 17)
American Ethnologist     Hybrid Journal   (Followers: 92, SJR: 2.325, h-index: 51)
American J. of Economics and Sociology     Hybrid Journal   (Followers: 29, SJR: 0.211, h-index: 26)
American J. of Hematology     Hybrid Journal   (Followers: 34, SJR: 1.761, h-index: 77)
American J. of Human Biology     Hybrid Journal   (Followers: 12, SJR: 1.018, h-index: 58)
American J. of Industrial Medicine     Hybrid Journal   (Followers: 16, SJR: 0.993, h-index: 85)
American J. of Medical Genetics Part A     Hybrid Journal   (Followers: 16, SJR: 1.115, h-index: 61)
American J. of Medical Genetics Part B: Neuropsychiatric Genetics     Hybrid Journal   (Followers: 4, SJR: 1.771, h-index: 107)
American J. of Medical Genetics Part C: Seminars in Medical Genetics     Partially Free   (Followers: 6, SJR: 2.315, h-index: 79)
American J. of Physical Anthropology     Hybrid Journal   (Followers: 37, SJR: 1.41, h-index: 88)
American J. of Political Science     Hybrid Journal   (Followers: 278, SJR: 5.101, h-index: 114)
American J. of Primatology     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 63)
American J. of Reproductive Immunology     Hybrid Journal   (Followers: 3, SJR: 1.347, h-index: 75)
American J. of Transplantation     Hybrid Journal   (Followers: 17, SJR: 2.792, h-index: 140)
American J. on Addictions     Hybrid Journal   (Followers: 9, SJR: 0.843, h-index: 57)
Anaesthesia     Hybrid Journal   (Followers: 138, SJR: 1.404, h-index: 88)
Analyses of Social Issues and Public Policy     Hybrid Journal   (Followers: 9, SJR: 0.397, h-index: 18)
Analytic Philosophy     Hybrid Journal   (Followers: 18)
Anatomia, Histologia, Embryologia: J. of Veterinary Medicine Series C     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 27)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1, SJR: 0.633, h-index: 24)
Andrologia     Hybrid Journal   (Followers: 2, SJR: 0.528, h-index: 45)
Andrology     Hybrid Journal   (Followers: 2, SJR: 0.979, h-index: 14)
Angewandte Chemie     Hybrid Journal   (Followers: 219)
Angewandte Chemie Intl. Edition     Hybrid Journal   (Followers: 222, SJR: 6.229, h-index: 397)
Animal Conservation     Hybrid Journal   (Followers: 41, SJR: 1.576, h-index: 62)
Animal Genetics     Hybrid Journal   (Followers: 8, SJR: 0.957, h-index: 67)
Animal Science J.     Hybrid Journal   (Followers: 6, SJR: 0.569, h-index: 24)
Annalen der Physik     Hybrid Journal   (Followers: 5, SJR: 1.46, h-index: 40)
Annals of Anthropological Practice     Partially Free   (Followers: 2, SJR: 0.187, h-index: 5)
Annals of Applied Biology     Hybrid Journal   (Followers: 7, SJR: 0.816, h-index: 56)
Annals of Clinical and Translational Neurology     Open Access   (Followers: 1)
Annals of Human Genetics     Hybrid Journal   (Followers: 9, SJR: 1.191, h-index: 67)
Annals of Neurology     Hybrid Journal   (Followers: 47, SJR: 5.584, h-index: 241)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1, SJR: 0.531, h-index: 38)
Annals of Public and Cooperative Economics     Hybrid Journal   (Followers: 8, SJR: 0.336, h-index: 23)
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5, SJR: 2.389, h-index: 189)
Annual Bulletin of Historical Literature     Hybrid Journal   (Followers: 13)
Annual Review of Information Science and Technology     Hybrid Journal   (Followers: 14)
Anthropology & Education Quarterly     Hybrid Journal   (Followers: 25, SJR: 0.72, h-index: 31)
Anthropology & Humanism     Hybrid Journal   (Followers: 17, SJR: 0.137, h-index: 3)
Anthropology News     Hybrid Journal   (Followers: 15)
Anthropology of Consciousness     Hybrid Journal   (Followers: 11, SJR: 0.172, h-index: 5)
Anthropology of Work Review     Hybrid Journal   (Followers: 11, SJR: 0.256, h-index: 5)
Anthropology Today     Hybrid Journal   (Followers: 89, SJR: 0.545, h-index: 15)
Antipode     Hybrid Journal   (Followers: 49, SJR: 2.212, h-index: 69)
Anz J. of Surgery     Hybrid Journal   (Followers: 8, SJR: 0.432, h-index: 59)
Anzeiger für Schädlingskunde     Hybrid Journal   (Followers: 1)
Apmis     Hybrid Journal   (Followers: 1, SJR: 0.855, h-index: 73)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 70, SJR: 0.754, h-index: 69)
Applied Organometallic Chemistry     Hybrid Journal   (Followers: 7, SJR: 0.632, h-index: 58)
Applied Psychology     Hybrid Journal   (Followers: 207, SJR: 1.023, h-index: 64)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 49, SJR: 0.868, h-index: 13)
Applied Stochastic Models in Business and Industry     Hybrid Journal   (Followers: 5, SJR: 0.613, h-index: 24)
Aquaculture Nutrition     Hybrid Journal   (Followers: 14, SJR: 1.025, h-index: 55)
Aquaculture Research     Hybrid Journal   (Followers: 31, SJR: 0.807, h-index: 60)
Aquatic Conservation Marine and Freshwater Ecosystems     Hybrid Journal   (Followers: 36, SJR: 1.047, h-index: 57)
Arabian Archaeology and Epigraphy     Hybrid Journal   (Followers: 11, SJR: 0.453, h-index: 11)
Archaeological Prospection     Hybrid Journal   (Followers: 12, SJR: 0.922, h-index: 21)
Archaeology in Oceania     Hybrid Journal   (Followers: 13, SJR: 0.745, h-index: 18)
Archaeometry     Hybrid Journal   (Followers: 27, SJR: 0.809, h-index: 48)
Archeological Papers of The American Anthropological Association     Hybrid Journal   (Followers: 15, SJR: 0.156, h-index: 2)
Architectural Design     Hybrid Journal   (Followers: 25, SJR: 0.261, h-index: 9)
Archiv der Pharmazie     Hybrid Journal   (Followers: 3, SJR: 0.628, h-index: 43)
Archives of Drug Information     Hybrid Journal   (Followers: 5)
Archives of Insect Biochemistry and Physiology     Hybrid Journal   (SJR: 0.768, h-index: 54)
Area     Hybrid Journal   (Followers: 12, SJR: 0.938, h-index: 57)
Art History     Hybrid Journal   (Followers: 246, SJR: 0.153, h-index: 13)
Arthritis & Rheumatology     Hybrid Journal   (Followers: 52, SJR: 1.984, h-index: 20)
Arthritis Care & Research     Hybrid Journal   (Followers: 27, SJR: 2.256, h-index: 114)
Artificial Organs     Hybrid Journal   (Followers: 1, SJR: 0.872, h-index: 60)
ASHE Higher Education Reports     Hybrid Journal   (Followers: 15)
Asia & the Pacific Policy Studies     Open Access   (Followers: 16)
Asia Pacific J. of Human Resources     Hybrid Journal   (Followers: 320, SJR: 0.494, h-index: 19)
Asia Pacific Viewpoint     Hybrid Journal   (Followers: 1, SJR: 0.616, h-index: 26)
Asia-Pacific J. of Chemical Engineering     Hybrid Journal   (Followers: 8, SJR: 0.345, h-index: 20)
Asia-pacific J. of Clinical Oncology     Hybrid Journal   (Followers: 6, SJR: 0.554, h-index: 14)
Asia-Pacific J. of Financial Studies     Hybrid Journal   (SJR: 0.241, h-index: 7)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 4, SJR: 0.377, h-index: 7)
Asian Economic J.     Hybrid Journal   (Followers: 8, SJR: 0.234, h-index: 21)
Asian Economic Policy Review     Hybrid Journal   (Followers: 4, SJR: 0.196, h-index: 12)
Asian J. of Control     Hybrid Journal   (SJR: 0.862, h-index: 34)
Asian J. of Endoscopic Surgery     Hybrid Journal   (SJR: 0.394, h-index: 7)
Asian J. of Organic Chemistry     Hybrid Journal   (Followers: 6, SJR: 1.443, h-index: 19)
Asian J. of Social Psychology     Hybrid Journal   (Followers: 5, SJR: 0.665, h-index: 37)
Asian Politics and Policy     Hybrid Journal   (Followers: 12, SJR: 0.207, h-index: 7)
Asian Social Work and Policy Review     Hybrid Journal   (Followers: 5, SJR: 0.318, h-index: 5)
Asian-pacific Economic Literature     Hybrid Journal   (Followers: 5, SJR: 0.168, h-index: 15)
Assessment Update     Hybrid Journal   (Followers: 4)
Astronomische Nachrichten     Hybrid Journal   (Followers: 2, SJR: 0.701, h-index: 40)
Atmospheric Science Letters     Open Access   (Followers: 29, SJR: 1.332, h-index: 27)
Austral Ecology     Hybrid Journal   (Followers: 15, SJR: 1.095, h-index: 66)
Austral Entomology     Hybrid Journal   (Followers: 9, SJR: 0.524, h-index: 28)
Australasian J. of Dermatology     Hybrid Journal   (Followers: 8, SJR: 0.714, h-index: 40)
Australasian J. On Ageing     Hybrid Journal   (Followers: 6, SJR: 0.39, h-index: 22)
Australian & New Zealand J. of Statistics     Hybrid Journal   (Followers: 14, SJR: 0.275, h-index: 28)
Australian Accounting Review     Hybrid Journal   (Followers: 3, SJR: 0.709, h-index: 14)
Australian and New Zealand J. of Family Therapy (ANZJFT)     Hybrid Journal   (Followers: 3, SJR: 0.382, h-index: 12)
Australian and New Zealand J. of Obstetrics and Gynaecology     Hybrid Journal   (Followers: 47, SJR: 0.814, h-index: 49)
Australian and New Zealand J. of Public Health     Hybrid Journal   (Followers: 11, SJR: 0.82, h-index: 62)
Australian Dental J.     Hybrid Journal   (Followers: 7, SJR: 0.482, h-index: 46)
Australian Economic History Review     Hybrid Journal   (Followers: 5, SJR: 0.171, h-index: 12)
Australian Economic Papers     Hybrid Journal   (Followers: 31, SJR: 0.23, h-index: 9)
Australian Economic Review     Hybrid Journal   (Followers: 6, SJR: 0.357, h-index: 21)
Australian Endodontic J.     Hybrid Journal   (Followers: 3, SJR: 0.513, h-index: 24)
Australian J. of Agricultural and Resource Economics     Hybrid Journal   (Followers: 3, SJR: 0.765, h-index: 36)
Australian J. of Grape and Wine Research     Hybrid Journal   (Followers: 5, SJR: 0.879, h-index: 56)
Australian J. of Politics & History     Hybrid Journal   (Followers: 14, SJR: 0.203, h-index: 14)
Australian J. of Psychology     Hybrid Journal   (Followers: 18, SJR: 0.384, h-index: 30)
Australian J. of Public Administration     Hybrid Journal   (Followers: 408, SJR: 0.418, h-index: 29)
Australian J. of Rural Health     Hybrid Journal   (Followers: 5, SJR: 0.43, h-index: 34)
Australian Occupational Therapy J.     Hybrid Journal   (Followers: 72, SJR: 0.59, h-index: 29)
Australian Psychologist     Hybrid Journal   (Followers: 12, SJR: 0.331, h-index: 31)
Australian Veterinary J.     Hybrid Journal   (Followers: 21, SJR: 0.459, h-index: 45)
Autism Research     Hybrid Journal   (Followers: 36, SJR: 2.126, h-index: 39)
Autonomic & Autacoid Pharmacology     Hybrid Journal   (SJR: 0.371, h-index: 29)
Banks in Insurance Report     Hybrid Journal   (Followers: 1)
Basic & Clinical Pharmacology & Toxicology     Hybrid Journal   (Followers: 11, SJR: 0.539, h-index: 70)
Basic and Applied Pathology     Open Access   (Followers: 2, SJR: 0.113, h-index: 4)
Basin Research     Hybrid Journal   (Followers: 5, SJR: 1.54, h-index: 60)
Bauphysik     Hybrid Journal   (Followers: 2, SJR: 0.194, h-index: 5)
Bauregelliste A, Bauregelliste B Und Liste C     Hybrid Journal  
Bautechnik     Hybrid Journal   (Followers: 1, SJR: 0.321, h-index: 11)
Behavioral Interventions     Hybrid Journal   (Followers: 9, SJR: 0.297, h-index: 23)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 24, SJR: 0.736, h-index: 57)
Berichte Zur Wissenschaftsgeschichte     Hybrid Journal   (Followers: 10, SJR: 0.11, h-index: 5)
Beton- und Stahlbetonbau     Hybrid Journal   (Followers: 2, SJR: 0.493, h-index: 14)
Biochemistry and Molecular Biology Education     Hybrid Journal   (Followers: 6, SJR: 0.311, h-index: 26)
Bioelectromagnetics     Hybrid Journal   (Followers: 1, SJR: 0.568, h-index: 64)
Bioengineering & Translational Medicine     Open Access  
BioEssays     Hybrid Journal   (Followers: 10, SJR: 3.104, h-index: 155)
Bioethics     Hybrid Journal   (Followers: 14, SJR: 0.686, h-index: 39)
Biofuels, Bioproducts and Biorefining     Hybrid Journal   (Followers: 1, SJR: 1.725, h-index: 56)
Biological J. of the Linnean Society     Hybrid Journal   (Followers: 16, SJR: 1.172, h-index: 90)
Biological Reviews     Hybrid Journal   (Followers: 4, SJR: 6.469, h-index: 114)
Biologie in Unserer Zeit (Biuz)     Hybrid Journal   (Followers: 41, SJR: 0.12, h-index: 1)
Biology of the Cell     Full-text available via subscription   (Followers: 9, SJR: 1.812, h-index: 69)
Biomedical Chromatography     Hybrid Journal   (Followers: 6, SJR: 0.572, h-index: 49)
Biometrical J.     Hybrid Journal   (Followers: 5, SJR: 0.784, h-index: 44)
Biometrics     Hybrid Journal   (Followers: 37, SJR: 1.906, h-index: 96)
Biopharmaceutics and Drug Disposition     Hybrid Journal   (Followers: 10, SJR: 0.715, h-index: 44)
Biopolymers     Hybrid Journal   (Followers: 18, SJR: 1.199, h-index: 104)
Biotechnology and Applied Biochemistry     Hybrid Journal   (Followers: 44, SJR: 0.415, h-index: 55)
Biotechnology and Bioengineering     Hybrid Journal   (Followers: 141, SJR: 1.633, h-index: 146)
Biotechnology J.     Hybrid Journal   (Followers: 14, SJR: 1.185, h-index: 51)
Biotechnology Progress     Hybrid Journal   (Followers: 39, SJR: 0.736, h-index: 101)
Biotropica     Hybrid Journal   (Followers: 20, SJR: 1.374, h-index: 71)
Bipolar Disorders     Hybrid Journal   (Followers: 9, SJR: 2.592, h-index: 100)
Birth     Hybrid Journal   (Followers: 38, SJR: 0.763, h-index: 64)
Birth Defects Research Part A : Clinical and Molecular Teratology     Hybrid Journal   (Followers: 2, SJR: 0.727, h-index: 77)
Birth Defects Research Part B: Developmental and Reproductive Toxicology     Hybrid Journal   (Followers: 6, SJR: 0.468, h-index: 47)
Birth Defects Research Part C : Embryo Today : Reviews     Hybrid Journal   (SJR: 1.513, h-index: 55)
BJOG : An Intl. J. of Obstetrics and Gynaecology     Partially Free   (Followers: 243, SJR: 2.083, h-index: 125)

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Journal Cover Addiction
  [SJR: 2.086]   [H-I: 143]   [35 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0965-2140 - ISSN (Online) 1360-0443
   Published by John Wiley and Sons Homepage  [1589 journals]
  • Cost-effectiveness of increasing the reach of smoking cessation
           interventions in Germany: results from the EQUIPTMOD
    • Authors: Manuel B. Huber; Maximilian Präger, Kathryn Coyle, Doug Coyle, Adam Lester-George, Marta Trapero-Bertran, Bertalan Nemeth, Kei Long Cheung, Renee Stark, Matthias Vogl, Subhash Pokhrel, Reiner Leidl
      Abstract: AimsTo evaluate costs, effects and cost-effectiveness of increased reach of specific smoking cessation interventions in Germany.DesignA Markov-based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health-care perspective (extended to include out-of-pocket payments) with life-time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates.SettingGermany.ParticipantsCohort of current smoking population (18+ years) in Germany.InterventionsInterventions included group-based behavioural support, financial incentive programmes and varenicline. For prospective scenario 1 the reach of group-based behavioral support, financial incentive programme and varenicline was increased by 1% of yearly quit attempts (= 57 915 quit attempts), while prospective scenario 2 represented a higher reach, mirroring the levels observed in England.MeasurementsEQUIPTMOD considered reach, intervention cost, number of quitters, quality-of-life years (QALYs) gained, cost-effectiveness and return on investment.FindingsThe highest returns through reduction in smoking-related health-care costs were seen for the financial incentive programme (€2.71 per €1 invested), followed by that of group-based behavioural support (€1.63 per €1 invested), compared with no interventions. Varenicline had lower returns (€1.02 per €1 invested) than the other two interventions. At the population level, prospective scenario 1 led to 15 034 QALYs gained and €27 million cost-savings, compared with current investment. Intervention effects and reach contributed most to the uncertainty around the return-on-investment estimates. At a hypothetical willingness-to-pay threshold of only €5000, the probability of being cost-effective is approximately 75% for prospective scenario 1.ConclusionsIncreasing the reach of group-based behavioural support, financial incentives and varenicline for smoking cessation by just 1% of current annual quit attempts provides a strategy to German policymakers that improves the population's health outcomes and that may be considered cost-effective.
      PubDate: 2017-12-15T04:33:58.480941-05:
      DOI: 10.1111/add.14062
  • Is it cost-effective to provide internet-based interventions to complement
           the current provision of smoking cessation services in the
           Netherlands' An analysis based on the EQUIPTMOD
    • Authors: Kei-Long Cheung; Ben F. M. Wijnen, Mickaël Hiligsmann, Kathryn Coyle, Doug Coyle, Subhash Pokhrel, Hein Vries, Maximilian Präger, Silvia M. A. A. Evers
      Abstract: Background and aimThe cost-effectiveness of internet-based smoking cessation interventions is difficult to determine when they are provided as a complement to current smoking cessation services. The aim of this study was to evaluate the cost-effectiveness of such an alternate package compared with existing smoking cessation services alone (current package).MethodsA literature search was conducted to identify internet-based smoking cessation interventions in the Netherlands. A meta-analysis was then performed to determine the pooled effectiveness of a (web-based) computer-tailored intervention. The mean cost of implementing internet based interventions was calculated using available information, while intervention reach was sourced from an English study. We used EQUIPTMOD, a Markov-based state-transition model, to calculate the incremental cost-effectiveness ratios [expressed as cost per quality-adjusted life years (QALYs) gained] for different time horizons to assess the value of providing internet-based interventions to complement the current package.). Deterministic sensitivity analyses tested the uncertainty around intervention costs per smoker, relative risks, and the intervention reach.ResultsInternet-based interventions had an estimated pooled relative risk of 1.40; average costs per smoker of €2.71; and a reach of 0.41% of all smokers. The alternate package (i.e. provision of internet-based intervention to the current package) was dominant (cost-saving) compared with the current package alone (0.14 QALY gained per 1000 smokers; reduced health-care costs of €602.91 per 1000 smokers for the life-time horizon). The alternate package remained dominant in all sensitivity analyses.ConclusionProviding internet-based smoking cessation interventions to complement the current provision of smoking cessation services could be a cost-saving policy option in the Netherlands.
      PubDate: 2017-12-15T03:09:10.530355-05:
      DOI: 10.1111/add.14069
  • Predictors of smoking cessation during pregnancy: a systematic review and
    • Authors: Muhammad Riaz; Sarah Lewis, Felix Naughton, Michael Ussher
      Abstract: AimTo identify factors found in the research literature to be associated with smoking cessation in pregnancy.MethodsElectronic searches of the bibliographic databases of PubMed, EMBASE, PsycINFO, Elsevier, Scopus and ISI Web of Science were conducted to April 2017. All studies reporting factors associated with smoking cessation or continuing smoking during pregnancy were included and systematically reviewed, irrespective of study design. The Newcastle Ottawa Quality Assessment Scale was used to assess the study quality. The DerSimonian and Laird random effects model was used to conduct meta-analyses, and where effect estimates were reported for factors included in at least three studies.ResultsFifty-four studies including 505,584 women globally who smoked before pregnancy, 15 clinical trials and 40 observational studies, were included in the review and 36 (65.5%) were considered to be of high quality. This review identified 11 socio-demographic, seven socially related, 19 smoking behaviour related, five pregnancy related, six health related and six psychological factors that were significantly associated with smoking cessation during pregnancy. The most frequently observed significant factors associated with cessation were: higher level of education, pooled OR (95% CI): 2.16 (1.80-2.84), higher socio-economic status: 1.97 (1.20-3.24), overseas maternal birth: 2.00 (1.40-2.84), Medicaid coverage or private insurance: 1.54 (1.29-1.85), living with partner or married: 1.49 (1.38-1.61), partner/other members of the household do not smoke: 0.42 (0.35-0.50), lower heaviness of smoking index score: 0.45 (0.27-0.77, lower baseline cotinine level: 0.78 (0.64-0.94), low exposure to second hand smoking: 0.45 (0.20-1.02), not consuming alcohol before and/or during pregnancy: 2.03 (1.47-2.80), primiparity: 1.85 (1.68-2.05), planned breastfeeding:1.99 (1.94-2.05), perceived adequate pre-natal care: 1.74 (1.38-2.19), no depression: 2.65 (1.62-4.30), and low stress during pregnancy: 0.58 (0.44-0.77).ConclusionA wide range of socio-demographics, relationship, social, smoking-related, pregnancy-related, health and psychological factors have been found to predict smoking cessation in pregnancy.
      PubDate: 2017-12-13T01:34:34.031675-05:
      DOI: 10.1111/add.14135
  • Improving Quit Rates of Web-Delivered Interventions for Smoking Cessation:
           Full Scale Randomized Trial of versus
    • Authors: Jonathan B. Bricker; Kristin E. Mull, Jennifer B. McClure, Noreen L. Watson, Jaimee L. Heffner
      Abstract: Background and aimsMillions of people worldwide use websites to help them quit smoking, but effectiveness trials have an average 34% follow-up data retention rate and an average 9% quit rate. We compared the quit rates of a website using a new behavioral approach called Acceptance and Commitment Therapy (ACT; with the current standard of the National Cancer Institute's (NCI) website.DesignA two-arm stratified double-blind individually randomized trial (n = 1319 for WebQuit; n = 1318 for with 12-month follow-up.SettingUSA.ParticipantsAdults (N = 2637) who currently smoked at least 5 cigarettes per day were recruited from March 2014 to August 2015. At baseline, participants were mean (SD) age of 46.2 (13.4), 79% women, and 73% website (experimental) provided ACT for smoking cessation; website (comparison) followed US Clinical Practice Guidelines for smoking cessation.MeasurementsThe primary outcome was self-reported 30-day point prevalence abstinence at 12 months.FindingsThe 12-month follow-up data retention rate was 88% (2309/2637). The 30-day point prevalence abstinence rates at the 12-month follow-up were 24% (278/1141) for and 26% (305/1168) for (OR = 0.91; 95% CI = 0.76, 1.10); p = 0.334) in the a priori complete case analysis. Abstinence rates were 21% (278/1319) for and 23% (305/1318) for (OR = 0.89 (0.74, 1.07); p = 0.200) when missing cases were imputed as smokers. The Bayes Factor comparing the primary abstinence outcome was 0.17, indicating “substantial” evidence of no difference between and had similar 30-day point prevalence abstinence rates at 12 months that were descriptively higher than those of prior published website-delivered interventions and telephone counselor-delivered interventions.
      PubDate: 2017-12-13T00:51:00.272842-05:
      DOI: 10.1111/add.14127
  • Validation of a Contextualized Assessment of Smoking Behavior in Students
    • Authors: Helle Larsen; Elske Salemink, Ilva Grond, Reinout W. Wiers, Kristen G. Anderson
      Abstract: AimsThe aim of this study was to validate an audio simulation of culture-specific social contexts associated with smoking to provide a medium for researchers to investigate social-contextual influences on tobacco use in the laboratory.Methods81 students (34.6% men; n = 28) listened to five audio simulations of peer social contexts where offers to smoke tobacco were made (S-SIDE). For each social scenario, participants answered questions about their willingness to accept the offer to smoke and completed measures of smoking cognitions and tobacco use. Thirty days later, participants completed online assessments of smoking behavior.ResultsWillingness to accept smoking offers in the S-SIDE procedure was related to smoking at both time points (T1: r(81) = .37, p
      PubDate: 2017-12-12T16:35:43.573921-05:
      DOI: 10.1111/add.14133
  • Risk of Amphetamine Use Disorder and Mortality Among Incident Users of
           Prescribed Stimulant Medications in the Veterans Administration
    • Authors: Arthur N. Westover; Paul A. Nakonezny, Ethan A. Halm, Bryon Adinoff
      Abstract: Background and aimsNonmedical use of prescribed stimulant medications is a growing concern. This study's aims were to ascertain the demographics of stimulant medication users compared with nonusers, examine temporal trends of stimulant medication use, and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications.DesignCox proportion hazards regression in a retrospective cohort adjusted by baseline covariates.SettingUnited States, national administrative database of the Veterans Affairs (VA) Healthcare systemParticipantsAdult incident users of stimulant medications (n=78,829) from fiscal years (FY) 2001 to 2012.MeasurementsPrimary outcomes were time-to-event: 1) occurrence of AUD diagnosis and 2) death. Baseline covariates included demographic information, FDA-approved indications for stimulant use, substance use disorders (SUD), and depression.FindingsStimulant users compared with nonusers were younger, more likely non-Hispanic white, and female. Incident stimulant medication users increased 3-fold from FY2001 to FY2012 and 8-fold among adults 18 to 44 years of age. Nearly 1 in 10 incident users in FY2012 had a comorbid baseline SUD. Off-label use was common—nearly 3 of every 5 incident users in FY2012. Comorbid SUDs among incident stimulant medication users were risk factors for occurrence of AUD during follow-up, with adjusted hazard ratio (AHR) estimates ranging from 1.54 to 2.62 (ps
      PubDate: 2017-12-07T09:55:29.742806-05:
      DOI: 10.1111/add.14122
  • Extending Addiction's conflict of interest policy to cover the emerging
           cannabis industry
    • Authors: Keith Humphreys; Shane Darke, John Marsden, Robert West
      PubDate: 2017-12-05T23:35:34.989517-05:
      DOI: 10.1111/add.14098
  • Moving beyond vaping as a cessation-only practice
    • Authors: Megan Weier
      Abstract: Commentary to: How do we determine the impact of e-cigarettes on cigarette smoking cessation or reduction' Review and recommendations for answering the research question with scientific rigor
      PubDate: 2017-12-04T00:11:12.836845-05:
      DOI: 10.1111/add.14095
  • Toxicity: exploring and expanding the concept
    • Authors: John Strang; Joanne Neale, Rebecca McDonald, Nicola Kalk
      PubDate: 2017-12-04T00:10:31.684814-05:
      DOI: 10.1111/add.14080
  • Relationship between high-risk patients receiving prescription opioids and
           high-volume opioid prescribers
    • Authors: Hsien-Yen Chang; Irene B. Murimi, Christopher M. Jones, G. Caleb Alexander
      Abstract: Aims(1) To characterize the amount of prescription opioids prescribed for high-risk patients by low-volume prescribers; (2) to quantify how high- and low-volume prescribers differ systematically in their prescribing patterns.DesignCross-sectional study using 2015 longitudinal, all-payer QuintilesIMS pharmacy claims. We conducted an aggregated analysis for the first aim and an individual-level analysis for the second aim.SettingCalifornia, Florida, Georgia, Maryland, and Washington, USA.ParticipantsAmong 4 046 275 patients, we identified 375 848 concomitant users (filling more than 30-days of concomitant opioids and benzodiazepines), 150 814 chronic users (using 100+ morphine milligram equivalents (MMEs) per day for more than 90 days), and 3190 patients prescribed opioids by> 3 prescribers and filling opioids at> 3 pharmacies during any 90-day period. Among 192 126 prescribers, we identified 8023 high-volume prescribers, who comprised the highest fifth percentile of opioid volume during four calendar quarters.Measurements(1) MME dose per transaction, (2) days supplied per transaction, (3) total opioid volume per patient and (4) number of prescriptions per patient. We also examined differences in opioid dispensing between high- and low-volume prescribers among patients receiving opioids from both.FindingsLow-volume prescribers accounted for 15–29% of opioid volume and 18–56% of opioid prescriptions for high-risk patients, compared with 28–37% and 53–58% for low-risk patients. After accounting for state of residence, comorbid burden, prescriber specialty and care sequence, patients were more likely to receive higher doses (60.9 versus 53.2 MMEs per day, P 
      PubDate: 2017-11-29T22:04:50.552394-05:
      DOI: 10.1111/add.14068
  • E-cigarette Price Sensitivity Among Middle and High School Students:
           Evidence from Monitoring the Future
    • Authors: Michael F. Pesko; Jidong Huang, Lloyd D. Johnston, Frank J. Chaloupka
      Abstract: AimsWe estimate associations between e-cigarette prices (both disposable and refill) and e-cigarette use among middle and high school students in the United States. We also estimate associations between cigarette prices and e-cigarette use.DesignWe use regression models to estimate the associations between e-cigarette and cigarette prices and e-cigarette use. In our regression models, we exploit changes in e-cigarette and cigarette prices across four periods of time and across 50 markets. We report the associations as price elasticities. In our primary model, we control for socio-demographic characteristics, cigarette prices, tobacco control policies, market fixed effects, and year-quarter fixed effects.SettingUnited States of America.Participants24,370 middle and high school students participating in the Monitoring the Future Survey in years 2014 and 2015.MeasurementsSelf-reported e-cigarette use over the last 30 days. Average quarterly cigarette prices, e-cigarette disposable prices, and e-cigarette refill prices were constructed from Nielsen retail data (inclusive of excise taxes) for 50 U.S. markets.FindingsIn a model with market fixed effects, we estimate that a 10% increase in e-cigarette disposable prices is associated with a reduction in the number of days vaping among e-cigarette users by approximately 9.7% (95% CI = -17.7% to 1.8%; p=0.02) and is associated with a reduction in the number of days vaping by the full sample by approximately 17.9% (95% CI=-31.5% to -4.2%; p=0.01). Refill e-cigarette prices were not statistically significant predictors of vaping. Cigarette prices were not significantly associated with e-cigarette use regardless of the e-cigarette price used. However, in a model without market fixed effects, cigarette prices were a statistically significant positive predictor of total e-cigarette use.ConclusionsHigher e-cigarette disposable prices appear to be associated with reduced e-cigarette use among adolescents in the US.
      PubDate: 2017-11-29T01:25:22.039218-05:
      DOI: 10.1111/add.14119
  • Excess overdose mortality immediately following transfer of patients and
           their care as well as after cessation of opioid substitution therapy.
    • Authors: Karolina M. Bogdanowicz; Robert Stewart, Chin-Kuo Chang, Hitesh Shetty, Mizanur Khondoker, Edward Day, Richard D. Hayes, John Strang
      Abstract: AimsTo investigate clustering of all-cause and overdose deaths after a transfer of patients and their care to alternative treatment provider and after the end of opioid substitution therapy (OST) in opioid-dependent individuals in specialist addiction treatment.Design, Setting and ParticipantsMortality data were identified within a sample of 5,445 patients with opioid use disorder who had received OST treatment between 1st April 2008 and 31st December 2013 from a large mental healthcare provider in United Kingdom. We investigated the circumstances and distribution of the 332 deaths identified within the observation window with a specific focus on overdose deaths (n=103) after a planned discharge, drop-out and transfer between services.MeasurementsCrude mortality rates for overdose mortality 7/14/28/180 days after the end of treatment/transfer for overdose mortality.FindingsOf 47 individuals who died from overdose after having been transferred between services, 9 died in the first 2 weeks (crude mortality rate [CMR] 136.4, 64.3 – 243.1 95% CI) and a further 5 died in the first month post-transfer (CMR 79.5, 44.2 – 129.7 95% CI). Of the 32 individuals who died from overdose after planned OST cessation, 5 died in the first 2 weeks (CMR 151.5, 51.1 – 319.0 95% CI) and a further 4 died in the first month post discharge (CMR 82.6, 38.4 – 151.0 95% CI).ConclusionsIn the UK, opioid-dependent people who are transferred to an alternative treatment provider for continuation of their opioid substitution therapy experience high overdose mortality rates, with substantially higher rates in the first month (especially first 14 days) following transfer.
      PubDate: 2017-11-27T19:01:01.78403-05:0
      DOI: 10.1111/add.14114
  • Advancing alcohol research and treatment: contentions and debates about
           treatment intensity, goals and outcomes in the 1970s and 1980s
    • Authors: Steve Allsop
      Abstract: AimsThis narrative exploration of alcohol treatment research focuses on key contentions and advances in alcohol treatment during the critical 1970s and 1980s.MethodsPapers and books which signal some of the major debates and advances in alcohol treatment research were selected from the 1970s and 1980s. The selection process was based on significant debate during this period, and included those that influenced the field in general and this author in particular.ResultsThis was a period where challenges to traditional models and concepts, and the perceived universal need for long-term treatment, were accompanied by contention but also advances in research and treatment approaches. The debates and advances resonate today. These include the recognition that: intensive and long-term treatment is not always required; for dependent drinkers, relapse is a common treatment outcome meriting specific treatment approaches to prevent and reduce this risk; controlled drinking is a treatment option, especially for younger and less dependent drinkers; and an important contributor to enduring change is access to, and realization of, improvements in the quality of life.ConclusionsPioneering research and publications in the 1970s and 1980s, sometimes conducted and produced in contentious contexts, influenced significantly conceptualizations of alcohol-related problems, and laid the foundations for treatment hypotheses and research, improving access to a broader range of evidence-based treatment. These underpinning works influenced the development of stepped-up care from brief to intensive interventions, relapse prevention and treatment options not limited to abstinence, and they identified the need to include a stronger focus on quality of life.
      PubDate: 2017-11-27T04:38:11.80713-05:0
      DOI: 10.1111/add.14064
  • Addiction research centres and the nurturing of creativity
    • Authors: Claire Wilkinson; Amy Pennay, Sarah MacLean, Michael Livingston, Robin Room, Margaret Hamilton, Anne-Marie Laslett, Heng Jiang, Sarah Callinan, Orratai Waleewong
      Abstract: Established in 2006, the Centre for Alcohol Policy Research (CAPR) is Australia's only research centre with a primary focus on alcohol policy. CAPR has four main areas of research: alcohol policy impacts; alcohol policy formation and regulatory processes involved in implementing alcohol policies; patterns and trends in drinking and alcohol problems in the population; and the influence of drinking norms, cultural practices and social contexts, particularly in interaction with alcohol policies. In this paper, we give examples of key publications in each area. During the past decade, the number of staff employed at CAPR has increased steadily and now hovers at approximately 10. CAPR has supported the development of independent researchers who collaborate on a number of international projects, such as the Alcohol's Harm to Others study which is now replicated in approximately 30 countries. CAPR receives core funding from the Foundation for Alcohol Research and Education, and staff have been highly successful in securing additional competitive research funding. In 2016, CAPR moved to a new institutional setting at La Trobe University and celebrated 10 years of operation.
      PubDate: 2017-11-26T23:03:40.400465-05:
      DOI: 10.1111/add.14075
  • Evaluating clinical stop-smoking services globally: towards a minimum data
    • Authors: Andrew L. Skinner; Robert West, Martin Raw, Emma Anderson, Marcus R. Munafò
      Abstract: Background and aimsBehavioural and pharmacological support for smoking cessation improves the chances of success and represents a highly cost-effective way of preventing chronic disease and premature death. There is a large number of clinical stop-smoking services throughout the world. These could be connected into a global network to provide data to assess what treatment components are most effective, for what populations and in what settings. To enable this, a minimum data set (MDS) is required to standardize the data captured from smoking cessation services globally.MethodsWe describe some of the key steps involved in developing a global MDS for smoking cessation services and methodologies to be considered for their implementation, including approaches for reaching consensus on data items to include in a MDS and for its robust validation. We use informal approximations of these methods to produce an example global MDS for smoking cessation. Our aim with this is to stimulate further discussion around the development of a global MDS for smoking cessation services.ResultsOur example MDS comprises three sections. The first is a set of data items characterizing treatments offered by a service. The second is a small core set of data items describing clients’ characteristics, engagement with the service and outcomes. The third is an extended set of client data items to be captured in addition to the core data items wherever resources permit.ConclusionsThere would be benefit in establishing a minimum data set (MDS) to standardize data captured for smoking cessation services globally. Once implemented, a formal MDS could provide a basis for meaningful evaluations of different smoking cessation treatments in different populations in a variety of settings across many countries.
      PubDate: 2017-11-26T22:50:45.40914-05:0
      DOI: 10.1111/add.14072
  • Communities Mobilizing for Change on Alcohol (CMCA): Secondary Analyses of
           an RCT Showing Effects of Community Organizing on Alcohol Acquisition by
           Youth in the Cherokee Nation
    • Authors: Alexander C. Wagenaar; Melvin D. Livingston, Dallas W. Pettigrew, Terrence K. Kominsky, Kelli A. Komro
      Abstract: AimsWe evaluated the effects of a community organizing intervention, Communities Mobilizing for Change on Alcohol (CMCA), on the propensity of retail alcohol outlets to sell alcohol to young buyers without age identification and on alcohol acquisition behaviors of underage youth.DesignRandom assignment of community to treatment (n=3) or control (n=2). Student surveys were conducted four times per year for three years; the cohort was in 9th and 10th grades in the 2012-13 academic year. Alcohol purchase attempts were conducted every 4 weeks at alcohol retailers in each community (31 repeated waves).SettingThe Cherokee Nation, located in northeastern Oklahoma, USA.Participants1399 high school students (50% male; 45% American Indian) and 113 stores licensed to sell alcohol across 5 study communities.InterventionLocal community organizers formed independent citizen Action Teams to advance policies, procedures and practices of local institutions in ways to reduce youth access to alcohol and foster community norms opposed to teen drinking.MeasurementsPerceptions regarding police enforcement and perceived difficulty of and self-reported actual acquisition of alcohol from parents, adults, peers, and stores.FindingsAlcohol purchases by young-appearing buyers declined significantly, an 18 (95% CI: 3, 33) percentage-point reduction over the intervention period. Student survey results show statistically significant differences in the trajectory of perceived police enforcement, increasing 7 (4, 10) percentage-points, alcohol acquisition from parents, decreasing 4, (0.1, 8) percentage-points, acquisition from 21+ adults, decreasing 6 (0.04, 11) percentage points, from
      PubDate: 2017-11-25T15:35:23.63499-05:0
      DOI: 10.1111/add.14113
  • Lifetime Marijuana Use and Subclinical Atherosclerosis: The Coronary
           Artery Risk Development in Young Adults (CARDIA) Study
    • Authors: Reto Auer; Stephen Sidney, David Goff, Eric Vittinghoff, Mark J. Pletcher, Norrina B. Allen, Jared P. Reis, Cora E. Lewis, Jeffrey Carr, Jamal S. Rana
      Abstract: Background and aimsUnlike tobacco, the effect of marijuana smoke on subclinical atherosclerosis, a surrogate measure for cardiovascular disease, is not known. This study aimed to determine the association between lifetime exposure to marijuana and measures of subclinical atherosclerosis in mid-life.Design, setting and participantsWe used data from the US-based Coronary Artery Risk Development in Young Adults (CARDIA) Study, a cohort of black and white men and women aged 18-30 years at baseline in 1985-86, with up to 7 follow-up exams over 25 years. The number of CARDIA participants included in this study was 3,498.MeasurementsCumulative years of exposure to marijuana (expressed in ‘marijuana-years’, with 1 marijuana-year equivalent to 365 days of use) using repeated assessments every 2-5 years, over 25 years. Abdominal artery calcium (AAC) and coronary artery calcium (CAC) scores measured by computed tomography at Year 25 exam.ResultsAmong 3,117 participants with AAC and CAC measurements, 2,627 (84%) reported past marijuana use and 1,536 (49%) past daily tobacco smoking. Compared with tobacco smokers, of which 46% reported 10 or more pack-years of use, only 12% of marijuana users reported 5 or more marijuana-years of use and only 6% reported having used marijuana daily. We found a significant interaction between never- and ever- tobacco users on the association between cumulative marijuana use and AAC (p=0.05). Among those who never smoked tobacco, cumulative marijuana-years were not associated with AAC or CAC in models adjusted for demographics, cardiovascular risk factors, licit and illicit drug exposure and depression symptoms. However, among ever tobacco smokers, marijuana exposure was associated with AAC and CAC. At 5 marijuana-years of exposure, using AAC=0 and CAC=0 as a reference group, the odds ratio (OR) was 1.97 (95%CI:1.21-3.21,p=0.007) for AAC>0/CAC=0 and 1.83 (95%CI:1.02-3.31,p=0.04) for CAC>0, regardless of AAC. Tobacco smoking was strongly associated with both AAC and CAC.ConclusionMarijuana use appears to be associated with subclinical atherosclerosis, but only among ever tobacco users.
      PubDate: 2017-11-22T22:35:31.397056-05:
      DOI: 10.1111/add.14110
  • Of moral judgments and sexual addictions
    • Authors: Keith Humphreys
      PubDate: 2017-11-21T22:45:22.492773-05:
      DOI: 10.1111/add.14066
  • Alcohol-related harm in emergency departments: a prospective, multicentre
    • Authors: Assoc Prof Diana Egerton-Warburton; Andrew Gosbell, Katie Moore, Angela Wadsworth, Drew Richardson, Daniel M. Fatovich
      Abstract: BackgroundEmergency department alcohol-related presentation data are not routinely collected. It is likely that previous research has underestimated the numbers of patients presenting with alcohol-related conditions.DesignMulticentre, prospective study. Patients were prospectively screened for alcohol-related presentations over a seven-day period in December 2014. Part one involved screening to determine alcohol positive ED presentations, and data collection of patient demographic and clinical information. Part two involved a consent-based survey conducted with patients aged ≥ 14 years to perform Alcohol Use Disorders Identification Test (AUDIT) scores.SettingEight EDs in Australia and New Zealand, representing differing hospital role delineations.ParticipantsA total of 8652 patients aged ≥ 14 years attended and 8435 (97.5%) were screened.MeasurementsThe main outcome measure was the proportion of patients who had an alcohol-related presentation termed ‘alcohol positive’, using predefined criteria. It included injuries, intoxication, medical conditions and injuries caused by an alcohol-affected third party. Secondary outcomes included demographic and clinical information, the type of alcohol-related presentations and AUDIT scores.Findings801 (9.5%; 95%CI, 8.9%-10.1%) presentations were identified as alcohol positive, ranging between 4.9% and 15.2% across sites. Compared with alcohol negative patients, alcohol positive patients were more likely to be male (OR 1.90) (95% CI 1.63-2.21), younger (median age 37 years vs 46 years, P
      PubDate: 2017-11-20T10:45:22.951632-05:
      DOI: 10.1111/add.14109
  • Incidence and risk factors for mortality after release from prison in
           Australia: A prospective cohort study
    • Authors: Simon J. Forsyth; Megan Carroll, Nicholas Lennox, Stuart A. Kinner
      Abstract: AimsTo estimate the incidence and identify risk factors for mortality in adults released from prisons in the state of Queensland, Australia.DesignProspective cohort study, linking baseline survey data with a national death register.SettingSelected prisons within Queensland, Australia.ParticipantsAdults (N=1320) recruited in Queensland prisons within 6 weeks of expected release, between August 2008 and July 2010, followed for up to 4.7 years in the community.MeasurementsParticipants completed a comprehensive baseline survey covering psychosocial circumstances, physical and mental health, substance use, and health risk behaviours. Clinical data were abstracted from prison medical records and obtained through probabilistic linkage with state-based, community health records. Dates of prison release and reincarceration were obtained from correctional records. Deaths were identified through probabilistic linkage with the National Death Index. Adjusted hazard ratios (AHR) were calculated using proportional hazards regression models. Standardised mortality ratios (SMR) were calculated using the population of Queensland as the reference. General population data were obtained from the Australian Bureau of Statistics.FindingsThe rate of mortality in the cohort was higher than in the age-sex matched general population of Queensland for all causes (SMR=4.0, 95%CI=2.9-5.4) and drug-related causes (SMR=32, 95%CI=19-55). In a multivariable model, adjusting for age, sex and Indigenous status, factors associated with increased mortality risk included expecting to have average or better funds available on release (AHR=2.9, 99%CI=1.2-7.1), poor mental health (AHR=2.6, 99%CI=1.1-6.1), and self-reported lifetime history of overdose (AHR=2.5, 99%CI=1.04-6.2).ConclusionsPeople released from prison in Queensland, Australia are at increased risk of death, particularly due to drug-related causes. Those at greatest risk of death are characterised by poor physical and mental health and a history of risky substance use.
      PubDate: 2017-11-20T07:50:50.291541-05:
      DOI: 10.1111/add.14106
  • The harm reduction impact of cryptomarkets: inequality and opportunity
    • Authors: Harry R. Sumnall
      Abstract: Commentary to: Will growth in cryptomarket drug buying increase the harms of illicit drugs'
      PubDate: 2017-11-19T21:10:20.536572-05:
      DOI: 10.1111/add.14065
  • Focus on cryptomarkets and online reviews too narrow to debate harms of
           drugs bought online
    • Authors: Daan Gouwe; Sander Rigter, Tibor Markus Brunt
      Abstract: Commentary to: Will growth in cryptomarket drug buying increase the harms of illicit drugs'
      PubDate: 2017-11-19T21:05:23.462854-05:
      DOI: 10.1111/add.14060
  • Looking to the future—more concern than optimism that cryptomarkets will
           reduce drug-related harms
    • Authors: Jane Mounteney; Andrew Cunningham, Teodora Groshkova, Roumen Sedefov, Paul Griffiths
      Abstract: Commentary to: Will growth in cryptomarket drug buying increase the harms of illicit drugs'
      PubDate: 2017-11-19T21:00:19.559295-05:
      DOI: 10.1111/add.14056
  • Applying recommended evidence standards to understand the impact of
           e-cigarettes on youth smoking and reporting of weak scientific evidence
    • Authors: Michael J. Green; Shona Hilton
      Abstract: Commentary to: How do we determine the impact of e-cigarettes on cigarette smoking cessation or reduction' Review and recommendations for answering the research question with scientific rigor
      PubDate: 2017-11-19T20:55:19.683671-05:
      DOI: 10.1111/add.14054
  • Pharmacokinetics of concentrated naloxone nasal spray for opioid overdose
           reversal: Phase I healthy volunteer study
    • Authors: Rebecca McDonald; Ulrike Lorch, Jo Woodward, Björn Bosse, Helen Dooner, Gill Mundin, Kevin Smith, John Strang
      Abstract: Background and AimsTake-home naloxone can prevent death from heroin/opioid overdose, but pre-provision is difficult because naloxone is usually given by injection. Non-injectable alternatives, including naloxone nasal sprays, are currently being developed. To be effective, the intranasal (i.n.) spray dose must be adequate but not excessive, and early absorption must be comparable to intramuscular (i.m.) injection. We report on the pharmacokinetics (PK) of a specially produced concentrated novel nasal spray. The specific aims were to: (1) estimate PK profiles of i.n. naloxone, (2) compare early systemic exposure with i.n. versus i.m. naloxone and (3) estimate i.n. bioavailability.DesignOpen-label, randomized, five-way cross-over PK study.SettingClinical trials facility (Croydon, UK).ParticipantsThirty-eight healthy volunteers (age 20–54 years; 11 female).Intervention and comparatorThree doses of i.n. (1 mg/0.1 ml, 2 mg/0.1 ml, 4 mg/0.2 ml) versus 0.4 mg i.m. (reference) and 0.4 mg intravenous (i.v.) naloxone.MeasurementsRegular blood samples were taken, with high-frequency sampling during the first 15 minutes to capture early systemic exposure. PK parameters were determined from plasma naloxone concentrations. Exploratory analyses involved simulation of repeat administration.FindingsMean peak concentration (Cmax) values for 1 mg (1.51 ng/ml), 2 mg (2.87 ng/ml) and 4 mg (6.02 ng/ml) i.n. exceeded 0.4 mg i.m. (1.27 ng/ml) naloxone. All three i.n. doses rapidly achieved plasma levels> 50% of peak concentrations (T50%) by 10 minutes, peaking at 15–30 minutes (Tmax). For comparison, the i.m. reference reached Tmax at 10 minutes. Mean bioavailability was 47–51% for i.n. relative to i.m. naloxone. Simulation of repeat dosing (2 × 2 mg i.n. versus 5 × 0.4 mg i.m. doses) at 3-minute intervals showed that comparable plasma naloxone concentrations would be anticipated.ConclusionsConcentrated 2 mg intranasal naloxone is well-absorbed and provides early exposure comparable to 0.4 mg intramuscular naloxone, following the 0.4 mg intramuscular curve closely in the first 10 minutes post-dosing and maintaining blood levels above twice the intramuscular reference for the next 2 hours.
      PubDate: 2017-11-16T04:00:01.106091-05:
      DOI: 10.1111/add.14033
  • A man before his time: Russell's insights into nicotine, smoking,
           treatment and curbing the smoking problem
    • Authors: Ann McNeill; Debbie Robson
      Abstract: Background and aimsThis narrative review aimed to provide a brief overview of five key research ‘classics’ produced by the innovative and radical thought leader, Professor Michael Anthony Hamilton Russell (1932–2009), drawing upon his other work wherever feasible.MethodsNarrative review. From more than 250 publications, we selected papers we considered seminal texts, published in 1971, 1976, 1978, 1979 and 1991.ResultsRussell was among the first researchers to explain that smoking was a dependence disorder caused by the drug nicotine decades before this was recognized formally. He therefore saw quickly the importance of delivering nicotine in a less harmful format as a way of controlling nicotine withdrawal when stopping smoking, first studying nicotine gum. In addition to pharmacotherapies, Russell's research also explored the role of behavioural support, particularly the role of general practitioners (GPs), alone as well as supported by specialist clinics; this research underpinned initiatives in England to reimburse doctors for giving advice to smokers, and to provide a national network of smoking cessation services. Research on nicotine uptake from other delivery systems and routes led Russell to theorize that the speed and dose of delivery impacted upon the effectiveness of a product to act as a substitute for smoking. He commented on the addictiveness of the high nicotine boli delivered in quick succession when smoking cigarettes and argued that alternative recreational nicotine delivery systems would need to be promoted actively to smokers in order for them to compete with cigarettes, a forerunner for contemporary debates on electronic cigarettes.ConclusionsThe legacy of Russell's landmark research is seen in present-day nicotine science, policy and discourse.
      PubDate: 2017-11-15T02:05:04.025765-05:
      DOI: 10.1111/add.14043
  • Opioid Dependence and Pregnancy in Early Twentieth-Century America
    • Authors: Nathan Tauger
      Abstract: Background and AimsResearch on Neonatal Abstinence Syndrome has prompted discussion over how to ensure best outcomes for pregnant women who use drugs and for drug-dependent newborns. Before Neonatal Abstinence Syndrome and the 1980s panic of “crack babies,” turn-of-the-century American medical journals discussed infants born to drug-using mothers. This paper aimed to determine whether women who used drugs while pregnant in early twentieth-century America were subject to the stigma many face today.MethodsRecords from early twentieth century medical journals, narcotic maintenance clinics, prisons that held drug users, and conferences on narcotics were examined. Dr. Charles Terry's outspokenness on drug addiction and pregnancy merited closer examination of his work, particularly The Opium Problem.ResultsSome physicians saw drug-dependent newborns as scientific proof that addiction was a physiological disease and not subject to questions of morality. This theory was discarded in the 1920s. In that decade, beliefs that children born to drug-using parents threatened national well-being proliferated. Following formal medicine's retreat from addiction treatment, research on drug addiction and pregnancy fell into obscurity until decades later.ConclusionsThe precedent that women who use drugs while pregnant deserve humane treatment extends to the early twentieth century in the US. From 1910 to 1930, perceptions of infants of drug-using women changed from hopeful to fearful.
      PubDate: 2017-11-11T09:45:20.708655-05:
      DOI: 10.1111/add.14100
  • Self-Reported Marijuana Use Over 25 Years and Abdominal Adiposity: The
           Coronary Artery Risk Development in Young Adults (CARDIA) Study
    • Authors: Michael P. Bancks; Reto Auer, J. Jeffrey Carr, David C. Goff, Catarina Kiefe, Jamal S. Rana, Jared Reis, Stephen Sidney, James G. Terry, Pamela J. Schreiner
      Abstract: AimsWe investigated the association between cumulative lifetime and current marijuana use with total abdominal adipose tissue (AT), visceral AT, subcutaneous AT, intermuscular AT, and mean liver attenuation (LA) at mid-life.DesignLongitudinal and cross-sectional secondary data analysis of participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.SettingCARDIA field centers in Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA, USA.
      PubDate: 2017-11-11T07:30:19.571369-05:
      DOI: 10.1111/add.14097
  • Cost-effectiveness of Personal Tailored Risk Information and Taster
           Sessions to increase the uptake of the NHS Stop Smoking Services: the
           Start2quit randomised controlled trial
    • Authors: Qi Wu; Hazel Gilbert, Irwin Nazareth, Stephen Sutton, Richard Morris, Irene Petersen, Simon Galton, Steve Parrott
      Abstract: AimsTo assess the cost-effectiveness of a two-component intervention designed to increase attendance at the NHS Stop Smoking Services (SSSs) in England.DesignCost-effectiveness analysis alongside a randomised controlled trial (Start2quit).SettingNHS SSS and general practices in England.ParticipantsThe study comprised 4,384 smokers aged 16 or over identified from medical records in 99 participating practices, who were motivated to quit and had not attended the SSS in the previous 12 months.Intervention and comparatorIntervention was a personalised and tailored letter sent from the General Practitioner (GP), and a personal invitation and appointment to attend a taster session providing information about SSS. Control was a standard generic letter from the GP advertising SSS and asking smokers to contact the service to make an appointment.MeasurementsCosts measured from an NHS/Personal Social Services perspective. Estimated health gains in quality-adjusted life-years (QALYs) measured with EQ-5D. Incremental cost per QALY gained over six-month and over a lifetime horizon.FindingsDuring the trial period, the adjusted mean difference in costs was £92 (95% CI: -£32-£216) and the adjusted mean difference in QALY gains was 0.002 (95% CI: -0.001-0.004). This generates an incremental cost per QALY gained of £59,401. The probability that the tailored letter and taster session is more cost-effective than the generic letter at six-month is never above 50%. In contrast, the discounted lifetime health care cost was lower in the intervention group while the lifetime QALY gains were significantly higher. The probability that the intervention is more cost-effective is over 83% using a £20,000-£30,000 per QALY gained decision-making threshold.ConclusionsAn intervention designed to increase attendance at the NHS Stop Smoking Services (tailored letter and taster session in the services) appears less likely to be cost-effective than a generic letter in the short-term but is likely to become more cost-effective than the generic letter in the long term.
      PubDate: 2017-11-04T13:30:57.592843-05:
      DOI: 10.1111/add.14086
  • Efficacy of a web-based intervention with and without guidance for
           employees with risky drinking: results of a three-arm randomized
           controlled trial
    • Authors: Leif Boß; Dirk Lehr, Michael Patrick Schaub, Raquel Paz Castro, Heleen Riper, Matthias Berking, David Daniel Ebert
      Abstract: AimsTo test the efficacy of a web-based alcohol intervention with and without guidance.DesignThree parallel groups with primary endpoint after 6 weeks.SettingOpen recruitment in the German working population.ParticipantsAdults (178 males/ 256 females, mean age of 47) consuming at least 21/14 weekly standard units of alcohol (SUA) and scoring ≥8/6 on the Alcohol Use Disorders Identification Test.InterventionFive web-based modules including personalized normative feedback, motivational interviewing, goal setting, problem solving, and emotion regulation over 5 weeks. One intervention group received an unguided self-help version (n=146) and the second received additional adherence-focused guidance by eCoaches (n=144). Controls were on a waiting list with full access to usual care (n=144).MeasurementsPrimary outcome was weekly consumed SUA after 6 weeks. SUA after 6 months was examined as secondary outcome, next to numbers of participants drinking within the low-risk range, and general and work-specific mental health measures.FindingsAll groups showed reductions of mean weekly SUA after six weeks (unguided: -8.0; guided: -8.5; control: -3.2). There was no significant difference between the unguided and guided intervention (P=0.37). Participants in the combined intervention group reported significantly fewer SUA than controls (B=-4.85, 95%-CI=-7.02 to -2.68, P
      PubDate: 2017-11-04T13:06:01.903621-05:
      DOI: 10.1111/add.14085
  • The prevalence, incidence, and gender and age-specific incidence of
           problem gambling: Results of the Swedish Longitudinal Gambling Study
    • Authors: Max Abbott; Ulla Romild, Rachel Volberg
      Abstract: AimsTo estimate the prevalence, incidence, and gender and age-specific incidence of problem gambling in the Swedish adult population.DesignLongitudinal cohort study with linkage to register data.SettingSweden.ParticipantsStratified random sample aged 16-84 at baseline (n = 8,165) re-assessed a year later (n = 6,021).MeasurementsProblem gambling (lifetime and past 12 months) was measured by the South Oaks Gambling Screen-Revised (SOGS-R). Past 12 months (current) problem gambling was also measured by the Problem Gambling Severity Index (PGSI).FindingsThe SOGS-R combined current pathological and problem gambling prevalence rate (PR) was 2.1 (CI 1.8-2.4) at baseline and 1.7 (1.4-2.0) at follow-up, approximately double the corresponding lifetime estimates. PGSI combined current problem and moderate-risk gambling PRs were 2.2 (1.9-2.5) at baseline and 1.9 (1.6-2.2) at follow-up. Combined incidence rates (IRs) were 1.0 (0.8-1.3) (SOGS-R) and 1.4 (1.1-1.7) (PGSI) with over three-quarters being new cases. While first time IRs did not vary by gender, males had a higher relapse IR and proportionately more females were new cases. The young adult IR was more than double the older adult IR. Similar proportions were new cases.ConclusionsThe actual incidence of problem gambling relapse in Sweden is likely to be higher than estimated. The profile of problem gambling in Sweden is likely to change over time, with increased proportions of women and older adults.
      PubDate: 2017-11-04T11:35:51.7392-05:00
      DOI: 10.1111/add.14083
  • A new resource for examining and responding to the contexts of
           alcohol-related harm
    • Authors: Norman Giesbrecht
      Abstract: Commentary to: All drinking is not equal: how a social practice theory lens could enhance public health research on alcohol and other health behaviours
      PubDate: 2017-10-27T22:41:32.45433-05:0
      DOI: 10.1111/add.14046
  • Publish and still perish'
    • Authors: Grant James Devilly
      PubDate: 2017-10-27T22:41:31.169334-05:
      DOI: 10.1111/add.14044
  • Hair testing: an ineffective DUI strategy in Brazil
    • Authors: Vilma Leyton; Gabriel Andreuccetti, Antonio Edson Souza Meira Júnior, Marcelo Filonzi Dos Santos, Henrique Silva Bombana, H. Chip Walls, Julia Maria D'Andrea Greve, Heraclito Barbosa Carvalho, José Heverardo Costa Montal, Flavio Emir Adura, Mauricio Yonamine
      PubDate: 2017-10-26T20:42:33.22786-05:0
      DOI: 10.1111/add.14045
  • The Genetic and Environmental Architecture of Substance Use Development
           from Early Adolescence into Young Adulthood: A Longitudinal Twin Study of
           Comorbidity of Alcohol, Tobacco and Illicit Drugs Use
    • Authors: T. Waaktaar; K.-J. Kan, S. Torgersen
      Abstract: AimsTo investigate how use of alcohol, illicit drugs and tobacco come from substance specific pathways and from pathways general to all three substances through adolescents’ developmentDesignAnalysis of population-based survey. Adolescent twins reported alcohol use (AU), tobacco use (TU), and illicit drug use (IDU) at 3 waves (2006, 2008, 2010). Restructuring data by age allowed for variance decomposition into age and substance specific and common genetic and environmental variance components.SettingNorway.ParticipantsSeven national twin birth cohorts 1988 to 1994, totaling 2340 individuals, 1483 pairs (558 monozygotic; 925 dizygotic, same and opposite sex).Measurements6-point Likert scores of AU, TU and IDU on items from the Monitoring the Future Study.FindingsSubstance use was found to be highly heritable; a2=.73 (CI .61-.94) for AU, a2=.36 (CI .18-.52); d2=.49 (CI95 = .29-.62) for IDU and a2=.46 (CI .23-.54); d2=.05 (CI95 = .00-.07) for TU over the whole adolescence period. General substance use (GSU) was also highly heritable at each age and averaged a2=.57 (CI95= 48-.66). There was a high genetic carry-over from earlier age to later age. Genetic effects on GSU at age 12-14 were still detectable 4 years later. New substance (general and specific) genetic effects also appeared. IDU demonstrated significant nonadditive genetic effects (age 12-14). Shared environment had a small impact on AU only. There was almost no nonshared environmental carry-over from age to age, the effect probably partly due to reliability deficiency. Common genetic effects across substance and substance-specific genetic effects were observed at each age period.ConclusionsAmong Norwegian adolescents, there appear to be strong genetic effects on both substance specific and comorbid use of alcohol, illicit drugs and tobacco. Among Norwegian adolescents, individual differences in alcohol use can be partially explained by family background.
      PubDate: 2017-10-22T19:00:38.389628-05:
      DOI: 10.1111/add.14076
  • Luck, come here! Automatic approach tendencies toward gambling cues in
           moderate-to-high risk gamblers
    • Authors: Marilisa Boffo; Ruby Smits, Joshua P. Salmon, Megan E. Cowie, David T. H. A. Jong, Elske Salemink, Pam Collins, Sherry H. Stewart, Reinout W. Wiers
      Abstract: Background and aimsSimilar to substance addictions, reward-related cognitive motivational processes, such as selective attention and positive memory biases, have been found in disordered gambling. Despite findings that individuals with substance use problems are biased to approach substance-related cues automatically, no study has yet focused on automatic approach tendencies for motivationally salient gambling cues in problem gamblers. We tested if moderate-to-high-risk gamblers show a gambling approach bias and whether this bias was prospectively related to gambling behaviour and problems.DesignCross-sectional assessment study evaluating the concurrent and longitudinal correlates of gambling approach bias in moderate-to-high-risk gamblers compared with non-problem gamblers.SettingOnline study across the Netherlands.ParticipantsTwenty-six non-treatment-seeking moderate-to-high risk gamblers and 26 non-problem gamblers community-recruited via the Internet.MeasurementsTwo online assessment sessions six months apart, including self-report measures of gambling problems and behaviour (frequency, duration, and expenditure) and the gambling Approach Avoidance Task, with stimuli tailored to individual gambling habits.FindingsRelative to non-problem gamblers, moderate-to-high-risk gamblers revealed a stronger approach bias towards gambling-related stimuli than neutral stimuli (p = .03). Gambling approach bias was positively correlated with past-month gambling expenditure at baseline (p = .03) and with monthly frequency of gambling at follow-up (p = .02). In multiple hierarchical regressions, baseline gambling approach bias positively predicted monthly frequency (p = .03) and total duration of gambling episodes (p = .01) six months later, but not gambling problems or expenditure.ConclusionsIn The Netherlands, relative to non-problem gamblers, moderate-to-high-risk gamblers appear to have a stronger tendency to approach rather than to avoid gambling-related pictures compared with neutral ones. This gambling approach bias is concurrently associated with past-month gambling expenditure and duration of gambling and has been found to predict persistence in gambling behaviour over time.
      PubDate: 2017-10-22T17:55:24.845781-05:
      DOI: 10.1111/add.14071
  • The impact diverging public opinion on cannabis and tobacco regulation has
           on constructive engagement between advocates
    • Authors: Deborah Arnott
      Abstract: Commentary to: The diverging trajectories of cannabis and tobacco policies in the United States: reasons and possible implications
      PubDate: 2017-10-16T21:15:34.910671-05:
      DOI: 10.1111/add.14024
  • Cryptomarkets, systemic violence and the ‘gentrification
    • Authors: James Martin
      Abstract: Commentary to: Will growth in cryptomarket drug buying increase the harms of illicit drugs'
      PubDate: 2017-10-16T20:55:34.189299-05:
      DOI: 10.1111/add.14029
  • The need to exercise caution in accepting addiction as a reason for
           performing euthanasia
    • Authors: Wayne Hall; Malcolm Parker
      Abstract: The recent practice in Belgium and the Netherlands of accepting addiction as a reason for performing euthanasia raises important issues for the field of addiction and the practice of euthanasia. In this paper we outline some of these issues. We also argue that physicians making decisions about whether to accept requests for euthanasia from people with an allegedly untreatable addiction should consider two issues carefully. They should ensure that: (1) the person has the capacity to give free and informed consent to undergo euthanasia; and (2) their request is the outcome of a deliberative process in which all reasonable treatment options and harm reduction measures have been offered to and considered by the person.
      PubDate: 2017-10-10T22:15:26.724056-05:
      DOI: 10.1111/add.14025
  • Associations between Methadone Maintenance Treatment and Crime: A 17-year
           Longitudinal Cohort study of Canadian Provincial Offenders
    • Authors: Angela Russolillo; Akm Moniruzzaman, Lawrence C. McCandless, Michelle Patterson, Julian M. Somers
      Abstract: AimsTo estimate and test the difference in rates of violent and non-violent crime during medicated and non-medicated methadone treatment episodes.Design, Setting and ParticipantsThe study involved linkage of population level administrative data (health and justice) for all individuals (n=14,530) in British Columbia, Canada with a history of conviction and who filled a methadone prescription between January 1, 1998 and March 31, 2015. Methadone maintenance treatment was the primary independent variable and was treated as a time-varying exposure. Each participant's follow-up (mean: 8 years) was divided into medicated (methadone was dispensed) and non-medicated (methadone was not dispensed) periods with mean durations of 3.3 and 4.6 years respectively.MeasurementsSocio-demographics of participants were examined along with the main outcomes of violent and non-violent offences.FindingsDuring the first two years of treatment (≤2.0 years), periods in which methadone was dispensed were associated with a 33% lower rate of violent crime [0.67 adjusted hazard ratio (AHR), 95% confidence intervals (CI) (0.59, 0.76)] and a 35% lower rate of non-violent crime [0.65 AHR 95% CI (0.62, 0.69) compared with non-medicated periods. This equates to a risk difference of 3.6 [95% CI (2.6, 4.4)] and 37.2 [95% CI (33.0, 40.4)] fewer violent and non-violent offences per 100 person years, respectively. Significant but smaller protective effects of dispensed methadone were observed across longer treatment intervals (2.0 to ≤ 5.0 years, 5.0 to ≤10.0 years).ConclusionsAmong a cohort of Canadian offenders, rates of violent and non-violent offending were lower during periods when individuals were dispensed methadone compared with periods in which they were not dispensed methadone.
      PubDate: 2017-10-07T12:31:04.965472-05:
      DOI: 10.1111/add.14059
  • Impulsivity predicts poorer improvement in quality of life during early
           treatment for people with methamphetamine dependence
    • Authors: Adam J. Rubenis; Rebecca E. Fitzpatrick, Dan I. Lubman, Antonio Verdejo-Garcia
      Abstract: Background and aimsMethamphetamine dependence is associated with heightened impulsivity and diminished quality of life, but the link between impulsivity and changes in quality of life during treatment has not been examined. We aimed to investigate how different elements of impulsivity predict change in quality of life in the six weeks after engaging in treatment.DesignLongitudinal, observational cohort study.SettingPublic and private detoxification and rehabilitation facilities in metropolitan Melbourne, Australia.ParticipantsOne hundred and eight individuals with methamphetamine dependence (81 male) tested within three weeks of commencing treatment, 80 (74%) were followed-up at six weeks.MeasurementsThe Continuous Performance Test-2 measured impulsive action (cognitive and motor impulsivity); the Delay Discounting Task measured impulsive choice. Quality of life was measured with the World Health Organization Quality of Life Scale – Brief, which includes social, psychological, physical and environment domains. Control variables included age, gender, estimated IQ, depression severity score, methamphetamine dependence severity score, cannabis dependence severity score and treatment modality.FindingsWe found that all three forms of impulsivity were significant predictors of change in the social domain: motor impulsivity (β = -0.54, p = .013), cognitive impulsivity (β = -0.46, p = .029) and impulsive choice (β = -0.26, p = .019). Change in the psychological domain was significantly predicted by motor impulsivity (β = -0.45, p = .046). Control variables of age and depression were significantly associated with changes in the physical domain.ConclusionsIn Australian methamphetamine-dependent individuals, elevated impulsivity predicts lower improvement of social and psychological quality of life in the first six to nine weeks of treatment.
      PubDate: 2017-10-07T11:20:26.429555-05:
      DOI: 10.1111/add.14058
  • Trends in age of smoking initiation in the Netherlands: a shift towards
           older ages'
    • Authors: Paulien A. W. Nuyts; Mirte A. G. Kuipers, Marc C. Willemsen, Anton E. Kunst
      Abstract: Background and aimAs smoking initiation generally occurs in adolescence, smoking prevention is primarily targeted at young adolescents (under 16 years old). We hypothesize that, with the adoption of increasingly stronger youth access laws, a shift in the age of smoking initiation may have occurred.DesignRepeated cross-sectional survey.SettingThe Netherlands.Participants11,574 respondents born between 1980 and 1995.MeasurementsIn the 2010-2015 National Health Survey we retrospectively measured self-reported initiation rates per year of age, by birth cohort (1980-83, 1984-87, 1988-91, 1992-95). Logistic regression analyses were performed to assess differences between cohorts, per sex and educational level.FindingsOf those who started smoking, 67.2% initiated smoking between 12 and 16 years of age. Contrary to our hypothesis, no shift in initiation towards higher ages was observed. The peak age of initiation was 16 years for all cohorts. Initiation at ages 17-21 was lower in younger birth cohorts than in older birth cohorts (e.g. cohort 1993-95 vs. 1980-83: OR for initiating at 19-21 years = 0.45, 95%CI:0.31-0.64). Trends in age of initiation were similar for males and females. Initiation at ages 15-17 decreased across cohorts for respondents in higher education levels, but not for those in lower education levels.ConclusionsIn the Netherlands, the peak age of smoking initiation did not shift across subsequent cohorts born between 1980 and 1995, suggesting that young adolescents remain the main target group for smoking initiation prevention policies.
      PubDate: 2017-10-07T10:40:21.013706-05:
      DOI: 10.1111/add.14057
    • Authors: Linn Gjersing; Anne Line Bretteville-Jensen
      Abstract: AimsTo examine the mortality risk in a cohort of “hard-to-reach” polysubstance users and its putative associations with substance use. Specifically, we estimated all-cause mortality risk as a function of individual substance use indicators, and then as a function of their complex, “real-life” patterns as identified through Latent Class Analysis (LCA).DesignProspective cohort study among street-and low-threshold-service-recruited polysubstance users included between September and November 2013 and followed through the National Cause of Death Registry until 31 October 2015.SettingSeven Norwegian cities.Participants884 users of illegal opioids and/or stimulants. Of these, 357 were in opioid substitution treatment (OST) at the time of inclusion. Forty-four participants died during follow-up.MeasurementsPrimary outcome: All-cause mortality risk. Unadjusted and adjusted Cox proportional hazard (PH) regression models (covariates: male, age, homelessness/shelter use, overdose experience, OST status, years of injecting, individual substance use indicators, city, use patterns). LCA models estimated separately for those in and those not in OST due to measurement invariance.FindingsThe crude mortality rate was 2.52 per 100 person-years. Standardized mortality ratio was 26.11 (95% confidence interval (CI) 10.06-54.87) for women and 10.71 (95% CI 6.39-16.81) for men. No single drug use indicator, such as “heroin injection” or “number of drugs used”, was associated with the mortality risk. However, meaningful use patterns were identified; three OST and non-OST patterns each. The non-OST patterns “Polysubstance injectors” (HR=3.44 95% CI 0.98-12.14) and “Low frequent injectors” (HR=3.17 CI 1.05-9.56) were significantly associated with the mortality risk even when adjusted for other known risk factors.ConclusionsIn a Norwegian prospective cohort study, “hard-to-reach” polysubstance users had more than ten times higher mortality risk than the general population. Mortality risk was not a function of any single drug use indicator, but two distinct combinations of substances, frequencies and routes of administration were associated with the mortality risk.
      PubDate: 2017-10-07T09:55:20.060787-05:
      DOI: 10.1111/add.14053
  • How do we determine the impact of e-cigarettes on cigarette smoking
           cessation or reduction' Review and recommendations for answering the
           research question with scientific rigor
    • Authors: Andrea C. Villanti; Shari P. Feirman, Raymond S. Niaura, Jennifer L. Pearson, Allison M. Glasser, Lauren K. Collins, David B. Abrams
      Abstract: AimsTo propose a hierarchy of methodological criteria to consider when determining whether a study provides sufficient information to answer the question of whether e-cigarettes can facilitate cigarette smoking cessation or reduction.DesignA PubMed search to 1 February 2017 was conducted of all studies related to e-cigarettes and smoking cessation or reduction.SettingsAustralia, Europe, Iran, Korea, New Zealand and the United States.Participants and studies91 articles.MeasurementsCoders organized studies according to six proposed methodological criteria: (1) examines outcome of interest (cigarette abstinence or reduction), (2) assesses e-cigarette use for cessation as exposure of interest, (3) employs appropriate control/comparison groups, (4) ensures that measurement of exposure precedes the outcome, (5) evaluates dose and duration of the exposure and (6) evaluates the type and quality of the e-cigarette used.FindingsTwenty-four papers did not examine the outcomes of interest. Forty did not assess the specific reason for e-cigarette use as an exposure of interest. Twenty papers did not employ prospective study designs with appropriate comparison groups. The few observational studies meeting some of the criteria (duration, type, use for cessation) triangulated with findings from three randomized trials to suggest that e-cigarettes can help adult smokers quit or reduce cigarette smoking.ConclusionsOnly a small proportion of studies seeking to address the effect of e-cigarettes on smoking cessation or reduction meet a set of proposed quality standards. Those that do are consistent with randomized controlled trial evidence in suggesting that e-cigarettes can help with smoking cessation or reduction.
      PubDate: 2017-10-03T19:50:28.218329-05:
      DOI: 10.1111/add.14020
  • Do practice approaches go far enough in shifting focus from the
    • Authors: Suzanne Fraser
      Abstract: Commentary to: All drinking is not equal: how a social practice theory lens could enhance public health research on alcohol and other health behaviours
      PubDate: 2017-10-03T19:45:34.193024-05:
      DOI: 10.1111/add.14018
  • The Effect of a Behavioral Activation Treatment for Substance Use on
           Post-treatment Abstinence: A Randomized Controlled Trial
    • Authors: Stacey B. Daughters; Jessica F. Magidson, Deepika Anand, C. J. Seitz-Brown, Yun Chen, Sydney Baker
      Abstract: Aimsto compare outcomes for a behavioral activation group treatment for substance use (LETS ACT), versus a time and group size matched control condition delivered in a residential treatment setting.Designsingle-site two-arm parallel-group randomized clinical trial with follow-up assessment at 3, 6 and 12 months post-treatment.Settingresidential substance use treatment facility in the USA.Participantsparticipants were 263 adults [mean age 42.7 [11.8]; 29.3% female; 94.7% African American; 72.6% court mandated] whose insurance dictated 30-day (65.4%) or 90-day (34.6%) treatment duration.Intervention and comparatorLETS ACT (n=142) is a treatment originally developed for depression and modified for substance use. It teaches participants to increase positively reinforcing value-driven activities in order to counter depression and relapse. The control group (SC; n=121) received time and group-size matched supportive counseling. Treatment was delivered in five or eight one-hour sessions depending on patient length of stay.Measurementspercent abstinent at follow-up, percent of substance use days among those reporting use, depressive symptoms (BDI), and adverse consequences of drug use (SIP-AD).FindingsLETS ACT had significantly higher abstinence rates at 3 months (odds ratio=2.2, 95% confidence interval=1.3-3.7), 6 months (odds ratio=2.6, 95% confidence interval=1.3-5.0), and 12 months (odds ratio=2.9, 95% confidence interval=1.3-6.1) post-treatment compared with SC. LETS ACT participants reported significantly fewer adverse consequences from substance use at 12 months post-treatment (B=4.50, SE=2.17, 95% confidence interval=0.22-8.78). Treatment condition had no effect on percent substance use days among those who resumed use or on change in depressive symptoms; the latter decreased over time only in those who remained abstinent after residential treatment irrespective of condition (B=0.43, SE=0.11, 95% confidence interval=0.22-0.65).Conclusionsa behavioral activation group treatment for substance use (LETS ACT) appears to increase the likelihood of abstinence and reduce adverse consequences from substance use up to 12 months post-treatment.
      PubDate: 2017-09-30T10:30:21.775934-05:
      DOI: 10.1111/add.14049
  • Sexual Identity Differences in High-Intensity Binge Drinking: Findings
           from a US National Sample
    • Authors: Jessica N. Fish; Tonda L. Hughes, Stephen T. Russell
      Abstract: AimTo estimate sexual identity differences in high-intensity binge drinking.Design and settingCross-sectional US adult health survey from 2014 and 2015.ParticipantsUS adults ages 18 and older (N = 215,684; n = 203,562 heterosexual, n = 2,784 lesbian/gay, n = 2,892 bisexual, n = 686 “other” and n = 1,947 don't know/unsure).MeasurementsSelf-reported past 30-day standard binge and high-intensity binge drinking. Standard binge drinking cutoff values were 4+/5+ drinks for women and men, respectively. High-intensity binge drinking was measured as 2 and 3 times the standard level (8+ and 12+ drinks for women and 10+ and 15+ drinks for men).FindingsLesbian and bisexual women were more likely than heterosexual women to report consuming 4+ drinks (adjusted odds ratio [aOR] =1.57, CI [1.18, 2.09] and aOR = 1.83, CI [1.45, 2.30] for lesbian and bisexual women, respectively); 8+ drinks (aOR = 3.86, CI [2.39, 6.24], aOR = 2.07, CI [1.39, 3.07]); and 12+ drinks (aOR = 3.81, CI [1.77, 8.19], aOR = 2.54, CI [1.25, 5.14]) in a single occasion in the past 30 days. Generally, gay and bisexual men were no more likely than heterosexual men to report standard or high-intensity binge drinking. However, bisexual men were more likely than heterosexual men to consume 15+ drinks, aOR = 1.76, 95% CI [1.01, 3.06]. Rates of standard and high-intensity binge drinking were similar between heterosexual and unsure men and women. Men and women who indicated “other” sexual identities were generally less likely than heterosexuals to report standard and high-intensity binge drinking with the exception of 4+ drinks for women and 10+ drinks for men.ConclusionsIn the USA, sexual minority women are more likely, and sexual minority men are equally likely, to drink at standard and high-intensity binge drinking levels as their heterosexual counterparts.
      PubDate: 2017-09-23T01:30:21.61053-05:0
      DOI: 10.1111/add.14041
  • Pharmacologically controlled drinking in the treatment of alcohol
           dependence or alcohol use disorders: a systematic review with direct and
           network meta-analyses on nalmefene, naltrexone, acamprosate, baclofen and
    • Authors: Clément Palpacuer; Renan Duprez, Alexandre Huneau, Clara Locher, Rémy Boussageon, Bruno Laviolle, Florian Naudet
      Abstract: Background and AimsPharmacologically controlled drinking in the treatment of alcohol dependence or alcohol use disorders (AUDs) is an emerging concept. Our objective was to explore the comparative effectiveness of drugs used in this indication.DesignSystematic review with direct and network meta-analysis of double-blind randomized controlled trials (RCTs) assessing the efficacy of nalmefene, naltrexone, acamprosate, baclofen or topiramate in non-abstinent adults diagnosed with alcohol dependence or AUDs. Two independent reviewers selected published and unpublished studies on Medline, the Cochrane Library, Embase,, contacted pharmaceutical companies, the European Medicines Agency and the Food and Drug Administration, and extracted data.SettingThirty-two RCTs.ParticipantsA total of 6036 patients.MeasurementsThe primary outcome was total alcohol consumption (TAC). Other consumption outcomes and health outcomes were considered as secondary outcomes.FindingsNo study provided direct comparisons between drugs. A risk of incomplete outcome data was identified in 26 studies (81%) and risk of selective outcome reporting in 17 (53%). Nalmefene [standardized mean difference (SMD) = −0.19, 95% confidence interval (CI) = −0.29, –0.10; I2 = 0%], baclofen (SMD = −1.00, 95% CI = −1.80, −0.19; one study) and topiramate (SMD = −0.77, 95% CI = −1.12, –0.42; I2 = 0%) showed superiority over placebo on TAC. No efficacy was observed for naltrexone or acamprosate. Similar results were observed for other consumption outcomes, except for baclofen (the favourable outcome on TAC was not reproduced). The number of withdrawals for safety reasons increased under nalmefene and naltrexone. No treatment demonstrated any harm reduction (no study was powered to explore health outcomes). Indirect comparisons suggested that topiramate was superior to nalmefene, naltrexone and acamprosate on consumption outcomes, but its safety profile is known to be poor.ConclusionsThere is currently no high-grade evidence for pharmacological treatment to control drinking using nalmefene, naltrexone, acamprosate, baclofen or topiramate in patients with alcohol dependence or alcohol use disorder. Some treatments show low to medium efficacy in reducing drinking across a range of studies with a high risk of bias. None demonstrates any benefit on health outcomes.
      PubDate: 2017-09-20T23:01:03.130784-05:
      DOI: 10.1111/add.13974
  • Addiction Lives: Wayne Hall
    • PubDate: 2017-09-19T19:26:09.282326-05:
      DOI: 10.1111/add.13965
  • Addiction Lives: Thomas F. Babor
    • PubDate: 2017-09-19T19:20:23.878267-05:
      DOI: 10.1111/add.13963
  • Assessing causal relationships using genetic proxies for exposures: An
           introduction to Mendelian randomisation
    • Authors: Srinivasa Vittal Katikireddi; Michael Green, Amy E. Taylor, George Davey Smith, Marcus R. Munafò
      Abstract: Background and aimsStudying the consequences of addictive behaviours is challenging, with understanding causal relationships from observational data being particularly difficult. For example, people who smoke or drink excessively are often systematically different from those who do not, are less likely to participate in research, and may misreport their behaviours when they do. Furthermore, the direction of causation between an addictive behaviour and outcome may be unclear. Mendelian randomisation (MR) offers potential solutions to these problems.MethodsWe describe MR's principles and the criteria under which it is valid. We identify challenges and potential solutions in its application (illustrated using two applied examples), and describe methodological extensions in its application.ResultsMR is subject to certain assumptions, and requires the availability of appropriate genetic data, large sample sizes, and careful design and conduct. However, it has already been successfully applied to the addiction literature. The relationship between alcohol consumption (proxied by a variant in the ADH1B gene) and cardiovascular risk has been investigated, finding that alcohol consumption increases risk, with no evidence of a cardio-protective effect at moderate consumption levels. In addition, heaviness of smoking (proxied by a variant in the CHRNA5-A3-B4 gene cluster) and risk of depression and schizophrenia have been investigated, with no evidence of a causal effect of smoking on depression but some evidence of a causal effect on schizophrenia.ConclusionsMendelian randomisation (MR) analyses are already producing robust evidence for addiction-related practice and policy. As genetic variants associated with addictive behaviours are identified, the potential for MR analyses will grow. Methodological developments are also increasing its applicability.
      PubDate: 2017-09-17T18:55:19.55835-05:0
      DOI: 10.1111/add.14038
  • Alcohol e-Help: Study protocol for a Web-based self-help program to reduce
           alcohol use in adults with drinking patterns considered harmful,
           hazardous, or suggestive of dependence in middle-income countries
    • Authors: Michael P. Schaub; Marcela Tiburcio, Nora Martinez, Atul Ambekar, Yatan Pal Singh Balhara, Andreas Wenger, André Luiz Monezi Andrade, Dzianis Padruchny, Sergey Osipchik, Elise Gehring, Vladimir Poznyak, Dag Rekve, Maria Lucia Oliveira Souza-Formigoni,
      Abstract: Background and aimsGiven the scarcity of alcohol prevention and alcohol use disorder treatments in many low and middle-income countries, the World Health Organization launched an e-health portal on alcohol and health that includes a Web-based self-help program. This paper presents the protocol for a multicenter randomised controlled trial (RCT) to test the efficacy of the Internet-based self-help intervention to reduce alcohol use.DesignTwo-arm RCT with follow-up 6 months after randomisation.SettingCommunity samples in middle-income countries.ParticipantsPeople aged 18+, with AUDIT scores of 8+ indicating hazardous alcohol consumption.Intervention and comparatorOffer of an Internet-based self-help intervention, “Alcohol e-Health,” compared with a ‘waiting list’ control group. The intervention, adapted from a previous program with evidence of effectiveness in a high-income country, consists of modules to reduce or entirely stop drinking.MeasurementsThe primary outcome measure is change in the Alcohol Use Disorders Identification Test (AUDIT) score assessed at 6 month follow-up. Secondary outcomes include self-reported the numbers of standard drinks and alcohol-free days in a typical week over the past six months, and cessation of harmful or hazardous drinking (AUDIT < 8).AnalysisData analysis will be by intention-to-treat, using analysis of covariance to test if program participants will experience a greater reduction in their AUDIT score than controls at follow-up. Secondary outcomes will be analysed by (generalized) linear mixed models. Complier average causal effect and baseline observations carried forward will be used in sensitivity analyses.CommentsIf the Alcohol e-Health program is found to be effective, the potential public health impact of its expansion into countries with underdeveloped alcohol prevention and alcohol use disorder treatment systems worldwide is considerable.
      PubDate: 2017-09-17T18:00:21.01881-05:0
      DOI: 10.1111/add.14034
  • Genome-wide association study of a nicotine metabolism biomarker in
           African American smokers: impact of chromosome 19 genetic influences
    • Authors: Meghan J. Chenoweth; Jennifer J. Ware, Andy Z. X. Zhu, Christopher B. Cole, Lisa Sanderson Cox, Nikki Nollen, Jasjit S. Ahluwalia, Neal L. Benowitz, Robert A. Schnoll, Larry W. Hawk, Paul M. Cinciripini, Tony P. George, Caryn Lerman, Joanne Knight, Rachel F. Tyndale,
      Abstract: Background and aimsThe activity of CYP2A6, the major nicotine-inactivating enzyme, is measurable in smokers using the nicotine metabolite ratio (NMR; 3’hydroxycotinine/cotinine). Due to its role in nicotine clearance, the NMR is associated with smoking behaviours and response to pharmacotherapies. The NMR is highly heritable (~80%), and on average lower in African Americans (AA) versus Whites. We previously identified several reduce and loss-of-function CYP2A6 variants common in individuals of African descent. Our current aim was to identify novel genetic influences on the NMR in AA smokers using genome-wide approaches.DesignGenome-wide association study (GWAS).SettingMultiple sites within Canada and the United States.ParticipantsAA smokers from two clinical trials: Pharmacogenetics of Nicotine Addiction Treatment (PNAT)-2 (NCT01314001; n=504) and Kick-it-at-Swope (KIS)-3 (NCT00666978; n=450).MeasurementsGenome-wide SNP genotyping, the NMR (phenotype), and population substructure and NMR covariates.FindingsMeta-analysis revealed three independent chromosome 19 signals (rs12459249, rs111645190, and rs185430475) associated with the NMR. The top overall hit, rs12459249 (P=1.47e-39; beta=0.59 per C (versus T) allele, SE=0.045), located ~9.5kb 3’ of CYP2A6, remained genome-wide significant after controlling for the common (~10% in AA) non-functional CYP2A6*17 allele. In contrast, rs111645190 and rs185430475 were not genome-wide significant when controlling for CYP2A6*17. In total, 96 signals associated with the NMR were identified; many were not found in prior NMR GWASs in European descent individuals. The top hits were also associated with the NMR in a third cohort of AA (KIS2; n=480). None of the hits were in UGT or OCT2 genes.ConclusionsThree independent chromosome 19 signals account for ~20% of the variability in the nicotine metabolite ratio in African-American smokers. The hits identified may contribute to inter-ethnic variability in nicotine metabolism, smoking behaviours, and tobacco-related disease risk.
      PubDate: 2017-09-16T17:00:30.543363-05:
      DOI: 10.1111/add.14032
  • Trends and age, period and cohort effects for marijuana use prevalence in
           the 1984 to 2015 US National Alcohol Surveys
    • Authors: William C. Kerr; Camillia Lui, Yu Ye
      Abstract: Background and AimsEpidemiological trends show marijuana use in the U.S. to have increased in recent years. Previous research has identified cohort effects as contributing to the rising prevalence, in particular birth cohorts born after 1945. However, given recent policy efforts to regulate marijuana use at the state level, period effects could also play a contributing role. This study aims to examine whether cohort or period effects play a larger role in explaining trends in marijuana use.DesignUsing data from seven National Alcohol Surveys, we estimate age-period cohort decomposition models for marijuana use controlling for socio-demographic measures.SettingUnited StatesParticipantsU.S. general population ages 18 and older from 1984 to 2015.MeasurementsAny past year marijuana useFindingsResults indicate that period effects are the main driver of rising marijuana use prevalence. Models including indicators of medical and recreational marijuana policies do not find any significant positive impacts.ConclusionsThe steep rise in marijuana use in the United States since 2005 occurred across the population and is attributable to general period effects not specifically linked to the liberalization of marijuana policies in some states.
      PubDate: 2017-09-12T02:00:02.073145-05:
      DOI: 10.1111/add.14031
  • Needle syringe programmes and opioid substitution therapy for preventing
           HCV transmission among people who inject drugs: findings from a Cochrane
           Review and meta-analysis
    • Authors: Lucy Platt; Silvia Minozzi, Jennifer Reed, Peter Vickerman, Holly Hagan, Clare French, Ashly Jordan, Louisa Degenhardt, Vivian Hope, Sharon Hutchinson, Lisa Maher, Norah Palmateer, Avril Taylor, Julie Bruneau, Matthew Hickman
      Abstract: AimsTo estimate the effects of needle syringe programmes (NSP) and opioid substitution therapy (OST), alone or in combination, for preventing acquisition of Hepatitis C virus (HCV) in people who inject drugs (PWID).MethodsSystematic review and meta-analysis. Bibliographic databases were searched for studies measuring concurrent exposure to current OST (within last 6 months) and/or NSP and HCV incidence among PWID. High NSP coverage was defined as regular NSP attendance or ≥100% coverage (receiving sufficient or greater number of needles/syringes per reported injecting frequency). Studies were assessed using the Cochrane risk of bias in non-randomised studies tool. Random effects models were used in meta-analysis.ResultsWe identified 28 studies (n=6279) in North America (13), UK (5), Europe (4), Australia (5), and China (1). Studies were at moderate (2), serious (17) critical (7) and non-assessable risk of bias (2). Current OST is associated with 50% (risk ratio (RR) 0.50 95% CI 0.40-0.63) reduction in HCV acquisition risk, consistent across region and with low heterogeneity (I2=0, p=0.889). Weaker evidence was found for high NSP coverage (RR=0.79 95% CI 0.39-1.61) with high heterogeneity (I2=77%, p=0.002). After stratifying by region, high NSP coverage in Europe was associated with a 56% reduction in HCV acquisition risk (RR=0.44, 95% CI 0.24-0.80) with low heterogeneity (I2=12.3%, p=0.337) but not in North America (RR=1.58, I2=89.5%, p=
      PubDate: 2017-09-11T04:00:00.857153-05:
      DOI: 10.1111/add.14012
  • The future of the international drug control system and national drug
    • Authors: Wayne Hall
      Abstract: A major impediment to any nation abandoning the policy of drug prohibition has been the fact that international drug treaties to which the majority of United Nations (UN) member states are signatory prohibit the non-medical use of amphetamines, cannabis, cocaine and heroin. The future of these treaties is now uncertain because of decisions by Uruguay, eight US states and Canada to legalize cannabis use. This paper: (1) provides a brief account of the international drug control treaties; (2) outlines the major criticisms of the treaties; (3) analyses critically proposals for treaty reform; and (4) provides a personal view on policies that nation states could adopt to minimize the harms from the use of cannabis, party drugs and hallucinogens, opioids, stimulants and new psychoactive substances. It is argued that: a major risk of cannabis legalization in the United States is promotion of heavy use and increased harm by a weakly regulated industry; some cautious national experiments with the regulation of party drugs and hallucinogens would be informative; a strong case remains for prohibiting the nonmedical use of opioids while mitigating the adverse effects that this policy has on opioid-dependent people; stimulant legalization will probably increase problem use but prohibition is difficult to enforce, highlighting the urgency of finding better ways to reduce demand for these drugs and respond to problem users; and that it is unclear what the best approach is to reducing possible harms that may arise from the use of new psychoactive substances.
      PubDate: 2017-09-08T00:15:00.928804-05:
      DOI: 10.1111/add.13941
  • Associations of parental alcohol use disorders and parental separation
           with offspring initiation of alcohol, cigarette and cannabis use and
           sexual debut in high-risk families
    • Authors: Vivia V. McCutcheon; Arpana Agrawal, Sally I-Chun Kuo, Jinni Su, Danielle M. Dick, Jacquelyn L. Meyers, Howard J. Edenberg, John I. Nurnberger, John R. Kramer, Samuel Kuperman, Marc A. Schuckit, Victor M. Hesselbrock, Andrew Brooks, Bernice Porjesz, Kathleen K. Bucholz
      Abstract: Background and AimsParental alcohol use disorders (AUDs) and parental separation are associated with increased risk for early use of alcohol in offspring, but whether they increase risks for early use of other substances and for early sexual debut is under-studied. We focused on associations of parental AUDs and parental separation with substance initiation and sexual debut to (1) test the strength of the associations of parental AUDs and parental separation with time to initiation (age in years) of alcohol, tobacco and cannabis use and sexual debut and (2) compare the strength of association of parental AUD and parental separation with initiation.DesignProspective adolescent and young adult cohort of a high-risk family study, the Collaborative Study on the Genetics of Alcoholism (COGA).SettingSix sites in the United States.ParticipantsA total of 3257 offspring (aged 14–33 years) first assessed in 2004 and sought for interview approximately every 2 years thereafter; 1945 (59.7%) offspring had a parent with an AUD.MeasurementsDiagnostic interview data on offspring substance use and sexual debut were based on first report of these experiences. Parental life-time AUD was based on their own self-report when parents were interviewed (1991–2005) for most parents, or on offspring and other family member reports for parents who were not interviewed. Parental separation was based on offspring reports of not living with both biological parents most of the time between ages 12 and 17 years.FindingsParental AUDs were associated with increased hazards for all outcomes, with cumulative hazards ranging from 1.19 to 2.71. Parental separation was also an independent and consistent predictor of early substance use and sexual debut, with hazards ranging from 1.19 to 2.34. The strength of association of parental separation with substance initiation was equal to that of having two AUD-affected parents, and its association with sexual debut was stronger than the association of parental AUD in one or both parents.ConclusionsParental alcohol use disorders (AUDs) and parental separation are independent and consistent predictors of increased risk for early alcohol, tobacco and cannabis use and sexual debut in offspring from families with a high risk of parental AUDs.
      PubDate: 2017-09-06T23:22:30.465193-05:
      DOI: 10.1111/add.14003
  • The short term impact of the Alcohol Act on alcohol-related deaths and
           hospital admissions in Scotland: a natural experiment.
    • Authors: Mark Robinson; Janet Bouttell, James Lewsey, Danny Mackay, Gerry McCartney, Clare Beeston
      Abstract: Background and aimThe introduction of the Alcohol Act in Scotland on 1 October 2011, which included a ban on multi-buy promotions, was likely associated with a fall in off-trade alcohol sales in the year after its implementation. The aim of this study was to test if the same legislation was associated with reduced levels of alcohol-related deaths and hospital admissions in the 3-year period after its introduction.DesignA natural experiment design using time series data to assess the impact of the Alcohol Act legislation in Scotland. Comparisons were made with unexposed populations in the rest of Great Britain.SettingScotland with comparable data obtained for geographical control groups in other parts of Great Britain.ParticipantsFor alcohol-related deaths, a total of 17,732 in Scotland and 88,001 in England/Wales across 169 four-week periods between January 2001 and December 2013. For alcohol-related hospital admissions, a total of 121,314 in Scotland and 696,892 in England across 182 four-week periods between January 2001 and December 2014.MeasurementsDeaths and hospital admissions in Scotland and control groups that were wholly attributable to alcohol for consecutive four-week periods between January 2001 and December 2014. Data were obtained by age, sex and area-based socioeconomic position.FindingsThere was no evidence to suggest that the Alcohol Act was associated with changes in the overall rate of alcohol-related deaths [incidence rate ratio (IRR) 0.99, 95% confidence interval (0.91 to 1.07)] or hospital admissions [IRR 0.98 (0.95 to 1.02)] in Scotland. In control group analyses, the pseudo intervention variable was not associated with a change in alcohol-related death rates in England/Wales [IRR 0.99 (0.95 to 1.02)], but was associated with an increase in alcohol-related hospital admission rates in England [IRR 1.05 (1.03 to 1.07)]. In combined models, the interaction analysis did not provide support for a ‘net effect’ of the legislation on alcohol-related deaths in Scotland compared with England/Wales [IRR 0.99 (0.95 to 1.04)], but suggested a net reduction in hospital admissions for Scotland compared with England [IRR 0.93 (0.87 to 0.98)].ConclusionThe implementation of the Alcohol Act in Scotland has not been associated clearly with a reduction in alcohol-related deaths or hospital admissions in the 3-year period after it was implemented in October 2011.
      PubDate: 2017-09-06T04:00:01.28577-05:0
      DOI: 10.1111/add.14019
  • Associations between adolescent cannabis use and neuropsychological
           decline: a longitudinal co-twin control study
    • Authors: Madeline H. Meier; Avshalom Caspi, Andrea Danese, Helen L. Fisher, Renate Houts, Louise Arseneault, Terrie E. Moffitt
      Abstract: AimsThis study tested whether adolescents who used cannabis or met criteria for cannabis dependence showed neuropsychological impairment prior to cannabis initiation and neuropsychological decline from before to after cannabis initiation.DesignA longitudinal co-twin control study.Setting and ParticipantsParticipants were 1989 twins from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative birth cohort of twins born in England and Wales from 1994 to 1995.MeasurementsFrequency of cannabis use and cannabis dependence were assessed at age 18. Intelligence quotient (IQ) was obtained at ages 5, 12 and 18. Executive functions were assessed at age 18.FindingsCompared with adolescents who did not use cannabis, adolescents who used cannabis had lower IQ in childhood prior to cannabis initiation and lower IQ at age 18, but there was little evidence that cannabis use was associated with IQ decline from ages 12–18. For example, adolescents with cannabis dependence had age 12 and age 18 IQ scores that were 5.61 (t = −3.11, P = 0.002) and 7.34 IQ points (t = −5.27, P  0.10). The one exception was that twins who used cannabis more frequently than their co-twin performed worse on one working memory test (Spatial Span reversed; β = −0.07, P = 0.036).ConclusionsShort-term cannabis use in adolescence does not appear to cause IQ decline or impair executive functions, even when cannabis use reaches the level of dependence. Family background factors explain why adolescent cannabis users perform worse on IQ and executive function tests.
      PubDate: 2017-09-05T01:10:29.01059-05:0
      DOI: 10.1111/add.13946
  • Practising drinking, practising health
    • Authors: Cameron Duff
      Abstract: Commentary to: All drinking is not equal: how a social practice theory lens could enhance public health research on alcohol and other health behaviours
      PubDate: 2017-09-03T23:39:07.079032-05:
      DOI: 10.1111/add.13966
  • A Developmental-based Motivational Intervention to Reduce Alcohol and
           Marijuana Use Among Non-Treatment-Seeking Young Adults: A Randomized
           Controlled Trial
    • Authors: Michael D. Stein; Celeste M. Caviness, Emily F. Morse, Kristin R. Grimone, Daniel Audet, Debra S. Herman, Ethan Moitra, Bradley J. Anderson
      Abstract: AimsTo test the hypothesis that among non-treatment-seeking emerging adults (EA) who both use marijuana and have alcohol binges, a brief, longitudinally-delivered, developmentally-based motivational intervention would show greater reductions in the use of these two substances compared with a health education control condition.DesignParallel, two group, randomized controlled trial with follow-up interventions conducted at 1, 3, 6, and 9 months and final assessments at 12 and 15 months.SettingHospital-based research unit in the United States.ParticipantsCommunity-based 18-25 year olds who reported at least monthly binge drinking and at least weekly marijuana use.InterventionMotivational intervention focused primarily on themes of emerging adulthood (identity exploration, instability, self-focus, feeling in-between, a sense of possibilities) and the subjects' relationship to substance use (n=110) compared with an attention-matched health education control condition (n=116).MeasurementsThe primary outcomes were days of binge alcohol, marijuana and dual use day as measured using the Timeline Followback Method analyzing the treatment by time interaction to determine relative differences in the rate of change between intervention arms.FindingsAt baseline, the mean rate (days / 30) of binge drinking was 5.23 (± 4.31), of marijuana use was 19.4 (± 10.0), and of dual (same day) use was 4.11 (± 4.13). Relative to baseline, there were reductions in the rate of binge alcohol use, marijuana use, and days of combined binge alcohol and marijuana use (p < .001) at all follow-up assessments. However, the treatment by time interaction was not statistically significant for alcohol (p = .37), for marijuana (p=.07), or for dual use (p=.55). Averaged over all follow-ups, mean reductions in binge, marijuana, and dual use days were 1.16, 1.45, and 1.08, respectively, in the health education arm, and 1.06, 1.69, and 0.96 in MI. Bayes factors were < .01 for frequency of binge alcohol use and frequency of dual binge alcohol and marijuana, and .016 for marijuana use.ConclusionsA brief, longitudinally-delivered, developmentally-based motivational intervention for young adults did not produce reductions in binge alcohol, marijuana use, or dual use days relative to a control condition.
      PubDate: 2017-09-02T09:45:22.869587-05:
      DOI: 10.1111/add.14026
  • Non-medical use of psychoactive prescription drugs is associated with
           fatal poisoning
    • Authors: Jari Haukka; Pirkko Kriikku, Claudia Mariottini, Timo Partonen, Ilkka Ojanperä
      Abstract: AimsThe aims of this study were to estimate the prevalence and predictors of non-medical substance use, and to assess the association between non-medical substance use and fatal poisoning or history of drug abuse in Finland.Design and settingRetrospective cohort study of all medico-legally investigated death cases in Finland. The post-mortem toxicology database was linked together with the register on reimbursed prescription medicines.Participants/CasesAll post-mortem cases between 2011 and 2013 positive for one or more of the following drugs: oxycodone, fentanyl, tramadol, clonazepam, gabapentin, pregabalin, tizanidine, olanzapine, quetiapine, risperidone, alprazolam, zolpidem, mirtazapine, and bupropion, n=2974.MeasurementsThe non-medical use of substance was outcome variable. Predictors were the following: gender, residence at the time of death, place of death, blood alcohol concentration, age, drug abuse, number of prescriptions of any psychoactive drugs in last year, proportion of prescriptions issued by psychiatrist in last year.FindingsIn 50.4% of the studied cases, at least one drug was detected without a prescription. Clonazepam, alprazolam and tramadol were the most prevalent non-medical findings in these cases (6.6%, 6.1% and 5.6%, respectively). The risk of non-medical use of prescription drugs was especially high in cases with history of drug abuse (88.5%) and in fatal poisonings (71.0%). The proportion of non-medical use of the studied substances varied between 5.9% (95% confidence interval (CI) = 3.1%–10.1%) for risperidone and 55.7% for fentanyl (95% CI = 44.1%–66.9%).Valid prescription for one or more of any psychoactive drug was associated with lower odds for non-medical use of the studied substances. Additionally, the higher the proportion of psychoactive drugs prescribed by a psychiatrist, the lower the probability of non-medical use.ConclusionsNon-prescribed psychoactive drugs are commonly found at post-mortem in drug poisoning deaths in Finland with history of drug abuse being a major contributing factor.
      PubDate: 2017-08-25T17:40:37.578138-05:
      DOI: 10.1111/add.14014
  • Evaluating the Mutual Pathways among Electronic Cigarette Use,
           Conventional Smoking, and Nicotine Dependence
    • Authors: Arielle S. Selya; Jennifer S. Rose, Lisa Dierker, Donald Hedeker, Robin J. Mermelstein
      Abstract: Background and AimsThe implications of the rapid rise in electronic cigarette (e-cigarette) use remain unknown. We examined mutual associations between e-cigarette use, conventional cigarette use, and nicotine dependence over time to 1) test the association between e-cigarette use and later conventional smoking (both direct and via nicotine dependence), 2) test the converse associations, and 3) determine the strongest pathways predicting each product's use.DesignData from 4 annual waves of a prospective cohort study were analyzed. Path analysis modeled the bi-directional, longitudinal relationships between past-month smoking frequency, past-month e-cigarette frequency, and nicotine dependence.SettingChicago area, Illinois, USA.ParticipantsN=1007 young adult smokers and nonsmokers (ages 19-23).MeasurementsFrequency of 1) cigarettes and 2) e-cigarettes was the number of days in the past 30 on which the product was used. The Nicotine Dependence Syndrome Scale measured nicotine dependence to cigarettes.FindingsE-cigarette use was not significantly associated with later conventional smoking, either directly (β=0.021, p=.081) or through nicotine dependence (β=0.005, p=.693). Conventional smoking was positively associated with later e-cigarette use, both directly (β=0.118, p
      PubDate: 2017-08-25T17:25:27.707123-05:
      DOI: 10.1111/add.14013
  • Socioeconomic differentials in cannabis use trends in Australia.
    • Authors: Gary C. K. Chan; Janni Leung, Catherine Quinn, Megan Weier, Wayne Hall
      Abstract: AimTo test if the degree of change in cannabis use between 2001 and 2013 differed according to socioeconomic status.DesignRepeated cross-sectional household surveys that were nationally representative.SettingAustralia.ParticipantsAdult samples from the 2001 and 2013 National Drug Strategy Household Surveys (N = 23,642 in 2001 and N = 21,353 in 2013), the largest nationally representative survey on drug use in Australia.MeasurementsFrequency of cannabis use coded as daily use, weekly use, less than weekly use and non-current use; socioeconomic status (SES) as measured by personal income and education level.FindingThere were significant differences in changes to levels of cannabis use between SES groups. Among participants who completed high school, the probability of daily use decreased from 0.014 to 0.009 (p < .001), and the probability of weekly use decreased from 0.025 to 0.017 (p < .001). These probabilities remained stable for participants who did not complete high school. The probability of weekly cannabis use decreased from 0.032 to 0.023 among participants with middle level income (p = .004), and from 0.021 to 0.013 among those with high income (p = .005). There were no significant changes in these probabilities among those with low income (0.026 in 2001 and 0.032 in 2013; p = .203).ConclusionThe decline in cannabis use in Australia from 2001 to 2013 largely occurred among higher socioeconomic status groups. For people with lower income and/or lower education, rates of frequent cannabis use remained unchanged.
      PubDate: 2017-08-22T03:25:18.853855-05:
      DOI: 10.1111/add.14010
  • New cancer cases in France in 2015 attributable to different levels of
           alcohol consumption
    • Authors: Kevin D. Shield; Claire Marant Micallef, Catherine Hill, Mathilde Touvier, Pierre Arwidson, Christophe Bonaldi, Pietro Ferrari, Freddie Bray, Isabelle Soerjomataram
      Abstract: Background and aimsAlcohol consumption increases the risk of cancer. Thus, to inform policy decisions, this study estimated the number of new cancer cases in France in 2015 attributable to alcohol consumption generally and to light (
      PubDate: 2017-08-22T03:02:14.44173-05:0
      DOI: 10.1111/add.14009
  • Effects of high Alcohol Intake, Alcohol-related Symptoms, and Smoking on
    • Authors: John B. Whitfield; Andrew C. Heath, Pamela A. F. Madden, J. George Landers, Nicholas G. Martin
      Abstract: Background and AimsBoth high alcohol intake and alcohol dependence increase mortality, and both are associated with smoking. We aimed to compare the associations of quantity of alcohol, number of alcohol-related symptoms, and smoking history with all-cause mortality, and to assess symptom count and smoking history as confounders or mediators of the effects of high alcohol intake.DesignSurvival was analysed by Cox regression with sex, body mass index, alcohol intake (overall and by beverage), maximum drinks on any day, alcohol symptom count and smoking status as potential predictors of age at death.SettingAustralia.ParticipantsParticipants were apparently healthy volunteers consisting of 33,593 Australian adult twins and their relatives who completed questionnaires or interviews between 1979 and 2005.MeasurementsData on alcohol use, smoking, and occurrence of symptoms related to alcohol use disorders, and death records from the Australian National Death Index.Findings3764 participants were matched with deaths occurring within Australia up to July 2014. Individually, alcohol intake (hazard ratio (HR) 1.0082, 95% CI 1.0063-1.0102, per drink per week), beer intake (HR 1.0159, 95% CI 1.0123-1.0195, per drink per week), lifetime maximum number of drinks in one day (HR 1.0176, 95% CI 1.0130-1.0221, per drink), symptom count (HR 1.0867, 95% CI 1.0633-1.1106, per symptom) and smoking status (HR 2.82, 95% CI 2.52-3.16, for smokers of 10+ cigarettes/day versus never-smokers) were each significant predictors of all-cause mortality. After adjustment for the independently significant predictors alcohol symptom count and smoking status, alcohol intake was no longer significant (adjusted HR 1.0012 per drink per week, 95% CI 0.9979-1.0145).ConclusionsNumber of symptoms related to high alcohol intake, and tobacco smoking, appear to account for the positive association between alcohol consumption and premature mortality.
      PubDate: 2017-08-22T02:45:22.551062-05:
      DOI: 10.1111/add.14008
  • Moral Disapproval and Perceived Addiction to Internet Pornography: A
           Longitudinal Examination
    • Authors: Joshua B. Grubbs; Joshua A. Wilt, Julie J. Exline, Kenneth I. Pargament, Shane W. Kraus
      Abstract: Background and AimsInternet pornography use is an increasingly common, yet controversial, behavior. Whereas mental health communities are divided about potentially problematic use patterns, many laypeople identify as feeling dysregulated or compulsive in their use. Prior work has labeled this tendency perceived addiction to internet pornography (PA). This study's aims were to 1) assess the association between PA at baseline and other factors, including actual levels of average daily pornography use and personality factors and 2) assess the associations between baseline variables and PA one year later.DesignTwo large-scale community samples were assessed using online survey methods, with subsets of each sample being recruited for follow up surveys one year later.SettingUSAParticipantsParticipants were adults who had used pornography within the past 6 months recruited in two samples Sample 1 (N = 1,507) involved undergraduate students from three US universities and Sample 2 (N =782) involved web-using adults. Sub-sets of each sample (Sample 1, N = 146; Sample 2, N = 211) were surveyed again one year later.MeasurementsAt baseline, we assessed average daily pornography use, PA, and relevant predictors (e.g., trait neuroticism, trait self-control, trait entitlement, religiousness, moral disapproval of pornography use). One year later, we assessed PA.FindingsCross-sectionally, PA was strongly correlated with moral disapproval of pornography use (Sample 1, Pearson's correlation: r = .68, [.65, .70]; Sample 2, r = .58 [.53, .63]). Baseline moral disapproval (Sample 1, r = .46, [.33, .56]; Sample 2, r = .61, [.51, .69]) and perceived addiction demonstrated relationships with perceived addiction one year later. We found inconclusive evidence of a substantial or significant association between pornography use and perceived addiction over time (Sample 1, r = .13, [-.02, .28]; Sample 2, r = .11 [-.04, .25]).ConclusionsPerceived addiction to internet pornography appears to be strongly related to moral scruples around pornography use, both concurrently and over time, rather than with amount of daily pornography use itself.
      PubDate: 2017-08-22T02:20:28.29838-05:0
      DOI: 10.1111/add.14007
  • Estimates of effectiveness and reach for ‘return on investment’
           modelling of smoking cessation interventions using data from England
    • Authors: Robert West; Kathryn Coyle, Lesley Owen, Doug Coyle, Subhash Pokhrel,
      Abstract: Background and aimsEstimating ‘return on investment’ (ROI) from smoking cessation interventions requires reach and effectiveness parameters for interventions for use in economic models such as the EQUIPT ROI tool ( This paper describes the derivation of these parameter estimates for England that can be adapted to create ROI models for use by other countries.MethodsEstimates were derived for interventions in terms of their reach and effectiveness in: 1) promoting quit attempts, and 2) improving the success of quit attempts (abstinence for at least 12 months). The sources were systematic reviews of efficacy supplemented by individual effectiveness evaluations and national surveys.FindingsQuit attempt rates were estimated to be increased by the following percentages (with reach in parentheses): 20% by tax increases raising the cost of smoking 5% above the cost of living index (100%); 10% by enforced comprehensive indoor public smoking bans (100%); 3% by mass media campaigns achieving 400 gross rating points (100%); 40% by brief opportunistic physician advice (21%); and 110% by use of a licensed nicotine product to reduce cigarette consumption (12%);. Quit success rates were estimated to be increased by the following ratios: 60% by single-form nicotine replacement therapy (NRT) (5%); 114% by NRT patch plus a faster acting NRT (2%);124% by prescribed varenicline (5%); 60% by bupropion (1%); 100% by nortriptyline (0%), 10) 298% by cytisine (0%); 40% by individual face-to-face behavioural support (2%); 37% by telephone support (0.5%); 88% by group behavioural support (1%); 63% by text messaging (0.5%); and 19% by printed self-help materials (1%). There was insufficient evidence to obtain reliable, country-specific estimates for interventions such as websites, smartphone apps and e-cigarettes.ConclusionsTax increases, indoor smoking bans, brief opportunistic physician advice, and use of nicotine replacement therapy (NRT) for smoking reduction can all increase population quit attempt rates. Quit success rates can be increased by provision of NRT, varenicline, bupropion, nortriptyline, cytisine and behavioural support delivered through a variety of modalities. Parameter estimates for the effectiveness and reach of these interventions can contribute to return on investment estimates in support of national or regional policy decisions.
      PubDate: 2017-08-18T02:05:23.06688-05:0
      DOI: 10.1111/add.14006
  • Development and Application of an Economic Model (EQUIPTMOD) to assess the
           Impact of Smoking Cessation
    • Authors: Kathryn Coyle; Doug Coyle, Adam Lester-George, Robert West, Bertalan Nemeth, Mickael Hiligsmann, Marta Trapero-Bertran, Reiner Leidl, Subhash Pokhrel,
      Abstract: Background and AimsAlthough clear benefits are associated with reducing smoking, there is increasing pressure on public health providers to justify investment in tobacco control measures. Decision makers need tools to assess the return on investment (ROI)/cost effectiveness of programs. The EQUIPT project adapted an ROI tool for England to four European countries (Germany, Netherlands, Spain and Hungary). EQUIPTMOD, the economic model at the core of the ROI tool, is designed to assess the efficiency of packages of smoking cessation interventions. The objective of this paper is to describe the methods for EQUIPTMOD and identify key outcomes associated with continued and cessation of smoking.MethodsEQUIPTMOD uses a Markov model to estimate lifetime costs, quality adjusted life years (QALYs) and life years associated with a current and former smoker. It uses population data on smoking prevalence, disease prevalence, mortality and the impact of smoking combined with associated costs and utility effects of disease. To illustrate the tool's potential, costs, QALYs and life expectancy were estimated for the average current smoker for five countries based on the assumptions that they continue and that they cease smoking over the next 12 months. Costs and effects were discounted at country specific rates.ResultsFor illustration, over a lifetime horizon, not quitting smoking within the next 12 months in England will reduce life expectancy by 0.66, reduce QALYs by 1.09 and result in £4,961 higher disease related health care costs - than if the smoker ceased smoking in the next 12 months. For all age-sex categories, costs were lower and QALYs higher for those who quit smoking in the twelve months than those who continued.ConclusionsEQUIPTMOD facilitates assessment of the cost effectiveness of smoking cessation strategies. The demonstrated results indicate large potential benefits from smoking cessation at both an individual and population level.
      PubDate: 2017-08-18T01:05:48.537225-05:
      DOI: 10.1111/add.14001
  • Factors moderating the relative effectiveness of varenicline and nicotine
           replacement therapy in clients using smoking cessation services
    • Authors: Neil Walker; Heather Gainforth, Vasiliki Kiparoglou, Hayley Robinson, Hugo Woerden, Robert West
      Abstract: AimsTo assess how far the greater effectiveness of varenicline over nicotine replacement therapy (NRT) is moderated by characteristics of the smokers or setting in clinical practice.DesignWe used observational data from 22,472 treatment episodes between 2013 and 2016 from smoking cessation services in England to assess whether differences between varenicline and NRT were moderated by a set of smoker and setting characteristics: these included level of social deprivation, age, gender, ethnic group, nicotine dependence, and treatment context. From the above, 15,640 episodes were analysed in relation to 4-week quit and 14,273 episodes at 12 weeks. All two-way interactions involving pharmacotherapy were fitted in addition to the main effects and a parsimonious model identified using a backwards stepwise selection procedure.SettingEnglandParticipantsClients of smoking cessation service (number of individuals in 4-week quit analysis = 15,640).Measurements4-week Carbon monoxide - validated (primary outcome) and 12-week self-reported (secondary outcome) quit success/failure.FindingsAt both follow-up points, varenicline was associated with higher success rates overall (p
      PubDate: 2017-08-13T21:10:24.168021-05:
      DOI: 10.1111/add.14004
  • Using Bayes Factors to Evaluate Evidence for No Effect: Examples from the
           Sips Project
    • Authors: Zoltan Dienes; Simon Coulton, Nick Heather
      Abstract: AimsTo illustrate how Bayes Factors are important for determining the effectiveness of interventions.MethodWe consider a case where inappropriate conclusions were publicly drawn based on significance testing, namely the SIPS Project (Screening and Intervention Programme for Sensible drinking), a pragmatic, cluster-randomized controlled trial in each of two healthcare settings and in the criminal justice system. We show how Bayes Factors can disambiguate the non-significant findings from the SIPS Project and thus determine whether the findings represent evidence of absence or absence of evidence. We show how to model the sort of effects that could be expected, and how to check the robustness of the Bayes Factors.ResultsThe findings from the three SIPS trials taken individually are largely uninformative but, when data from these trials are combined, there is moderate evidence for a null hypothesis (H0) and thus for a lack of effect of brief intervention compared with simple clinical feedback and an alcohol information leaflet (B = 0.24, p = 0.43).ConclusionScientists who find non-significant results should suspend judgment – unless they calculate a Bayes Factor to indicate either that there is evidence for a null hypothesis (H0) over a (well-justified) alternative hypothesis (H1), or else that more data are needed.
      PubDate: 2017-08-13T19:10:26.44732-05:0
      DOI: 10.1111/add.14002
  • Associations of coffee genetic risk scores with consumption of coffee, tea
           and other beverages in the UK Biobank
    • Authors: Amy E. Taylor; George Davey Smith, Marcus R. Munafò
      Abstract: AimsTo evaluate the utility of coffee-related genetic variants as proxies for coffee consumption in Mendelian randomisation studies, by examining their association with non-alcoholic beverage consumption (including subtypes of coffee and tea) and a range of sociodemographic and lifestyle factors.DesignObservational study of the association of genetic risk scores for coffee consumption with different types of non-alcoholic beverage consumption.SettingUK general populationParticipantsIndividuals of European ancestry aged 40-70 years from the UK Biobank between 2006 and 2010 (N = 114,316).MeasurementsGenetic risk scores were constructed using two, four and eight independent single nucleotide polymorphisms (SNPs) identified in genomewide association studies (GWAS) of coffee consumption. Drinks were self-reported in a baseline questionnaire (all participants) and in detailed 24 dietary recall questionnaires in a subset (N = 48,692).FindingsGenetic risk scores explained up to 0.38%, 0.19% and 0.76% of the variance in coffee, tea and combined coffee and tea consumption respectively. Genetic risk scores demonstrated positive associations with both caffeinated and decaffeinated coffee and tea consumption, and with most subtypes of coffee consumption, but only with standard tea consumption. There was no clear evidence for positive associations with most other non-alcoholic beverages, but higher genetic risk for coffee consumption was associated with lower daily water consumption. The genetic risk scores were associated with increased alcohol consumption, but not consistently with other sociodemographic and lifestyle factors.ConclusionsCoffee-related genetic risk scores could be used as instruments for combined coffee and tea consumption in Mendelian randomisation studies. However, associations observed with alcohol consumption require further investigation to determine whether these are due to causal effects of coffee and tea consumption, or biological pleiotropy.
      PubDate: 2017-08-09T12:50:21.079285-05:
      DOI: 10.1111/add.13975
  • Measuring treatment outcomes in gambling disorders: A systematic review
    • Authors: Dylan Pickering; Brittany Keen, Gavin Entwistle, Alex Blaszczynski
      Abstract: Background and AimsConsiderable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery.MethodsA systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum six-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to.ResultsThirty-four studies were systematically reviewed (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author designed questionnaires. Units of measurement were inconsistent particularly in the assessment of gambling behavior. All studies assessed indices of gambling behavior and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing.ConclusionsIn research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviors suggests a multidimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help facilitate uniform reporting practices across the field.
      PubDate: 2017-08-05T05:55:27.160626-05:
      DOI: 10.1111/add.13968
  • Ecological momentary analysis of the relations among stressful events,
           affective reactivity, and smoking among smokers with high vs. low
           depressive symptoms during a quit attempt
    • Authors: Haruka Minami; Brandon E. Frank, Krysten W. Bold, Danielle E. McCarthy
      Abstract: AimsTo assess whether individuals trying to quit smoking who have high depressive symptoms (HD), compared with low-depressive-symptom (LD) symptoms: 1) report more frequent stressful events (SEs), 2) are more likely to smoke after SEs, 3) experience greater acute or persistent changes in affect after a SE, and 4) are at greater risk of smoking following affective changes.DesignSmoking cessation data were analyzed using multilevel path modeling to examine the moderating effects of depressive symptoms on relations among SEs, subsequent affect, and smoking.SettingAn academic research center in Central New Jersey, USA.ParticipantsSeventy-one adult treatment-seeking daily smokers recruited from 2010 to 2012.MeasurementsBaseline depressive symptoms (HD: Center for Epidemiological Studies Depression Scale [CES-D] ≥ 16 vs. LD: CES-D < 16); and real-time ecological momentary assessment (EMA) reports of SEs, affect, and smoking assessed over 21 days post-quit.FindingsMultilevel models indicated that HD smokers were more likely than LD smokers to report stressful events (OR = 2.32, p = .009), but had similar post-stress acute affective changes (negative affect: b = - .12, p = .137, positive affect: b = .02, p = .805). Only HD smokers reported increased negative affect (NA) (b = .20, p = .030) and decreased positive affect (PA) up to 12 hours later (b = -.22, p = .021), and greater lapse risk up to 24 hours after an SE (OR = 3.21, p = .017). The persistence of elevated NA and suppressed PA was partially explained by increased odds of subsequent SEs among HD smokers. However, the heightened stress-lapse association over 24 hours found in HD smokers was not fully explained by sustained aversive affect or subsequent SEs.ConclusionsDepressed and non-depressed smokers trying to quit appear to experience similar acute affective changes following stress: however, depressed smokers experience higher rates of exposure to stress, longer-lasting post-stress affective disturbance, and greater risk of replase to smoking 12-24 hours after a stressful event than non-depressed smoker.
      PubDate: 2017-08-05T05:30:23.231158-05:
      DOI: 10.1111/add.13964
  • German EstSmoke: Estimating adult smoking-related costs and consequences
           of smoking cessation for Germany
    • Authors: Diana Sonntag; Simon Gilbody, Winkler Volker, Shehzad Ali
      Abstract: AimsWe compared predicted lifetime health care costs for current, never and ex-smokers in Germany under the current set of tobacco control polices. We compared these economic consequences of the current situation with an alternative in which Germany were to implement more comprehensive tobacco control policies consistent with the WHO Framework Convention for Tobacco Control (FCTC) guidelines.DesignGerman EstSmoke, an adapted version of the UK EstSmoke simulation model, applies the Markov modelling approach. Transition probabilities for (re-)currence of smoking-related disease were calculated from large German disease-specific registries and the German Health Update (GEDA 2010). Estimations of both health care costs and effect sizes of smoking cessation policies were taken from recent German studies and discounted at 3.5%/year.SettingGermanyParticipantsGerman population of prevalent current, never and ex-smokers in 2009: 81 millionMeasurementLifetime cost and outcomes in current, never and ex-smokersFindingsIf tobacco control policies are not strengthened, the German smoking population will incur €41.56 billion lifetime excess costs compared with never smokers. Implementing tobacco control policies consistent with WHO FCTC guidelines would reduce the difference of lifetime costs between current smokers and ex-smokers by at least €1.7 billion.ConclusionsModelling suggests that the lifetime healthcare costs of people in Germany who smoke are substantially greater than those of people who have never smoked. However, more comprehensive tobacco control policies could reduce healthcare expenditure for current smokers by at least 4%.
      PubDate: 2017-07-22T12:00:34.137674-05:
      DOI: 10.1111/add.13956
  • Scaling up HCV prevention and treatment interventions in rural USA –
           model projections for tackling an increasing epidemic
    • Authors: Hannah Fraser; Jon Zibbell, Thomas Hoerger, Susan Hariri, Claudia Vellozzi, Natasha K. Martin, Alex H. Kral, Matthew Hickman, John W. Ward, Peter Vickerman
      Abstract: Background and aimsEffective strategies are needed to address dramatic increases in hepatitis C virus (HCV) infection among people who inject drugs (PWID) in rural settings of the United States (US). We determined the required scale-up of HCV treatment with or without scale-up of HCV prevention interventions to achieve a 90% reduction in HCV chronic prevalence or incidence by 2025 and 2030 in a rural US setting.DesignAn ordinary differential equation model of HCV transmission calibrated to HCV epidemiological data obtained primarily from a HIV-outbreak investigation in Indiana.SettingScott County, Indiana (population 24,181), USA, a rural setting with negligible baseline interventions, increasing HCV epidemic since 2010, and 55.3% chronic HCV prevalence amongst PWID in 2015ParticipantsPWIDMeasurementsRequired annual HCV treatments per 1000 PWID (and initial annual percentage of infections treated) to achieve a 90% reduction in HCV chronic prevalence or incidence by 2025/30, either with or without scaling-up syringe service programs (SSPs) and medication-assisted treatment (MAT) to 50% coverage. Sensitivity analyses considered whether this impact could be achieved without retreatment of reinfections, and whether greater intervention scale-up was required due to the increasing epidemic in this setting.FindingsTo achieve a 90% reduction in incidence and prevalence by 2030, without MAT and SSP scale-up, 159 per 1000 PWID (initially 25% of infected PWID) need to be HCV-treated annually. However, with MAT and SSP scaled-up, treatment rates are halved (89 per 1000 annually or 15%). To reach the same target by 2025 with MAT and SSP scaled-up, 121 per 1000 PWID (20%) need treatment annually. These treatment requirements are 3-fold higher than if the epidemic was stable, and the impact targets are unattainable without retreatment.ConclusionsCombined scale-up of hepatitis C virus (HCV) treatment and prevention interventions is needed to decrease the increasing burden of HCV incidence and prevalence in rural Indiana, USA, by 90% by 2025/30.
      PubDate: 2017-07-22T07:55:21.246999-05:
      DOI: 10.1111/add.13948
  • Mecamylamine Treatment for Alcohol Dependence: A Randomized Controlled
    • Authors: Ismene L. Petrakis; Elizabeth Ralevski, Ralitza Gueorguieva, Stephanie S. O’Malley, Albert Arias, Kevin A. Sevarino, Jane S. Jane, Erin O’Brien, John H. Krystal
      Abstract: Background and aimsThe nicotinic acetylcholine receptor antagonist, mecamylamine, is a potential novel pharmacotherapy for alcohol use disorder. The aims were to compare alcohol consumption between mecamylamine and placebo and test if smoking status modified treatment effects.DesignOutpatient, randomized, double-blind clinical trial for 12 weeks of treatment with mecamylamine (10mg) (n=65) vs. placebo (n=63).SettingConnecticut, USA.ParticipantsIndividuals had current alcohol dependence (n=128), had an average age of 48.5 (SD=9.4), 110 (85.9%) were men, and included 74 smokers (57.8%) and 54 non-smokers (42.2%)Intervention and comparatorParticipants were randomized to mecamylamine 10mg per day or placebo. All subjects also received Medical Management therapy administered by trained research personnel.MeasurementsPrimary outcome was percent heavy drinking days during the last month of treatment; other outcomes included drinking days, drinks per drinking days, alcohol craving, smoking, symptoms of nicotine withdrawal and side effects.FindingsThere were no significant differences in the percent of heavy drinking days at 3 months between the mecamylamine (mean=18.4, SD=29.0) and placebo treatment groups (mean=20.4, SD=29.2) (F1, 100 =1.3, p=0.25; effect size d=0.07; mean difference=2.06, 95% confidence interval (CI) =-8.96 to 13.08). There were no significant differences in percent of drinking days or in drinks per drinking day at month 3 between the mecamylamine and placebo groups; and were no significant interactions.ConclusionsMecamylamine 10mg pd did not significantly reduce alcohol consumption in treatment seeking smokers and non-smokers with alcohol use disorder.
      PubDate: 2017-07-15T07:25:22.589473-05:
      DOI: 10.1111/add.13943
  • Issue Information - Cover, Editorial Board, Guidelines for submission,
           Title, Aims & Scope
    • Pages: 1 - 2
      Abstract: No abstract is available for this article.
      PubDate: 2017-12-11T02:47:51.589553-05:
      DOI: 10.1111/add.13977
  • Introducing Addiction Lives
    • Authors: Jean O'Reilly; Robert West
      Pages: 5 - 5
      PubDate: 2017-12-11T02:47:56.703279-05:
      DOI: 10.1111/add.14036
  • Prediction of alcohol use disorder using personality disorder traits: a
           twin study
    • Authors: Tom Rosenström; Fartein Ask Torvik, Eivind Ystrom, Nikolai Olavi Czajkowski, Nathan A. Gillespie, Steven H. Aggen, Robert F. Krueger, Kenneth S. Kendler, Ted Reichborn-Kjennerud
      Pages: 15 - 24
      Abstract: Background and AimsThe DSM-IV personality disorders (PDs) are comorbid with alcohol use disorder (AUD) and with each other. It remains unclear which PD criteria are most likely to drive onset and recurrence of AUD and which are merely confounded with those criteria. We determine which individual PD criteria predict AUD and the degree of underlying genetic and/or environmental aetiology.DesignA prospective observational twin study.SettingNorway 1999–2011.ParticipantsA total of 2528 and 2275 Norwegian adult twins in waves 1 and 2 variable-selection analyses, and 2785 in biometric analyses.MeasurementsDSM-IV PDs and their 80 criteria were assessed using a structured personal interview, and AUD using the World Health Organization's Composite International Diagnostic Interview.FindingsIn a variable-selection analysis, two PD criteria were associated with AUD even after taking all the other criteria into account: criterion 8 of antisocial PD (childhood conduct disorder) and criterion 4 of borderline PD (self-damaging impulsive behaviours). Adjusting for each other, their respective odds ratios were 3.4 [confidence interval (CI) = 2.1–5.4] and 5.0 (CI = 3.3–7.7). Endorsement strength of the criteria was associated with AUD in a dose–response manner and they explained 5.5% of variation in AUD risk—more than the full diagnoses of antisocial and borderline PDs together (0.5%). The association between borderline criterion 4 and AUD 10 years later derived mainly from their overlapping genetic factors, whereas the association between antisocial criterion 8 and AUD 10 years later was due to both genetic and non-genetic factors.ConclusionsConduct disorder and self-harming impulsivity are the foremost risk traits for alcohol use disorder among the 80 personality disorder criteria of DSM-IV, predicting alcohol use disorder more effectively than personality disorder diagnoses. The twin-study analysis suggested that conduct disorder represents a joint genetic and developmental risk for alcohol use disorder and that impulsivity is a genetic risk.
      PubDate: 2017-08-23T21:30:29.060793-05:
      DOI: 10.1111/add.13951
  • Major life events and risk of alcohol use disorders: a prospective cohort
    • Authors: Emilie Just-Østergaard; Erik L. Mortensen, Trine Flensborg-Madsen
      Pages: 25 - 33
      Abstract: AimsTo estimate associations of individual major life events as well as accumulated major life events in childhood, adult private life and adult work life with risk of alcohol use disorders (AUD).DesignProspective cohort study with baseline examination in 1991–93 and linkage to national registers to identify AUD at follow-up.SettingCopenhagen, Denmark.ParticipantsIndividuals (aged 21–93 years) who participated in the Copenhagen City Heart Study in 1991–93 (n = 8758).MeasurementsThe primary outcome was first registration with AUD during follow-up (n = 249). AUD was identified in the Danish National Patient Register, in the Danish Psychiatric Central Register and in an outpatient treatment register. Major life events were assessed by a questionnaire in the Copenhagen City Heart study. Data were analysed by Cox proportional hazards models adjusted for age, sex, educational level, household income, cohabitation status and psychiatric comorbidity.FindingsSerious family conflicts in childhood [hazard ratio (HR) = 1.35; 95% confidence interval (CI) = 1.00, 1.83] and serious economic problems in adult life (HR = 2.22; 95% CI = 1.64, 3.01) were associated significantly with increased risk of AUD. Prospective analyses did not show consistent effects of accumulation of major life events in childhood or adult life, but an additional analysis based on all AUD registrations suggested an association between accumulated childhood events and risk of AUD.ConclusionsSerious economic problems in adult life are associated strongly with risk of alcohol use disorders, and there may be an influence of accumulated childhood events on risk of alcohol use disorders.
      PubDate: 2017-08-23T21:00:33.456463-05:
      DOI: 10.1111/add.13947
  • The stability of baseline-defined categories of alcohol consumption during
           the adult life-course: a 28-year prospective cohort study
    • Authors: Craig S. Knott; Steven Bell, Annie Britton
      Pages: 34 - 43
      Abstract: Background and aimsStudies that report the relationship between alcohol consumption and disease risk have predominantly operationalized drinking according to a single baseline measure. The resulting assumption of longitudinal stability may be simplistic and complicate interpretation of risk estimates. This study aims to describe changes to the volume of consumption during the adult life-course according to baseline categories of drinking.DesignA prospective observational study.SettingUnited Kingdom.ParticipantsA cohort of British civil servants totalling 6838 men and 3372 women aged 34–55 years at baseline, followed for a mean 19.1 (standard deviation = 9.5) years.MeasurementsThe volume of weekly alcohol consumption was estimated from data concerning the frequency and number of drinks consumed. Baseline categories were defined: non-current drinkers, infrequent drinkers, 0.1–50.0 g/week, 50.1–100.0 g/week, 100.1–150.0 g/week, 150.1–250.0 g/week and>250.0 g/week. For women, the highest category was defined as> 100.0 g/week. Baseline frequency was derived as ‘daily or almost daily’ and ‘not daily or almost daily’. Trajectories were estimated within baseline categories using growth curve models.FindingsTrajectories differed between men and women, but were relatively stable within light-to-moderate categories of baseline consumption. Drinking was least stable within the highest categories of baseline consumption (men:> 250.0 g/week; women:> 100.0 g/week), declining by 47.0 [95% confidence interval (CI) = 40.7, 53.2] and 16.8 g/week (95% CI = 12.6, 21.0), respectively, per 10-year increase in age. These declines were not a consequence of sudden transitions to complete abstention. Rates of decline appear greatest in older age, with trajectories converging toward moderate volumes.ConclusionAmong UK civil servants, consumption within baseline drinking categories is generally stable during the life-course, except among heavier baseline drinkers, for whom intakes decline with increasing age. This shift does not appear to be driven by transitions to non-drinking. Cohorts of older people may be at particular risk of misclassifying former heavy drinkers as moderate consumers of alcohol.
      PubDate: 2017-08-24T01:05:44.27701-05:0
      DOI: 10.1111/add.13949
  • Childhood traumatic experiences and the association with marijuana and
           cocaine use in adolescence through adulthood
    • Authors: Joy D. Scheidell; Kelly Quinn, Susan P. McGorray, B. Christopher Frueh, Nisha N. Beharie, Linda B. Cottler, Maria R. Khan
      Pages: 44 - 56
      Abstract: Background and aimsExamination of longitudinal relationships between childhood traumatic experiences and drug use across the life-course at the national level, with control of confounding by other forms of trauma, is needed. We aimed to estimate the prevalence of nine typologies of childhood traumas and the cumulative number experienced, correlation between traumas and associations between individual and cumulative number of traumas with drug use during adolescence, emerging adulthood and adulthood.DesignSecondary data analysis using the National Longitudinal Study of Adolescent to Adult Health.SettingUnited States.ParticipantsA nationally representative sample of individuals in grades 7–12 (aged 11–21 years) during 1994–95, who were re-interviewed during emerging adulthood (2001–02; aged 18–28) and adulthood (2007–08; aged 24–34). The analytical sample comprised 12 288 participants with data at all three waves.MeasurementsNine typologies of childhood traumas: neglect; emotional, physical and sexual abuse; parental incarceration and binge drinking; and witnessing, being threatened with and experiencing violence. Indicators of each were summed to measure cumulative dose. Outcomes were marijuana and cocaine use during adolescence, emerging adulthood and adulthood.FindingsApproximately half experienced at least one childhood trauma; traumas were not highly correlated. We observed a dose–response relationship between the number of traumas and drug use in adolescence [marijuana, adjusted odds ratio (aOR) one trauma versus none = 1.65, 95% confidence interval (CI) = 1.42, 1.92; two traumas = 2.58, 95% CI = 2.17, 3.06; ≥ four traumas = 6.92, 95% CI = 5.17, 9.26; cocaine, aOR one trauma = 1.87, 95% CI = 1.23, 2.84; two traumas = 2.80, 95% CI = 1.74, 4.51; ≥ four traumas = 9.54, 95% CI = 5.93, 15.38]. Similar dose–response relationships with drug use were observed in emerging adulthood and adulthood. Each individual trauma was associated independently with either marijuana or cocaine use in adolescence, emerging adulthood and/or adulthood.ConclusionsChildhood trauma is prevalent in the United States, and individual types as well as the total number experienced are associated significantly with marijuana and cocaine use throughout the life-course.
      PubDate: 2017-08-04T18:50:23.477789-05:
      DOI: 10.1111/add.13921
  • Commentary on Scheidell et al. (2018): En-counting adversities; the
           ‘building blocks’ of psychopathology
    • Authors: Maggie Schauer; Katy Robjant
      Pages: 57 - 58
      PubDate: 2017-12-11T02:47:57.775588-05:
      DOI: 10.1111/add.14067
  • Risk factors for severe respiratory depression from prescription opioid
    • Authors: Lindsay M. Fox; Robert S. Hoffman, David Vlahov, Alex F. Manini
      Pages: 59 - 66
      Abstract: Background and aimsPrescription opioid overdose is a leading cause of injury-related morbidity and mortality in the United States. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose.DesignThis was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD).SettingThis study was conducted at two urban academic emergency departments in New York City, USA.ParticipantsAdult patients who presented with acute prescription opioid overdose between 2009 and 2013 were included in the current study. We analyzed 307 patients (mean age = 44.7, 42% female, 2.0% mortality).MeasurementsPatient demographics, reported substances ingested, suspected intent for ingesting the substance, vital signs, laboratory data, treatments including antidotes and intubation and outcome of death were recorded by trained research assistants. Intent was categorized into four mutually exclusive categories: suicide, misuse, therapeutic error and undetermined. The primary outcome was SRD, defined as administration of either (a) naloxone or (b) endotracheal intubation (ETI).FindingsA total of 109 patients suffered SRD with 90 patients receiving naloxone alone, nine ETI alone and 10 both naloxone and ETI. The most common opioids were oxycodone (n = 124) and methadone (n = 116). Mean age was higher in patients with SRD (51.1 versus 41.1, P 
      PubDate: 2017-09-06T09:19:28.023281-05:
      DOI: 10.1111/add.13925
  • To take or not to take: the association between perceived addiction risk,
           expected analgesic response and likelihood of trying novel pain relievers
           in self-identified chronic pain patients
    • Authors: D. Andrew Tompkins; Andrew S. Huhn, Patrick S. Johnson, Michael T. Smith, Eric C. Strain, Robert R. Edwards, Matthew W. Johnson
      Pages: 67 - 79
      Abstract: Background and aimsProbability discounting refers to the effect of outcome uncertainty on decision making. Using probability discounting, we examined the degree to which self-identified chronic pain patients (CPP) were likely to try a novel analgesic medication given increasing addiction risk. We postulated that propensity for opioid misuse, trait impulsivity and previous opioid experience would be associated positively with likelihood of risky medication use.DesignThis cross-sectional on-line study determined state/trait associations with addiction-related medication decisions in CPP.SettingUS-based CPP participated via Amazon Mechanical Turk; data were collected and analyzed in Baltimore, Maryland.ParticipantsA total of 263 CPP (70.6% female) participated in the study from 12–13 December 2014.MeasurementsCPP responded to the Benefit versus Addiction Risk Questionnaire (BARQ) assessing likelihood of taking a hypothetical once-daily oral analgesic medication as a function of two factors: risk of addiction (0–50%) and duration of expected complete pain relief (3, 30 or 365 days). The primary outcome was the BARQ, quantified as area under the curve (AUC). Grouping of CPP at high or low risk for opioid misuse was based on the Screener and Opioid Assessment for Patients with Pain–Revised (SOAPP-R). Predictors included previous experience with opioids, as well as various measures of chronic pain and mental health.FindingsAcross hypothetical addiction risk assessed in the BARQ, the likelihood of taking a novel analgesic medication was elevated significantly in patients with high (≥18; n = 137) versus low (
      PubDate: 2017-08-10T21:35:37.718677-05:
      DOI: 10.1111/add.13922
  • Association between universal hepatitis B prison vaccination, vaccine
           uptake and hepatitis B infection among people who inject drugs
    • Authors: Norah E. Palmateer; David J. Goldberg, Alison Munro, Avril Taylor, Alan Yeung, Lesley A. Wallace, Alan Mitchell, Samantha J. Shepherd, Rory N. Gunson, Celia Aitken, Sharon J. Hutchinson
      Pages: 80 - 90
      Abstract: Background and aimsIn Scotland, hepatitis B virus (HBV) vaccination for all prisoners was introduced in 1999; here, we examine the impact of this programme among people who inject drugs (PWID) in the community. This study aimed to compare rates of HBV vaccine uptake before and after implementation of the prison programme and to estimate the determinants of vaccine uptake, the levels of ever/current HBV infection and the associations between vaccine uptake and ever/current HBV infection.DesignData collected via serial cross-sectional surveys were used to compare the proportion who reported being vaccinated over time. For the 2013–14 survey, rates of ever/current HBV infection were calculated and the associations between vaccine uptake and ever/current HBV infection were examined using logistic regression.SettingServices providing injecting equipment and drug treatment and street sites in Glasgow (1993–2002) and throughout Scotland (2008–14).ParticipantsMore than 10 000 PWID in total were recruited in the surveys.MeasurementsParticipants completed a questionnaire (all years) to ascertain self-reported vaccine uptake and provided a blood spot (in 2013–14), tested for HBV core antibodies (anti-HBc) and surface antigen (HBsAg).FindingsAmong recent-onset PWID in Glasgow, vaccine uptake increased from 16% in 1993 to 59% in 2008–14 (P 
      PubDate: 2017-08-21T20:11:33.539258-05:
      DOI: 10.1111/add.13944
  • The relationship between gambling expenditure, socio-demographics,
           health-related correlates and gambling behaviour—a cross-sectional
           population-based survey in Finland
    • Authors: Sari Castrén; Jukka Kontto, Hannu Alho, Anne H. Salonen
      Pages: 91 - 106
      Abstract: AimsTo investigate gambling expenditure and its relationship with socio-demographics, health-related correlates and past-year gambling behaviour.DesignCross-sectional population survey.SettingPopulation-based survey in Finland.ParticipantsFinnish people aged 15–74 years drawn randomly from the Population Information System. The participants in this study were past-year gamblers with gambling expenditure data available (n = 3251, 1418 women and 1833 men).MeasurementsExpenditure shares, means of weekly gambling expenditure (WGE, €) and monthly gambling expenditure as a percentage of net income (MGE/NI, %) were calculated. The correlates used were perceived health, smoking, mental health [Mental Health Inventory (MHI)-5], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)-C], game types, gambling frequency, gambling mode and gambling severity [South Oaks Gambling Screen (SOGS)].FindingsGender (men versus women) was found to be associated significantly with gambling expenditure, with exp(β) = 1.40, 95% confidence interval (CI) = 1.29, 1.52 and P 
      PubDate: 2017-09-05T01:00:36.572629-05:
      DOI: 10.1111/add.13929
  • Self-changing behaviour in smoking cessation linked to trait and cognitive
    • Authors: Jaume Celma-Merola; Francesc Abella-Pons, Fernanda Mata, Gerard Pedra-Pagés, Antonio Verdejo-Garcia
      Pages: 107 - 112
      Abstract: Background and aimsTo compare impulsivity, measured using self-report and cognitive tasks in people who ceased smoking without treatment (self-changers) with each of the following groups: (i) smoking non-treatment-seekers, (ii) people in smoking cessation treatment and currently abstinent and (iii) people in smoking cessation treatment but non-abstinent.DesignCross-sectional, observational study.SettingThe smoking cessation unit of a public general hospital, Hospital de Santa Maria, in Lleida, Spain. All participants were from the hospital's catchment area.ParticipantsOne hundred and twenty participants, classified in four groups: (1) self-changers (n = 30, 21 females, mean age = 41.50 years), (2) non-treatment-seekers (n = 30, 17 females, mean age = 35.27 years), (3) people in smoking cessation treatment and currently abstinent (n = 30, 17 females, mean age = 48.93 years) and (4) people in smoking cessation treatment but non-abstinent (n = 30, 21 females, mean age = 33.70 years).MeasurementsThe Barratt Impulsiveness Scale, including measures of non-planning, attentional and motor impulsivity, and two behavioural tasks measuring cognitive inhibition (Stroop test) and choice impulsivity (delay-discounting task). Confounders included sex, age, education, employment, smoking severity, depression and trait and state anxiety.FindingsAlthough not on the other three measures, we found significant group differences on trait non-planning impulsivity and Stroop performance. Self-changers, compared with non-treatment-seekers, had lower non-planning impulsivity (P = 0.018, Cohen's d = 0.62) and better Stroop performance (P = 0.001, Cohen's d = 0.66). Self-changers also had better Stroop performance than participants in treatment and currently abstinent (P = 0.002, Cohen's d = 0.85).ConclusionsPeople who have stopped smoking without treatment appear to have lower non-planning impulsivity and more effective cognitive inhibition compared with smoking non-treatment-seekers, and better cognitive inhibition than people who cease smoking with treatment aid.
      PubDate: 2017-08-21T20:16:00.253654-05:
      DOI: 10.1111/add.13942
  • Adult interest in using a hypothetical modified risk tobacco product:
           findings from wave 1 of the Population Assessment of Tobacco and Health
           Study (2013–14)
    • Authors: Jennifer L. Pearson; Amanda L. Johnson, Sarah E. Johnson, Cassandra A. Stanton, Andrea C. Villanti, Raymond S. Niaura, Allison M. Glasser, Baoguang Wang, David B. Abrams, K. Michael Cummings, Andrew Hyland
      Pages: 113 - 124
      Abstract: Background and aimsThe US Family Smoking Prevention and Tobacco Control Act provides a pathway for manufacturers to market a modified risk tobacco product (MRTP). This study examines socio-demographic and tobacco use correlates of interest in a hypothetical MRTP in a nationally representative sample of US adults.DesignCross sectional wave 1 data from the 2013–14 Population Assessment of Tobacco and Health (PATH) Study.SettingHousehold Audio-Computer Assisted Self-Interviews of US adults conducted in 2013–14.ParticipantsA total of 32 320 civilian, non-institutionalized adults in the United States.MeasurementsInterest in using a hypothetical MRTP (‘If a tobacco product made a claim that it was less harmful to health than other tobacco products, how likely would you be to use that product'’), socio-demographics, tobacco use history and mental health and substance use problems. All estimates were weighted.FindingsOverall, 16.7% [95% confidence interval (CI) = 16.28, 17.18] of US adults reported interest in a hypothetical MRTP. Tobacco use was associated significantly with interest in a hypothetical MRTP, with interest most common among current established smokers (54.4%; 95% CI = 53.31, 55.39) and least common among never tobacco users (3.0%; 95% CI = 2.49, 3.55). Interest in a hypothetical MRTP was associated with experimental e-cigarette use among current experimental, current established and former smokers. Among non-smokers, race, age, education and substance use were associated with interest in using a hypothetical MRTP.ConclusionsAmong adults in the United States, interest in using a hypothetical modified risk tobacco product is low overall, and highest among current experimental and established smokers. A small percentage of non-smokers are interested in using a hypothetical hypothetical modified risk tobacco product.
      PubDate: 2017-09-06T22:55:37.308585-05:
      DOI: 10.1111/add.13952
  • Effects of comorbid substance use disorders on outcomes in a Housing First
           intervention for homeless people with mental illness
    • Authors: Karen Urbanoski; Scott Veldhuizen, Michael Krausz, Christian Schutz, Julian M. Somers, Maritt Kirst, Marie-Josée Fleury, Vicky Stergiopoulos, Michelle Patterson, Verena Strehlau, Paula Goering
      Pages: 137 - 145
      Abstract: Background and AimsEvidence supports the effectiveness of Housing First (HF) programmes for people who are experiencing homelessness and mental illness; however, questions remain about its use in people with comorbid substance use disorders (SUD). The aim of this project was to test whether SUD modifies the effectiveness of an HF intervention.DesignSecondary analysis of data from a randomized controlled trial of HF versus treatment-as-usual (TAU) with 24-month follow-up, comparing those with and without SUD at trial entry.SettingVancouver, Toronto, Winnipeg, Moncton and Montreal, Canada.ParticipantsA total of 2154 participants recruited from 2009 to 2013 and randomized to HF versus TAU (67% male, mean age 40.8 ± 11.2, 25% ethno-cultural minority). All were homeless and had a mental disorder at baseline; 35% reported symptoms consistent with SUD.InterventionHousing paired with Intensive Case Management or Assertive Community Treatment.MeasurementsPrimary outcomes were days housed and community functioning. Secondary outcomes were general and health-related quality of life and mental health symptoms. Predictors were SUD status crossed with intervention group (HF versus TAU).FindingsPeople with SUD in both the HF and TAU groups spent less time in stable housing, but the effect of HF did not vary by SUD status [odds ratio (OR) = 1.17, 95% confidence interval (CI) = −0.77, 1.76]. Similarly, there was no difference between those with and without SUD in the effect of HF (over TAU) on community functioning (b = 0.75, 95% CI = −0.36, 1.87), quality of life (b = −1.27, 95% CI = −4.17, 1.63), health-related quality of life (b = −0.01, 95% CI = −0.03, 0.02) or mental health symptoms (b = 0.43, 95% CI = −0.99, 1.86).ConclusionsHousing First programs in Canada are equally effective in people with and without comorbid substance use disorder (SUD). Overall, the intervention appears to be able to engage people with SUD and is reasonably successful at housing them, without housing being contingent upon abstinence or treatment.
      PubDate: 2017-08-01T01:40:35.259738-05:
      DOI: 10.1111/add.13928
  • Commentary on Urbanoski et al. (2018): Housing First and
           addiction–exploring the evidence
    • Authors: Nicholas Pleace
      Pages: 146 - 147
      PubDate: 2017-12-11T02:47:54.822727-05:
      DOI: 10.1111/add.14030
  • Qualitative research
    • Authors: Lisa Maher; George Dertadian
      Pages: 167 - 172
      Abstract: Background and aimsThis narrative review aims to highlight key insights from qualitative research on drug use and drug users by profiling a selection of classic works.MethodsConsensus methods were used to identify and select four papers published in 1938, 1969, 1973 and 1984 considered to be classics.ResultsThese landmark qualitative studies included the first account of addiction as a social process, demonstrating that people have meaningful responses to drug use that cannot be reduced to their pharmacological effects; the portrayal of inner-city heroin users as exacting, energetic and engaged social agents; identification of the interactive social learning processes involved in becoming a drug user; the application of the ‘career’ concept to understanding transitions and trajectories of drug use over time; and the articulation of a framework for understanding drug use that incorporates the interaction between pharmacology, psychology and social environments.ConclusionsThese classic sociological and anthropological studies deployed qualitative research methods to show how drug use is shaped by complex sets of factors situated within social contexts, viewing drug users as agents engaged actively in social processes and worlds. Their findings have been used to challenge stereotypes about drug use and drug users, develop a deeper understanding of drug use among hidden, hard-to-research and under-studied populations, and provide the foundations for significant developments in scientific knowledge about the nature of drug use. They continue to retain their relevance, providing important correctives to biomedical and behaviourist paradigms, reminding us that drug use is a social process, and demonstrating how the inductive approach of qualitative research can strengthen the way we understand and respond to drug use and related harms.
      PubDate: 2017-08-07T23:35:21.080896-05:
      DOI: 10.1111/add.13931
  • Commentary on Fraser et al. (2018): Evidence base for harm reduction
           services—the urban–rural divide
    • Authors: Kathryn E. Lancaster; Carlos D. Malvestutto, William C. Miller, Vivian F. Go
      Pages: 183 - 184
      PubDate: 2017-12-11T02:47:53.642796-05:
      DOI: 10.1111/add.14052
  • Erratum
    • Pages: 189 - 189
      PubDate: 2017-12-11T02:47:50.77116-05:0
      DOI: 10.1111/add.14077
  • New Books
    • Pages: 190 - 192
      PubDate: 2017-12-11T02:47:52.651475-05:
      DOI: 10.1111/add.14088
  • News and Notes
    • Pages: 193 - 196
      PubDate: 2017-12-11T02:47:53.049814-05:
      DOI: 10.1111/add.14094
  • Issue Information
    • Pages: 200 - 200
      Abstract: No abstract is available for this article.
      PubDate: 2017-12-11T02:47:56.131165-05:
      DOI: 10.1111/add.13978
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