Dépouillements

*** / SIMPSON T. L. ; KIVLAHAN D. R. ; BUSH K. R. ; MCFALL M. E. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.241-250 Titre : *** Titre autre langue : Telephone self-monitoring among alcohol use disorder patients in early recovery : a randomized study of feasibility and measurement reactivity Type de document : Périodique Auteurs : SIMPSON T. L. ; KIVLAHAN D. R. ; BUSH K. R. ; MCFALL M. E. Année de publication : 2005 Article en page(s) : p.241-250 Caractéristiques matérielles : tabl. Langues : Anglais (eng) Mots-clés : Thésaurus DEPENDANCE ; ALCOOL ; SUIVI DU PATIENT ; ABSTINENCE ; TELEPHONE Résumé : Frequent symptom self-monitoring protocols have become popular tools in the addiction field. Interactive Voice Response (IVR) is a telephone monitoring system that has been shown to be feasible for collecting frequent self-reports from a variety of research populations. Little is known, however, about the feasibility of using IVR monitoring in clinical samples, and few controlled trials exist assessing the impact of any type of frequent self-report monitoring on the behaviors monitored. This pilot study with patients in early recovery from an alcohol use disorder (n = 98) evaluated compliance with two IVR monitoring protocols, subjective experiences with monitoring, and change in symptoms associated with monitoring (i.e., measurement reactivity). Participants were randomly assigned to call an IVR system daily for 28 days, once per week for 4 weeks, or only to complete 28-day follow-up assessment including retrospective drinking reports. Monitoring calls assessed alcohol craving, substance use, emotional well-being, and PTSD symptoms. Most monitoring participants completed calls on at least 75 % of scheduled days (72,2 % and 59,2 % for daily and weekly, respectively). Including reconstructed data from follow-up of missed calls yielded 77,8 % and 74,1 % of maximum data points, respectively. Most monitoring participants indicated the protocol was manageable and reported positive or no effects of monitoring on urges to use alcohol, actual drinking, and PTSD symptoms. Analyses of measurement reactivity based on assessment one month after randomization found no significant group differences on drinking, craving for alcohol, or PTSD-related symptoms. Results suggest that IVR technology is feasible and appropriate for telephone symptom monitoring in similar clinical samples. (Review's abstract). Cote CIRDD : 804983 Thématique : Alcool Bibliographie : 50 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6295 [article]

*** / KURZTHALER I. ; WAMBACHER M. ; GOLSER K. ; SPERNER M. ; SPERNER-UNTERWEGER B. ; HAIDEKKER A. ; PAVLIC M. ; KEMMLER G. ; FLEISCHHACKER W. W. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.225-230 Titre : *** Titre autre langue : Alcohol and benzodiazepines in falls : An epidemiological view Type de document : Périodique Auteurs : KURZTHALER I. ; WAMBACHER M. ; GOLSER K. ; SPERNER M. ; SPERNER-UNTERWEGER B. ; HAIDEKKER A. ; PAVLIC M. ; KEMMLER G. ; FLEISCHHACKER W. W. Année de publication : 2005 Article en page(s) : p.225-230 Caractéristiques matérielles : tabl. Langues : Anglais (eng) Mots-clés : Thésaurus FACTEUR DE RISQUE ; PERSONNE AGEE ; ALCOOL ; ACCIDENT ; BENZODIAZEPINES Résumé : Falls are common at all ages and especially in the elderly ; it is important to understand contributing causes. Over a 1-year period we studied blood alcohol (BAC) and benzodiazepine concentrations in patients attending an emergency department because of a fall. The 22 % of 615 patients tested were positive for alcohol, 55 % were positive for benzodiazepines (BZD) and 1. 5 % were positive for both substances. A significantly larger proportion of males tested positive for alcohol (40,2 %) than females (7,6 %). Both in males and females the percentage as well as the extent of blood alcohol levels decreased significantly with age. Benzodiazepines were also consumed more frequently in males (8,5 %) than in females (3,2 %, p = 0,007). Concerning BAC there was no difference between males (1,75 + 0,81 g/l) and females (1,66 + 0,91 g/l). In patients older than 70 years the BAC (1,30 + 0,80 g/l) was lower in comparison to younger ones. All blood samples positive for benzodiazepines could be traced back to diazepam consumption. We found a high number of young and middle aged patients using alcohol (males = 49,7 % ; females = 18,9 %) and a lower but still relevant number of benzodiazepine users (males = 9,5 %; females = 2,4 %). In addition, this study shows that alcohol plays a more important role in patients up to 70 years in fall-related accidents when compared to accidents of other causes. (Review's abstract). Cote CIRDD : 804981 Thématique : Drogues illicites Bibliographie : 13 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6296 [article]

*** / PENETAR D. M. ; KOURI E. M. ; GROSS M. M. ; MCCARTHY E. M. ; RHEE C. K. ; PETERS E. N. ; LUKAS S. E. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.211-223 Titre : *** Titre autre langue : Transdermal nicotine alters some of marihuana's effects in male and female volunteers Type de document : Périodique Auteurs : PENETAR D. M. ; KOURI E. M. ; GROSS M. M. ; MCCARTHY E. M. ; RHEE C. K. ; PETERS E. N. ; LUKAS S. E. Année de publication : 2005 Article en page(s) : p.211-223 Caractéristiques matérielles : fig., graph., tabl. Langues : Français (fre) Mots-clés : Thésaurus INTERACTION CHIMIQUE ; CANNABIS ; SUBSTITUTS NICOTINIQUES Résumé : Despite the fact that tobacco and marihuana are often used together, relatively little is known about the effects of this combination. In order to investigate the effects of the principal psychoactive component in tobacco smoke, nicotine, on marihuana-induced intoxication, we conducted a double blind, cross-over experiment using nicotine transdermal patches. Ten male and 10 female participants received either placebo or a 21 mg transdermal nicotine patch 4 h before smoking one of two marihuana cigarettes (1,99 or 3,51 % delta-9-tetrahydrocannabinol content). Measurements of physiological activity (heart rate, blood pressure, and skin temperature) and subjective effects (self-reports of drug effects on visual analog scales (VAS) and the Addiction Research Center Inventory (ARCI)) were made periodically before and for 3 h after smoking. Nicotine pre-treatment enhanced several responses to marihuana, in particular, heart rate, reports of "stimulated" on the visual analog scales, and scores on the Amphetamine scale of the ARCI. Male participants reported a more pronounced effect of marihuana that persisted longer than that of the female participants. Compared to the male participants, female participants experienced an attenuated response to marihuana and were less affected by the drug combination. The results of this study show that nicotine can have an important influence on the subjective and physiological effects of smoked marihuana. These effects have implications for the safety and efficacy of marihuana smokers who are self-medicating with the nicotine transdermal patch to manage their tobacco dependence. (Review's abstract). Cote CIRDD : 804980 Thématique : Drogues illicites Bibliographie : 55 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6297 [article]

*** / TERMORSHUIZEN F. ; KROL A. ; PRINS M. ; GESKUS R. ; VAN DEN BRINK W. ; VAN AMEIJDEN E. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.231-240 Titre : *** Titre autre langue : Prediction of relapse to frequent heroin use and the role of methadone prescription : An analysis of the Amsterdam Cohort Study among drug users Type de document : Périodique Auteurs : TERMORSHUIZEN F. ; KROL A. ; PRINS M. ; GESKUS R. ; VAN DEN BRINK W. ; VAN AMEIJDEN E. Année de publication : 2005 Article en page(s) : p.231-240 Caractéristiques matérielles : fig., graph., tabl. Langues : Anglais (eng) Mots-clés : Thésaurus DUREE ; ETUDE LONGITUDINALE ; METHADONE ; RECHUTE ; ABSTINENCE ; REDUCTION DES RISQUES ; TRAITEMENT DE MAINTENANCE ; COHORTE ; HEROINE Résumé : The risk of relapse into frequent heroin use was studied among 732 participants of the Amsterdam Cohort Study (ACS) on HIV/AIDS among drug users, who experienced an episode of abstinence from or occasional use of heroin. Participants of the ACS were recruited primarily from easy access ("low-threshold") methadone programs. The duration of abstinence/occasional use and relative risks (RR) of relapse were estimated by analyzing 1577 episodes by means of survival analysis using characteristics of patients and methadone treatment as covariates. The majority of episodes (85,8 %) were followed by relapse within 5 years. Less education, intense use of heroin prior to the episode of abstinence or well-controlled use, occasional use of heroin and intense use of cocaine during the episode, and having a drug-using partner or having no partner were significantly associated with a higher risk of relapse. Among frequent attendees of a "low-threshold" methadone program, relapse was associated with the daily dose of methadone : RR for dosages <40 and 40-60 mg, compared with doses of >100 mg, were 1,45 (P < 0,01) and 1,59 (P < 0,01), respectively. No beneficial influence was revealed of methadone dosage or program attendance in itself on the risk of relapse into cocaine. High doses of methadone in a harm-reduction setting extend the duration of an episode of no or occasional use of heroin. Other factors, such as no occasional use of heroin during the episode, no use of cocaine, and having a non-using partner, seem to be equally important. (Review's abstract). Cote CIRDD : 804982 Thématique : Drogues illicites Bibliographie : 43 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6298 [article]

*** / BARGAGLI A. M. ; SCHIFANO P. ; DAVOLI M. ; FAGGIANO F. ; PERUCCI C. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.191-199 Titre : *** Titre autre langue : Determinants of methadone treatment assignment among heroin addicts on first admission to public treatment centres in Italy Type de document : Périodique Auteurs : BARGAGLI A. M. ; SCHIFANO P. ; DAVOLI M. ; FAGGIANO F. ; PERUCCI C. Année de publication : 2005 Article en page(s) : p.191-199 Caractéristiques matérielles : tabl. Langues : Anglais (eng) Mots-clés : Thésaurus DEPENDANCE ; ANAMNESE ; TRAITEMENT DE MAINTENANCE ; HEROINE Résumé : Aims : To identify factors associated with entering any methadone treatment at first admission at an NHS treatment centre in Italy and to investigate determinants of receiving detoxification or maintenance methadone treatments. Methods : Data were analysed from 565 heroin addicts who entered for the first time one of 90 NHS treatment centres in 12 Italian regions between September 1998 and March 2001. Subjects were interviewed at admission by the centre's staff and followed-up for 18 months. Details on treatments provided were recorded using a standardised form. Random effects logistic regression analysis was applied. Results : Factors positively associated with any methadone treatment assignment were: being younger than 25 years and using heroin more than twice a day, having been recently incarcerated, and living with a partner. Independent predictors of admission to methadone maintenance were injecting heroin, having sex without a condom in the previous six months, being HIV positive and having been enrolled at a NHS TC where a psychiatrist was present. Using heroin once a day or more and using cocaine were factors associated with enrolment into detoxification treatment. A significant heterogeneity between centres was observed. Conclusions : Results from this study give an insight into different patient profiles who are enrolled in methadone treatments. The observed heterogeneity between centres indicates the need to develop and implement common guidelines for the access of heroin addicts to substitution treatment. (Review's abstract). Cote CIRDD : 804978 Thématique : Drogues illicites Bibliographie : 22 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6299 [article]

*** / SCHWEINSBURG A. D. ; SCHWEINSBURG B. C. ; CHEUNG E. H. ; BROWN G. G. ; BROWN S. A. ; TAPERT S. F. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.201-210 Titre : *** Titre autre langue : fMRI response to spatial working memory in adolescents with comorbid marijuana and alcohol use disorders Type de document : Périodique Auteurs : SCHWEINSBURG A. D. ; SCHWEINSBURG B. C. ; CHEUNG E. H. ; BROWN G. G. ; BROWN S. A. ; TAPERT S. F. Année de publication : 2005 Article en page(s) : p.201-210 Caractéristiques matérielles : ill., tabl. Langues : Anglais (eng) Mots-clés : Thésaurus ADOLESCENT ; ALCOOL ; TROUBLES DE LA MEMOIRE ; ABUS ; CANNABIS Résumé : Alcohol and marijuana use are prevalent in adolescence, yet the neural impact of concomitant use remains unclear. We previously demonstrated functional magnetic resonance imaging (fMRI) response to spatial working memory (SWM) among teens with alcohol use disorders (AUD) compared to controls, and predicted that adolescents with marijuana and alcohol use Edisorders would show additional abnormalities. Participants were three groups of 15-17-year-olds : 19 non-abusing controls, 15 AUD teens with limited exposure to drugs, and 15 teens with comorbid marijuana and alcohol use disorders (MAUD) and minimal other drug experience. After > 2 days' abstinence, participants performed a SWM task during fMRI acquisition. fMRI brain response patterns differed between groups, despite similar performance on the task. MAUD youths showed less activation in inferior frontal and temporal regions than controls, and more response in other prefrontal regions. Compared to AUD teens, MAUD youths also showed less inferior frontal and temporal activation, but more medial frontal response. Overall, MAUD youths showed different brain response abnormalities than teens with AUD alone, despite relatively short histories of substance involvement. This pattern could suggest compensation for marijuana-related attention and working memory deficits. However, relatively recent use and premorbid features may influence results, and should be examined in future studies. (Review's abstract). Cote CIRDD : 804979 Thématique : Drogues illicites Bibliographie : 61 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6300 [article]

*** / CARLSON R. G. ; WANG J. ; FALCK R. S. ; SIEGEL H. A. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.167-179 Titre : *** Titre autre langue : Drug use practices among MDMA/ecstasy users in Ohio : a latent class analysis Type de document : Périodique Auteurs : CARLSON R. G. ; WANG J. ; FALCK R. S. ; SIEGEL H. A. Année de publication : 2005 Article en page(s) : p.167-179 Caractéristiques matérielles : tabl. Langues : Anglais (eng) Mots-clés : Thésaurus ECSTASY ; USAGER ; POLYCONSOMMATION ; EPIDEMIOLOGIE DESCRIPTIVE Résumé : This study describes the drug use practices among 402 recent MDMA (3,4-methelyenedioxymethamphetamine) users recruited in Ohio using respondent-driven sampling. About 64 % of the participants were men, 81,6 % were white, and the mean age was 20,9 years. Latent class analysis was used to identify subgroups of MDMA users. Use of cocaine, opioids, amphetamines, tranquilizers, inhalants, marijuana, and hallucinogens during the previous 6 months, and days of "drunkenness" in the past 30, were used for classification. A three-class model was preferable and reflected "Limited range," "Moderate range," and "Wide range" drug use patterns. For example, the conditional probability of using opioids during the previous 6 months was .07 in Class 1, .59 in Class 2, and .88 in Class 3. Other substances followed similar patterns. Predictors of class membership were examined in a multinomial logit model in which the "Limited range" Class was treated as the reference group. Participants who were white, younger, and who reported more than 10 occasions of MDMA use were more likely to be in the "Wide range" drug use Class. Latent class analysis is a useful method to help describe and understand variability in polydrug use patterns. (Review's abstract). Cote CIRDD : 804976 Thématique : Drogues illicites Bibliographie : 73 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6301 [article]

*** / TRACY M. ; PIPER M. T. ; OMPAD D. ; BUCCIARELLI A. ; COFFIN P. O. ; VLAHOV D. ; GALEA S. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.181-190 Titre : *** Titre autre langue : Circumstances of witnessed drug overdose in New York City : implications for intvention Type de document : Périodique Auteurs : TRACY M. ; PIPER M. T. ; OMPAD D. ; BUCCIARELLI A. ; COFFIN P. O. ; VLAHOV D. ; GALEA S. Année de publication : 2005 Article en page(s) : p.181-190 Caractéristiques matérielles : tabl. Langues : Anglais (eng) Mots-clés : Thésaurus MORTALITE ; PRISE EN CHARGE ; OVERDOSE ; PAIR ; HEROINE Résumé : Drug users frequently witness the nonfatal and fatal drug overdoses of their peers, but often fail to intervene effectively to reduce morbidity and mortality. We assessed the circumstances of witnessed heroin-related overdoses in New York City (NYC) among a predominantly minority population of drug users. Among 1184 heroin, crack, and cocaine users interviewed between November 2001 and February 2004, 672 (56,8 %) had witnessed at least one nonfatal or fatal heroin-related overdose. Of those, 444 (67,7 %) reported that they or someone else present called for medical help for the overdose victim at the last witnessed overdose. In multivariable models, the respondent never having had an overdose her/himself and the witnessed overdose occurring in a public place were associated with the likelihood of calling for medical help. Fear of police response was the most commonly cited reason for not calling or delaying before calling for help (52,2 %). Attempts to revive the overdose victim through physical stimulation (e.g., applying ice, causing pain) were reported by 59,7 % of respondents, while first aid measures were attempted in only 11,9 % of events. Efforts to equip drug users to manage overdoses effectively, including training in first aid and the provision of naloxone, and the reduction of police involvement at overdose events may have a substantial impact on overdose-related morbidity and mortality. (Review's abstract). Cote CIRDD : 804977 Thématique : Drogues illicites Bibliographie : 40 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6302 [article]

*** / OLIVETO A. ; POLING J. ; SEVARINO K. A. ; GONSAI K. R. ; MCCANCE KATZ E. F. ; STINE S. M. ; KOSTEN T. R. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.157-165 Titre : *** Titre autre langue : Efficacy of dose and contingency management procedures in LAAM-maintained cocaine-dependent patients Type de document : Périodique Auteurs : OLIVETO A. ; POLING J. ; SEVARINO K. A. ; GONSAI K. R. ; MCCANCE KATZ E. F. ; STINE S. M. ; KOSTEN T. R. Année de publication : 2005 Article en page(s) : p.157-165 Caractéristiques matérielles : graph., tabl. Langues : Anglais (eng) Mots-clés : Thésaurus EFFICACITE ; LAAM ; TRAITEMENT DE MAINTENANCE Résumé : Opioid-and cocaine-dependent participants (N = 140) were randomly assigned to one of the following in a 12-week clinical trial : LAAM (30, 30, 39 mg/MWF) with contingency management (CM) procedures (LC) ; LAAM (30, 30, 39 mg/MWF) without CM (LY) ; LAAM (100, 100, 130 mg/MWF) with CM (HC) ; LAAM (100, 100, 130 mg/MWF) without CM (HY). Urine samples were collected thrice-weekly. In CM, each urine negative for both opioids and cocaine resulted in a voucher worth a certain monetary value that increased for consecutively drug-free urines. Subjects not assigned to CM received vouchers according to a yoked schedule. Vouchers were exchanged for mutually agreed upon goods and services. Groups generally did not differ on retention and baseline characteristics. Overall opioid use was least in the HC and HY groups ; opioid use decreased most rapidly over time in the HC group relative to the HY, LC and LY groups. Overall cocaine use was least in the HC group relative to the HY, LC, and LY groups; cocaine use decreased over time most rapidly in the HC and LY groups. Abstinence from both was greatest in the HC group. Opioid withdrawal symptoms decreased most rapidly in the high-dose groups relative to the low-dose groups. These results suggest that an efficacious maintenance dose is necessary for contingencies to be effective in facilitating both opioid and cocaine abstinence. (Review's abstract). Cote CIRDD : 804975 Thématique : Drogues illicites Bibliographie : 56 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6303 [article]

*** / MARLOWE D. ; FESTINGER D. S. ; DUGOSH K. L. ; LEE P. A. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.145-155 Titre : *** Titre autre langue : Are judicial status hearings a "key component" of drug court ? Six and twelve months outcomes Type de document : Périodique Auteurs : MARLOWE D. ; FESTINGER D. S. ; DUGOSH K. L. ; LEE P. A. Année de publication : 2005 Article en page(s) : p.145-155 Caractéristiques matérielles : fig., tabl. Langues : Anglais (eng) Mots-clés : Thésaurus RECIDIVE ; TRAITEMENT ; RETENTION ; SANCTION PENALE ; CRIME Résumé : Substantial evidence indicates that drug courts can be superior to traditional probation programs for enhancing treatment retention and reducing substance use and crime among drug offenders. Few studies have isolated the effects of the hypothesized ôkey componentsö of drug courts to determine their contributions to outcomes. This article presents outcomes at 6 and 12 months post-admission for misdemeanor drug court clients who were randomly assigned to different dosages of judicial status hearings. Although earlier work [Festinger, D.S., Marlowe, D.B., Lee, P.A., Kirby, K.C., Bovasso, G., McLellan, A.T., 2002. Status hearings in drug court: when more is less and less is more. Drug Alcohol Depend. 68, 151-157] revealed superior during-treatment effects for high-risk participants who were assigned to more frequent bi-weekly hearings, those effects did not extend post-treatment. The results did reveal significant pre-to-post improvements for participants, as a whole, in self-reported drug use, alcohol use, and criminal recidivism; however, lacking a no-drug court control condition, it is not possible to discern the magnitude of the effect of the drug court program. Approximately, half of the participants resumed drug or alcohol use within 12 months of admission to drug court, and approximately 10-15 % resumed illegal activities. These findings lend credence to the potential effectiveness of drug courts ; however, continuing-care strategies are required to extend the effects of drug courts beyond the initial active phases of the program. (Review's abstract). Cote CIRDD : 804974 Thématique : Drogues illicites Bibliographie : 41 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6304 [article]

*** / REHM J. ; FRICK U. ; HARTWIG C. ; GUTZWILLER F. ; GSCHWEND P. ; UCHTENHAGEN A. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.137-143 Titre : *** Titre autre langue : Mortality in heroin-assisted treatment in Switzerland 1994-2000 Type de document : Périodique Auteurs : REHM J. ; FRICK U. ; HARTWIG C. ; GUTZWILLER F. ; GSCHWEND P. ; UCHTENHAGEN A. Année de publication : 2005 Article en page(s) : p.137-143 Caractéristiques matérielles : tabl. Langues : Anglais (eng) Mots-clés : Thésaurus EFFICACITE ; MORTALITE ; OVERDOSE ; TRAITEMENT ; HEROINE ; DISTRIBUTION CONTROLEE Descripteurs géographiques SUISSE Résumé : Background : A major goal of heroin-assisted treatment in Switzerland has been to reduce the drug-related mortality of heroin users. Therefore, a continuous monitoring of deaths under treatment is essential. Aims : To assess mortality of participants in heroin-assisted treatment in Switzerland over a 7-year period from 1994 to 2000, and to compare this mortality to the general population and to other populations of opioid users, as reported in the literature. Method : Estimation of person years under heroin-assisted treatment from the complete case registry of heroin-assisted treatment in Switzerland. Estimation of standardized mortality ratios comparing the population in treatment to the Swiss population (standardized to the year 2000). Results : Over the 7-year period, the crude death rate of patients in heroin-assisted treatment, and including one month after discharge from treatment, was 1 % per year. The standardized mortality ratio for the entire observation period was 9,7 (95 % C.I. 7,3-12,8), with females having higher standardized mortality ratios (SMR 17,2) than males (SMR 8, 4). There was no clear time trend. Conclusion : Mortality in heroin-assisted treatment was low compared to the mortality rate of Swiss opioid users 1990s (estimated to be between 2,5 and 3 %). It was also low compared to mortality rates of opioid users in other maintenance treatments in other countries as reported in the literature. The SMR was also lower than that reported in the only meta-analysis in the literature: 13,2 (95 % C.I. 12,3-14,1). The low mortality rate is all the more noteworthy as heroin-assisted treatment in Switzerland included only refractory opioid addicts with existing severe somatic and/or mental problems. (Review's abstract). Cote CIRDD : 804973 Thématique : Drogues illicites Bibliographie : 60 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6305 [article]

*** / DEGENHARDT L. ; CONROY E. ; DAY C. ; GILMOUR S. ; HALL W. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.129-135 Titre : *** Titre autre langue : The impact of a reduction in drug supply on demand for and compliance with treatment for drug dependence Type de document : Périodique Auteurs : DEGENHARDT L. ; CONROY E. ; DAY C. ; GILMOUR S. ; HALL W. Année de publication : 2005 Article en page(s) : p.129-135 Caractéristiques matérielles : graph. Langues : Anglais (eng) Mots-clés : Thésaurus EVOLUTION ; OFFRE ; TRAITEMENT ; DEMANDE ; MARCHE DE LA DROGUE Résumé : Background : In early 2001, Australia experienced a sudden, dramatic and sustained decrease in heroin availability that was accompanied by sharp increases in price and decreases in street level purityÄthe so-called ôheroin shortageö. These unprecedented changes occurred in a context of widespread treatment availability, which made it possible for the first time to examine the impact of a sharp reduction in heroin supply in New South Wales (NSW) on entry to and adherence with treatment for heroin dependence. Given the evidence of drug substitution by some users, the current paper also examines the effects of the shortage on entry to treatment for other forms of drug dependence. Methods : Interrupted time-series analysis of the number of persons entering opioid pharmacotherapy and other treatment modalities in NSW for heroin dependence and for the treatment for other types of drug dependence. Findings : The heroin shortage was associated with a reduction in the number of younger persons entering opioid pharmacotherapy. There was a dramatic decrease in the number of persons entering heroin withdrawal or "assessment only" treatment episodes. There appear to have been small improvements in adherence to and retention in heroin treatment after the reduction in heroin supply. Relatively small increases were observed in numbers being treated for cocaine dependence. Conclusions : In the context of good treatment provision, a reduction in heroin supply appeared to produce modest improvements in intermediate outcomes. Supply and demand reduction measures, when both are implemented successfully, may be complementary. (Review's abstract). Cote CIRDD : 804972 Thématique : Drogues illicites Bibliographie : 37 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6306 [article]

*** / JONES H. E. ; WONG C. J. ; TUTEN M. ; STITZER M. L. in Drug and Alcohol Dependence, 79 (2) (2005)

[article]  in Drug and Alcohol Dependence > 79 (2) (2005)  - p.119-128 Titre : *** Titre autre langue : Reinforcement-based therapy : 12-month evaluation of an outpatient drug-free treatment for heroin abusers Type de document : Périodique Auteurs : JONES H. E. ; WONG C. J. ; TUTEN M. ; STITZER M. L. Année de publication : 2005 Article en page(s) : p.119-128 Caractéristiques matérielles : fig., tabl. Langues : Anglais (eng) Mots-clés : Thésaurus DEPENDANCE ; RENFORCEMENT ; ABSTINENCE ; OPIACES Résumé : This controlled study examined the efficacy of reinforcement-based therapy (RBT) for producing enhanced abstinence outcomes over 12 months in opioid-dependent patients exiting a brief residential detoxification. Patients were randomly assigned upon completing their medically managed taper (i.e., detoxification) to RBT (N = 66) or usual care (N = 64) referral to community treatment programs. The 6-month RBT program offered an array of abstinence-based incentives including rent payment for recovery housing, program-led recreational activities and skills training for procuring employment. RBT produced significantly higher self-report and urinalysis-confirmed rates of abstinence from opioids and cocaine relative to usual care at 1 (42 % versus 15 %) and 3 (38 % versus 17 %) months during treatment but not at 6 or 12 months after enrollment. The RBT but not the usual care group showed significant increases in the number of days worked and the amount of legal income earned at 3, 6 and 12 months. The results of this randomized study suggest that an intensive reinforcement-based therapy that includes abstinence-based recovery housing is a promising approach; however, further research is needed to determine the role of treatment intensity and the specific efficacy of RBT's component parts. (Review's abstract). Cote CIRDD : 804971 Thématique : Drogues illicites Bibliographie : 46 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6307 [article]

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