Beer à No-Go: Learning to stop responding to alcohol cues reduces alcohol intake via reduced affective associations rather than increased response inhibition.
Addiction. 2012 Feb 1;
Authors: Houben K, Havermans RC, Nederkoorn C, Jansen A
Abstract
Aims Previous research showed that consistently not responding to alcohol-related stimuli in a Go/No-Go training reduces drinking behavior. This study aimed to further examine the mechanisms underlying this Go/No-Go training effect. Design, setting, and participants Fifty-seven heavy drinkers were randomly assigned to two training conditions: In the beer/no-go condition, alcohol-related stimuli were always paired with a stopping response, while in the beer/go condition, participants always responded to alcohol-related stimuli. Participants were individually tested in a laboratory at Maastricht University. Measurements Weekly alcohol intake, implicit attitudes toward beer, approach-avoidance action tendencies toward beer, and response inhibition were measured before and after the training. Findings Results showed a significant reduction in both implicit attitudes (p= .03) and alcohol intake (p= .02) in the beer/no-go condition, but not in the beer/go condition. There were no significant training effects on action tendencies or response inhibition. Conclusions Repeatedly stopping prepotent responses toward alcohol-related stimuli effectively reduces excessive alcohol use via a devaluation of alcohol-related stimuli rather than via increased inhibitory control over alcohol-related responses.
PMID: 22296168 [PubMed - as supplied by publisher]
Assessment of Exposure to Drugs of Abuse During Pregnancy by Hair Analysis in a Mediterranean Island.
Addiction. 2012 Feb 1;
Authors: Friguls B, Joya X, Garcia J, Gómez-Culebras M, Pichini S, Martinez S, Vall O, Garcia-Algar O
Abstract
Aims: The study aims to estimate the prevalence of drug use by pregnant women living in Ibiza, using structured interviews and biomarkers in maternal hair In addition, the potential detrimental effects of maternal drug abuse on their newborns were investigated. Ibiza has a large international night-life resort associated with clubs, music and use of recreational drugs. Design, setting and participants: Hair samples were prospectively collected from January to March 2010 from a cohort of consecutive mothers after giving birth in the Hospital Can Misses in Ibiza. Measurements: Opiates, cocaine, cannabis, methadone, amphetamines, MDMA and their metabolites were detected in a 3cm. long proximal segment of maternal hair corresponding to last trimester of pregnancy by gas chromatography coupled to mass spectrometry (N = 107). Data on sociodemographic characteristics and on tobacco, alcohol, drugs of prescription and drugs of abuse consumption during pregnancy were collected using a structured questionnaire. Findings: Hair analysis showed an overall 16% positivity for drugs of abuse in the third trimester of pregnancy, with a specific prevalence of cannabis, cocaine, MDMA and opiates use of 10.3%, 6.4%, 0.9% and 0%, respectively. In the questionnaires, only 1.9% of mothers declared using drugs of abuse during pregnancy. Gestational drug of abuse consumption was associated with active tobacco smoking, a higher number of smoked cigarettes and the mother being Spanish. Conclusions: Illicit drug use is substantially under-reported among pregnant women living in Ibiza, particularly among Spanish nationals. Voluntary, routine objective biological toxicology screening should be considered as part of routine examinations in antenatal clinics on this Mediterranean Island.
PMID: 22296208 [PubMed - as supplied by publisher]
Prevalence And Correlates Of Alcohol Use Disorders In The Singapore Mental Health Survey.
Addiction. 2012 Feb 1;
Authors: Mythily S, Abdin E, Vaingankar J, Phua AM, Tee J, Chong SA
Abstract
Aims: To establish the prevalence, correlates, comorbidity, and treatment gap of alcohol use disorders in the Singapore resident population. Design: The Singapore Mental Health Study is a cross-sectional epidemiological survey. Setting: A nationally representative survey of the resident (citizens and permanent residents) population in Singapore. Participants: 6616 Singaporean adults aged 18 years and older. Measurements: The diagnoses were established using the World Mental Health Composite International Diagnostic Interview (WMH-CIDI) diagnostic modules for lifetime and 12-month prevalence of select mental illnesses including alcohol use disorders. Results: The lifetime prevalence of alcohol abuse and alcohol dependence was 3.1% and 0.5%, while the 12-month prevalence of alcohol abuse and alcohol dependence was 0.5% and 0.3%, respectively. The lifetime and 12-month prevalence of alcohol use disorders was 3.6% and 0.8%, respectively. Those with alcohol use disorder had significantly higher odds of having major depressive disorder (OR 3.1) and nicotine dependence (OR 4.5). Compared to the rest of the population, those with an alcohol use disorder had significantly higher odds of having gastric ulcers (OR 3.0), respiratory conditions OR (2.1) and chronic pain (OR 2.1). Only 1 in 5 of those with alcohol use disorder had ever sought treatment. Conclusions: The prevalence of alcohol use disorders is relatively low in the Singapore adult population. Comorbidity with mental and physical disorders is significant emphasizing the need to screen persons with alcohol use disorders for these comorbidities.
PMID: 22296228 [PubMed - as supplied by publisher]
Healthcare service utilization in substance abusers receiving contingency management and standard care treatments.
Addiction. 2012 Feb 1;
Authors: Olmstead TA, Cohen JP, Petry NM
Abstract
Aims: To determine the impact of standard care and contingency management treatments on the utilization of general healthcare services by substance abusers. Participants, Design and Measurements: This secondary analysis pooled 1,028 treatment-seeking substance abusers from five randomized clinical trials that compared the effects of standard care (SC, n = 362) to standard care plus contingency management (CM, n = 666). In each trial, subjects in the CM condition showed significantly greater reductions in substance use than their SC counterparts. For each subject, utilization of 15 general healthcare services was measured one year prior to treatment intake and up to nine months following treatment intake. Post-intake utilization data were prorated to be comparable to the one-year pre-intake data. Paired t-tests evaluated changes in service utilization pre- and post-intake, and difference-in-differences regression models were used to estimate the impact of CM, compared to SC, on changes in the utilization of each of the 15 health services. Setting: Outpatient community substance abuse clinics in Connecticut and Massachusetts, USA. Findings: Utilization of several types of outpatient services significantly increased between the pre-intake and post-intake periods (e.g., dental visits (+0.47, P < 0.001), community health center visits (+0.50, P < 0.001), visits to a mental health professional office (+1.03, P = 0.001)), while inpatient hospital care for mental health problems decreased significantly (-3.50 nights, P < 0.001). A substantial portion of these changes occurred during the treatment period. No significant differences were found between the two treatment conditions. Conclusions: Initiating outpatient substance abuse treatment is associated with changes in general healthcare service utilization, independent of the type of treatment offered.
PMID: 22296262 [PubMed - as supplied by publisher]
Preferences for Evidence-Based Practice Dissemination in Addiction Agencies Serving Women: A Discrete-Choice Conjoint Experiment.
Addiction. 2012 Feb 1;
Authors: Cunningham CE, Henderson J, Niccols A, Dobbins M, Sword W, Chen Y, Mielko S, Milligan K, Lipman E, Thabane L, Schmidt L
Abstract
Aims: To model variables influencing the dissemination of evidence-based practices to addiction service providers and administrators. Design: A discrete-choice conjoint experiment. We systematically varied combinations of 16 dissemination variables that might influence the adoption of evidence-based practices. Participants chose between sets of variables. Setting: Canadian agencies (n = 333) providing addiction services to women. Participants: Service providers and administrators (n = 1379). Measurements: We estimated the relative importance and optimal level of each dissemination variable. We used Latent Class analysis to identify subsets of participants with different preferences and simulated the conditions under which participants would use more demanding professional development options. Findings: Three subsets of participants were identified: Outcome Sensitive (52%), Process Sensitive (30%), and Demand Sensitive (18%). Across all participants, the number of clients who were expected to benefit from an evidence-based practice exerted the most influence on dissemination choices. If a practice was seen as feasible, co-worker and administrative support influenced decisions. Client benefits were most important to Outcome Sensitive participants; type of dissemination process (e.g., active versus passive learning) was more important to Process Sensitive participants. Brief options with little follow-up were preferred by Demand Sensitive participants. Simulations predicted that initiatives selected and endorsed by government funders would reduce participation.. Conclusions: Clinicians and administrators are more like to adopt evidence-based addiction practices if the practice is seen as helpful to clients, and if it is supported by co-workers and program administration.
PMID: 22296280 [PubMed - as supplied by publisher]
The Co-occurring Use and Misuse of Cannabis and Tobacco: A Review.
Addiction. 2012 Feb 2;
Authors: Agrawal A, Budney AJ, Lynskey MT
Abstract
Aims: Cannabis and tobacco use and misuse frequently co-occur. This review examines the epidemiological evidence supporting the lifetime co-occurrence of cannabis and tobacco use and outlines the mechanisms that link these drugs to each other. Mechanisms include (a) shared genetic factors; (b) shared environmental influences, including (c) route of administration (via smoking), (d) co-administration and (e) models of co-use. We also discuss respiratory harms associated with co-use of cannabis and tobacco, overlapping withdrawal syndromes and outline treatment implications for co-occurring use. Methods: Selective review of published studies. Results: Both cannabis and tobacco use and misuse are influenced by genetic factors and a proportion of these genetic factors influence both cannabis and tobacco use and misuse. Environmental factors such as availability play an important role, with economic models suggesting a complementary relationship where increases in price of one drug decrease the use of the other. Route of administration and smoking cues may contribute to their sustained use. Similar withdrawal syndromes, with many symptoms in common, may have important treatment implications. Emerging evidence suggests that dual abstinence may predict better cessation outcomes, yet empirically researched treatments tailored for co-occurring use are lacking. Conclusion: There is accumulating evidence that some mechanisms linking cannabis and tobacco use are distinct from those contributing to co-occurring use of drugs in general. There is an urgent need for research to identify the underlying mechanisms and harness their potential etiological implications to tailor treatment options for this serious public health challenge.
PMID: 22300456 [PubMed - as supplied by publisher]
Controlling new drugs under marketing regulations.
Addiction. 2012 Jan 31;
Authors: Hughes B, Winstock AR
Abstract
Aims The rapid emergence of myriad substances openly marketed as ‘legal highs’ is straining traditional drug control systems which require time and basic scientific data on harms to react, presenting governments with the dilemma of no response or a disproportionate response. Some countries have side-stepped this using novel policy and legislative approaches. Should other countries consider them? Methods We review the different laws invoked to stop the open sale of new psychoactive substances, focusing on the European Union (EU). Results Some countries have designed new catch-all control systems, or faster systems to classify substances as drugs. Others have enforced consumer safety or medicines legislation to stop the open sale of these products. The latter originate from harmonization of the internal market of the EU. Rigorous, objective evaluation is required, but first results suggest that these have been effective, while avoiding criminalization of users. Conclusions Every EU country should have existing laws for protecting public health that can be applied swiftly yet proportionately to new drugs appearing on the open market with minimum political involvement. It seems the key is the speed, not the weight, of response. Given support for their enforcement mechanisms, these systems might be as effective and more efficient than the old ones.
PMID: 22288473 [PubMed - as supplied by publisher]
Aims: The study aimed at examining the associations between cannabis use and work commitment. Design: We used a 25 year panel survey initiated in 1985 with follow-ups in 1987, 1989, 1993, 2003 and 2010. Registered data from a range of public registers were matched with individual responses for the entire period. . Setting: The panel survey was a nation-wide study set in Norway. Participants: 1997 respondents born between 1965 and 1968 were included in the panel. Measurements: Work involvement scale (WIS) was used to assess work commitment. Involvement with cannabis was based on self-reported smoking of cannabis within last 12 months and exposure to cannabis through friends. This information was categorized into “abstaining”, “exposed”, “experimented” and “involved”. Control measures included socioeconomic background, mental health (HSCL-10), education, work satisfaction, unemployment, receipt of social assistance, consumption of alcohol, alcohol related problems and use of other illicit drugs. Findings: The level of work commitment was associated with involvement with cannabis. In 1993, when the respondents were in their mid-20ies, those who were involved or had experimented with cannabis displayed lower levels of work commitment than those who were abstaining or merely exposed to cannabis through friends (p < 0.05). Work commitment among those who experimented with cannabis converged towards the levels reported by abstainers and the exposed as they grew older, whereas the involved reported decreasing work commitment into adulthood (p < 0.001). Using linear regression models for panel data, an association with continued use of cannabis across the life course and a lowering of work commitment was established. Results remained significant even when controlling for a range of other factors known to be related to work commitment, such as socioeconomic background, education, labor market experiences, mental health and family characteristics (p < 0.05). Conclusions: In Norway the use of Cannabis is associated with a reduction in work commitment among adults.
PMID: 22276981 [PubMed - as supplied by publisher]
Continuing to wear nicotine patches after smoking lapses promotes recovery of abstinence.
Addiction. 2012 Jan 26;
Authors: Ferguson SG, Gitchell JG, Shiffman S
Abstract
Aims: Smokers who lapse during a cessation attempt are at particularly high risk of relapse, so interventions to help smokers recover from lapses are urgently needed. Two recent studies have suggested continuing to use nicotine patches following a lapse may be a beneficial relapse prevention strategy. However, to date no study that uses approved doses of nicotine patches under real-world conditions has tested this hypothesis. Design & Setting: Clinical trial conducted across eight US study sites. Participants & Measurements: Using data from 509 subjects (240 active; 269 placebo) who lapsed during weeks 3-5 of treatment in a randomized, double blind placebo controlled trial of 21-mg nicotine patches, we examined whether active nicotine patch use improved the chances of recovering abstinence (7-day point-prevalence) at weeks 6 and 10. Findings: Active patch use (versus placebo) increased the likelihood of recovery from a lapse both at 6 weeks (8.3% vs 0.8%; Relative Risk [RR]=11.0, p<.001) and at 10 weeks (9.6% vs 2.6%; RR=3.7, p<.001). Conclusions: Continuing treatment to aid smoking cessation with active patches promotes recovery from lapses. Smokers should be encouraged to persist with patch treatment if they lapse to smoking.
PMID: 22276996 [PubMed - as supplied by publisher]
Implicit and Explicit Alcohol Cognitions and Observed Alcohol Consumption: Three Studies in (Semi-) Naturalistic Drinking Settings.
Addiction. 2012 Jan 19;
Authors: Larsen H, Engels RC, Wiers RW, Granic I, Spijkerman R
Abstract
Aims: Dual-process models imply that alcohol use is related to implicit as well as explicit cognitive processes. Few studies have tested whether both types of processes are related to ad libitum drinking. In a series of three studies, we tested whether both implicit and explicit alcohol-related cognitions predicted the amount of alcohol consumed in an ad libitum (semi-) naturalistic drinking situation. Design: Two experimental studies used trained confederates (same-sex peers) who consumed either alcoholic or non-alcoholic beverages, while observing participants’ drinking behaviour in a 30-min session. The third study involved observations of participants’ alcohol use during a 45-min session in which participants spent time with 5-7 friends. Setting: A (semi-)naturalistic drinking setting, a laboratory bar. Participants: Participants were undergraduates recruited at Radboud University (Study 1: N = 115; Study 2: N = 121; Study 3: N = 200). Measurements: We used coding of drinking behaviour from observations, questionnaire data on positive alcohol expectancies and alcohol use patterns, and Implicit Association Tests to assess alcohol associations. Findings: Implicit associations were not related to observed alcohol use(all three studies P > .05), whereas explicit positive expectancies were positively related to observed alcohol use in Study 1 (P = .049) and Study 2 (P = .048). Conclusion: Among undergraduate students in (semi-)naturalistic drinking settings with peers, implicit alcohol-related cognitions do not predict the amount of alcohol consumed.
PMID: 22260335 [PubMed - as supplied by publisher]
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