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  • 1
    Electronic Resource
    Electronic Resource
    The National Treatment Outcome Research Study (NTORS): 4–5 year follow-up results (2003)
    Oxford, UK : Blackwell Science Ltd
    Addiction 98 (2003), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims  The National Treatment Outcome Research Study (NTORS) is the first prospective national study of treatment outcome among drug misusers in the United Kingdom. NTORS investigates outcomes for drug misusers treated in existing services in residential and community settings.Design, setting and participants  The study used a longitudinal, prospective cohort design. Data were collected by structured interviews at intake to treatment, 1 year, 2 years and at 4–5 years. The sample comprised 418 patients from 54 agencies and four treatment modalities.Measurements  Measures were taken of illicit drug use, injecting and sharing injecting equipment, alcohol use, psychological health and crime.Findings  Rates of abstinence from illicit drugs increased after treatment among patients from both residential and community (methadone) programmes. Reductions were found for frequency of use of heroin, non-prescribed methadone, benzodiazepines, injecting and sharing of injecting equipment. For most variables, reductions were evident at 1 year with outcomes remaining at about the 1 year level or with further reductions. Crack cocaine and alcohol outcomes at 4–5 years were not significantly different from intake.Conclusions  Substantial reductions across a range of problem behaviours were found 4–5 years after patients were admitted to national treatment programmes delivered under day-to-day conditions. The less satisfactory outcomes for heavy drinking and use of crack cocaine suggest the need for services to be modified to tackle these problems more effectively. Despite differences between the United Kingdom and the United States in patient populations and in treatment programmes, there are many similarities between the two countries in outcomes from large-scale, multi-site studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2003.00296.x
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  • 2
    Electronic Resource
    Electronic Resource
    Factors associated with abstinence, lapse or relapse to heroin use after residential treatment: protective effect of coping responses (2002)
    Oxford, UK : Blackwell Science Ltd
    Addiction 97 (2002), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims  This study investigates factors associated with abstinence, lapse or relapse to heroin use after residential treatment and, specifically, the extent to which changes in cognitive, avoidance and distraction coping responses were related to heroin use and other drug use outcomes.Design, setting, participants  The sample comprised 242 clients from 23 residential programmes in the NTORS project, who used heroin before treatment and who were followed-up after treatment during the first 12 months of the study.Measurements  Data on client characteristics and problems, coping responses, drug use and other outcomes, were collected by structured face-to-face interviews.Findings  Many clients (60%) used heroin after treatment, with the first occasion of heroin use usually occurring very soon after leaving treatment: 40% remained abstinent from heroin. Analyses were conducted for three groups based upon heroin outcome status (abstinent, lapsed, relapsed). Clients who avoided a full relapse to heroin use (abstinent and lapse groups) consistently made more use of cognitive, avoidance and distraction coping strategies at follow-up than at intake. Treatment completion was related to better outcome. The lapse and relapse groups reported higher rates of use of illicit drugs other than heroin after treatment than the abstinent group.Conclusions  Despite generally satisfactory drug use outcomes, the lapses and relapses to heroin use give rise to concern. Treatment services should develop further and strengthen relapse prevention and relapse coping skills among drug misusers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2002.00227.x
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  • 3
    Electronic Resource
    Electronic Resource
    A web of dependence (2001)
    Oxford, UK : Carfax Publishing, part of the Taylor & Francis Group
    Addiction 96 (2001), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2001.9656771.x
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  • 4
    Electronic Resource
    Electronic Resource
    Self-reported overdose among injecting drug users in London: extent and nature of the problem (1999)
    Oxford, UK : Carfax Publishing, Taylor & Francis Ltd.
    Addiction 94 (1999), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims. To estimate the extent and nature of overdose and factors associated with overdose among injecting drug users in London. Design. Three hundred and twelve current injecting drug users were recruited and interviewed in community settings by a team of "privileged access interviewers". Measurements. A structured questionnaire was used that covered the following areas: demographic characteristics, drug use, injecting behaviour, sharing practices, severity of drug dependence, experience of overdose, injecting-related health problems and treatment history. Findings. The results showed that experience of overdose was common (38%). A majority (54%) had witnessed someone else overdose. Overdosing was not a solitary experience; over 80% of subjects who had overdosed had done so in the presence of someone else, but only 27% reported ambulances having been called. Factors found to be associated with overdose were: age at which injecting began; gender (women being more likely to experience overdose); use of alcohol; and polydrug injection. The overall rate of overdosing was one per 6 years of injecting; however, once an individual had an overdose the chance of having another increased. The risk of experiencing a first overdose fell with years of injecting. Conclusions. Harm-reduction interventions with drug injectors should educate users on the risk factors associated with overdose and actions that should be taken when someone has overdosed. Interventions designed to reduce the risk of overdose may be more effective if they are differentially targeted on drug injectors who have already experienced an overdose.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.1999.9444712.x
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  • 5
    Electronic Resource
    Electronic Resource
    Preventing opiate overdose fatalities with take-home naloxone: pre-launch study of possible impact and acceptability (1999)
    Oxford, UK : Carfax Publishing Limited
    Addiction 94 (1999), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims. Before proceeding with the introduction of an overdose fatality prevention programme including teaching in cardio-pulmonary resuscitation and distribution of naloxone, a pre-launch study of treatment and community samples of injecting drug misusers has been undertaken to establish (i) the extent of witnessing overdoses, (ii) the acceptability of naloxone distribution and training; and (iii) the likely impact of such measures. Design and setting. Structured interview of two samples: (a) a community sample of injecting drug misusers recruited by selected privileged access interviewers (PAI) and interviewed by them in community settings and (b) a treatment sample of opiate addicts recruited from our methadone maintenance clinic (interviewed by in-house research staff). Participants. (a) Three hundred and twelve injecting drug misusers with a history of having injected and currently still using injectable drugs; and (b) 142 opiate addicts in treatment at our local catchment area methadone maintenance clinic in South London. Findings. History of personal overdose was found with 38% of the community sample and 55% of the treatment samplemainly involving opiates and in the company of friends. Most (54% and 92%, respectively) had witnessed at least one overdose (again mostly involving opiates), of whom a third had witnessed a fatal overdose. Only a few (35%) already knew of the existence and effects of naloxone. After explanation to the treatment sample, 70% considered naloxone distribution to be a good proposal. Of the 13% opposed to the proposal, half thought it may lead them to use more drugs. Eighty-nine per cent of those who had witnessed an overdose fatality would have administered naloxone if it had been available. We estimate that at least two-thirds of witnessed overdose fatalities could be prevented by administration of home-based supplies of naloxone. Conclusions. Substantial proportions of both community and treatment samples of drug misusers have witnessed an overdose death which could have been prevented through prior training in resuscitation techniques and administration of home-based supplies of naloxone. Such a new approach would be supported by most drug misusers. On the basis of these findings, we conclude that it is appropriate to proceed to a carefully constructed trial of naloxone distribution.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.1999.9421993.x
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  • 6
    Electronic Resource
    Electronic Resource
    Book reviews (1998)
    Oxford, UK : Carfax Publishing Limited
    Addiction 93 (1998), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.1998.93460717.x
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  • 7
    Electronic Resource
    Electronic Resource
    Book Reviews (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Addiction 92 (1997), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Books Reviewed in this Article: The Selfish Brain: learning from addiction ROBERT L. DUPONT America's Drug War Debacle LEIF RODERICK ROSENBERGER Drug Abuse and Social Policy in America—the War that must be Won BARRY STIMMEL Women and Alcohol: contemporary and historical perspectives MOIRA PLANT Drug Misuse: prevention, harm minimisation and treatment JAN KEENE Alcohol and Speech STEVEN B. CHIN & DAVID B. PISONI
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.1997.tb02899.x
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  • 8
    Electronic Resource
    Electronic Resource
    The Maudsley Addiction Profile (MAP): a brief instrument for assessing treatment outcome (1998)
    Oxford, UK : Carfax Publishing Limited
    Addiction 93 (1998), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aim. To develop a brief, multi-dimensional instrument for assessing treatment outcome for people with drug and/or alcohol problems. The Maudsley Addiction Profile (MAP) is the first instrument to be developed in the United Kingdom for this purpose. Design. Field testing with quota-recruitment of problem drug users and problem alcohol users in treatment with researcher and clinician-administered test-retest interviews. Setting. Two community and two inpatient services at the Bethlem Royal and Maudsley Hospital, London. Participants. Subjects (160 drug users and 80 alcohol users) interviewed by eight interviewers (four researchers and four clinicians), each of whom interviewed 30 subjects on two occasions. Measures. Sixty items across substance use, health risk, physical/psychological health and personal/social functioning domains. Findings. Average completion time of the MAP was 12 minutes. The questionnaire was acceptable to a majority of subjects and performed well with both researcher and clinician interviewers. Internal reliability and feasible concurrent validity assessments of the scales and items were highly satisfactory. Test-retest reliability was good, average intraclass correlation coefficients across eight substances were 0.94 and 0.81 across health risk, health problems, relationship conflict, employment and crime measures. Conclusions. The MAP can serve as a core research instrument with additional outcome measures added as required. The collection of a set of reliable quantitative measures of problems among drug and alcohol users by research or treatment personnel for outcome evaluation purposes need not be time-consuming.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.1998.9312185711.x
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  • 9
    Electronic Resource
    Electronic Resource
    Heroin smoking by ‘chasing the dragon’: origins and history (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Addiction 92 (1997), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: The history of heroin smoking and the subsequent development and spread of ‘chasing the dragon’ are examined. The first heroin smoking originated in Shanghai in the 1920s and involved use of porcelain bowls and bamboo lubes, thereafter spreading across much of Eastern Asia and to the United States over the next decode. ‘Chasing the dragon’ was a later refinement of this form of heroin smoking, originating in or near Hong Kong in the 1950s, and refers to the ingestion of heroin by inhaling the vapours which result when the drug is heated-typically on tin-foil above aflame. Subsequent spread of ‘chasing the dragon’ included spread to other parts of South East Asia during the 1960s and 1970s, to some pans of Europe during the late 1970s and early 1980s, and to much of the Indian sub-continent during the 1980s. At the time of writing, ‘chasing the dragon’ has now been reliably reported from many parts of the world but no: from others with an established heroin problem-such as the United States and Australia. The significance of this new form of heroin use is examined, including consideration of the role of the different effect with this new form of use, the different types of heroin, and changing public attitudes to injecting.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.1997.tb02927.x
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  • 10
    Electronic Resource
    Electronic Resource
    Chasing the elusive dragon: the need for better definition (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Addiction 92 (1997), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.1997.tb02935.x
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