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  • 1
    Electronic Resource
    Electronic Resource
    Cannabis use and dependence among Australian adults: results from the National Survey of Mental Health and Wellbeing (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
    Notes: Aims. To examine: (i) the prevalence of cannabis use and DSM-IV cannabis dependence among Australian adults, and (ii) correlates of level of cannabis involvement. Design. Cross-sectional survey assessing substance use and DSM-IV substance use disorders (abuse and dependence). Setting and participants. A household survey of a nationally representative sample of 10 641 Australians aged 18 years and older. Measurements. Trained interviewers administered a structured, modified version of the Composite International Diagnostic Interview (CIDI). Findings. In the past 12 months, 2.2% (95%CI:1.8, 2.6) of adults were diagnosed with DSM-IV cannabis use disorder, comprising cannabis dependence (1.5%; 95%CI: 1.2, 1.8) and cannabis abuse (0.7%, 95%CI: 0.6, 0.8). Almost one-third of cannabis users (31.7%; 95%CI: 27.7, 35.7) met criteria for cannabis dependence (21%; 95%CI: 16.7, 25.3) and abuse (10.7%; 95%CI: 8.0, 13.4). Multinomial logistic regression revealed that compared to non-dependent cannabis users, non-users were more likely to be female, aged 25 + years, out of the labour force and married/de facto, and displayed lower levels of co-morbidity. In contrast, dependent cannabis users were more likely to be 18-24 years old, unemployed, and displayed higher levels of co-morbidity than non-dependent users. Conclusions. Cannabis use disorders affect approximately 300 000 Australian adults. A better understanding of the factors associated with cannabis dependence may help identify groups who have difficulties controlling use and aid the development of strategies for reducing cannabis-related harm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2001.9657379.x
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  • 2
    Electronic Resource
    Electronic Resource
    Another mirror shattered? Tobacco industry involvement suspected in a book which claims that nicotine is not addictive (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
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2002.00001.x
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  • 3
    Electronic Resource
    Electronic Resource
    Heroin overdose: causes and consequences (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
    Notes: Over the past decade fatal opioid overdose has emerged as a major public health issue internationally. This paper examines the risk factors for overdose from a biomedical perspective. While significant risk factors for opioid overdose fatality are well recognized, the mechanism of fatal overdose remains unclear. Losses of tolerance and concomitant use of alcohol and other CNS depressants clearly play a major role in fatality; howeve, such risk factors do not account for the strong age and gender patterns observed consistently among victims of overdose. There is evidence that systemic disease may be more prevalent in users at greatest risk of overdose. We hypothesize that pulmonary and hepatic dysfunction resulting from such disease may increase susceptibility to both fatal and non-fatal overdose. Sequelae of non-fatal overdose are recognized in the clinical literature but few epidemiological data exist describing the burden of morbidity arising from such sequelae. The potential for overdose to cause persisting morbidity is reviewed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2001.96811135.x
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  • 4
    Electronic Resource
    Electronic Resource
    Attention Deficit Hyperactivity Disorder and substance use disorders: is there a causal link? (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
    Notes: Attention-deficit hyperactivity disorder (ADHD), characterized by restless, inattentive and hyperactive behaviours, is a relatively common childhood disorder that affects approximately 5% of the general population. There has been controversy about whether ADHD increases risks of developing substance use disorders. The available evidence suggests that, in the absence of conduct disorder, ADHD is not associated with an increased risk of substance use problems in males. There is only limited evidence on the role of ADHD in the aetiology of substance use disorders among females. While ADHD has traditionally been considered as a childhood disorder, it may also occur in adults; research needs to examine the extent to which ADHD in adulthood increases the risk of substance use disorders.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2001.9668153.x
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  • 5
    Electronic Resource
    Electronic Resource
    The integrity of the science base: a test case (2005)
    Oxford, UK : Blackwell Science Ltd
    Addiction 100 (2005), 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.1360-0443.2005.01109.x
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  • 6
    Electronic Resource
    Electronic Resource
    Evaluating explanations of the Australian ‘heroin shortage’ (2005)
    Oxford, UK : Blackwell Science Ltd
    Addiction 100 (2005), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims  In this paper we outline and evaluate competing explanations for a heroin shortage that occurred in Australia during 2001 with an abrupt onset at the beginning of 2001.Methods  We evaluated each of the explanations offered for the shortage against evidence from a variety of sources: government reports, police and drug law enforcement documents and briefings, key informant (KI) interviews, indicator data and research data.Results  No similar shortage occurred at the same time in other markets (e.g. Vancouver, Canada or Hong Kong) whose heroin originated in the same countries as Australia’s. The shortage was due most probably to a combination of factors that operated synergistically and sequentially. The heroin market had grown rapidly in the late 1990s, perhaps helped by a decline in drug law enforcement (DLE) in Australia in the early 1990s that facilitated high-level heroin suppliers in Asia to establish large-scale importation heroin networks into Australia. This led to an increase in the availability of heroin, increasingly visible street-based drug markets, increased purity and decreased price of heroin around the country. The Australian heroin market was well established by the late 1990s, but it had a low profit margin with high heroin purity, and a lower price than ever before. The surge in heroin problems led to increased funding of the Australian Federal Police and Customs as part of the National Illicit Drug Strategy in 1998–99, with the result that a number of key individuals and large seizures occurred during 1999–2000, probably increasing the risks of large-scale importation. The combination of low profits and increased success of law enforcement may have reduced the dependability of key suppliers of heroin to Australia at a time when seized heroin was becoming more difficult to replace because of reduced supplies in the Golden Triangle. These factors may have reduced the attractiveness of Australia as a destination for heroin trafficking.Conclusions  The Australian heroin shortage in 2001 was due probably to a combination of factors that included increased effectiveness of law enforcement efforts to disrupt networks bringing large shipments of heroin from traditional source countries, and decreased capacity or willingness of major traffickers to continue large scale shipments to Australia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.2005.01000.x
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  • 7
    Electronic Resource
    Electronic Resource
    Choosing a diagnostic cut-off for cannabis dependence (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. While cannabis dependence has been increasingly recognized, there is little research on the measurement issues involved in operationalizing the dependence syndrome for this drug. This paper aimed to investigate the diagnostic utility and appropriate diagnostic cut-offs of three short dependence measures among long-term cannabis users. Setting and participants. Two hundred long-term, regular cannabis users were recruited and interviewed in Sydney, Australia. Measurements. Receiver Operating Characteristic analyses compared the diagnostic performance of the short University of Michigan CIDI, a measure of ICD-10 dependence and the Severity of Dependence Scale against the "gold standard" of moderate or more severe DSM-III-R cannabis dependence, as diagnosed by the Substance Abuse Module of the CIDI. Findings. The measures were of equal utility in diagnosing at least moderate DSM-III-R cannabis dependence. While the optimal diagnostic cut-offs for the short University of Michigan CIDI and the ICD-10 dependence measure remained unchanged from those conventionally applied, a more liberal cut-off was optimal for the Severity of Dependence Scale. The amended prevalence of cannabis dependence was 77% using the short University of Michigan CIDI, 72% by the ICD-10 measure and 62% by the Severity of Dependence Scale. Conclusions. The three instruments were able to diagnose cannabis dependence at levels substantially better than chance. They were generally robust in terms of the optimal diagnostic cut-off in a population of long-term cannabis users. This paper provides guidelines for choosing optimal cut-offs within different contexts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.1998.931116816.x
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  • 8
    Electronic Resource
    Electronic Resource
    The distribution of naloxone to heroin users (1997)
    Oxford, UK : Carfax Publishing Limited
    Addiction 92 (1997), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Overdose deaths are a major contributor to excess mortality among heroin users. It has been proposed that opioid overdose morbidity and mortality could be reduced substantially by distributing the opioid antagonist naloxone to heroin users. The ethical issues raised by this proposal are evaluated from a utilitarian perspective. The potential advantages of naloxone distribution include the increased chance of comatose opioid users being quickly resuscitated by others present at the time of an overdose, naloxone's safety and its lack of abuse potential. The main problems raised by the proposal are: the medico-legal complications of medical practitioners prescribing a drug that is most likely to be administered to and by people other than the one for whom it is prescribed; the economic costs of distributing naloxone sufficiently widely to have an impact on overdose morbidity and mortality; and the potentially greater cost-effectiveness of simpler educational interventions. Given the possible benefits of naloxone distribution, it may be worthwhile considering a controlled trial of naloxone distribution to high-risk heroin users.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.1997.tb03681.x
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  • 9
    Electronic Resource
    Electronic Resource
    Transitions between routes of benzodiazepine administration among heroin users in Sydney (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: A sample of 312 heroin users were interviewed regarding their benzodiazepine use. The majority (94%) had used bensodiazepines, 72% in the 6 months prior to interview. Benzodiazepine injecting was common, with 28% of the sample having injected these drugs, 13% in the 6 months preceding interview. Current benzodiazepine injectors showed greater polydrug use, injection-related HIV risk-taking behaviour, criminal involvement, psychological distress and injection-related health problems, as well as poorer general health, and an increased risk of having overdosed, than other users of benzodiazepines. Of those subjects mho had injected benzodiasepines, 55% were no longer current benzodiazepine injectors. Concern for general health emerged as the most common reason for having made a transition away from injecting, and for being likely to make such a transition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.1997.tb02936.x
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  • 10
    Electronic Resource
    Electronic Resource
    Alcohol, cannabis and tobacco use among Australians: a comparison of their associations with other drug use and use disorders, affective and anxiety disorders, and psychosis (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
    Notes: Aim. To compare relationships between alcohol, cannabis and tobacco and indicators of mental health problems in the general population. 
Method. A survey of a nationally representative sample of 10 641 Australian adults (the National Survey of Mental Health and Well-Being (NSMHWB)) provided data on alcohol, cannabis and tobacco use and mental health (DSM-IV anxiety disorders, affective disorders, other substance use disorders and screening positively for psychosis). 
Findings. Alcohol showed a "J-shaped" relationship with DSM-IV affective and anxiety disorders: alcohol users had lower rates of these problems than non-users of alcohol, while those meeting criteria for alcohol dependence had the highest rates. Tobacco and cannabis use were both associated with increased rates of all mental health problems examined. However, after controlling for demographics, neuroticism and other drug use, cannabis was not associated with anxiety or affective disorders. Alcohol dependence and tobacco use remained associated with both of these indicators of mental health. All three types of drug use were associated with higher rates of other substance use problems, with cannabis having the strongest association. 
Conclusions. The use of alcohol, tobacco and cannabis are associated with different patterns of co-morbidity in the general population.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2001.961116037.x
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