| 1. |
- Jansson, Irene, et al.
(författare)
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Influence of personality disorder features on social functioning in substance-abusing women five years after compulsive residential treatment.
- 2009
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Ingår i: European Addiction Research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 15:1, s. 25-31
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Personality disorders (PD) are related to negative outcome in substance abuse treatment, and in the general population, personality disorders are related to negative outcome in overall functioning. Little is known about the impact of PD on adjustment following substance abuse treatment. METHODS: A cohort of 132 women was followed for 5 years after their index treatment episode in compulsory treatment. During treatment, patients were assessed with the SCID-II. At follow-up, patients were administered a timeline follow-back interview covering their functioning, including employment status over the years, and linked with hospital and criminal justice registers. RESULTS: The impact of PD on functioning varied substantially between disorders and outcome domains. Conduct disorder alone was associated with criminal justice involvement, and conduct disorder and avoidant PD features were associated with unemployment. Dependent PD and obsessive-compulsive personality disorder features were positively associated with employment. Borderline PD features were associated with hospital admissions. DISCUSSION: We discuss how strategies associated with various PDs may foster or hinder social adjustment in general and employment patterns in particular.
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| 2. |
- Andersson, Claes
(författare)
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Comparison of WEB and Interactive Voice Response (IVR) Methods for Delivering Brief Alcohol Interventions to Hazardous-Drinking University Students : A Randomized Controlled Trial
- 2015
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Ingår i: European Addiction Research. - : S. Karger. - 1022-6877 .- 1421-9891. ; 21:5, s. 240-252
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated automated techniques including personalized normative feedback and protective behavioral strategies, for brief interventions intended to reduce peak alcohol concentrations in university students. After completing baseline assessment, a total of 1,678 hazardous-drinking consumers were randomized to a single or a repeated Internet (WEB) or Interactive Voice Response (IVR) intervention, or to a control group (Single WEB: 323; Single IVR: 329; Repeated WEB: 318; Repeated IVR: 334; Control group: 374). At follow-up, six weeks after baseline, questionnaires were returned by 1,422 participants (Single WEB: 277; Single IVR: 286; Repeated WEB: 259; Repeated IVR: 279; Control group: 321). It was found that peak estimated BAC was reduced in the total group (b -0.14, 95% confidence interval (CI) -0.023; -0.005), in the total (b -0.17, 95% CI -0.027; -0.007) and single (b -0.021, 95% CI -0.032; -0.011) WEB group, and in the total (b -0.011, 95% CI -0.021; -0.015) and repeated (b -0.012, 95% CI -0.023; -0.000) IVR groups, compared to controls. The reduction in peak estimated BAC was greater in the single WEB group compared to the single IVR group (b -0.011, 95% CI -0.022; -0.000). This study concluded that both WEB and IVR interventions have a small but significant effect in reducing heavy episodic drinking, which may be due to the relatively large sample size. Repeated intervention may be needed if delivered by IVR.
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| 3. |
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| 4. |
- Berman, Anne H., et al.
(författare)
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Evaluation of the Drug Use Disorders Identification Test (DUDIT) in criminal justice and detoxification settings and in a Swedish population sample
- 2005
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 11:1, s. 22-31
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Tidskriftsartikel (refereegranskat)abstract
- Psychometric properties of the 11-item self-report Drug Use Disorders Identification Test (DUDIT) were evaluated in a sample of heavy drug users from prison, probation, and inpatient detoxification settings, and in a general Swedish population sample. In the drug user sample, the DUDIT predicted drug dependence with a sensitivity of 90% for both DSM-4 and ICD-10 and a respective specificity of 78 and 88%. Reliability according to Cronbach’s α coefficient was 0.80. In the population sample, 3.1% scored positive on the DUDIT; T-score values are suggested. The DUDIT screens effectively for drug-related problems in clinically selected groups and may prove useful in the context of public health surveys.
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| 5. |
- Bjarnadottir, G. D., et al.
(författare)
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Intravenous Use of Prescription Psychostimulants; A Comparison of the Pattern and Subjective Experience between Different Methylphenidate Preparations, Amphetamine and Cocaine
- 2016
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 22:5, s. 259-267
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Methylphenidate (MPH) has been the most commonly used intravenous (i.v.) substance in Iceland in recent years. In Iceland, MPH is available in 3 forms: immediate-release (IR) tablets (MPH IR, short-acting), sustainable-release (SR) capsules (MPH SR, long-acting) and osmotic-release (OROS) tablets (MPH OROS, long-acting). The aims of the study were to compare the pattern and subjective effects of i.v. MPH use to other i.v. psychostimulants and examine whether the pattern of use differs among MPH preparations. Methods: This is a nationwide descriptive study. Information was collected from 95 i.v. substance users undergoing inpatient detoxification and reporting i.v. MPH use in the last 30 days using a semi-structured interview. Results: MPH SR was both the most commonly used (96%) and preferred i.v. psychostimulant (57%). The intensity and duration of 'euphoria' did not differ between cocaine and MPH SR. No participant reported MPH OROS as their preferred substance even though a third had used it in the past month. Conclusions: The pattern of i.v. MPH use is similar to other psychostimulants among treatment seeking patients. MPH OROS was the least preferred i.v. psychostimulant, despite having the largest market share in Iceland. The results indicate that MPH OROS has less abuse potential than other MPH preparations. (C) 2016 S. Karger AG, Basel
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| 6. |
- Bloomfield, K., et al.
(författare)
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Changes in Alcohol-Related Harm after Alcohol Policy Changes in Denmark
- 2009
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 15:4, s. 224-231
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This paper examines changes in alcohol-related harm in Denmark between 2003 and 2005 after changes in alcohol policies were introduced between 2003 and 2005. Methods: Interrupted time series analysis was performed with data on violent assaults and hospitalisations for acute alcohol intoxication from 2003 through 2005. Results: A 26% increase in the number of acute alcohol intoxication hospitalisations among people aged 15 years and younger was detected after the tax reduction on spirits. No significant increase in violent assaults and acute intoxication among adults was found. Conclusions: Even modest alcohol price policies can affect more vulnerable population sub-groups such as under-age youth. Policy makers should consider such consequences when forming economic policies that also have public health implications.
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| 7. |
- Bodin, MC, et al.
(författare)
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Predictors of 2-year drinking outcomes in a Swedish treatment sample
- 2007
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Ingår i: European addiction research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 13:3, s. 136-143
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Few studies have investigated predictors of short- and longer-term outcomes in relatively well functioning treatment samples. <i>Methods:</i> Multivariate logistic regression analyses were used to identify predictors of continuous abstinence in 188 individuals during their 2nd year after private 12-step treatment in Sweden, and findings are related to a previous report on 1-year outcomes. <i>Results:</i> Individual baseline characteristics were not directly related to 2nd year outcomes, while a higher 1st-year drinking severity decreased the likelihood of 2nd-year abstinence. Satisfaction with treatment and affiliation with Alcoholics Anonymous, but not program aftercare during the 1st year increased the likelihood of 2nd-year abstinence. <i>Conclusion:</i> Results are consistent with previous studies showing that shorter-term outcomes are likely to be maintained, and that baseline characteristics and treatment factors account less for outcomes over longer terms.
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| 8. |
- Bramness, Jorgen G., et al.
(författare)
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A Bibliometric Analysis of European versus USA Research in the Field of Addiction. Research on Alcohol, Narcotics, Prescription Drug Abuse, Tobacco and Steroids 2001-2011
- 2014
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Ingår i: European Addiction Research. - : Karger. - 1022-6877 .- 1421-9891. ; 20:1, s. 16-22
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Tidskriftsartikel (refereegranskat)abstract
- Background: To compare the publication and citation rate within the areas of drug abuse and dependence research in Europe with that in the USA. Methods: This is a bibliometric study using the Thomson Reuters Web of Knowledge as data source, 40 key words were used as search terms, but certain scientific publications not concerning the issue were excluded. Scientific publications from Denmark, England, Finland, France, Germany, Italy, the Netherlands, Norway, Spain, Sweden, and the USA were studied. The number of publications in each country and in each year in addition to the citation indices for these publications was retrieved. Results: Approximately two thirds of the publications came from the USA. Both in absolute and relative figures, Europe lagged behind. The trend over the last decade was a greater gap between the amount of research performed in Europe versus the USA. There were thematic differences. Smaller European countries had a greater relative publication rate. The citations were relatively evenly distributed. Conclusions: It has been claimed that 85% of the world's research within the field of drug abuse and dependence is carried out in the USA. This study challenges this figure, but European research within this field is lagging behind. Copyright (C) 2013 S. Karger AG, Basel
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| 9. |
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| 10. |
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| 11. |
- Buchholz, Angela, et al.
(författare)
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Patient-Centered Placement Matching of Alcohol-Dependent Patients Based on a Standardized Intake Assessment : Primary Outcomes of an Exploratory Randomized Controlled Trial
- 2020
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 26:3, s. 109-121
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Tidskriftsartikel (refereegranskat)abstract
- Background: Placement matching guidelines are promising means to optimize patient-centered care and to match patients' treatment needs. Despite considerable research regarding placement matching approaches to optimize alcohol abuse treatment, findings are inconclusive. Objectives: To investigate whether the use of patient-centered placement matching (PCPM) guidelines is more effective in reducing heavy drinking and costs 6 months after discharge from an inpatient alcohol withdrawal treatment compared to usual referral to aftercare. Secondary aims were to investigate whether age, gender, trial site or level of care (LOC) are moderators of efficacy and whether patients who were actually referred to the recommended LOC had better treatment outcomes compared to patients who were treated under- or overmatched. Methods: Design. Exploratory randomized controlled trial with measurements during withdrawal treatment and 6 months after initial assessment. Setting. Four German psychiatric clinics offering a 7-21 day inpatient qualified withdrawal program for patients suffering from alcohol dependence. Participants. From 1,927 patients who had a primary diagnosis of alcohol dependence and did not have organized aftercare when entering withdrawal treatment, 299 were invited to participate. Of those, 250 were randomized to the intervention group (IG, n = 123) or the control group (CG, n = 127). Intervention. The PCPM were applied to patients of the IG by feeding back a recommendation to a LOC for aftercare that was calculated from the Measurements in the Addictions for Triage and Evaluation (MATE) and discussed with the staff of the treatment unit. Patients of the CG received a general feedback regarding their MATE interview on request. Measurements. The MATE, the Client Socio-Demographic and Service Receipt Inventory--European Version and the MATE-Outcomes were administered. Data were analyzed using generalized linear models. Results: In the intention-to-treat analysis, there were no significant differences between IG and CG regarding days of heavy drinking (incident risk ratio [IRR] 1.09; p = 0.640), direct (IRR 1.06; p = 0.779), indirect (IRR 0.77; p = 0.392) and total costs (IRR 0.89; p = 0.496). Furthermore, none of the investigated moderator variables affected statistically significant drinking or cost-related primary outcomes. Regardless of group allocation, patients who received matched aftercare reported significantly fewer days of heavy drinking than undermatched patients (IRR 2.09; p = 0.004). For patients who were overmatched, direct costs were significantly higher (IRR 1.79; p = 0.024), but with no additional effects on alcohol consumption compared to matched patients. Conclusions: While the use of PCPM failed to affect the actual referral to aftercare, our findings suggest that treating patients on the recommended LOC may have the potential to reduce days of heavy drinking compared to undertreatment and costs compared to overtreatment.
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| 12. |
- Cederfjäll, Jenny, et al.
(författare)
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Alcohol Consumption among Middle-Aged Women: A Population-Based Study of Swedish Women. The Women's Health in Lund Area (WHILA) Study.
- 2004
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Ingår i: European Addiction Research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 10:1, s. 15-21
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Tidskriftsartikel (refereegranskat)abstract
- From a total population of 10,766 Swedish 50- to 59-year-old women, 6,917 (64.2%) participated in the Women’s Health in Lund Area (WHILA) study, and among them 6,623 (95.7%) answered the questions on alcohol consumption. One out of 4 women (26.0%) consumed no alcohol in an ordinary week (non-drinkers), 57.4% consumed not more than 83 g alcohol, 12.5% consumed 84–167 g and 4.2% consumed 168 g or more. The weekly drinkers had a median consumption of 40.0 g alcohol (range 2.5–1,036.0) and the main sort of alcohol was wine. Comparing the four drinking groups, most differences occurred between the non-drinking and the weekly drinking women. The non-drinkers had lower socio-demographic status, poorer health and more symptoms, especially physical symptoms. In a multivariate logistic regression analysis, most associations between non-drinking and lower socio-demographic status remained.
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| 13. |
- Costa Storti, Claudia, et al.
(författare)
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The Double Effect of COVID-19 Confinement Measures and Economic Recession on High-Risk Drug Users and Drug Services.
- 2021
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Ingår i: European Addiction Research. - : S. Karger. - 1022-6877 .- 1421-9891. ; 27, s. 239-241
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The ongoing COVID-19 pandemic is likely to have a profound impact on the lives of high-risk drug users and on the services responding to their needs in at least two important ways: first, through the restrictive measures introduced to mitigate the spread of the virus and, second, as a result of extensive economic downturn. Currently there is great uncertainty as to the future intensity and duration of the pandemic. In addition, the lessons we have been able to learn from previous economic downturns may be of limited applicability to the current situation, which differs in a number of significant respects. Experience nevertheless suggests that the potential consequences for drug users' health and well-being may be severe. The ongoing uncertainty serves to underline the importance of close monitoring of the drug situation and preparing flexible and innovative solutions to be able to meet new challenges which may arise.
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| 14. |
- Crunelle, CL, et al.
(författare)
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International Consensus Statement on Screening, Diagnosis and Treatment of Substance Use Disorder Patients with Comorbid Attention Deficit/Hyperactivity Disorder
- 2018
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 24:1, s. 43-51
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Tidskriftsartikel (refereegranskat)abstract
- Adult attention deficit/hyperactivity disorder (ADHD) often co-occurs with substance use disorders (SUD) and is associated with early onset and more severe development of SUD and with reduced treatment effectiveness. Screening tools allow for a good recognition of possible ADHD in adults with SUD and should be used routinely, followed by an ADHD diagnostic process initiated as soon as possible. Simultaneous and integrated treatment of ADHD and SUD, using a combination of pharmaco- and psychotherapy, is recommended. Long-acting methylphenidate, extended-release amphetamines, and atomoxetine with up-titration to higher dosages may be considered in patients unresponsive to standard doses. This paper includes evidence- and consensus-based recommendations developed to provide guidance in the screening, diagnosis and treatment of patients with ADHD-SUD comorbidity.
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| 15. |
- Czobor, Pal, et al.
(författare)
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The European Adolescent Assessment Dialogue (EuroADAD) : A Psychometric Evaluation
- 2011
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 17:6, s. 302-315
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Adolescent Drug Abuse Diagnosis (ADAD) has been a gold standard for assessing drug use and associated problems in adolescents. Criticism of the instrument has been increasing. A new instrument, the European Adolescent Assessment Dialogue (EuroADAD) that builds on ADAD's strengths but seeks to address its limitations is now available, but has not been subjected to comprehensive psychometric evaluation. Objective: To examine the psychometric properties of the EuroADAD across various settings in adolescent populations who developed or were at a high risk of developing substance use and psychosocial adaptation problems. Participants and Settings: Three of the samples were collected in Hungary, including: institutionalized youths from juvenile residential facility (n = 295); adolescents from outpatient psychiatry facility (n = 278), and controls (n = 59). An additional sample was collected in the Netherlands, and consisted of adolescent boys from an independent residential institution for youth with severe behavioral problems (n = 51). Procedure: The EuroADAD was administered by trained interviewers. Data were collected through face-to-face interviews and self-report questionnaires. Results: Reliability: the intraclass correlation was high for all domains of the EuroADAD; reliability analyses indicated good test-retest reliability, and internal consistency. Validity: difference among study samples was significant (p < 0.05) for the majority of the domains, with juvenile institution and psychiatric outpatient subjects exhibiting higher severity in most areas compared to controls. The Hungarian and Dutch samples were comparable, expect for the legal domain, due to the higher severity of behavioral problems in the Dutch sample. Several domains of the instrument, including 'alcohol', 'drugs' and 'legal' showed an association with trait aggression as measured by the Buss-Perry Aggression Questionnaire and with Novelty Seeking on the Cloninger Temperament and Character Inventory. Conclusion: Based on the pattern and significance of group differences, and correlations with other measures, the scale has good criterion, and convergent and discriminant construct validity. The EuroADAD is a reliable and valid tool for the assessment of alcohol and drug use, and related psychosocial problems in adolescents.
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| 16. |
- Ekendahl, Mats
(författare)
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Will and Skill : An Exploratory Study of Substance Abusers´ Attitudes towards Lifestyle Change
- 2007
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 13:3, s. 148-155
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: This exploratory study focus attitudes towards lifestyle change among untreated, voluntarily and compulsorily treated Swedish substance abusers (n=97). Methods: Attitudes were measured with scales on e.g. problem recognition, treatment readiness and the time perspective of future orientation. Subjects were categorised into four ‘addict-types’ according to their viewpoint on changing substance use habits, i.e. ‘less change willing’: non-addicts (n=16) and consonant addicts (n=32); ‘more change willing’: dissonant (n=13) and transient addicts (n=36). Results: It was shown that ‘less change willing’ subjects had experienced less dependence disorders and expressed less treatment demand and motivation than ‘more change willing’ subjects. A general measure of willingness to lifestyle change correlated with future orientation among ‘more change willing’ subjects. Conclusions: The study suggests that individuals’ time perspectives ought to be considered when trying to illuminate the process of change and understand what attitudes exercise positive influence on and are associated with successful lifestyle change-efforts. The consistency of substance abusers’ motivational structures over time and in different social contexts is discussed.
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| 17. |
- Frick, Ulrich, et al.
(författare)
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Average volume of alcohol consumption, drinking patterns and related burden of mortality in young people in established market economies in Europe
- 2001
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 7:3, s. 148-151
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine the burden of mortality in young people (age 15-29) in established market economies in Europe in 1999, which is attributable to alcohol consumption. Two dimensions of alcohol consumption were considered: average volume of consumption, and patterns of drinking.METHODS:Mortality data were obtained from the WHO EIP data bank, average volume data from the WHO global databank on alcohol, pattern of drinking data from a questionnaire sent out to experts, from the published literature and from the WHO global databank. Methods are explained and discussed in detail in two other contributions to this volume.RESULTS:More than 8,000 deaths of people aged 15-29 in Europe in 1999 were attributable to alcohol. Young males show a higher proportion of alcohol-attributable deaths (12.8%) than females (8.3%). Both average volume and patterns of drinking contribute to alcohol-related death.CONCLUSIONS:Alcohol-related deaths constitute a considerable burden in young people in Europe.
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| 18. |
- Gonzalez, RA, et al.
(författare)
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Onset and Severity of Early Disruptive Behavioral Disorders in Treatment-Seeking Substance Use Disorder Patients with and without Attention-Deficit/Hyperactivity Disorder
- 2020
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 26:4-5, s. 211-222
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Aims:</i></b> This study addressed the age of onset of conduct disorder (CD) and oppositional defiant disorder (ODD) in treatment-seeking substance use disorder (SUD) patients with and without adult attention-deficit/hyperactivity disorder (ADHD) and its association with early onset of SUD. <b><i>Methods:</i></b> We examined data from the 2nd <i>International ADHD in Substance Use Disorders Prevalence Study</i>, including 400 adults in SUD treatment from Puerto Rico, Hungary, and Australia. ADHD, SUD, and CD/ODD were assessed with the <i>Conners Adult ADHD Diagnostic Interview for DSM-IV</i>, the <i>MINI International Neuropsychiatric Interview</i>, and the K-SADS, respectively. Cox regression analyses modeled time to emergence of CD/ODD separately for SUD patients with and without adult ADHD. Linear regression models examined associations between age of onset of SUD and presence of ADHD and adjusted for sex, age, and country. To assess the mediating role of CD/ODD on the association of ADHD with onset of SUD, adjusted regression models were estimated. <b><i>Results:</i></b> Treatment-seeking SUD patients with ADHD presented an earlier onset of CD/ODD compared with those without ADHD. CD/ODD symptom loads were higher among the SUD and ADHD group. Age of first substance use and SUD were significantly earlier in SUD patients with ADHD, and these findings remained significant after adjustment for demographics and coexisting CD/ODD. <b><i>Conclusions:</i></b> ADHD is associated with earlier onset of SUD as well as with an earlier onset of more frequent and more severe disruptive behavioral disorders. These findings may inform preventive interventions to mitigate adverse consequences of ADHD.
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| 19. |
- Grabski, M, et al.
(författare)
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Drug Use Changes at the Individual Level: Results from a Longitudinal, Multisite Survey in Young Europeans Frequenting the Nightlife Scene
- 2022
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 28:2, s. 155-160
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- <b><i>Background:</i></b> Monitoring emerging trends in the increasingly dynamic European drug market is vital; however, information on change at the individual level is scarce. In the current study, we investigated changes in drug use over 12 months in European nightlife attendees. <b><i>Method:</i></b> In this longitudinal online survey, changes in substances used, use frequency in continued users, and relative initiation of use at follow-up were assessed for 20 different substances. To take part, participants had to be aged 18–34 years; be from Belgium, Italy, the Netherlands, Sweden, or the UK; and have attended at least 6 electronic music events in the past 12 months at baseline. Of 8,045 volunteers at baseline, 2,897 completed the survey at both time points (36% follow-up rate), in 2017 and 2018. <b><i>Results:</i></b> The number of people using ketamine increased by 21% (<i>p</i> < 0.001), and logarithmized frequency of use in those continuing use increased by 15% (<i>p</i> < 0.001; 95% CI: 0.07–0.23). 4-Fluoroamphetamine use decreased by 27% (<i>p</i> < 0.001), and logarithmized frequency of use in continuing users decreased by 15% (<i>p</i> < 0.001, 95% CI: −0.48 to −0.23). The drugs with the greatest proportion of relative initiation at follow-up were synthetic cannabinoids (73%, <i>N</i> = 30), mephedrone (44%, <i>N</i> = 18), alkyl nitrites (42%, <i>N</i> = 147), synthetic dissociatives (41%, <i>N</i> = 15), and prescription opioids (40%, <i>N</i> = 48). <b><i>Conclusions:</i></b> In this European nightlife sample, ketamine was found to have the biggest increase in the past 12 months, which occurred alongside an increase in frequency of use in continuing users. The patterns of uptake and discontinuation of alkyl nitrates, novel psychoactive substances, and prescription opioids provide new information that has not been captured by existing cross-sectional surveys. These findings demonstrate the importance of longitudinal assessments of drug use and highlight the dynamic nature of the European drug landscape.
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| 20. |
- Grittner, Ulrike, et al.
(författare)
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Changes in Alcohol Consumption in Denmark after the Tax Reduction on Spirits
- 2009
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Ingår i: European Addiction Research. - Basel : Karger AG. - 1022-6877 .- 1421-9891. ; 15:4, s. 216-223
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This paper examines changes in alcohol consumption in Denmark between 2003 and 2006 after the excise tax on spirits in Denmark was lowered by 45% on October 1, 2003 and travelers' allowances for the import of alcohol were increased on January 1, 2004. Methods: Cross-sectional and panel data from Denmark from 2003 to 2006 were analyzed. Samples were collected by telephone interviews using random digit dialing. Results: Panel data for Denmark revealed that alcohol consumption remained relatively stable. Similar results were found in the Danish cross-sectional data. It appears that 'substitution' rather than increased importation occurred. Conclusion: We found no evidence to support earlier research stating that decreased prices and increased availability is related to higher alcohol consumption. This could be partly because (1) Denmark has reached a 'saturation' level of consumption over the past 30 years and (2) the survey mode of data collection did not capture specific subpopulations who might have increased their consumption. It may be necessary to examine other indicators of alcohol use or alcohol-related harm in order to fully assess the consequences of such changes in alcohol availability.
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| 21. |
- Gundersen, OH, et al.
(författare)
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Evaluation of the alcohol use disorders identification test and the drug use disorders identification test among patients at a Norwegian psychiatric emergency ward
- 2013
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 19:5, s. 252-260
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Tidskriftsartikel (refereegranskat)abstract
- High rates of substance use disorders (SUD) among psychiatric patients are well documented. This study explores the usefulness of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) in identifying SUD in emergency psychiatric patients. Of 287 patients admitted consecutively, 256 participants (89%) were included, and 61-64% completed the questionnaires and the Mini-International Neuropsychiatric Interview (MINI), used as the reference standard. Both AUDIT and DUDIT were valid (area under the curve above 0.92) and reliable (Cronbach's alpha above 0.89) in psychotic and nonpsychotic men and women. The suitable cutoff scores for AUDIT were higher among the psychotic than nonpsychotic patients, with 12 versus 10 in men and 8 versus 5 in women. The suitable cutoff scores for DUDIT were 1 in both psychotic and nonpsychotic women, and 5 versus 1 in psychotic and nonpsychotic men, respectively. This study shows that AUDIT and DUDIT may provide precise information about emergency psychiatric patients' problematic alcohol and drug use.
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| 22. |
- Gustafsson, Nina-Katri, 1976-
(författare)
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Alcohol consumption in southern Sweden after major decreases in Danish spirits tax and increases in Swedish traveller's quotas
- 2010
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Ingår i: European Addiction Research. - Basel : S. Karger AG. - 1022-6877 .- 1421-9891. ; 16:4, s. 152-161
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Tidskriftsartikel (refereegranskat)abstract
- Background. In 2003, Denmark lowered its tax on spirits, and in 2004, Sweden increased its traveller import quotas. Aim. The aim was to determine whether these two changes increased self-reported alcohol consumption in southern Sweden, which is located near to Denmark. Method. Data were collected through telephone interviews with the general population between 2003 and 2006. People aged 16-80 years were interviewed. Some lived in southern Sweden, others in the northern region, which was assumed to be unaffected by the policy changes and thus used as a control site. Analyses were performed for the total population as well as by sex, age, socio-economic group and by consumption pattern. Results. The expected results were not found; alcohol consumption in southern Sweden had not changed. The few statistically significant changes found in southern Sweden indicated decreases. In the north, however, consumption seemed to have increased. Conclusion. In addition to the two policy changes mentioned above, other changes seem to have affected alcohol consumption in Sweden. It is possible, however, that the policy changes have affected population groups not reached by surveys, and thus other types of data need to be analysed before drawing any far-reaching conclusions.
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| 23. |
- Guterstam, J, et al.
(författare)
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The Hypothesis of Subliminal Cue Reactivity in Addiction Revisited: An fMRI Study
- 2022
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 28:3, s. 210-219
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Introduction:</i></b> Exposure to conditioned cues is a common trigger of relapse in addiction. It has been suggested that such cues can activate motivationally relevant neurocircuitry in individuals with substance use disorders even without being consciously perceived. We aimed to see if this could be replicated in a sample with severe amphetamine use disorder and a control group of healthy subjects. <b><i>Methods:</i></b> We used fMRI to test the hypothesis that individuals with amphetamine use disorder, but not healthy controls, exhibit a specific neural reactivity to subliminally presented pictures related to amphetamine use. Twenty-four amphetamine users and 25 healthy controls were recruited and left data of sufficient quality to be included in the final analysis. All subjects were exposed to drug-related and neutral pictures of short duration (13.3 ms), followed by a backward visual mask image. The contrast of interest was drug versus neutral subliminal pictures. <b><i>Results:</i></b> There were no statistically significant differences in BOLD signal between the drug and neutral cues, neither in the limbic regions of primary interest nor in exploratory whole-brain analyses. The same results were found both in amphetamine users and controls. <b><i>Discussion/Conclusion:</i></b> We found no evidence of neural reactivity to subliminally presented drug cues in this sample of subjects with severe amphetamine dependence. These results are discussed in relation to the earlier literature, and the evidence for subliminal drug cue reactivity in substance use disorders is questioned.
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| 24. |
- Gyepesi, Aron, et al.
(författare)
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Psychometric Properties of the Cannabis Abuse Screening Test in Hungarian Samples of Adolescents and Young Adults
- 2014
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 20:3, s. 119-128
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of our study was to analyze psychometric properties of the Cannabis Abuse Screening Test (CAST). Methods: Our sample comprised Hungarian high school (n = 476; male 56.3%; mean age 19.0 years, SD = 0.65 years) and college students (n = 439; male 65.1%; mean age 23.9 years, SD = 1.56 years) who reported cannabis use in the past year. The sample covered the five biggest universities of Hungary. Besides the CAST, participants responded to the Munich-Composite International Diagnostic Interview. Factor structure was analyzed by a confirmatory factor analysis. Receiver operating characteristic curve analysis was made to assess cut-off scores. Data collection took place in 2010. Results: CAST proved to be a reliable (Cronbach's alpha 0.71 and 0.76) one-dimensional measure. Regarding both cannabis dependence and cannabis use disorders, a cut-off of 2 points proved to be ideal in both samples, resulting in optimal specificity, negative predictive values and accuracy, but less than optimal positive predictive values (dependence) and low sensitivity (cannabis use disorder). Discussion and Conclusions: In line with former results, the CAST proved to be an adequate measure for the screening of cannabis-related problems among adolescents and young adults in an Eastern European country where this scale has not been studied before. (C) 2013 S. Karger AG, Basel
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| 25. |
- Haasen, C., et al.
(författare)
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Cocaine use in Europe - a multi-centre study : Methodology and prevalence estimates
- 2004
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Ingår i: European Addiction Research. - 1022-6877 .- 1421-9891. ; 10:4, s. 139-146
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Tidskriftsartikel (refereegranskat)abstract
- An increase in the use of cocaine and crack in several parts of Europe has raised the question whether this trend is similar to that of the USA in the 1980s. However, research in the field of cocaine use in Europe has been only sporadic. Therefore, a European multi-centre and multi-modal project was designed to study specific aspects of cocaine and crack use in Europe, in order to develop guidelines for public health strategies. Data on prevalence rates were analysed for the general population and for specific subgroups. Despite large differences between countries in the prevalence of cocaine use in the general population, most countries show an increase in the last few years. The highest rate with a lifetime prevalence of 5.2% was found for the United Kingdom, although with a plateau effect around the year 2000. With regard to specific subgroups, three groups seem to show a higher prevalence than the general population: (1) youth, especially in the party scene; (2) socially marginalized groups, such as homeless and prostitutes or those found in open drug scenes; (3) opiate-dependent patients in maintenance treatment who additionally use cocaine. Specific strategies need to be developed to address problematic cocaine use in these subgroups.
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| 26. |
- Hallgren, M, et al.
(författare)
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Anti-Social Behaviors Associated with Anabolic-Androgenic Steroid Use among Male Adolescents
- 2015
-
Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 21:6, s. 321-326
-
Tidskriftsartikel (refereegranskat)abstract
- Anabolic-androgenic steroids (AAS) have been linked to a range of problematic behaviors, but AAS use is still sometimes portrayed as more benign than other forms of classical drug abuse. To address this issue, we compared the prevalence of anti-social behaviors among adolescent AAS users, non-AAS illicit drug users, and drug non-users. We examined 3 waves (2004, 2008, and 2012) of self-reported cross-sectional data from a secondary school survey conducted in Stockholm, Sweden (total n = 19,773; response percentage, 79.6%). Across all survey years, the risk ratios for virtually all measured anti-social behaviors were significantly higher among AAS users compared to non-AAS illicit drug users and to drug non-users.
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| 27. |
- Hansagi, Helen, et al.
(författare)
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Predictors of Repeated Emergency Department Visits among Persons Treated for Addiction
- 2012
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 18:2, s. 47-53
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: To determine whether frequent emergency department (ED) users who enter specialized treatment programs for alcohol and/or drug problems have any characteristics that predict their future ED use. Methods: Adult patients (783 alcohol users, 405 illicit drug users) were interviewed. Data from the medical database on utilization of ED and the emergency departments' specific units for addictive diseases (EDAD) 12 months before and 12 months after the interview were linked with patient characteristics in logistic regression models. Results: Among alcohol users, prior ED/EDAD visits predicted repeat future visits to these sites (OR 11.6; 95% CI 6.5-20.5). Prior inpatient hospital care with addiction diagnosis was a predictor of future multiple visits to the EDAD only (OR 3.1; 95% CI 1.5-6.5). Among drug users, predictors of future ED/EDAD visits were use of heroin (OR 2.7; 95% CI 1.4-5.4) and prior ED/EDAD visits (OR 27.3; 95% CI 12.7-58.4). Drug users' EDAD utilization was also predicted by inpatient hospital care with addiction diagnosis. Conclusion: The strongest predictive factors of visiting ED repeatedly were previous repeat emergency care use and hospitalization with addiction diagnosis. Entering regular addiction treatment does not appear to alter the pattern of ED utilization.
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| 28. |
- Haver, B
(författare)
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Comorbid psychiatric disorders predict and influence treatment outcome in female alcoholics
- 2003
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Ingår i: European addiction research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 9:1, s. 39-44
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Tidskriftsartikel (refereegranskat)abstract
- Drinking patterns, psychiatric comorbidity and personality disorders (PD) at intake and at a 2-year follow-up were studied in 120 female alcoholics early in their treatment career. At follow-up, the women had improved their drinking patterns, but their mental health still differed significantly from women of the general population. Psychiatric comorbidity at intake correlated with a significantly worse drinking and mental health outcome. Subjects with high scores on phobias more frequently dropped out of treatment and thereby had a worse drinking outcome. Subjects with depression at follow-up also had a poorer drinking outcome, as well as subjects with schizoid PD. When tested by multivariate analyses, only depression at follow-up contributed significantly to the increased explained variance in drinking outcome when controlling for drinking pattern and treatment duration.
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| 29. |
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| 30. |
- Hiltunen, AJ, et al.
(författare)
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Withdrawal from methadone maintenance treatment. Reasons for not trying to quit methadone
- 2002
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Ingår i: European addiction research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 8:1, s. 38-44
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Tidskriftsartikel (refereegranskat)abstract
- Although factors associated with successful termination of methadone maintenance treatment (MMT) have been well studied, the question of why certain methadone patients try to taper off methadone while others do not is still unanswered. Those patients who wish to continue MMT should of course be allowed to stay in treatment. However, even if only a small portion of the MMT patients wish to quit maintenance treatment, they should be offered all possible support by the treatment staff to maximize the possibility of a successful outcome. In the present study, we compared two groups of well-functioning MMT patients with respect to background factors, methadone-related factors, drug-related factors and psychological characteristics: one group consisted of patients who were trying to terminate their MMT (group 1) and the other group consisted of patients who were not trying (group 2). Each of the groups contained 25 well-rehabilitated subjects matched by age, gender and the number of years in MMT. The results show that the patients who were not trying to terminate MMT (in comparison to group 1) were not influenced by others to try to quit methadone, had a long history of opiate use as well as mixed drug use prior to MMT, had a higher methadone dose and reported a lower degree of anticipated abstinence symptoms. According to the statements of the subjects in group 2, the most important reason for not quitting treatment was the belief that they needed the methadone. The fact that they knew others who had failed to quit MMT and low confidence in succeeding were other common answers. Further, our results suggest that patients who were satisfied with their overall drug situation were less inclined to make a withdrawal attempt.
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| 31. |
- Holma, Kari, et al.
(författare)
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Perceptions of Addictions as Societal Problems in Canada, Sweden, Finland and St. Petersburg, Russia
- 2011
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 17:2, s. 106-112
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This study reports on the relative gravity people attribute to various addictive behaviors with respect to other societal concerns in four northern populations with different history, social policy and treatment alternatives for addicted individuals. Methods: Random population surveys were conducted in Canada, Sweden, Finland and St. Petersburg, Russia. In Finland and Sweden, the survey was conducted by mail, in Canada and St. Petersburg by phone. As a part of this survey, the respondents were asked to assess the gravity of various societal problems, some of which involved various addictive behaviors. The data were analyzed by descriptive statistical methods, factor analysis, contextual analysis and multiple regression analysis. Results: Hard drugs, criminality and environmental issues belonged to the topmost problems in all data samples. Overall, Finns and Canadians appeared the least worried about various societal problems, Swedes seemed the most worried and St. Petersburgian views were the most polarized. Two factors were extracted from the combined data. Factor 1 covered criminal behavior and various addictions; it was named Threats to Safety factor. Factor 2 comprised social equality issues. The country context explained 12.5% of the variance of the safety factor and 7.9% of the equality factor. Conclusions: Despite some cultural variation in the gravity assessments, the central core of the social representation of addictive behaviors tends still to be linked with 'badness' since they were mainly grouped with various forms of criminal behavior in all these countries.
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| 32. |
- Håkansson, Anders C, et al.
(författare)
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Anabolic Androgenic Steroids in the General Population: User Characteristics and Associations with Substance Use.
- 2012
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Ingår i: European Addiction Research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 18:2, s. 83-90
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To analyse correlates of anabolic androgenic steroids (AAS) use in the general male population. Design: A national household survey. Participants: Individuals aged 15-64 years in Sweden. Measurements: AAS use and potential correlates of AAS use, including demographic data, financial situation, physical training, and substance use. In hierarchical logistic regression analyses, lifetime users of AAS (n = 240) were compared to all nonusers (n = 13,920) and to nonusers who reported that they had been offered AAS (n = 487). Results: AAS use was most strongly associated with a lifetime history of illicit drug use and the misuse of prescription drugs. When controlling for substance use, AAS was associated with physical training and lower education. Illicit drug use and misuse of prescription drugs separated AAS users from nonusers who had been offered AAS. No associations were seen with AUDIT scores for risk alcohol drinking. Conclusions: In this general population survey in men, lifetime use of AAS appears to share common characteristics with illicit substance use. Both substance use variables and physical training remained associated with AAS use when controlling for one another.
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| 33. |
- Håkansson, Anders C, et al.
(författare)
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Buprenorphine misuse among heroin and amphetamine users in malmo, Sweden: Purpose of misuse and route of administration
- 2007
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Ingår i: European Addiction Research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 13:4, s. 207-215
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Tidskriftsartikel (refereegranskat)abstract
- Buprenorphine misuse by injecting drug users was assessed in a survey of 350 needle exchangers, either amphetamine (57%) or heroin users (42%). 89% of heroin users and 24% of amphetamine users reported using buprenorphine at some time during the previous year. Most users reported illicit acquisition. Among illicit users, 87% of heroin users reported intake for withdrawal treatment or self-detoxification, and 11% for euphoria. Euphoria seeking was more common among amphetamine users (62%, p < 0.001). Intravenous misuse was reported by 43% of illicit users, and snorting by 29%. Sole sublingual intake was more common among heroin users than among amphetamine users (46 vs. 20%, p < 0.05), and less common among patients reporting euphoria seeking (20 vs. 46%, p < 0.05).
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| 34. |
- Håkansson, Anders C, et al.
(författare)
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Characteristics of primary amphetamine users in Sweden: a criminal justice population examined with the Addiction Severity Index.
- 2009
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Ingår i: European Addiction Research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 15:1, s. 10-18
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: Characteristics of primary amphetamine, heroin and cocaine users were compared in a criminal justice population. METHODS: 7,085 clients with suspected or reported substance use were studied using the Addiction Severity Index. Variables separating amphetamine, heroin and cocaine users were analyzed in stepwise logistic regression. RESULTS: There were considerably more primary amphetamine users (n = 1,396) than heroin (n = 392) and cocaine (n = 119) users. Amphetamine users were older, a more rural population, and less likely to be non-Nordic immigrants. Compared with heroin, amphetamine use was associated with older age, Nordic origin, nonurban residence, memory/concentration problems, parental alcohol problems, and less history of other opioid use, overdose and detoxification. Compared with cocaine, amphetamine use was associated with older age, Nordic origin, nonurban residence, injecting, tobacco and institution treatment. Overlap of drug use between groups was relatively uncommon. CONCLUSION: This pattern of amphetamine use, common among Swedish criminals, has relatively distinct boundaries from heroin and cocaine use, commonly involves injecting, and differs from other countries. Psychiatric problems and alcohol heredity were common, and evidence-based treatment for amphetamine users is needed. The connection between amphetamine use and criminal behavior is insufficiently understood and should be further addressed.
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| 35. |
- Israelsson, Magnus, et al.
(författare)
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Compulsory commitment to care of substance misusers - international trends during 25 years
- 2012
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Ingår i: European Addiction Research. - Basel : S. Karger. - 1022-6877 .- 1421-9891. ; 6:18, s. 302-321
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Tidskriftsartikel (refereegranskat)abstract
- Purpose:The study explores international trends in law on compulsory commitment to care of substance misusers (CCC), and two subtypes – civil CCC and CCC within criminal justice legislation – as well as maximum length and amount of applications of such care. Method: The time period covers more than 25 years, and a total of 104 countries and territories. The study is based on available data in three times of observation (1986, 1999 and 2009). Applications of CCC in number of cases are studied on European level for the years 2002–2006. Trends are analyzed using nonparametric tests and general linear models for repeated measures. Findings are discussed from contextual analysis. Result: There is a trend towards decrease in the number of countries worldwide having civil CCC legislation after the millennium, while CCC under criminal law has increased since the mid-1980s, resulting in some total net decrease. The shift results in longer mean duration of CCC and an increase in the number of cases sentenced. Conclusion: There is a risk that the shift from civil CCC to penal CCC implies more focus on young outacting males in compulsory treatment and that the societal responsibility for more vulnerable persons might be neglected.
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| 36. |
- Israelsson, Magnus, 1967-
(författare)
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Welfare, temperance and compulsory commitment to care for persons with substance misuse problems: a comparative study of 38 European countries
- 2011
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 17:6, s. 329-341
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The study explores the existence and types of law on compulsory commitment to care (CCC) of adult substance misusers in Europe and how such laws are related to variations in demographics, alcohol consumption and epidemiology in misuse of opiates, cocaine, amphetamines, temperance culture heritage, health and welfare expenditure, and involvement and role of the state in welfare distribution. Material and Methods: Legal information on laws on CCC of misusers was obtained primarily through a survey of 38 European countries. Predictors of laws on CCC, and types of such, were analyzed from country descriptors in multivariate models. Results: A majority (74%) of the explored countries have a law concerning CCC. The most common type of CCC law is within criminal justice legislation (45%), but civil CCC is almost as frequent (37%). These two models of CCC legislation are related to differences in cultural heritage and welfare distribution models. Conclusions: Temperance cultures, i.e. countries with a history of a strong temperance movement, and countries with a Beveridgean distribution of welfare, i.e. through the state, tend to favor civil CCC, while countries with a Bismarckian distribution of welfare, i.e. through insurance with less state interference, tend to favor CCC within criminal justice legislation.
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| 37. |
- Jenner, Håkan, et al.
(författare)
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The Swedish DOC System : An attempt to combine documentation and self-evaluation
- 2005
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Ingår i: European Addiction Research. - 1022-6877 .- 1421-9891. ; 11:4, s. 186-192
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Tidskriftsartikel (refereegranskat)abstract
- This article addresses the issue of how documentation can become a regular and competence-raising activity in treatment settings. A documentation system in Sweden (the DOC system) is used as an illustrative example. Two propositions are put forward and discussed: it is important that (i) the documentation be in accordance with the interests of the practitioners, and (ii) that the documentation be used for self-evaluation, in order to enhance practitioners’ competence. Based on experiences using the DOC system, some general observations about how to implement the forms and self-evaluation are presented. Finally, some research prospects are outlined.
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| 38. |
- Johnsson, Kent, et al.
(författare)
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College students' drinking patterns: trajectories of AUDIT scores during the first four years at university.
- 2008
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Ingår i: European Addiction Research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 14:1, s. 11-18
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Changes in AUDIT score trajectories were examined in a student population during their first 4 years at a university, including high-risk consumers and a subsample of low-risk consumers. METHOD: 359 students were selected for the present study, comprising all high-risk consumers (the 27% with highest scores, i.e. 11 for males and 7 for females) and a randomized sample of low-risk consumers (n = 177 and 182, respectively). The Alcohol Use Disorder Identification Test (AUDIT) was used as screening instrument. Trajectory analyses were made using a semiparametric group-based model. RESULTS: In the low-AUDIT group, five distinct trajectories were identified: three stable non-risky consumption groups (83%) and two increasing groups (17%; from non-risky to risky). In the high-AUDIT group, three groups were identified: two stable high groups (58%) and one decreasing group (from risky to non-risky consumption; 41%). In the integrated model, stable risky consumption comprised 16% of the total sample, decreasing consumption 11%, increasing consumption comprised 13% and stable non-risky consumption 60% of the sample. Gender influenced the trajectories. CONCLUSION: The pattern of changes in risk consumption is similar to that found in corresponding US studies.
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| 39. |
- Kallmen, Hakan, et al.
(författare)
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Alcohol Habits in Sweden during 1997-2009 with Particular Focus on 2005 and 2009, Assessed with the AUDIT : A Repeated Cross-Sectional Study
- 2011
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 17:2, s. 90-96
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study aimed to survey the changes in alcohol habits during a period with the European Union legal practices. Methods: Alcohol habits in Sweden were surveyed in the general Swedish population at four timepoints, in 1997, 2001, 2005 and 2009, using the 10-item AUDIT questionnaire. Design: Four separate randomly drawn cross-sectional samples of 1,250 individuals were surveyed at each timepoint. Results: An average of 70% of the sampled individuals responded to the AUDIT questionnaire. Men had higher total AUDIT scores than women in 2005 and 2009, but scores increased among women 61-71 years old and decreased among men 61-71 years old. Younger men and women 17-27 years old decreased their AUDIT-C consumption scores by almost 20% between 2005 and 2009. An analysis of problem drinkers (+8 for men/+6 for women) indicated that a larger proportion of elderly women drank moderately in 2009 compared with 2005, but fewer elderly women drank hazardously. Conclusions: Earlier increases in drinking levels between 1997 and 2001 may reflect a latent high demand that was restricted by low availability. When availability due to European Union harmonization increased, alcohol consumption followed suit. After a period of adaptation, alcohol consumption appears to have stabilized.
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| 40. |
- Kallmen, H, et al.
(författare)
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Psychometric Properties of the AUDIT, AUDIT-C, CRAFFT and ASSIST-Y among Swedish Adolescents
- 2019
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 25:2, s. 68-77
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background/Aims:</i></b> Not enough is known about the psychometric properties of screening instruments for problematic alcohol consumption among adolescents. The aim of the current study was to evaluate and compare the performance of the screening instruments: Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, CRAFFT, and the alcohol domain of Alcohol, Smoking and Substance Involvement Screening Test-Youth (ASSIST-Y) among adolescents and to suggest optimal cut-offs indicating problematic use. <b><i>Methods:</i></b> Data was collected from a general population sample (<i>n</i> = 1,421) and a treatment-seeking sample (<i>n</i> = 59) using electronic versions of the instruments. <b><i>Results:</i></b> The internal consistencies for the instruments were fair (alpha’s AUDIT 0.74, AUDIT-C 0.75, CRAFFT 0.67, ASSIST-Y 0.62), and test-retest reliabilities were good to excellent (intraclass correlation coefficients AUDIT 0.86, AUDIT-C 0.93, CRAFFT 0.77, ASSIST-Y 0.63). The CRAFFT and ASSIST-Y demonstrated reasonable construct validities while factor solutions for AUDIT and AUDIT-C could not be determined. The optimal cut-off score was 2 for both CRAFFT and ASSIST-Y (61 and 73% sensitivities and 79 and 65% specificities, respectively), while sensitivity scores were poor for AUDIT and AUDIT-C. <b><i>Conclusion:</i></b> Based on the current sample, ASSIST-Y and the CRAFFT performed better than AUDIT and AUDIT-C. Health-care clinics working with adolescents should carefully consider their choice of screening instruments.
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| 41. |
- Khemiri, L, et al.
(författare)
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Family History of Alcohol Abuse Associated with Higher Impulsivity in Patients with Alcohol Use Disorder: A Multisite Study
- 2020
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 26:2, s. 85-95
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Alcohol use disorder (AUD) is to a high degree heritable, and in clinical practice it is common to assert presence of alcohol abuse family history (FH) in treatment-seeking AUD patients. Patients with AUD also exhibit cognitive deficits, including elevated impulsivity and impairments in executive functions (EF), but less is known regarding the relation between FH and these cognitive domains. The aim of the current study was to investigate if alcohol abuse FH in AUD patients is associated with a specific cognitive profile. <b><i>Methods:</i></b> Patients with AUD (<i>n</i> = 197) from Sweden (<i>n</i> = 106) and Belgium (<i>n</i> = 91) were recruited. Self-rated impulsivity was assessed by the Barratt Impulsiveness Scale (BIS). EF assessed were response inhibition (stop signal task), attention (rapid visual processing task), and working memory (digit span). A series of linear regression models were run to explore the effect of FH on cognitive outcomes. <b><i>Results:</i></b> A FH of alcohol abuse was associated with elevated score in self-rated impulsivity assessed by the BIS, with the greatest effect on the subscale of nonplanning. There was no statistically significant association between FH and any of the other neuropsychological task outcomes. <b><i>Conclusion:</i></b> Presence of alcohol abuse FH within AUD patients could be a marker of higher impulsivity, which may have clinical implications regarding diagnostic evaluation and treatment.
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| 42. |
- Kraus, Ludwig, et al.
(författare)
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Temporal Changes in Alcohol-Related Morbidity and Mortality in Germany
- 2015
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 21:5, s. 262-272
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Trends in morbidity and mortality, fully or partially attributable to alcohol, for adults aged 18-64 were assessed for Germany. Methods: The underestimation of population exposure was corrected by triangulating survey data with per capita consumption. Alcohol-attributable fractions by sex and two age groups were estimated for major disease categories causally linked to alcohol. Absolute numbers, population rates and proportions relative to all hospitalizations and deaths were calculated. Results: Trends of 100% alcohol-attributable morbidity and mortality over thirteen and eighteen years, respectively, show an increase in rates of hospitalizations and a decrease in mortality rates. Comparisons of alcohol-attributable morbidity including diseases partially caused by alcohol revealed an increase in hospitalization rates between 2006 and 2012. The proportion of alcohol-attributable hospitalizations remained constant. Rates of alcohol-attributable mortality and the proportion among all deaths decreased. Conclusions: The increasing trend in mortality due to alcohol until the mid-1990s has reversed. The constant proportion of all hospitalizations that were attributable to alcohol indicates that factors such as improved treatment and easier health care access may have influenced the general increase in all-cause morbidity. To further reduce alcohol-related mortality, efforts in reducing consumption and increasing treatment utilization are needed.
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| 43. |
- Kuendig, H, et al.
(författare)
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Beyond drinking: differential effects of demographic and socioeconomic factors on alcohol-related adverse consequences across European countries
- 2008
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 14:3, s. 150-160
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background/Aims:</i> Evidence underlines the importance of drinking patterns and individual characteristics in experiencing adverse alcohol-related consequences; however, little research has been conducted to explore who does and who does not experience consequences with similar drinking patterns. Using data from seven European countries, this study assesses the association between demographic and socioeconomic characteristics and six adverse consequences. <i>Methods:</i> Conditional logistic regression models were estimated, cases (experiencing a consequence) being matched to controls (not experiencing the consequence) by drinking patterns. <i>Results:</i> In general, protective effects with increasing age and being in a partnership were consistent. Gender effects were mixed, but mainly protective for women. Educational achievement and economic status showed consistent effects across countries, but different directions of effect across consequences. Consequences mostly associated with individual drinking pattern <i>(injury, blackout</i>, and <i>loss of control over drinking)</i> exhibited similar patterns of associations, but varying ones arose for consequences additionally influenced by societal reaction to drinking <i>(guilt</i>, <i>role failure</i>, and <i>pressure to cut down drinking)</i>. <i>Conclusion:</i> Differences in strengths and directions of effects across consequences pointed to the possibility that the reporting of adverse consequences is not only influenced by alcohol consumption, but also by attributional processes related to demographic and socioeconomic statuses.
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| 44. |
- Landberg, Jonas, 1974-
(författare)
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Population drinking and fatal injuries in Eastern Europe : A time-series analysis of six countries
- 2010
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 16:1, s. 43-52
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To estimate to what extent injury mortality rates in 6 Eastern European countries are affected by changes in population drinking during the post-war period. Data and Methods: The analysis included injury mortality rates and per capita alcohol consumption in Russia, Belarus, Poland, Hungary, Bulgaria and the former Czechoslovakia. Total population and gender-specific models were estimated using auto regressive integrated moving average time-series modelling. Results: The estimates for the total population were generally positive and significant. For Russia and Belarus, a 1-litre increase in per capita consumption was associated with an increase in injury mortality of 7.5 and 5.5 per 100,000 inhabitants, respectively. The estimates for the remaining countries ranged between 1.4 and 2.0. The gender-specific estimates displayed national variations similar to the total population estimates although the estimates for males were higher than for females in all countries. Conclusions: The results suggest that changes in per capita consumption have a significant impact on injury mortality in these countries, but the strength of the association tends to be stronger in countries where intoxication-oriented drinking is more common.
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| 45. |
- Landberg, Jonas, et al.
(författare)
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The Contribution of Alcohol Use, Other Lifestyle Factors and Working Conditions to Socioeconomic Differences in Sickness Absence
- 2020
-
Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 26:1, s. 40-51
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This study investigates how alcohol use contributes to the social gradient in sickness absence. Other factors assessed include lifestyle factors (smoking, physical activity and body mass index), physical and psychosocial working conditions. Methods: The study used baseline data from the Stockholm public health cohort 2006, with an analytical sample of 17,008 respondents aged 25-64 years. Outcome variables included self-reported short-term (<14 days) and register-based long-term (>14 days) sickness absence. Socioeconomic position (SEP) was measured by occupational class. Alcohol use was measured by average weekly volume and frequency of heavy episodic drinking. Negative binominal regression was used to estimate sex-specific SEP differences in sickness absence, before and after adjusting for alcohol use and the additional explanatory factors. Results: Adjusting for alcohol use attenuated the SEP differences in long-term sickness absence by 20% for men and 14% for women. Alcohol use explained a smaller proportion of the differences in short-term sickness absence. Alcohol use in combination with other lifestyle factors attenuated the SEP differences (20-35%) for both outcomes. Physical working conditions explained more than half of the gradient in long-term sickness absence, whereas psychosocial conditions had greater impact on short-term sickness absence among men. Discussion/Conclusion: Alcohol use explains a substantial proportion of the SEP disparities in long-term sickness absence among men. The effect is smaller among women and for short-term sickness absence. Our findings support the notion that physical working conditions constitute the key explanatory variable for SEP differences in long-term sickness absence, but add that psychosocial working conditions have greater impact on the gradient in short-term sickness absence among men.
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| 46. |
- Lapeyre-Mestre, M, et al.
(författare)
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A European community pharmacy-based survey to investigate patterns of prescription fraud through identification of falsified prescriptions
- 2014
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 20:4, s. 174-182
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Aim:</i></b> To identify prescription drugs involved in falsified prescriptions in community pharmacies in 6 European countries. <b><i>Methods:</i></b> A cross-sectional survey among 2,105 community pharmacies in Belgium, France, Italy, the Netherlands, Spain and Sweden was carried out to collect all suspect prescription forms. For each reported drug, the number of reported falsified prescriptions per thousand inhabitants was estimated. A falsification ratio was calculated by dividing the number of reports by the number of defined daily doses per 1,000 inhabitants per day for this drug, computed from national sale or reimbursement data. <b><i>Results:</i></b> On 862 prescription forms, benzodiazepines (zolpidem, bromazepam, alprazolam), buprenorphine (as an opioid maintenance drug) and tramadol were the most frequently reported. Depending on their level of use in each country, methylphenidate, morphine and flunitrazepam presented the highest falsification ratios, particularly in Spain, Belgium and France. <b><i>Conclusions:</i></b> Stimulants, opioids and some benzodiazepines were the most frequently reported drugs in this survey on falsified prescriptions, but differences between countries were observed.
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| 47. |
- Legleye, Stephane, et al.
(författare)
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Validation of the cannabis abuse screening test in a sample of cannabis inpatients
- 2012
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Ingår i: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 18:4, s. 193-200
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Tidskriftsartikel (refereegranskat)abstract
- The present study aims at validating the Cannabis Abuse Screening Test (CAST) in a clinical sample of adolescent and young adult cannabis users seeking treatment. Applying a classical test theory approach using DSM-IV diagnoses as gold standard, two versions of the CAST questionnaire are compared. The sample consisted of 140 subjects aged 15-26 years (mean 18.9) recruited from two cannabis treatment centers. Gold standard diagnoses were assessed using the Adolescent Diagnostic Interview-Light. Internal structure and consistency of the CAST were assessed by principal component analysis and Cronbach's alpha. Optimal thresholds were defined using receiver operating characteristic analysis. Both the binary and the full test version revealed unidimensional structures with moderate to satisfactory internal consistency (alpha = 0.66 and 0.73). Screening properties were unsatisfactory when the CAST was compared against cannabis dependence. With regard to cannabis use disorders, both test versions yielded comparable and good sensitivity and specificity at cut-off 3 (binary: 92.2%, 66.7%) and 6 (full: 93.0%, 66.7%). Overall, the full CAST may be used for screening cannabis use disorders in clinical settings. Further research may use validation methods that do without gold standard.
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| 48. |
- Marceau, K, et al.
(författare)
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Interactions between Genetic, Prenatal, Cortisol, and Parenting Influences on Adolescent Substance Use and Frequency: A TRAILS Study
- 2022
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 28:3, s. 176-185
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Introduction:</i></b> Dynamic relations between genetic, hormone, and pre- and postnatal environments are theorized as critically important for adolescent substance use but are rarely tested in multifactorial models. This study assessed the impact of interactions of genetic risk and cortisol reactivity with prenatal and parenting influences on both any and frequency of adolescent substance use. <b><i>Methods:</i></b> Data are from the TRacking Adolescents’ Individual Lives Survey (TRAILS), a prospective longitudinal, multi-rater study of 2,230 Dutch adolescents. Genetic risk was assessed via 3 substance-specific polygenic scores. Mothers retrospectively reported prenatal risk when adolescents were 11 years old. Adolescents rated their parents’ warmth and hostility at age 11. Salivary cortisol reactivity was measured in response to a social stress task at age 16. Adolescents’ self-reported cigarette, alcohol, and cannabis use frequency at age 16. <b><i>Results:</i></b> A multivariate hurdle regression model showed that polygenic risk for smoking, alcohol, and cannabis predicted any use of each substance, respectively, but predicted more frequent use only for smoking. Blunted cortisol reactivity predicted any use and more frequent use for all 3 outcomes. There were 2 interactions: blunted cortisol reactivity exacerbated the association of polygenic risk with any smoking and the association of prenatal risk with any alcohol use. <b><i>Conclusion:</i></b> Polygenic risk seems of importance for early use but less so for frequency of use, whereas blunted cortisol reactivity was correlated with both. Blunted cortisol reactivity may also catalyze early risks for substance use, though to a limited degree. Gene-environment interactions play no role in the context of this multifactorial model.
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| 49. |
- Nordström, Göran, et al.
(författare)
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Stability of successful long-term adjustment in alcohol dependence: a follow-up study 15 years after the first long-term follow-up.
- 2004
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Ingår i: European Addiction Research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 10:3, s. 126-132
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Tidskriftsartikel (refereegranskat)abstract
- From a large consecutive sample (n = 1,312) of hospital-treated alcoholics with multiaxial ratings, 105 were chosen for personal examination two decades after the subjects’ first admission (1949–1969) for alcohol problems. To study patterns of successful adjustment, 70 were chosen on the basis of a good social adjustment (health insurance data) at follow-up, whereas the control subjects had been granted a disability pension. The first follow-up was carried through in 1982–1983. In 1998–1999, the same 105 subjects were studied concerning mortality rate and adjustment patterns. In the good social adjustment group, 33% had deceased as compared with 63% in the control group (p < 0.01). Twenty-three out of 44 surviving subjects accepted a personal interview. Favourable adjustment was generally reported as being stable over the follow-up period. Several subjects reported stable non-problem drinking and others a change between abstinent and non-abstinent adjustment patterns.
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| 50. |
- Ozgen, H, et al.
(författare)
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International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder
- 2020
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Ingår i: European addiction research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 26:4-5, s. 223-232
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not sufficient to justify robust treatment recommendations. <b><i>Objective:</i></b> The aim of the study was to obtain a consensus statement based on a combination of scientific data and clinical experience. <b><i>Method:</i></b> A modified Delphi study to reach consensus based upon the combination of scientific data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. <b><i>Results:</i></b> After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (<i>n</i> = 4), risk of developing SUD (<i>n</i> = 3), screening and diagnosis (<i>n</i> = 7), psychosocial treatment (<i>n</i> = 5), pharmacological treatment (<i>n</i> = 11), and complementary treatments (<i>n</i> = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the first-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. <b><i>Conclusion:</i></b> This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD.
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