Sleep related beliefs and their association with alcohol relapse following residential alcohol detoxification treatment.

Background: Alcohol dependence is known to impact upon sleep, and poor sleep has been shown to affect relapse rates following treatment for alcohol dependence.

Aims: The aim of this study was to investigate the association between sleep problems and relapse in dependent drinkers in an inpatient setting. This was done by studying sleep related cognitions in individuals undergoing medically assisted alcohol withdrawal.

Rates of undiagnosed attention deficit hyperactivity disorder in London drug and alcohol detoxification units.

Background: ADHD is a common childhood onset mental health disorder that persists into adulthood in two-thirds of cases. One of the most prevalent and impairing comorbidities of ADHD in adults are substance use disorders. We estimate rates of ADHD in patients with substance abuse disorders and delineate impairment in the co-morbid group.

Does active referral by a doctor or 12-Step peer improve 12-Step meeting attendance? Results from a pilot randomised control trial.

Background: Active engagement in 12-Step self-help groups (SHG) is associated with improvements in substance use outcomes during and after treatment, yet levels of participation in SHG meetings in the U.K. remain low.

Long-term misuse of zopiclone in an alcohol dependent woman with a history of anorexia nervosa: a case report.

Introduction: The Z-drugs, zaleplon, zopiclone and zolpidem, are short-acting hypnotics which act at the same receptor as the benzodiazepines, but seemingly without the potential for misuse and the development of dependence of the older benzodiazepines. However, with increased prescribing of Z-drugs, reports of misuse and possible dependence began to appear in the literature, particularly in people with a history of substance misuse and comorbid psychiatric illness. Here we report the case of a woman with a history of chronic zopiclone use and anorexia nervosa, admitted for alcohol detoxification.

Illicit drug use as a predictor of smoking cessation treatment outcome.

Introduction: Evidence from cross-sectional survey data suggests a negative association between illicit drug use and smoking cessation. In a prospective clinical cohort, we examined whether illicit drug users were less successful than other smokers when making an attempt to stop smoking.

Methods: A total of 100 smokers attending a tobacco dependence clinic were studied.

Drugs, alcohol and sexual health: opportunities to influence risk behaviour.

Background: Alcohol and drug consumption can affect judgment and may contribute towards an increased likelihood of engaging in risky sexual behaviour. In this cross sectional survey of clients attending STI services levels of drug and alcohol use were assessed using two standardised drug and alcohol screening instruments (the PAT and the SDS).

Findings: The rates of hazardous alcohol consumption were similar to those found among patients attending A&E departments.

Measuring the use and career histories of drug users in treatment: reliability of the Lifetime Drug Use History (LDUH) and its data yield relative to clinical case notes.

Introduction And Aims: There is no generally accepted clinical or research instrument available for recording the longitudinal course of a drug-using 'career'. This paper reports on an initial examination of the properties of the Lifetime Drug Use History Questionnaire (LDUH), built around monthly mapping of drug use patterns in relation to other life events.

Design And Methods: Forty heroin and cocaine users completed structured interviews at two treatment sites.

Mapping heroin careers: utilising a standardised history-taking method to assess the speed of escalation of heroin using careers in a treatment-seeking cohort.

Introduction And Aims: Although there has been increasing research attention to the concept of addiction careers and treatment careers, there are few standardised measures for assessing illicit drug using careers. A new instrument for mapping lifetime drug use history (LDUH) was used to assess transitions in the initial stages of heroin use careers among illicit drug users.

Design And Methods: 58 lifetime heroin users completed a one-off researcher-administered interview in treatment settings in two English cities, London and Birmingham, about their histories of drug use, drug treatment and other key life events.

Dying for heroin: the increasing opioid-related mortality in the Republic of Ireland, 1980-1999.

Background: Over the past 20 years there has been a steady rise in mortality associated with opioid misuse in several Western countries. We aimed to examine trends in opioid-related mortality over a 20-year period in the Republic of Ireland.

Methods: Retrospective analysis of deaths attributed to ICD-9 codes 304.

The unique role of diamorphine in British medical practice: a survey of general practitioners and hospital doctors.

Aims: Diamorphine (heroin) is one of the longest established medications with a 130-year history. In British medicine diamorphine is sometimes used as a maintenance treatment for opiate addiction but is also routinely used in clinical practice to treat a number of general medical conditions. These uses are very different but are often confused by observers of the British system.

Does anyone care about names? How attendees at substance misuse services like to be addressed by health professionals.

Objective: To determine the preference of substance misusers for the terms 'patient', 'client' and 'service user' in the context of their contact with health professionals, if they consider substance misuse problems to exist appropriately under the category of mental health problems and if they consider themselves to have mental health problems.

Methods: A self-completion questionnaire was administered to 150 National Health Service and private in- and outpatients with alcohol, drug and smoking problems.

Results: The majority (54%) preferred the term 'patient', felt substance misuse problems was a category of mental health problems (59%), even though the majority (62%) did not consider themselves to have a mental health problem.

Treatment of nicotine dependence with bupropion SR: review of its efficacy, safety and pharmacological profile.

Bupropion hydrochloride, an atypical antidepressant, is the first non-nicotine product that, in its sustained release form (bupropion SR), has been licensed as an aid for smoking cessation. The specialized literature on bupropion SR and smoking cessation is critically reviewed. The pharmacological profile, dosage and administration, contraindications, as well as the clinical efficacy, safety and tolerability data of bupropion are discussed.

Unplanned versus planned discharges from in-patient alcohol detoxification: retrospective analysis of 470 first-episode admissions.

Failure to complete treatment during alcohol detoxification is a major complication of effective clinical management. We determined the socio-demographic characteristics, the pattern of alcohol and drug use, the hepatitis C status and the psychiatric state of these patients, using retrospective data on 470 first admissions to a specialist alcohol in-patient unit. The 316 patients (67.

A Short Alcohol Withdrawal Scale (SAWS): development and psychometric properties.

The measurement of alcohol withdrawal symptoms is important for the assessment of the alcohol withdrawal syndrome and for the evaluation of the effectiveness of withdrawal treatment interventions. There continues to be a need for an instrument for the measurement of alcohol withdrawal severity which is short, easy to understand (especially by respondents who may feel anxious, confused or physically ill) and easy to administer (for example, within clinical services with limited time and resources).This paper describes the development and psychometric properties of the 10-item Short Alcohol Withdrawal Scale.

Hepatitis B and C in alcohol-dependent patients admitted to a UK alcohol inpatient treatment unit.

The prevalence of hepatitis B and C infection was studied in a sample of alcohol-dependent patients admitted to a specialist alcohol inpatient unit to identify factors associated with hepatitis B and C infection. Laboratory, clinical and socio-demographic data were collected from 277 admissions over a 3-year period who were tested routinely for markers of hepatitis B and C infection. Of the 275 subjects tested for hepatitis C, 27 (9.

Lofexidine and desipramine: Interaction results in breakthrough opioid withdrawal symptoms.

A patient was receiving treatment for concurrent opioid and stimulant dependency. When desipramine was added to his lofexidine regimen for treatment of stimulant withdrawal, there was an exacerbation of opioid withdrawal symptoms. With the increasing use of lofexidine for opioid withdrawal, clinicians need to be aware of the potential for interactions with tricyclic antidepressants in the treatment of concomitant stimulant users.