Drug and alcohol review
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Drug and alcohol review · Jan 2006
A web-based smoking cessation and prevention curriculum for medical students: why, how, what, and what next.
This paper summarises some major developments in medical education relating to the health risks of tobacco and to training in tobacco cessation and prevention strategies, and discusses some of the barriers to training. We also describe a project whose purpose was to design, implement and evaluate a web-based self-study tobacco curriculum for medical students to teach medical students to assist smokers to quit and to counsel non-smoking adolescents not to start smoking. This curriculum addresses some of the barriers, namely lack of curriculum time, lack of access to materials and experts, and relevance of the materials. ⋯ The amount of exposure (measured only at Morehouse) was not related to overall change in scores but was associated with self-reported improvement in skill in assisting patients to quit smoking, confidence in counselling patients not interested in quitting, and confidence in counselling teens. The web-based curriculum successfully improved the students' self-rated counselling skills. Given the need and desire on the part of practitioners for training, the curriculum may be found useful by practising physicians and other health-care professionals who wish to improve their skills in smoking prevention and cessation.
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Drug and alcohol review · Jan 2006
Review Comparative StudyThe internet and the industrial revolution in smoking cessation counselling.
The internet can provide wide access to online smoking cessation programmes developed by highly qualified professionals. Compared with one-to-one counselling in smoking cessation clinics or on telephone quitlines, the mass-level dissemination of automatised, individualised counselling on the internet is comparable to the industrial revolution, when skilled craftsmen working in small shops were replaced by huge plants. Hundreds of websites provide information and advice on smoking cessation, but very few of them have been evaluated scientifically. ⋯ The internet is being used increasingly by tobacco companies to promote their products. The overall effect of internet smoking cessation programs on smoking prevalence is unknown. Greater efforts should be expended to improve the reach and efficacy of smoking cessation websites.
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Drug and alcohol review · Sep 2005
ReviewApplication of the Transtheoretical Model to substance abuse: historical development and future directions.
As a growing literature has documented applications of the Transtheoretical Model (TTM) to substance abuse, the utility or futility of such an application has been debated widely. The purpose of this paper is to critically examine the TTM, and its conceptual and empirical applications to the field of substance abuse. This review focuses not only on the stage of change dimension of the TTM, but also the processes, decisional balance, and self-efficacy dimensions, which have received less attention in earlier reviews. ⋯ Unanswered questions and directions for future research are identified. It is concluded that, to effectively determine the TTM's applicability to substance abuse, all dimensions must be more fully developed, validated and evaluated across a range of substance abuse problems. Further, prospective studies are needed to determine the predictive utility of the TTM, and evaluation of TTM-matched interventions will help to address the model's specificity.
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Drug and alcohol review · Sep 2005
The characteristics of heroin users entering treatment: findings from the Australian treatment outcome study (ATOS).
The current study aimed to describe the characteristics (demographics, drug use, mental and physical health) of entrants to treatment for heroin dependence in three treatment modalities; and to compare these characteristics with heroin users not in or seeking treatment. Participants were 825 current heroin users recruited from Sydney, Adelaide and Melbourne: 277 entering methadone/buprenorphine maintenance treatment (MT), 288 entering detoxification (DTX), 180 entering drug-free residential rehabilitation (RR) and 80 not in treatment (NT). Treatment entrants were generally long-term heroin users with previous treatment experience. ⋯ There were high degrees of psychiatric co-morbidity, with 49% reporting severe psychological distress, 28% having current major depression, 37% having attempted suicide and 42% having a lifetime history of post-traumatic stress disorder. Personality disorders were also prevalent, with 72% meeting criteria for antisocial personality disorder and 47% screening positive for borderline personality disorder. Striking similarities were noted between the non-treatment and treatment groups in length of heroin use career, drug use and treatment histories.