Addiction
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To provide an overview of recent privatization/deregulation experiences in North America and other settings, in order to draw conclusions about the impacts that might be expected from such changes on rates of alcohol consumption and related problems. ⋯ The existing evaluation literature on the subject of privatization has tended to focus on examining the net short-term results in terms of alcohol consumption levels. Overall, there are too few studies employing adequate statistical methodologies to explore the underlying causes of changing alcohol consumption and alcohol-related harm. Finally, seven specific suggestions that may assist future studies are discussed.
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There has been increasing recognition of the problem of fatal opioid overdose. This review examines the pharmacological basis of respiratory depression following opioid administration. Respiration is controlled principally through medullary respiratory centres with peripheral input from chemoreceptors and other sources. ⋯ While agonist administration modifies receptor function, changes (usually in the opposite direction) also result from use of antagonists. The potential for supersensitivity to opioids following a period of administration of antagonists such as naltrexone warrants further investigation. While our understanding of the pharmacological basis of opioid-related respiratory depression has advanced, better understanding of the role of heroin metabolites, the metabolism of methadone, drug interactions and tolerance would all be of considerable value in knowing how best to respond to this problem.
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To study the efficacy of standard hepatitis B (HB) vaccination in methadone-maintained former intravenous drug users. ⋯ Standard HB vaccination is both feasible and effective.