Addiction
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Buprenorphine is marketed in a sublingual formulation for treatment of opioid dependence. A transdermal formulation has been developed that may provide extended relief from opioid withdrawal, reduce required clinic visits and improve adherence, while having less potential for diversion and abuse. This study evaluated the safety and biodelivery (blood levels) of this transdermal buprenorphine formulation (i.e. buprenorphine patch), and its apparent efficacy in suppressing the opioid withdrawal syndrome. ⋯ The significant biodelivery of buprenorphine and the suppression of the opioid withdrawal syndrome during patch application and its reappearance after patch removal indicate clinically useful pharmacodynamic activity. Transdermal buprenorphine may be a useful opioid detoxification treatment that reduces compliance concerns, and delivers buprenorphine in a formulation less likely to be diverted to illicit use.
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Randomized Controlled Trial
What difference does training make? A randomized trial with waiting-list control of general practitioners seeking advanced training in drug misuse.
To measure changes in knowledge, attitudes and clinical practice of general practitioners (GPs) enrolled to receive training in the management of drug misusers. ⋯ GPs seeking special training for the care of drug misusers are both positively disposed to this patient population and clinically active. Benefits unambiguously attributable to the course were modest. While a TR effect was observed, strict adherence to ITT analysis failed to identify significant benefits observed with the training provided. Randomisation and waiting-list controls design are insufficient as a research method for training evaluation studies if ITT analysis is used exclusively.
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We examine the phenomenon of low-frequency smoking (non-daily smoking or smoking = 5 cigarettes daily) among California Latinos and address its implications for addiction theory and population tobacco control. ⋯ The fact that most Latino smokers are low-frequency smokers calls for a new theoretical framework--beyond withdrawal-based theories--to account for the prevalence of this behavior on the population level. It also calls into question the harm-reduction approach as a tobacco control strategy for California Latino populations. Strategies emphasizing that every cigarette can hurt, and encouraging complete cessation, seem more fitting for this group of smokers.
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Despite good evidence of increased availability and use of amphetamines world-wide, relatively little is known about the epidemiology of young adult amphetamine use; relationships with social functioning, other drug use and mental health at this age; nor of the adolescent predictors of such use. We examined these issues using a representative cohort of young people followed-up in Victoria, Australia. ⋯ Young people in Australia using amphetamine at age 24 years are highly likely to be significant polydrug users. The risks for both initiation of young adult amphetamine use, and maintenance of such use, pertain to the heavy use of other drugs. Interventions for heavy amphetamine users at this age are likely to require attention to multiple drug problems.
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Randomized Controlled Trial Comparative Study
Motivational interviewing versus feedback only in emergency care for young adult problem drinking.
To establish the efficacy of a brief motivational intervention compared to feedback only when delivered in an emergency department for reducing alcohol use and problems among young adults. ⋯ This study provides new data supporting the potential of the motivational intervention tested to reduce alcohol consumption among high-risk youth.