A Life Course Perspective on Economic Stress and Tobacco Smoking: A Population Based Study.

A life course perspective on economic stress and tobacco smoking: a population based study.

Addiction. 2013 Feb 25;
Lindström M, Modén B, Rosvall M

AIMS: To investigate the associations between economic stress in childhood and adulthood, and tobacco smoking, with reference to the accumulation, critical period and social mobility hypotheses from life-course epidemiology. DESIGN/SETTING/PARTICIPANTS/MEASUREMENTS: The 2008 public health survey in Skåne, Sweden is a cross-sectional postal questionnaire study based on a random sample which yielded 28,198 participants aged 18-80 (55% participation). Logistic regression models were used to investigate associations between economic stress in childhood and adulthood, and tobacco smoking. FINDINGS: A 17.4% prevalence of men and 19.1% of women reported tobacco smoking. Tobacco smoking was more prevalent among middle-aged men and young women, among those born outside Sweden, with low occupational status, low social support, low trust, economic stress in childhood and adulthood. The accumulation hypothesis was confirmed because combined childhood and adulthood exposures to economic stress were associated (p<0.001) with tobacco smoking in a graded manner. The critical period hypothesis was not supported because the associations between economic stress in childhood as well as adulthood, respectively, and tobacco smoking were significant (p=0.004 and p<0.001) throughout the analyses. The social mobility hypothesis was confirmed because upward social mobility was significantly associated (p<0.001) with lower odds of smoking, while downward social mobility was significantly associated (p<0.001) with higher odds of smoking. CONCLUSIONS: Downward social mobility and economic stress in both childhood and adulthood should be considered as risk factors for tobacco smoking over the life course. HubMed – addiction

Reducing Heavy Drinking in HIV Primary Care: A Randomized Trial of Brief Intervention, with and without Technological Enhancement.

Addiction. 2013 Feb 25;
Hasin DS, Aharonovich E, O’Leary A, Greenstein E, Pavlicova M, Arunajadai S, Waxman R, Wainberg M, Helzer J, Johnston B

AIMS: In HIV-infected individuals, heavy drinking compromises survival. In HIV primary care, the efficacy of brief motivational interviewing (MI) to reduce drinking is unknown, alcohol-dependent patients may need greater intervention, and resources are limited. Using Interactive Voice Response (IVR) technology, HealthCall was designed to enhance MI via daily patient self-monitoring calls to an automated telephone system with personalized feedback. We tested the efficacy of MI-only and MI+HealthCall for drinking reduction among HIV primary care patients. DESIGN: Parallel random assignment to control (N=88), MI-only (N=82), or MI+HealthCall (N=88). Counselors provided advice-education (control) or MI (MI-only or MI+HealthCall) at baseline. At 30 and 60 days (end-of-treatment), counselors briefly discussed drinking with patients, using HealthCall graphs with MI+HealthCall patients. SETTING: Large urban HIV primary care clinic. PARTICIPANTS: Patients consuming ?4 drinks at least once in prior 30 days. MEASUREMENTS: Using TimeLine FollowBack, primary outcome was number of drinks per drinking day, last 30 days. FINDINGS: End-of-treatment number of drinks per drinking day (NumDD) means were 4.75, 3.94, and 3.58 in control, MI-only and MI+HealthCall, respectively (overall model X(2) ,df=9.11,2, p=.01). For contrasts of NumDD, p=.01 for MI+HealthCall vs. control; p=.07 for MI-only vs. control; and p=.24 for MI+HealthCall vs. MI-only. Secondary analysis indicated no intervention effects on NumDD among non-alcohol dependent patients. However, for contrasts of NumDD among alcohol dependent patients, p<.01 for MI+HealthCall vs. control; p=.09 for MI-only vs. control; and p=.03 for MI+HealthCall vs. MI-only. By 12-month follow-up, although NumDD remained lower among alcohol-dependent patients in MI+HealthCall than others, effects were no longer significant. CONCLUSIONS: For alcohol-dependent HIV patients, enhancing MI with HealthCall may offer additional benefit, without extensive additional staff involvement. HubMed – addiction

One More Beer? Serving Alcohol to Pseudo-Intoxicated Guests in Bars.

Alcohol Clin Exp Res. 2013 Feb 21;
Gosselt JF, Van Hoof JJ, Goverde MM, De Jong MD

BACKGROUND: Consuming large quantities of alcohol might result in negative consequences for both individual drinkers (alcohol dependency and addiction) and society (violence, traffic crashes). In order to decrease the prevalence of alcohol abuse, many countries have adopted regulations prohibiting the catering industry to serve alcohol to intoxicated guests. This article investigated compliance with these regulations in the Netherlands. METHODS: A study was conducted in which pseudo-intoxicated actors tried to order alcoholic drinks in 58 bars. A 2 × 2 design was used, based on (i) the number of actors involved (1 vs. 2) and (ii) the level of intoxication (moderately vs. very drunk). In contrast to earlier studies, research accomplices checked afterward whether the bartenders noticed that the actors appeared intoxicated. RESULTS: In 86% of the cases, the actors were able to buy alcohol, without comments or questions. In 10%, the actors were refused entrance by a bouncer. Only in 4%, the bartender refused to serve. In 81% of the cases, the bartenders remembered the actors: In 93% of those cases, they noticed that the actor appeared intoxicated. Only the “very drunk” script involving 2 actors led to refusals. CONCLUSIONS: The results show that compliance with the regulations regarding overserving to intoxicated guests is problematic in the Netherlands. Misinterpretations of the situation could be ruled out: Most bartenders noticed that the actors appeared intoxicated but served nonetheless. HubMed – addiction

[Naloxone].

Masui. 2013 Jan; 62(1): 5-9
Setoguchi D, Kakihana Y

Naloxone hydrochloride is an agent capable of antagonizing respiratory depression and analgesic actions which are inherent to the opioid by competitively acting at opioid receptors. It greatly contributed to basic research on antagonistic action of opioid receptors due to its high affinity to opioid receptors, in particular, micro-receptor. Naloxone has been recommended as an analeptic agent at a guideline level for patients with revealed or suspicious opioid addiction. Further, it has also been used as a preventive and treatment agent for spinal cord ischemia. Moreover, even though it has been confirmed in 1980’s that naloxone has vasopressor effect in septic shock, further clinical trials are required for its wide clinical application. HubMed – addiction