The Use and Costs of Health and Social Services in Patients With Longstanding Substance Abuse.

The use and costs of health and social services in patients with longstanding substance abuse.

BMC Health Serv Res. 2013 May 22; 13(1): 185
Vossius C, Testad I, Skjæveland R, Nesvåg S

BACKGROUND: Persons with longstanding substance abuse might become increasingly dependent on help by the public, eventually requiring permanent care. In 2006 the municipality of Stavanger established a so-called addiction ward for these clients, comprising 17 beds at the largest municipal nursing home. We assumed that the residents of this ward were high consumers of health care and social services during the last months preceding their admission. The aim of the study was to register the type and extent of services that were claimed by this client group during the last six months prior to admission, and to calculate the costs that were caused. Further, we estimated the incremental costs for nursing home placement. METHODS: In 15 residents from the addiction ward the use of all welfare services during the six months prior to admission were registered. Costs were calculated by unit costs from a municipal, national and societal perspective. RESULTS: Mean total costs during this period were [euro sign]32 474. Approximately half of these costs were borne by state-funded institutions, and half were borne by the municipality. The clients used a great variety of services aimed at subsistence, health care and support in independent living, while services aimed at drug withdrawal were not claimed. There was no correlation between costs and the level of functioning. The incremental costs for nursing home admission were borne by the municipalities. CONCLUSION: Persons with longstanding substance abuse represent a group with a high use of welfare resources and hence cause high costs. However, our findings do not indicate any correlation between the amount of services rendered and the level of functioning. Further research should focus on the identification of the clients’ need for support in order to facilitate targeted interventions that might prevent further deterioration and, finally, the need for permanent care. HubMed – addiction


Alcohol consumption and self-reported (SF12) physical and mental health among working aged-men in a typical Russian city: A cross sectional study.

Addiction. 2013 May 21;
Dissing AS, Gil A, Keenan K, McCambridge J, McKee M, Oralov A, Saburova L, Leon DA

AIM: To investigate the association between patterns of alcohol consumption and self-reported physical and mental health in a population with a high prevalence of hazardous drinking. DESIGN: Cross-sectional study of an age-stratified random sample of a population register. SETTING: The city of Izhevsk, The Russian Federation, 2008-9. PARTICIPANTS: 1031 men aged 25 to 60 years (68% response rate). MEASUREMENTS: Self-reported health was evaluated with the SF12 physical (PCS) and mental (MCS) component summaries. Measures of hazardous drinking (based on frequency of adverse effects of alcohol intake including hangover, excessive drunkenness and extended episodes of intoxication lasting two or more days) were used in addition to frequency of alcohol consumption and total volume of beverage ethanol per year. Information on smoking, and socio-demographic factors were obtained. FINDINGS: Compared with abstainers, those drinking 10-19 L of beverage ethanol per year had a PCS score 2.66 (95%CI = 0.76; 4.56) higher. Hazardous beverage drinking was associated with a lower PCS score (mean diff: -2.95 (95%CI = -5.28; -0.62)) and even more strongly with a lower MCS score (mean diff: -4.29 (95%CI = -6.87; -1.70)), with frequent non-beverage alcohol drinking being associated with a particularly low MCS score (-7.23 (95%CI = -11.16; -3.29)). Adjustment for smoking and socio-demographic factors slightly attenuated these associations, but the same patterns persisted. Adjustment for employment status attenuated the associations with PCS considerably. CONCLUSION: Among working age male adults in Russia, hazardous patterns of alcohol drinking are associated with poorer self-reported physical health, and even more strongly with poorer self-reported mental health. Physical health appears to be lower in those reporting complete abstinence from alcohol compared with those drinking 10-19 L per year. HubMed – addiction


Specific subcellular changes in oxidative stress in prefrontal cortex from patients with bipolar disorder.

J Neurochem. 2013 May 20;
Andreazza AC, Wang JF, Salmasi F, Shao L, Young LT

Previously, we found decreased mitochondrial complex I subunits levels and increased protein oxidation and nitration in postmortem prefrontal cortex (PFC) from patients with bipolar disorder (BD) and schizophrenia (SCZ). The objectives of this study were to replicate our findings in an independent sample of subjects with BD, and to examine more specifically oxidative and nitrosative damage to mitochondrial and synaptosomal proteins and lipid peroxidation in myelin. We isolated mitochondria, synaptosomes and myelin using a percoll gradient from postmortem PFC from patients with BD, SCZ, and healthy controls. Levels of mitochondrial complex I and III proteins, protein oxidation (carbonylation), and nitration (3-nitrotyrosine) were assessed using immunobloting analysis. Lipid peroxidation (lipid hydroperoxides, LPH, 8-isoprostane, 8-Iso, 4-hydroxy-2-nonenal, 4-HNE) were measured using colorimetric or ELISA assays. We found decreased complex I subunits levels in BD subjects compared to control (CTL), but no difference in complex III subunits. Carbonylation was increased in synaptosomes from BD group while 3-nitrotyrosine was increased in mitochondria from BD and SCZ groups. 8-Iso was found increased in the BD group while 4-HNE was increased in both SCZ and BD when compared to controls with no differences in LPH. Our results suggest that in BD mitochondrial proteins are more susceptible to potentially reversible nitrosative damage while more longstanding oxidative damage occurs to synaptic proteins. This article is protected by copyright. All rights reserved. HubMed – addiction


Alcohol-Related Biases in Selective Attention and Action Tendency Make Distinct Contributions to Dysregulated Drinking Behaviour.

Addiction. 2013 May 21;
Sharbanee JM, Stritzke WG, Wiers RW, Macleod C

AIMS: There is increasing evidence that alcohol-related biases in selective attention and action tendency contribute to the eitiology of dysregulated drinking. However, previous research has been equivocal about whether these biases are concurrent manifestations of the same underlying selectivity in a common mechanism, or whether each bias is due to selectivity in a distinct mechanism. Our aim was to distinguish between these positions by assessing whether alcohol-related biases in selective-attention and action tendency uniquely predict the ability to regulate alcohol consumption. DESIGN AND PARTICIPANTS: Two groups of undergraduate social drinkers (total N=55) who differed in their ability to regulate their alcohol consumption completed a novel Selective-Attention/Action-Tendency Task (SA/ATT), which separately assessed alcohol-related biases in selective attention and action tendency. SETTING: University of Western Australia, Australia. MEASUREMENT: Selective attention and action tendency were assessed using the SA/ATT, working memory was assessed using the operation-span task, and participant characteristics were assessed using the AUDIT and SOCRATES. FINDINGS: Results indicated that a) there was no significant association between alcohol-related biases in selective attention and action tendency, r = 0.16, p =.274, and b) biases towards alcohol, in both selective attention, ?=1.01, odds ratio = 2.74, p = .022, and action tendency, ?=1.24, odds ratio = 3.45, p = .015, predicted independent variance in dysregulated-drinker status. CONCLUSION: Biases in selective attention and action tendency appear to be distinct mechanisms that independently contribute to difficulty regulating alcohol consumption. Treatment components that could be combined to target both mechanisms may enhance treatment outcomes for alcohol-use disorders. HubMed – addiction



Peg Diehl of Seabrook House Addiction Treatment Rehab – History of the founding of Seabrook House addiction treatment center for chemical dependency.