Alcohol Concern says to PCTs: show us the money

Alcohol Concern is challenging Primary Care Trusts to account for the extra funds they received to improve alcohol services in their area. Public Health Minister, Caroline Flint announced last year that £15 million was earmarked to help PCTs improve the commissioning and delivery of alcohol treatment services but there is growing evidence that some PCTs have not yet assigned the money.

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Contributor: Libby Ranzetta

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MEDIA RELEASE: Kids Dying From Drugs: It's All About Supply and Demand

Date: March 27, 2007 A third of deaths among young people in developed countries such as Canada are caused by alcohol and illicit drugs. That’s according to a new paper—coauthored by University of Victoria psychologist and Centre for Addictions Research of British Columbia (CARBC) at the University of Victoria director Dr. Tim Stockwell—published today in the medical journal The Lancet. The paper, “Interventions to Reduce Harm Associated with Adolescent Substance Use,” identifies strategies from the international scientific literature that will reduce death, illness and injury among young people. “The drug that’s killing the greatest amount of young people globally is alcohol—nearly 90 per cent of substance-related deaths in developed countries such as Canada are due to alcohol,” says Stockwell. “A substantial dent could be made in these figures by combining regulatory, early-intervention and harm reduction approaches.” Stockwell says regulating the price and physical availability of alcohol and tobacco is known to be highly effective. “These lessons could also be applied to the management of some other widely-used drugs such as cannabis,” he says. A previous CARBC study * showed cannabis is “very easy” to obtain in British Columbia and its use is more widespread among BC residents than the rest of Canadians. Stockwell says another strategy is to reduce the demand for drugs by supporting young people and families at key stages in their development from before birth to teenage years. This includes educating parents on the dangers of using illicit substances during pregnancy and the risks associated with childhood exposure to second-hand smoke. Harm reduction is another approach Stockwell highlights. Strategies such as random breath testing and graduated driver licensing have reduced the amount of driving-related deaths and injuries. _________________________________________________________________

AFRICAN JOURNAL OF DRUG AND ALCOHOL STUDIES

Special Issue on ‘Substance abuse, poverty and human
development in Africa’
Global Theme Issue on Poverty and Human Development: October 2007


We are pleased to inform you that the African Journal of Drug and Alcohol Studies is planning a special issue on “Substance abuse, poverty and human development in Africa” as a participant in the Council of Science Editors’ call for a Global Theme Issue on Poverty and Human Development scheduled for publication in October 2007.

In this special initiative, more than 100 journals throughout the world will simultaneously publish papers on this topic of worldwide interest - to raise awareness, stimulate interest, and encourage research on poverty and human development. This represents a unique, unprecedented international collaboration with journals from developed and developing countries

The AJDAS will accept papers on all aspects of alcohol and other psychoactive substances as long as they focus on the link with poverty and development issues. We invite authors to submit to the journal high-quality original research, reviews and commentaries for consideration. Papers on alcohol production and consumption (including traditional beverages), trafficking in illicit drugs, abuse of inhalants and local substances by poor urban youth, developmental aspects of national drug control policies, the impact of substance use on health and development, etc. are of interest tom the journal.

To be included in this special issue, manuscripts should be received by the 31 May 2007. Please send inquiries and completed papers directly to the Editor-inchief of the journal (E-mail: isobot@hotmail.com). In keeping with the tradition of the journal, all papers for this special issue (whether solicited or not) will undergo peer review.

If you are interested in more information on the Global Theme Issue on Poverty and Human Development, you can visit the Council of Science Editors Web site at http://www.councilscienceeditors.org/globalthemeissue.cfm.

For more information about the AJDAS and for papers published in back issues of the journal visit http://www.crisanet.org/html/journal.htm.

Work on the publication of this and other special issue is supported by a grant from the IOGT-NTO, Sweden, through a twinning arrangement with the journal Nordic Studies on Alcohol and Drugs (NAT). In this arrangement, copies of the African journal are distributed to all NAT subscribers globally.

Please distribute this announcement to colleagues who might be interested in contributing to this special issue of the journal.

www.crisanet.org
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SUMMARY OF THE PROCEEDINGS OF MEETING ON ‘ALCOHOL, HIV RISK BEHAVIOURS AND TRANSMISSION IN AFRICA: DEVELOPING PROGRAMMEMES FOR THE UNITED STATES PRESIDENT’S EMERGENCY PLAN FOR AIDS RELIEF (PEPFAR)’

African Journal of Drug & Alcohol Studies, 5(2), 2006


In response to growing concern among public health experts about alcohol use and HIV in Africa, several U.S. government (USG) agencies, including the Department of Health and Human Services/Centres for Disease Control and Prevention/Global AIDS Programme (HHS/CDC/GAP), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the Department of Defense (DoD) and the United States Agency for International Development (USAID) hosted a meeting in Dar es Salaam, Tanzania, 30-31 August 2005, "Alcohol, HIV Risk Behaviours and Transmission in Africa: Developing Programmes for the United States President’s Emergency Plan for AIDS Relief (PEPFAR)."

The primary objective of the meeting was to provide scientific and programmatic updates on alcohol-related HIV risk behaviours and transmission in Africa and to inform the development of PEPFAR programming. PEPFAR is a 5- year, US$15 billion initiative intended to support treatment for 2 million HIV positive patients with antiretroviral drugs (ARVs), to prevent 7 million new cases of HIV/AIDS and to care for 10 million patients suffering with AIDS. HIV prevention and treatment initiatives which address alcohol abuse and increase adherence to ARV treatment have the potential to contribute to PEPFAR’s goals.

This article summarizes the major technical issues and key points raised in the meeting which included presentations in several key areas: epidemiology and ethnography of alcohol and alcohol-related risk factors for HIV transmission; prevention and treatment of HIV in the context of alcohol use; and approaches to policy and partnership designed to promote the exchange of resources and knowledge related to programmes addressing alcohol use and
HIV/AIDS risk behaviours.

Finally, the meeting sought to strengthen partnerships between USG agencies implementing PEPFAR and multi-sectoral organizations, including faith based communities, nongovernmental organizations (NGOs), community-based organizations (CBOs), uniformed services, and the alcohol industry to support HIV prevention interventions.

The meeting benefited from a diverse range of experts and participants from across the region and the United States including USG PEPFAR-implementationstaff, host-country government staff, alcohol and substance abuse specialists, researchers on alcohol and on HIV/ AIDS, policy experts, community-based programme managers, and communicatione experts.

Representatives of the military and the alcohol industry from across the region also participated and expressed commitment as partners in addressing the issue of alcohol abuse. Approximately 80 participants from 13 African countries participated in the technical meeting.

FULL TEXT (PDF)
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THREE-COUNTRY ASSESSMENT OF ALCOHOL-HIV RELATED
POLICY AND PROGRAMMEMATIC RESPONSES IN AFRICA
African Journal of Drug & Alcohol Studies, 5(2), 2006


The significant role of alcohol in HIV transmission and treatment has not been addressed in Africa. Given the widespread use of alcohol in Africa and its impact on HIV/AIDS, decision makers are now recognizing that action is needed.

The authors conducted a situational analysis of the relationships between alcohol and HIV in three sub-Saharan countries: Kenya, Zambia and Rwanda.

Key findings emerging from these countries include: the importance of youth as a risk group for harmful use of alcohol and increased HIV risk; the lack of enforcement of laws relating to alcohol leading to increased HIV risk; the central role of traditional and informal alcohol production in alcohol use; the lack of alcohol screening tools in antiretroviral therapy (ART); and the lack of alcohol treatment availability especially linked to voluntary HIV counselling and testing (VCT) and ART.


FULL TEXT (PDF)
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REPORT OF FIRST PAN AFRICAN CONSULTATION ON ALCOHOL POLICY AND ITS SIGNIFICANCE FOR THE REGION
African Journal of Drug & Alcohol Studies, 5(2), 2006


The World Health Organization (WHO) Technical Consultation on the “Public health problems caused by harmful use of alcohol in the African Region” was held at WHO/AFRO, in Brazzaville, Congo, from 10-12 May 2006. The meeting was convened as a follow-up to the adoption of Resolution WHA58.26 on Public Halth Problems Caused by Harmful Alcohol Use at the fifty-eighth World Health Assembly in May 2005 (WHO, 2005) which gave the WHO the mandate to make a number of specific requests of Member States and the WHO Director- General to intensify efforts to reduce the burden of alcohol-related problems nationally, regionally and globally.

The primary goals of the consultation were to assess the situation related to alcohol production and consumption and its harmful consequences, and to develop a programme to guide the work on alcohol in the African region over the next five years.

The meeting was attended by representatives from 13 sub-Saharan countries, representatives of nongovernmental organizations, the United Nations Office on Drugs and Crime, and the WHO Secretariat. Participants were representatives of health ministries, academia, medical and allied professions, non-governmental organizations and civil society.

FULL TEXT (PDF)

Risk Taking in Adolescence: New Perspectives From Brain and Behavioral Science
Current Directions in Psychological Science 16 (2), 55–59.



Trying to understand why adolescents and young adults take more risks than younger or older individuals do has challenged psychologists for decades. Adolescents' inclination to engage in risky behavior does not appear to be due to irrationality, delusions of invulnerability, or ignorance.

This paper presents a perspective on adolescent risk taking grounded in developmental neuroscience. According to this view, the temporal gap between puberty, which impels adolescents toward thrill seeking, and the slow maturation of the cognitive-control system, which regulates these impulses, makes adolescence a time of heightened vulnerability for risky behavior.

This view of adolescent risk taking helps to explain why educational interventions designed to change adolescents' knowledge, beliefs, or attitudes have been largely ineffective, and suggests that changing the contexts in which risky behavior occurs may be more successful than changing the way adolescents think about risk.

READ FULL ABSTRACT

REPRINT REQUEST E-MAIL: lds@temple.edu.

eNewsletter - April 13,2007

Job Opening at Faces & Voices of Recovery
Faces & Voices is pleased to announce a new position as Administrative Assistant made possible by the generous support of the Robert Wood Johnson Foundation and our members. The application deadline is Tuesday, May 1st.

Sign up for our Webinar on Peer Recovery Support Services!
On Saturday April 21st, Faces & Voices is sponsoring an hour-long recovery advocacy training on peer recovery support services. We’re excited to have Tom Hill, Bev Haberle and Patty McCarthy as speakers for this session, where you can listen and learn about the innovative programs building communities of recovery across the country. Please sign up by Friday, April 20th. More...

TAKE ACTION ON THE SECOND CHANCE ACT TODAY!
There’s an April 16th deadline for US Representatives to sign up as co-sponsors of The Second Chance Act, which was bottled-up at the end of the last Congress. Use Faces & Voices of Recovery’s new Online Advocacy Action Center for contacting your US Representative to ask him or her to co-sponsor the Second Chance Act of 2007, H.R. 1593 by Monday, April 16th.

Name changes proposed for key federal agencies to help reduce stigma
Senator Joe Biden (D-DE) joined other members of Congress to introduce a bill that “is a small but important step towards stripping away the social stigma surrounding the treatment of diseases of addiction," according to Biden. Under the bill, S. 1011, The National Institute on Drug Abuse (NIDA) would become the National Institute on Diseases of Addiction, and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) would be renamed the National Institute on Alcohol Disorders and Health. more…

RESOURCES
Researchers at Rutgers University School of Criminal Justice in Newark, New Jersey are conducting a research project which is designed to collect stories of healing and transformation from about 500 people across the country including people in recovery from addiction. More…
The Substance Abuse Policy Research Program is accepting applications for small grants (under $100,000) with a May 8, 2007 deadline. An initiative of The Robert Wood Johnson Foundation more…
The Second Road is an online community for the tens of millions of people affected by addiction. A pre-release site includes film clips of just a few of the individuals who have told their recovery stories, many of whom are part of the Faces & Voices network of recovery advocates. More…

Faces & Voices of Recovery launches our membership campaign! Join now!

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COMMENTARY: IS THERE A FUTURE FOR QUANTIFYING DRINKING IN THE DIAGNOSIS, TREATMENT, AND PREVENTION OF ALCOHOL USE DISORDERS?
Alcohol and Alcoholism 2007 42(2):57-63;


INTRODUCTION

This commentary is based on a Plenary Address at the 2006 Meeting of the International Society for Biomedical Research on Alcoholism (ISBRA) held in Sydney, Australia, which posed the simple question: Is There a Future for Quantifying Drinking in the Diagnosis, Treatment, and Prevention of Alcohol Use Disorders?

The intention is to stimulate dialogue among the many disciplines represented in the alcohol field about where we should be going with respect to diagnostic criteria for alcohol use disorders (AUDs), now that the American Psychiatric Association (APA) and the World Health Organization (WHO) have launched initiatives for the construction of the fifth revision of the APA Diagnostic and Statistical Manual (DSM-V) and the l1th edition of the WHO International Classification of Diseases (ICD-11).

Our position is that quantifying drinking is very relevant to the diagnosis, treatment, and prevention of AUDs. Good examples are the diagnostic criteria developed over time for other complex diseases (e.g. hypertension and diabetes), in which diagnoses are a combination of quantifiable measures (e.g. blood pressure and blood glucose level) and risk factors for disease (e.g. age, weight, lifestyle, and co-morbid conditions).

For each of these disorders, diagnostic criteria have developed from simple cutpoints (e.g. diastolic and systolic blood pressure cutpoints for diagnosing hypertension in relation to heart attack and stroke), but have been continually refined as data on other dimensions of risk became available.

The data to develop multidimensional, scalable diagnostic criteria for AUDs similar to those for hypertension (National Heart, Lung, and Blood Institute, 2001a), diabetes (American Diabetes Association, 2006), and high blood cholesterol (National Heart, Lung, and Blood Institute, 2001b) are not yet sufficiently refined owing to the absence of quantifiable biomarkers.

However, as described below, we do have enough data to begin developing diagnostic criteria for AUDs based on symptom severity and the quantification of drinking as a dimension in the diagnosis, treatment, and prevention of AUDs. An effort in this direction to guide future treatment prevention strategies is both opportune and feasible.

EXTRACT

REPRINT REQUEST E-MAIL: bhewitt@willco.niaaa.nih.gov

Scottish Alcohol Research Framework
Summary of Current Alcohol Research and Research Gaps

NHS Health Scotland undertook a scoping of the alcohol research literature in Scotland identifying current research and research gaps. This summary was produced and circulated to the Alcohol Evidence Group and was used as a tool to inform the development of the Alcohol Research Framework.
The Scottish Executive has identified the following priorities for action:
• To develop a strong evidence base on the extent and nature of alcohol problems and the effectiveness of harm reduction interventions, and ensure this is reflected in policy development and service delivery.
• To tackle health inequalities.
• To reduce alcohol-related violence and offending.
• To change the culture of excessive drinking and drinking to get drunk to a culture of drinking for responsible enjoyment.
• To reduce the number of young people and young adults under the age of 25 who drink excessively and face particular health and social risks.
• To reduce the number of people of working age (25-64) who are routinely exceeding weekly limits and are at risk of future health harm.
• To reduce the number of women whose drinking puts them at particular health and personal safety risks.
• To develop educational and workplace cultures which promote healthy lifestyle choices and provide people with or at risk of developing alcohol problems with appropriate support.

SUMMARY (PDF)

FULL REPORT (PDF)
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How do public health policies tackle alcohol-related harm: a review of 12 developed countries

Alcohol and Alcoholism Advance Access published online on March 6, 2007

To identify how current public health policies of 12 developed countries assess alcohol-related problems, the goals and targets that are set and the strategic directives proposed.

All the countries studied state that alcohol causes substantial harm to individual health and family well-being, increases crime and social disruption, and results in economic loss through lost productivity.

All are concerned about consumption of alcohol by young adults and by heavy and problem drinkers. Few aim to reduce total consumption. Only five of the countries set specific targets for changes in drinking behaviour.

Countries vary in their commitment to intervene, particularly on taxation, drink-driving, the drinking environment and for high-risk groups. Australia and New Zealand stand out as having coordinated intervention programmes in most areas.

Policies differ markedly in their organization, the goals and targets that are set, the strategic approaches proposed and areas identified for intervention. Most countries could improve their policies by following the recommendations in the World Heath Organization's European Alcohol Action Plan.

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REPRINT REQUEST E-MAIL: i.k.crombie@chs.dundee.ac.uk

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RECOVERY OF HIPPOCAMPUS-RELATED FUNCTIONS IN CHRONIC ALCOHOLICS DURING MONITORED LONG-TERM ABSTINENCE

Alcohol and Alcoholism 2007 42(2):92-102;

The hippocampus (HC) is characterized by high vulnerability to noxious influence, but also by a considerable regenerative potential. Although deficits in HC-related functions are among the most commonly reported cognitive sequelae in alcoholism, little and conflicting information is available concerning regeneration upon abstinence.

The present study has been designed to evaluate (i) the frequency of measurable dysfunction in so called HC tests and (ii) its predictive value for risk to relapse in a cohort of 50 severely affected chronic alcoholic patients and (iii) to monitor recovery of HC-related functions upon strict abstention from alcohol.

Demonstrating slow but remarkable regeneration of HC functions upon strict abstention from alcohol, our data strongly support abstinence-oriented long-term treatment of alcoholics. The absence of functional recovery in patients with additional causes of brain damage might be explained by the ‘dual hit’ exhausting the regenerative potential of the HC.

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REPRINT REQUEST E-MAIL: ehrenreich@em.mpg.de

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Impact of the Alcohol-Dehydrogenase (ADH) 1C and ADH1B polymorphisms on drinking behavior in nonalcoholic Japanese
Human Mutation
Volume 28, Issue 5 , Pages 506 - 510

A linkage disequilibrium (LD) between the alcohol-dehydrogenase 1B (ADH1B) and alcohol-dehydrogenase 1C (ADH1C) polymorphisms adds complexity to differentiating the significance of these two genetic polymorphisms on drinking behavior and alcoholism.

We have recently shown the importance of the ADH1B polymorphism on habitual drinking in the Japanese population; however, the issue regarding the LD between the ADH1B and ADH1C polymorphisms remains to be clarified.

Here, we conducted a cross-sectional study in 2,299 nonalcoholic Japanese individuals. Drinking behavior was examined with regard to haplotypes of the ADH1B and ADH1C polymorphisms.

In conclusion, this study showed a significant impact of the ADH1C polymorphism on habitual drinking, regardless of the ADH1B/ALDH2 polymorphisms.

READ FULL ABSTRACT

REPRINT REQUEST E-MAIL: kmatsuo@aichi-cc.jp
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Center Line

a quarterly newsletter published by the Bowles Center for Alcohol Studies to bring greater understanding of alcoholism and alcoholic disease research

Volume 18, Issue 1, March 2007

(download in PDF format)

• Crews Lab Discovers Inflammatory Mechanisms Underlying
  Alcohol-Induced Brain Damage
• ASAP Clinic- A National Model for Alcohol and Substance Abuse Treatment
• Director's Column

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College Attendance and Its Effect on Drinking Behaviors in a Longitudinal Study of Adolescents
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles).

While college attendance has been shown to be associated with increased drinking behaviors, there are no studies to our knowledge that have examined whether college attendance moderates genetic influences for drinking.

We first tested for changes in alcohol consumption in adolescents who did and did not subsequently attend college, and then tested for variation of the genetic and environmental determinants of drinking in these 2 groups.

Participants who did not attend college reported more binge drinking and consumed greater quantities of alcohol as adolescents than participants who subsequently attended college. However, the college students not only surpassed their noncollege peers in alcohol use as young adults, but also exhibited a greater genetic influence on quantity of alcohol consumed per drinking episode.

Exposure to a college environment acts as an environmental moderator, supporting the hypothesis that the magnitude of genetic influence on certain aspects of alcohol consumption is greater in environments where drinking behaviors are more likely to be promoted.

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REPRINT REQUEST E-MAIL: dtimberl@uci.edu

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Heterogeneous Effects of Alcohol on Dopamine Release in the Striatum: A PET Study

Alcoholism: Clinical and Experimental Research (OnlineEarly Articles).

A dopaminergic response to alcohol in humans has not been demonstrated consistently with positron emission tomography (PET). We hypothesized that the effect of alcohol on striatal dopamine (DA) release may be anatomically heterogeneous between subjects.

Our approach was to identify voxels that exhibited alcohol-induced DA responses within the striatum, and to determine the relationships between DA responses and alcohol-related behavior.

Data from the striatal ΔBP maps nevertheless showed that the anatomic extent and magnitude of alcohol-induced DA release in the striatum are correlated with subjective responses to alcohol.

The heterogeneity of dopaminergic responses to alcohol across subjects may be a reason for the lack of reports demonstrating DA involvement in alcohol-related behaviors. By allowing for different spatial patterns of DA release within each subject's striata, we showed correlations between alcohol-induced DA release in the striata and behavioral outcomes related to alcohol.

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REQUEST REPRINT E-MAIL: kkyoder@iupui.edu

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Drug statistics series no. 18

This report is the twelfth in a series originally titled Statistics on Drug Abuse in Australia. The report provides a comprehensive summary of major drug use statistical collections, with references to sources of more detailed information. It also serves as the 'companion document' to the National Drug Strategy 2004-2009.

Data are presented on patterns of drug use, international comparisons, drugs and health, special population groups, and crime and law enforcement. New to this edition is a feature on methamphetamine use, drug use among prisoners and juvenile offenders, and alcohol use among those in the workforce.

This report and others in the Drug Statistics Series are useful resources for policy-makers, planners and researchers interested in drug-related matters.

Key findings

Alcohol

• In 2004, 9% of Australians drank daily, 41% drank weekly and 34% drank less than
weekly.

• This pattern has remained relatively unchanged over the period 1991 to 2004.

• In 2004, 35% of Australians drank alcohol at levels considered risky or high risk for
short-term harm and 10% at levels considered risky or high risk for long-term harm.

READ FULL REPORT (PDF)
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Care of Adults With Mental Health and Substance Abuse Disorders in U.S. Community Hospitals, 2004 HCUP Fact Book No. 10

This Fact Book examines community hospital care for adults 18 years of age and older with mental health and substance abuse MHSA diagnoses. Community hospitals are non-Federal, short-term (or acute care) general and specialty hospitals. They include any type of hospital that is open to the public, such as academic medical centers, medical specialty hospitals, and public hospitals, but they do not include specialty psychiatric or substance abuse treatment facilities.

This Fact Book provides an overview of hospital stays involving MHSA disorders and addresses these key questions:

• What are the common reasons for hospitalization, by type and diagnosis?
• How do stays vary by gender and age?
• How are patients admitted to the hospital?
• What is the mean length of stay?
• How much do hospital stays cost?
• What percentage of hospital resource use is attributable to MHSA disorders?
• Who is billed for hospital stays?
• Where do patients go after they are discharged?

In addition, this Fact Book presents detailed statistics on three special topics related to MHSA hospitalizations:

• Dual diagnosis stays (i.e., the patient has both a substance-related and a mental health disorder).
• Stays related to suicide or attempted suicide.
• Maternal stays complicated by a mental health or substance abuse disorder.

Eleven mutually exclusive categories of MHSA disorders are examined in this Fact Book:

• Mood disorders.
• Substance-related disorders.
• Delirium, dementia, and amnestic and cognitive disorders.
• Anxiety disorders.
• Schizophrenia and other psychotic disorders.
• Personality disorders.
• Adjustment disorders.
• Disruptive behavior disorders.
• Impulse control disorders.
• Disorders usually diagnosed in infancy, childhood, and adolescence.
• Miscellaneous mental disorders.

READ FULL FACT BOOK (PDF)

Contributor: Don Phillips

Hispanic Female Admissions in Substance Abuse Treatment, Highlights: Female Hispanic admissions comprise about 10% (61,000 admissions) of the female substance abuse treatment admissions reported to SAMHSA's 2005 Treatment Episode Data Set (TEDS). Among female Hispanic admissions in SAMHSA's 2005 Treatment Episode Data Set (TEDS), 41% were of Mexican origin, 24% were Puerto Rican, 4% were Cuban, and 31% were Other Hispanic origin. Hispanic female admissions were less likely than nonHispanic female admissions to substance abuse treatment to report alcohol as their primary drug of abuse (23% vs. 32%). Hispanic female admissions were more likely than nonHispanic female admissions to substance abuse treatment to report stimulants as their primary drug of abuse (21% vs. 12%). The primary drug of abuse differed among the Hispanic origin groups of female admissions: Puerto Ricans (43%) and Cubans (29%) were more likely to report opiates, Mexicans (35%) were more likely to report stimulants, and other Hispanic origins (23%) were more likely to report alcohol as their primary drug of abuse. The average age at admission also varied among the Hispanic groups of female admissions in SAMHSA's Treatment Episode Data Set (TEDS). READ FULL REPORT (PDF) _____________________________________________________________

Reasons for increased substance use in psychosis
Clinical Psychology Review
Volume 27, Issue 4 , May 2007, Pages 494-510

Around half of all patients with schizophrenia are thought to abuse drugs or alcohol and there is good evidence to suggest that they have poorer outcomes than their non substance using counterparts.

This paper provides an update of the literature examining the reasons for substance use by people with psychosis, and includes a comprehensive review of the self report literature. The main theories as to why people with psychosis use substances are presented.

The self report literature provides support for an ‘alleviation of dysphoria’ model of substance use but there is little empirical support for the self medication hypothesis, or for common factor models and bidirectional models of comorbidity.

It is likely that there are multiple risk factors involved in substance use in psychosis and more work to develop and test multiple risk factor models is required.

READ FULL ABSTRACT

REPRINT REQUEST E-MAIL: lynsey.gregg@manchester.ac.uk

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