kim wolff

In most developed countries cannabis is the illicit drug that is most often used by adolescents, and the one that adolescents are most likely to develop problems with that require treatment (Crowley, 2006; SAMHSA, 2006). Cannabis problems consequently predominate among young people seen in specialist addiction services, mental health services and criminal justice settings in Australia (Spooner et al., 1996), Europe (EMCDDA, 2006) and the USA (Crowley et al., 1998; Grella, 2006). Other illicit drugs, such as the ...

Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.

Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.

Sweat deposited via latent fingerprints (LFPs) was previously used to detect cocaine, opioids, cannabis and amphetamine via a point-of-care test (POCT). This screening method combined non-invasive sampling with a rapid result turnaround to produce a qualitative result outside of the laboratory. We report the novel application of a LFP drug screening test in a social care setting. Clients were tested on either an ad hoc or a routine basis using the POCT DOA114 (Intelligent Fingerprinting Ltd) drug screening cartridge. Screening cutoff values were 45, 35 and 95 pg/fingerprint for benzoylecgonine (BZE), morphine and amphetamine analytes, respectively. Confirmation LFP samples (DOA150, Intelligent Fingerprinting Ltd) and oral fluid (OF) were analyzed using ultra-performance liquid chromatography with tandem mass spectrometry. Thirty-six clients aged 36 ± 11 years participated (53% females). Individuals self-reported alcohol consumption (39%) and smoking (60%). Of 131 screening tests col...

Substance misuse has been a major health and social issue worldwide and has become an important public health issue in China over the past two decades. Methadone maintenance treatment (MMT) has been proved worldwide by large bodies of research to be one of the most effective practices for illicit drug users. The Treatment Outcome Profile (TOP) was developed in 2007 by the UK National Treatment Agency (NTA). It has been proved to be a reliable instrument for outcome measure. This study aim to develop the Chinese version of the Treatment Outcome Profile (TOP), and to assess whether TOP is a reliable outcome measure that can be recommended for use in Chinese MMT program. The Chinese version of TOP was translated and revised based on the English version of TOP. Psychometric properties of TOP were evaluated through face-to-face interviews in 197 patients who had been attending methadone maintenance treatment clinics in Kunming city, Yunnan Institute for Drug Abuse, for less than three mo...

There is a reasonable theoretical base for understanding the possible causes and motivations behind substance misuse and its dependency. There is a need for a reliable and valid measure that delineates the markers of substance use from its initiation and identifies different motivations for drug use transitioning, maintenance, and dependency. We addressed this gap in the United Kingdom by examining and validating the Substance Transitions in Addiction Rating Scale (STARS). For this review, 390 male prisoners were screened for conduct disorder and assessed with a clinical diagnostic interview for attention deficit/hyperactivity disorder (ADHD). They completed the four STARS subscales regarding their substance use. Exploratory structural equation modeling was performed to assess the STARS structure and to derive factors to assess validity against ADHD and conduct disorder diagnostic categories. Each of the subscales produced meaningful and reliable factors that supported the self-medi...

The objective of the study is to quantify the extent of specific polysubstance use, drug transitions to current substances, and describe the association with alcohol use disorders among inmates with ADHD. We also examined health risk behaviors and patterns of offending in relation with ADHD. A total of 387 male British prison inmates were screened and interviewed via the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2). Male prisoners with ADHD endorse more methadone and amphetamine use. There was a significantly higher linear trend among those with ADHD for the number of substances ever used. ADHD was positively associated with increasing levels of alcohol use disorder severity, and with alcohol dependence. Transition along the pathways of substance misuse and persistence of drug misuse was better explained by the presence of conduct disorder/antisocial personality traits. Higher rates of alcohol dependence and stimulant-cocaine misuse suggest these inmates have maladaptive cop...

To determine at the peak age for sudden infant death syndrome (SIDS) the ventilatory response to hypoxia of infants whose mothers substance misused in pregnancy (SM infants), or smoked during pregnancy (S mothers) and controls whose mothers neither substance misused or smoked. In addition, we compared the ventilatory response to hypoxia during the neonatal period and peak age of SIDS. Infants of S or SM mothers compared to control infants would have a poorer ventilatory response to hypoxia at the peak age of SIDS. Prospective, observational study. Twelve S; 12 SM and 11 control infants were assessed at 6-12 weeks of age and in the neonatal period. Changes in minute volume, oxygen saturation, heart rate, and end tidal carbon dioxide levels on switching from breathing room air to 15% oxygen were assessed. Maternal and infant urine samples were tested for cotinine, cannabinoids, opiates, amphetamines, methadone, cocaine, and benzodiazepines. The S and SM infants had a greater decline i...

To evaluate the impact of excessive alcohol consumption on the health-related quality of life of patients receiving methadone treatment for opioid dependence. A cross-sectional survey. One hundred and ninety-two patients attending out-patient methadone clinics in the south-east of England, United Kingdom. Quality of life (QoL) was assessed using the Medical Outcomes Study: General Health Survey, Short Form (SF-12). Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Approximately one-third of the sample (57/192) were AUDIT-positive (score > or = 8) and 20 of the 135 AUDIT-negative patients reported past history of alcohol problems. AUDIT-positive patients were less satisfied with their methadone dose than AUDIT-negative patients (P = 0.002), despite having a higher dose. AUDIT-positive patients reported more physical (P = 0.020) and psychological (P = 0.034) health problems and poorer QoL (P = 0.008) with an estimated effect size of 0.46. Lower QoL scores for AUDIT-positive patients affected both 'physical' (P = 0.009) and 'psychological' (P = 0.012) health domains with poor role functioning ('role limitation' due to physical health, P < 0.001 and to emotional health, P = 0.009), social functioning (P = 0.015) and self-perceived general health (P = 0.029). Excessive alcohol consumption may be associated with a distinctive pattern of QoL impairment in methadone patients. In addition to advising methadone patients regarding their alcohol consumption, comprehensive care plans should seek to restore normal personal, family and social role functioning through the provision of appropriate health and social care.

IntroductionOver the last decade a series of guidelines and recommendations have been published in the UK by the Department of Health, the Home Office, Professional and Non-Professional bodies. However, an optimal strategy and consensus in the management and care of opioid dependent pregnant users has yet to be established.ObjectivesDetermination of existing methods for identifying and managing pregnancy in opioid users prescribed methadone by NHS Treatment Services and regional differences.AimTo survey the management, treatment and follow-up of pregnant opioid users prescribed methadone by Drug Treatment Services in England and Wales.MethodsIn 2006 a POSTAL survey was conducted among 223 Community Drug Treatment Services (CDTS).ResultsSixty-six percent of CDTS responded to the survey (n = 154/233). A Chi-square, Mann_Whitney U Test and/or Kruskal-Wallis analysis revealed significant differences in the composition of CDTS and service provision across regions. Half of CDTS (55.3%) provided a methadone dosage regime lower than that recommended for non-pregnant drug users. There were also significant variations on how professionals approached the management of pregnant opioid users. CDTS with an addiction specialist were significantly more likely (p < .01) to advocate high doses of methadone whereas those with a midwife, obstetrician or social worker involved were more likely (p < .05) to suggest low dose methadone and/or detoxification.ConclusionsService provision for pregnant opioid users is comprehensive but there is still variability in some aspects of the treatment received. The way in which methadone is prescribed is not always optimal. Further work is required in this area.