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Find video protocols related to scientific articles indexed in Pubmed.
The cost-effectiveness and public health benefit of nalmefene added to psychosocial support for the reduction of alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels: a Markov model.
BMJ Open
PUBLISHED: 09-18-2014
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To determine whether nalmefene combined with psychosocial support is cost-effective compared with psychosocial support alone for reducing alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels (DRLs) as defined by the WHO, and to evaluate the public health benefit of reducing harmful alcohol-attributable diseases, injuries and deaths.
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Efficacy of an alcohol-focused intervention for improving adherence to antiretroviral therapy (ART) and HIV treatment outcomes - a randomised controlled trial protocol.
BMC Infect. Dis.
PUBLISHED: 08-22-2014
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Little research has examined whether alcohol reduction interventions improve antiretroviral therapy (ART) adherence and HIV treatment outcomes. This study assesses the efficacy of an intervention for reducing alcohol use among HIV patients on ART who are hazardous/harmful drinkers. Specific aims include adapting a blended Motivational Interviewing (MI) and Problem Solving Therapy (PST) intervention for use with HIV patients; evaluating the efficacy of the intervention for reducing alcohol consumption; and assessing counsellors' and participants' perceptions of the intervention.
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Gender differences in socioeconomic inequality of alcohol-attributable mortality: A systematic review and meta-analysis.
Drug Alcohol Rev
PUBLISHED: 08-08-2014
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The present analysis contributes to understanding the societal distribution of alcohol-attributable harm by investigating socioeconomic inequality and related gender differences in alcohol-attributable mortality.
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Associations of hair cortisol concentration with self-reported measures of stress and mental health-related factors in a pooled database of diverse community samples.
Stress
PUBLISHED: 06-25-2014
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A pooled database from diverse community samples was used to examine the associations of hair cortisol concentration (HCC) with self-reported stress and stress-linked mental health measures, including depression, anxiety, alcohol and drug use, disability and experiences with aggression. As part of innovative research using a mobile laboratory to study community mental health, data were pooled from five sub-studies: a random sample of the general population (n?=?70), people who had received treatment for a mental health and/or substance use problem (n?=?78), family members of people treated for mental health and/or substance use problems (n?=?49), community volunteers who sometimes felt sad or blue or thought they drank too much (n?=?83) and young adults in intimate partner relationships (n?=?44). All participants completed a computerized questionnaire including standard measures of perceived stress, chronic stress, depression, anxiety, hazardous drinking, tobacco use, prescription drug use, illicit drug use, disability and intimate partner aggression. HCC was significantly associated with use of antidepressants, hazardous drinking, smoking and disability after adjusting for sub-study and potential confounders (sex, body-mass index, use of glucocorticoids and hair dyed). In addition, preliminary analyses suggest a significant curvilinear relationship between HCC and perceived stress; specifically, HCC increased with higher perceived stress but decreased at the highest level of stress. Overall, HCC was associated with mental health-related variables mainly reflecting substance use or experiencing a disability. The relationship between HCC and self-reported stress is unclear and needs further research.
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Harms of prescription opioid use in the United States.
Subst Abuse Treat Prev Policy
PUBLISHED: 06-18-2014
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Consumption levels of prescription opioids (POs) have increased substantially worldwide, particularly the United States. An emerging perspective implicates increasing consumption levels of POs as the primary system level driving factor behind the observed PO-related harms. As such, the present study aimed to assess the correlations between consumption levels of POs and PO-related harms, including non-medical prescription opioid use (NMPOU), PO-related morbidity and PO-related mortality.
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Alcohol-attributable mortality in Switzerland in 2011--age-specific causes of death and impact of heavy versus non-heavy drinking.
Swiss Med Wkly
PUBLISHED: 05-20-2014
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Alcohol use causes high burden of disease and injury globally. Switzerland has a high consumption of alcohol, almost twice the global average. Alcohol-attributable deaths and years of life lost in Switzerland were estimated by age and sex for the year 2011. Additionally, the impact of heavy drinking (40+grams/day for women and 60+g/day for men) was estimated.
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Contribution of six risk factors to achieving the 25×25 non-communicable disease mortality reduction target: a modelling study.
Lancet
PUBLISHED: 05-02-2014
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Countries have agreed to reduce premature mortality (defined as the probability of dying between the ages of 30 years and 70 years) from four main non-communicable diseases (NCDs)--cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes--by 25% from 2010 levels by 2025 (referred to as 25×25 target). Targets for selected NCD risk factors have also been agreed on. We estimated the contribution of achieving six risk factor targets towards meeting the 25×25 mortality target.
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Individuals receiving specialized treatment for drug and alcohol dependence and gambling disorder in Israel--characteristics and implications for prevalence estimates.
Subst Abus
PUBLISHED: 05-01-2014
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Substance dependence is one of the main factors contributing to morbidity and mortality worldwide. Gambling disorder has recently been included as an addictive disorder in DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) and is associated with substantial psychiatric comorbidity and respective disability. Nevertheless, the vast majority of those suffering from these disorders do not receive treatment. In Israel, prevalence of substance dependence has traditionally been estimated to be lower than those in high-income countries, though prevalence estimates from the recent decade are lacking. Moreover, characteristics of individuals seeking treatment for substance dependence and gambling disorder have not been published.
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Alcoholic beverage strength discrimination by taste may have an upper threshold.
Alcohol. Clin. Exp. Res.
PUBLISHED: 04-19-2014
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Given the association between alcohol consumption and negative health consequences, there is a need for individuals to be aware of their consumption of ethanol, which requires knowledge of serving sizes and alcoholic strength. This study is one of the first to systematically investigate the ability to discriminate alcoholic strength by taste.
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A comparison of the prevalence of prenatal alcohol exposure obtained via maternal self-reports versus meconium testing: a systematic literature review and meta-analysis.
BMC Pregnancy Childbirth
PUBLISHED: 03-26-2014
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Maternal self-reports, used for the detection of prenatal alcohol exposure (PAE), may lack validity, necessitating the use of an objective biomarker. The detection of fatty acid ethyl esters (products of non-oxidative ethanol metabolism) in meconium has been established as a novel biomarker of PAE. The purpose of the current study was to compare the prevalence of PAE as reported via maternal self-reports with the results of meconium testing, and to quantify the disparity between these two methods.
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A predictive microsimulation model to estimate the clinical relevance of reducing alcohol consumption in alcohol dependence.
Eur Addict Res
PUBLISHED: 03-22-2014
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Alcohol consumption is one of the most important factors for disease and disability in Europe. In clinical trials, nalmefene has resulted in a significant reduction in the number of heavy-drinking days (HDDs) per month and total alcohol consumption (TAC) among alcohol-dependent patients versus placebo.
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Socioeconomic differences in alcohol-attributable mortality compared with all-cause mortality: a systematic review and meta-analysis.
Int J Epidemiol
PUBLISHED: 03-11-2014
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Factors underlying socioeconomic inequalities in mortality are not well understood. This study contributes to our understanding of potential pathways to result in socioeconomic inequalities, by examining alcohol consumption as one potential explanation via comparing socioeconomic inequalities in alcohol-attributable mortality and all-cause mortality.
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Prevalence of and Potential Influencing Factors for Alcohol Dependence in Europe.
Eur Addict Res
PUBLISHED: 03-04-2014
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Alcohol use disorders (AUDs), and alcohol dependence (AD) in particular, are prevalent and associated with a large burden of disability and mortality. The aim of this study was to estimate prevalence of AD in the European Union (EU), Iceland, Norway, and Switzerland for the year 2010, and to investigate potential influencing factors. The 1-year prevalence of AD in the EU was estimated at 3.4% among people 18-64 years of age in Europe (women 1.7%, men 5.2%), resulting in close to 11 million affected people. Taking into account all people of all ages, AD, abuse and harmful use resulted in an estimate of 23 million affected people. Prevalence of AD varied widely between European countries, and was significantly impacted by drinking cultures and social norms. Correlations with level of drinking and other drinking variables and with major known outcomes of heavy drinking, such as liver cirrhosis or injury, were moderate. These results suggest a need to rethink the definition of AUDs. © 2014 S. Karger AG, Basel.
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Trends and changes in prescription opioid analgesic dispensing in Canada 2005-2012: an update with a focus on recent interventions.
BMC Health Serv Res
PUBLISHED: 02-21-2014
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Prescription opioid analgesic (POA) utilization has steeply increased globally, yet is far higher in established market economies than elsewhere. Canada features the world's second-highest POA consumption rates. Following increases in POA-related harm, several POA control interventions have been implemented since 2010.
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Terrorism, civil war and related violence and substance use disorder morbidity and mortality: a global analysis.
J Epidemiol Glob Health
PUBLISHED: 02-19-2014
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The purpose of this study is to examine associations between deaths owing to terrorism, civil war, and one-sided violence from 1994-2000 and substance use disorder disability-adjusted life years (DALYs).
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Cycling-related crash risk and the role of cannabis and alcohol: a case-crossover study.
Prev Med
PUBLISHED: 02-10-2014
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To examine whether alcohol and cannabis consumption increase crash risk among non-fatally injured bicyclists (N=393) seen in three Canadian emergency departments, between April 2009 and July 2011.
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Cause-specific mortality risk in alcohol use disorder treatment patients: a systematic review and meta-analysis.
Int J Epidemiol
PUBLISHED: 02-10-2014
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Alcohol use disorders (AUD) are highly disabling. Recent studies reported much higher relative risks for all-cause mortality in AUD patients compared with earlier studies. Systematic evidence regarding cause-specific mortality among AUD patients has been unavailable to date.
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Non-medical prescription opioid use, prescription opioid-related harms and public health in Canada: an update 5 years later.
Can J Public Health
PUBLISHED: 02-09-2014
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Five years ago, we highlighted Canada's emerging problem of prescription opioid (PO)-related harms and emphasized the need for targeted surveillance, research and interventions. Overall levels of PO use in the Canadian population have grown by 70% since then, while at the same time levels of non-medical PO use (NMPOU) in general and in key risk populations have continued to be high; furthermore, PO-related harms - specifically morbidity (e.g., treatment admissions) and mortality (e.g., overdose deaths) - have risen substantively. Unfortunately, major knowledge gaps related to systematic monitoring of PO-related harms continue to exist; for example, no national morbidity or mortality statistics are available. Investigator-driven research has generated important insights into the epidemiology and impacts of PO-related harms: high correlations between population-level PO dispensing and/or PO dosing and harms; high rates of co-occurrence of NMPOU and co-morbidities; and distinct NMPOU-related risk dynamics among street drug users. Select policy measures have been implemented only recently at the federal and provincial levels; these interventions remain to be systematically evaluated, especially given preliminary indications of reductions in PO-related harms (e.g., NMPOU) unfolding prior to the interventions. For these purposes, improvements in surveillance tools and research resources devoted to the extensive public health problem of PO-related harms in Canada continue to be urgently needed.
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Canadian Children and Youth in Care: The Cost of Fetal Alcohol Spectrum Disorder.
Child Youth Care Forum
PUBLISHED: 02-04-2014
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A high prevalence of prenatal alcohol exposure has been reported among children in care and thus, the risk of fetal alcohol spectrum disorder (FASD) in this population is high.
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A systematic review of the epidemiology of unrecorded alcohol consumption and the chemical composition of unrecorded alcohol.
Addiction
PUBLISHED: 01-22-2014
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Unrecorded alcohol constitutes about 30% of all alcohol consumed globally. The aims of this systematic review were to determine the epidemiology (occurrence, types, prevalence) of unrecorded alcohol consumption in different countries/regions, analyse the chemical composition of unrecorded alcohol and examine health outcomes caused by the consumption of unrecorded alcohol, based on either epidemiology or toxicology.
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Burden of disease associated with alcohol use disorders in the United States.
Alcohol. Clin. Exp. Res.
PUBLISHED: 01-15-2014
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Alcohol use disorders (AUD) have long been considered to be some of the most disabling mental disorders; however, empirical data on the burden of disease associated with AUD have been sparse. The objective of this article is to quantify the burden of disease (in disability-adjusted life years [DALYs] lost), deaths, years of life lost due to premature mortality (YLL), and years of life lost due to disability (YLD) associated with AUD for the United States in 2005.
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Influence of unrecorded alcohol consumption on liver cirrhosis mortality.
World J. Gastroenterol.
PUBLISHED: 01-10-2014
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Unrecorded alcohol includes illegally distributed alcohol as well as homemade or surrogate alcohol which is unintended for consumption by humans (e.g., cosmetics containing alcohol). The highest unrecorded alcohol consumption occurs in Eastern Europe and some of these countries have an over proportional liver cirrhosis mortality. Compounds besides ethanol have been hypothesized as being responsible for this observation. On the other hand, chemical investigations were unable to prove that unrecorded alcohol regularly contains contaminants above toxicological thresholds. However, illegally produced spirits regularly contain higher percentages of alcohol (above 45% by volume), but for considerably less costs compared with licit beverages, potentially causing more problematic patterns of drinking. In this review, it is investigated whether patterns of drinking rather than product composition can explain the liver cirrhosis mortality rates. Statistical examination of World Health Organization country data shows that the originally detected correlation of the percentage of unrecorded alcohol consumption and liver cirrhosis mortality rates disappears when the data is adjusted for the prevalence of heavy episodic drinking. It may be concluded that there is currently a lack of data to demonstrate causality between the composition of illicit spirits (e.g., higher levels of certain contaminants in home-produced products) and liver toxicity on a population scale. Exceptions may be cases of poisoning with antiseptic liquids containing compounds such as polyhexamethyleneguanidine, which were reported to be consumed as surrogate alcohol in Russia, leading to an outbreak of acute cholestatic liver injury, histologically different from conventional alcoholic liver disease.
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Doing it by numbers: a simple approach to reducing the harms of alcohol.
J. Psychopharmacol. (Oxford)
PUBLISHED: 01-09-2014
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Alcohol use is one of the top five causes of disease and disability in almost all countries in Europe, and in the eastern part of Europe it is the number one cause. In the UK, alcohol is now the leading cause of death in men between the ages of 16-54 years, accounting for over 20% of the total. Europeans above 15 years of age in the EU on average consume alcohol at a level which is twice as high as the world average. Alcohol should therefore be a public health priority, but it is not. This paper puts forward a new approach to reduce alcohol use and harms that would have major public health and social impacts. Our approach comprises individual behaviour and policy elements. It is based on the assumption that heavy drinking is key. It is simple, so it would be easy to introduce, and because it lacks stigmatising issues such as the diagnosis of addiction and dependence, it should not be contentious.
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The potential impact of increased treatment rates for alcohol dependence in the United Kingdom in 2004.
BMC Health Serv Res
PUBLISHED: 01-07-2014
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Alcohol consumption has been linked to a considerable burden of disease in the United Kingdom (UK), with most of this burden due to heavy drinking and Alcohol Dependence (AD). However, AD is undertreated in the UK, with only 8% of those individuals with AD being treated in England and only 6% of those individuals with AD being treated in Scotland. Thus, the objective of this paper is to quantify the deaths that would have been avoided in the UK in 2004 if the treatment rate for AD had been increased.
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Chronic heavy drinking and ischaemic heart disease: a systematic review and meta-analysis.
Open Heart
PUBLISHED: 01-01-2014
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Previous meta-analyses have reported either a protective, neutral or detrimental association from chronic heavy drinking in relation to ischaemic heart disease (IHD). We investigated the potential for systematic error because of study design. Using MOOSE guidelines, studies were identified through MEDLINE, EMBASE and Web of Science up to end of March, 2014. Epidemiological studies reporting on chronic heavy drinking and IHD risk in population studies and samples of people with alcohol use disorder (AUD) were included. Random-effects meta-analysis was used to pool eligible studies. The I(2) statistic was used to assess heterogeneity across studies. In total, 34 observational studies with 110?570 chronic heavy drinkers and 3086 IHD events were identified. In population studies among men, the pooled risk for IHD incidence (fatal+non-fatal events) among chronic heavy drinkers (on average ?60?g pure alcohol/day) in comparison to lifetime abstainers (n=11 studies) was relative risk (RR)=1.04 (95% CI 0.83 to 1.31, I(2)=54%). Few studies were available for women. In patients with AUD, the risk of IHD mortality in comparison to the general population was elevated with a RR=1.62 (95% CI 1.34 to 1.95, I(2)=81%) in men and RR=2.09 (95% CI 1.28 to 3.41, I(2)=67%) in women. There was a general lack of adjustment other than sex and age in studies among patients with AUD. There is no systematic evidence for a protective association from any type of chronic heavy drinking on IHD risk. Patients with AUD were at higher risk for IHD mortality, but better quality evidence is needed with regard to potential confounding.
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The moderating effects of sex and age on the association between traumatic brain injury and harmful psychological correlates among adolescents.
PLoS ONE
PUBLISHED: 01-01-2014
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Although it is well established that sex is a risk factor in acquiring a traumatic brain injury (TBI) among adolescents, it has not been established whether it also moderates the influence of other TBI psychological health correlates.
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Tobacco smoking, alcohol drinking, diabetes, low body mass index and the risk of self-reported symptoms of active tuberculosis: individual participant data (IPD) meta-analyses of 72,684 individuals in 14 high tuberculosis burden countries.
PLoS ONE
PUBLISHED: 01-01-2014
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The effects of multiple exposures on active tuberculosis (TB) are largely undetermined. We sought to establish a dose-response relationship for smoking, drinking, and body mass index (BMI) and to investigate the independent and joint effects of these and diabetes on the risk of self-reported symptoms of active TB disease.
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Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents.
PLoS ONE
PUBLISHED: 01-01-2014
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Our knowledge on the adverse correlates of traumatic brain injuries (TBI), including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario.
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Cost of speech-language interventions for children and youth with foetal alcohol spectrum disorder in Canada.
Int J Speech Lang Pathol
PUBLISHED: 12-18-2013
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This study, which is part of a large economic project on the overall burden and cost associated with Foetal Alcohol Spectrum Disorder (FASD) in Canada, estimated the cost of 1:1 speech-language interventions among children and youth with FASD for Canada in 2011. The number of children and youth with FASD and speech-language disorder(s) (SLD), the distribution of the level of severity, and the number of hours needed to treat were estimated using data from the available literature. 1:1 speech-language interventions were computed using the average cost per hour for speech-language pathologists. It was estimated that ˜ 37,928 children and youth with FASD had SLD in Canada in 2011. Using the most conservative approach, the annual cost of 1:1 speech-language interventions among children and youth with FASD is substantial, ranging from $72.5 million to $144.1 million Canadian dollars. Speech-language pathologists should be aware of the disproportionate number of children and youth with FASD who have SLD and the need for early identification to improve access to early intervention. Early identification and access to high quality services may have a role in decreasing the risk of developing the secondary disabilities and in reducing the economic burden of FASD on society.
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Prevalence of Pain Among Nonmedical Prescription Opioid Users in Substance Use Treatment Populations: Systematic Review and Meta-analyses.
Pain Physician
PUBLISHED: 11-29-2013
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Prescription opioid analgesics (POA) are widely used in the pharmacotherapeutic treatment of acute and chronic pain in North America, where nonmedical prescription opioid use (NMPOU) has become a substantial public health concern in recent years. Existing epidemiological data suggest an association between NMPOU and pain problem symptoms in different populations, including samples in substance use treatment, although the extent of these correlations has not been systematically assessed.
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What research is being done on prenatal alcohol exposure and fetal alcohol spectrum disorders in the Russian research community?
Alcohol Alcohol.
PUBLISHED: 10-23-2013
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Although Russia has one of the highest rates of alcohol consumption and alcohol-attributable burden of disease, little is known about the existing research on prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorders (FASDs) in this country. The objective of this study was to locate and review published and unpublished studies related to any aspect of PAE and FASD conducted in or using study populations from Russia.
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The burden of mental illness and addiction in ontario.
Can J Psychiatry
PUBLISHED: 10-09-2013
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Public Health Ontario and the Institute for Clinical Evaluative Sciences have collaborated to estimate the burden of illness attributable to mental disorder and addictions in Ontario.
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Prevalence of fetal alcohol spectrum disorders in child care settings: a meta-analysis.
Pediatrics
PUBLISHED: 09-09-2013
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Children often enter a child-care system (eg, orphanage, foster care, child welfare system) because of unfavorable circumstances (eg, maternal alcohol and/or drug problems, child abuse/neglect). Such circumstances increase the odds of prenatal alcohol exposure, and thus this population can be regarded as high risk for fetal alcohol spectrum disorders (FASD). The primary objective was to estimate a pooled prevalence for fetal alcohol syndrome (FAS) and FASD in various child-care systems based on data from existing studies that used an active case ascertainment method.
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Correlations between prescription opioid analgesic dispensing levels and related mortality and morbidity in Ontario, Canada, 2005-2011.
Drug Alcohol Rev
PUBLISHED: 09-06-2013
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Prescription opioid analgesic (POA)-related harms constitute a major public health problem in North America. Ontario features above-average POA use levels in Canada and has seen consistent increases in related mortality and morbidity. Recent studies documented strong correlations between POA dispensing levels and related harm outcomes on population levels. We examined correlations between POA dispensing and key POA-related mortality and morbidity indicators in Ontario, 2005-2011.
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Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.
Lancet
PUBLISHED: 08-29-2013
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We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to estimate the burden of disease attributable to mental and substance use disorders in terms of disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs).
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Naltrexone may block euphoria-like placebo effect.
BMJ Case Rep
PUBLISHED: 08-09-2013
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Naltrexone is a first-line treatment for alcohol use disorders in North America and Europe. It was prescribed to a 63-year-old patient in order to help control amounts of alcohol consumed per drinking occasion. The patient experienced a paradoxical, but consistent side effect of feeling inebriated each time he took naltrexone. In order to investigate this phenomenon we administered naltrexone and a placebo in a randomised double-blind fashion. The patient exhibited a high-like response to all placebo capsules and a decrease in the subjectively perceived euphoria shortly after ingestion of naltrexone. Given that this placebo effect could be mediated via opioid receptors we suggest that this case illustrates the ability of naltrexone to eliminate the placebo effect. This feature of naltrexone, upon further investigation, might be used in randomised clinical trials in addition to or as an alternative to a placebo.
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Prevalence of Axis-1 psychiatric (with focus on depression and anxiety) disorder and symptomatology among non-medical prescription opioid users in substance use treatment: Systematic review and meta-analyses.
Addict Behav
PUBLISHED: 07-31-2013
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Non-medical prescription opioid use (NMPOU) constitutes a substantial clinical and public health concern in North America. Although there is evidence of elevated rates of mental health problems among people with NMPOU, the extent of these correlations specifically in treatment samples has not been systematically assessed. A systematic review and meta-analysis were conducted for Axis-1 psychiatric diagnoses and symptoms with a principal focus on depression and anxiety disorders in substance use treatment samples reporting NMPOU at admission to treatment (both criteria within past 30days). 11 unique studies (all from either the United States or Canada) met inclusion criteria and were included in the meta-analysis. The pooled prevalence of any mental health problems (both diagnosis and symptoms) among substance abuse treatment patients reporting NMPOU was 43% (95% CI: 32%-54%; I(2) for inter-study heterogeneity: 99.5%). The pooled prevalence of depression diagnosis among substance abuse treatment patients reporting NMPOU was 27% (95% CI: 9%-45%; I(2): 99.2%); the pooled prevalence of anxiety diagnosis in the sample was 29% (95% CI: 14%-44%; I(2): 98.7%). The prevalence rates of psychiatric problems (both diagnosis and symptoms), depression diagnosis and anxiety diagnosis are disproportionately high in substance use treatment samples reporting NMPOU relative to general population rates. Adequate and effective clinical strategies are needed to address co-occurring NMPOU and mental health in substance use treatment systems, especially given rising treatment demand for NMPOU. Efforts are needed to better understand the temporal and causal relationships among NMPOU, mental health problems, and treatment seeking in order to improve interventions.
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Establishing disability weights from pairwise comparisons for a US burden of disease study.
Int J Methods Psychiatr Res
PUBLISHED: 05-28-2013
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To determine valid and reliable disability weights for a U.S. burden of disease study, a convenience sample of 68 clinical experts was recruited, including representatives from over 20 NIH institutes and Centers for Disease Control and Prevention. Experts were given various health state valuation tasks including pairwise comparison, ranking, and Person Trade Off. Materials consisted of standardized descriptions of 11 attributes per health state (Classification and Measurement System of Functional Health, CLAMES). Attributes comprised up to 5 ordinal levels of disability. All states were displayed either with or without health state labels. Health state descriptions were taken from an existing comprehensive Canadian system. Conditional Logistic (CLR) and Probit Regression (PR) were used to derive disability weights. CLR and PR converged in yielding stable regression weights to construct disability weights, with a correlation of 0.816. The overall test-retest reliability amounted to 92.5% identical decisions. No significant difference was found for the presentation of health states with or without labels. A comparison of the expert valuations from our study with a standard gamble based valuation in the general population resulted in agreement of r = 0.61. The chosen methodology yielded valid and reliable and disability weights. As it is based on a modularized set of attributes, this methodology will allow derivation of disability weights on the basis of existing descriptions using the CLAMES.
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Alcohol consumption, alcohol dependence, and related mortality in Italy in 2004: effects of treatment-based interventions on alcohol dependence.
Subst Abuse Treat Prev Policy
PUBLISHED: 05-18-2013
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BACKGROUND: The tradition of consuming alcohol has long been a part of Italian culture and is responsible for a large health burden. This burden may be reduced with effective interventions, one of the more important of which is treatment for Alcohol Dependence (AD). The aim of this article is to estimate the burden of disease in Italy attributable to alcohol consumption, heavy alcohol consumption, and AD. An additional aim of this paper is to examine the effects of increasing the coverage of treatment for AD on the alcohol-attributable burden of disease. METHODS: Alcohol-attributable deaths and the effects of treatments for AD were estimated using alcohol-attributable fractions and simulations. Deaths, potential years of life lost, years lived with disability, and disability adjusted life years lost were obtained for 2004 for Italy and for the European Union from the Global Burden of Disease study. Alcohol consumption data were obtained from the Global Information System on Alcohol and Health. The prevalences of current drinkers, former drinkers, and lifetime abstainers were obtained from the GENder Alcohol and Culture International Study. The prevalence of AD was obtained from the World Mental Health Survey. Alcohol relative risks were obtained from various meta-analyses. RESULTS: 5,320 deaths (1,530 female deaths; 3,790 male deaths) or 5.9% of all deaths (4.9% of all female deaths; 6.3% of all male deaths) of people 15 to 64 years of age were estimated to be alcohol-attributable. Of these deaths, 74.5% (61.3% for females; 79.8% for males) were attributable to heavy drinking, and 26.9% (25.6% for females; 27.5% for males) were attributable to AD. Increasing pharmacological AD treatment coverage to 40% would result in an estimated reduction of 3.3% (50 deaths/year) of all female and 7.6% (287 deaths/year) of all male alcohol-attributable deaths. CONCLUSIONS: Alcohol was responsible for a large proportion of the burden of disease in Italy in 2004. Increasing treatment coverage for AD in Italy could reduce that countrys alcohol-attributable burden of disease.
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[Alcohol consumption pattern and Coronary Heart Disease risk in Metropolitan São Paulo: analyses of GENACIS Project].
Rev Bras Epidemiol
PUBLISHED: 05-18-2013
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To examine the association between patterns of drinking and coronary heart disease (CHD) risk in a populational sample.
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Use and nonmedical use of prescription opioid analgesics in the general population of Canada and correlations with dispensing levels in 2009.
Pain Res Manag
PUBLISHED: 05-11-2013
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In Canada, harm from nonmedical prescription opioid analgesic (POA) use (NMPOU) has increased in recent years; however, there are limitations to the current estimates of NMPOU. The 2009 Canadian Alcohol and Drug Use Monitoring Survey presents an opportunity to produce more accurate estimates of NMPOU.
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Antidepressant exposure during pregnancy and congenital malformations: is there an association? A systematic review and meta-analysis of the best evidence.
J Clin Psychiatry
PUBLISHED: 05-10-2013
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Depression is often not optimally treated during pregnancy, partially because of conflicting data regarding antidepressant medication risk. This meta-analysis was conducted to determine whether antenatal antidepressant exposure is associated with congenital malformations and to assess the effect of known methodological limitations.
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Non-medical use of prescription opioids and prescription opioid-related harms: why so markedly higher in North America compared to the rest of the world?
Addiction
PUBLISHED: 04-15-2013
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AIMS: This paper aims to identify possible system-level factors contributing to the marked differences in the levels of non-medical prescription opioid use (NMPOU) and prescription opioid (PO)-related harms in North America (i.e. the United States and Canada) compared to other global regions. METHODS: Scientific literature and information related to relevant areas of health systems, policy and practice were reviewed and integrated. RESULTS: We identified several but different factors contributing to the observed differences. First, North American health-care systems consume substantially more Pos-even when compared to other high-income countries-than any other global region, with dispensing levels associated strongly with levels of NMPOU and PO-related harms. Secondly, North American health-care systems, compared to other systems, appear to have lesser regulatory access restrictions for, and rely more upon, community-based dispensing mechanisms of POs, facilitating higher dissemination level and availability (e.g. through diversion) of POs implicated in NMPOU and harms. Thirdly, we note that the generally high levels of psychotrophic drug use, dynamics of medical-professional culture (including patient expectations for effective treatment), as well as the more pronounced for-profit orientation of key elements of health care (including pharmaceutical advertising), may have boosted the PO-related problems observed in North America. CONCLUSIONS: Differences in the organization of health systems, prescription practices, dispensing and medical cultures and patient expectations appear to contribute to the observed inter-regional differences in non-medical prescription opioid use and prescription opioid-related harms, although consistent evidence and causal analyses are limited. Further comparative examination of these and other potential drivers is needed, and also for evidence-based intervention and policy development.
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Can resveratrol in wine protect against the carcinogenicity of ethanol? A probabilistic dose-response assessment.
Int. J. Cancer
PUBLISHED: 04-02-2013
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Resveratrol, which may occur in wine, was suggested to act as a chemopreventive agent against the carcinogenic effects of ethanol. The assumption was based on data from experimental animals, which have shown that resveratrol above certain thresholds may reduce the incidence of tumours in several of the alcohol-related cancer sites (colon, liver and female breast). Using a probabilistic Monte Carlo type methodology, we estimated daily intake based on chemical analysis of resveratrol (n = 672) and ethanol (n = 867). Benchmark dose (BMD)-response modelling was conducted for resveratrol based on eight animal experiments, whereas BMD data for ethanol were taken from the literature. The margin of exposure (MOE) was calculated for both substances as an indicator if the intake may reach effective dosages. For intake of one 100-mL glass of wine, the average MOE was found to be 4.1 for ethanol and 459,937 for resveratrol. In the best-case scenario for resveratrol (e.g., very high contents and assuming a low effective dosage), the minimum MOE would be 111, which means that 111 glasses of wine need to be consumed daily to reach the BMD. The MOE ratio between resveratrol and ethanol is 166,128 on average, meaning that per glass of wine, ethanol is more than 100,000 times more potent than resveratrol. As resveratrol intake may not optimally reach the effective dosage, our study excludes a preventive effect of this substance on alcohol-related cancer. Commercial information about cancer-preventive or -protective effects of resveratrol in wine is misleading and must be prohibited.
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Alcohol consumption, alcohol dependence and related harms in Spain, and the effect of treatment-based interventions on alcohol dependence.
Adicciones
PUBLISHED: 03-15-2013
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Alcohol consumption in Spain has traditionally followed the Mediterranean drinking pattern, featuring daily drinking with meals, beer as the preferred beverage, and comparatively little drinking to intoxication. Alcohol dependence (AD), one of the most detrimental disorders caused by alcohol, was prevalent in 0.2% of women and 1.2% of men, corresponding to 31,200 women and 186,000 men in Spain with AD in 2005 in the age group of 15 to 64 year. These prevalence estimates of alcohol dependence are likely underestimated due to limitations in the World Mental Health Survey which cannot be fully corrected for; however, the estimates of AD for Spain represent the most accurate and up to date estimates available. Alcohol creates a significant health burden in Spain with 11.3 premature deaths in women per 100,000 aged 15 to 64 years, and 40.9 premature deaths in men per 100,000 in the same age group were due to alcohol consumption (data for 2004). This amounts to 8.4% of all female deaths and 12.3% of all the male deaths in this age group being attributable to alcohol consumption. A large percentage of these harms were due to heavy alcohol consumption and AD. AD is undertreated in Spain, with less than 10% of all people with AD treated. For those who are treated, psychotherapy is the most utilized form of treatment to avoid relapse. If 40% of AD patients in Spain were treated with pharmacological treatment (the most effective treatment method), 2.2% of female and 6.2% of male deaths due to AD would be prevented within one year. Thus by increasing treatment rates is an important means of reducing the alcohol-attributable mortality and health burden in Spain.
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Global burden of alcoholic liver diseases.
J. Hepatol.
PUBLISHED: 03-06-2013
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Liver diseases contribute markedly to the global burden of mortality and disease. This paper provides an overview from a global perspective of the contribution of alcohol to liver diseases. The Global Burden of Disease study methodology was used to estimate the burden of alcohol-attributable liver cirrhosis and alcohol-attributable liver cancer in 2010 as measured by deaths and disability adjusted life years (DALYs). This methodology estimates attributable fractions based on alcohol exposure distribution and relative risks associated with different levels of drinking. Globally, in 2010, alcohol-attributable liver cirrhosis was responsible for 493,300 deaths (156,900 female deaths and 336,400 male deaths) and 14,544,000 DALYs (4,112,000 DALYs for women and 10,432,000 DALYs for men), representing 0.9% (0.7% for women and 1.2% for men) of all global deaths and 0.6% (0.4% for women and 0.8% for men) of all global DALYs, and 47.9% of all liver cirrhosis deaths (46.5% for women and 48.5% for men) and 46.9% of all liver cirrhosis DALYs (44.5% for women and 47.9% for men). Alcohol-attributable liver cancer was responsible for 80,600 deaths (14,800 female deaths and 65,900 male deaths) and 2,142,000 DALYs (335,000 DALYs for women and 1,807,000 DALYs for men). The burden of alcohol-attributable liver cirrhosis and liver cancer is high and entirely preventable. Interventions to reduce alcohol consumption are recommended as a population health priority and may range from taxation increases for alcoholic beverages to increases in screening and treatment rates for alcohol use disorders.
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Selected pregnancy and delivery outcomes after exposure to antidepressant medication: a systematic review and meta-analysis.
JAMA Psychiatry
PUBLISHED: 03-01-2013
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Untreated depression during pregnancy has been associated with increased morbidity and mortality for both mother and child and, as such, optimal treatment strategies are required for this population.
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Exploring the association between lifetime prevalence of mental illness and transition from substance use to substance use disorders: results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC).
Am J Addict
PUBLISHED: 02-19-2013
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The association between substance use disorders (SUDs) and mental illness (MI) has been well established. Previous studies reporting this association in various clinical populations have not taken into account former substance use. This may be important as increased prevalence of substance use among individuals with MI may partially explain the strong association between SUDs and MI.
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Conflict and diarrheal and related diseases: a global analysis.
J Epidemiol Glob Health
PUBLISHED: 02-15-2013
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The purpose of this study was to determine the association between deaths owing to terrorism, civil war and one-sided violence from 1994-2000 and disability-adjusted life years (DALYs) attributable to diarrheal and related diseases, schistosomiasis, trachoma and the nematode infections (DSTN diseases) in 2002 among World Health Organization Member States. Deaths resulting from terrorism, civil war and one-sided violence were significantly related to DSTN DALYs across the majority of sex-age subgroups of the populace, after controlling for baseline levels of improved water/sanitation and a variety of economic measures: overall, a 1.0% increase in deaths owing to terrorism and related violence was associated with an increase of 0.16% in DALYs lost to DSTN diseases. Associations were greatest among 0-to-4-year olds. The results of the present study suggest that DSTN disease control efforts should target conflict-affected populations with particular attention to young children who suffer disproportionately from DSTN diseases in these settings. In view of the evidence that terrorism and related violence may influence DSTN DALYs in the longer term, control strategies should move beyond immediate responses to decrease the incidence and severity of DSTN diseases to seek solutions through bolstering health systems infrastructure development among conflict-affected populations.
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Alcohol-attributable cancer deaths and years of potential life lost in the United States.
Am J Public Health
PUBLISHED: 02-14-2013
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Our goal was to provide current estimates of alcohol-attributable cancer mortality and years of potential life lost (YPLL) in the United States.
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The effects of capping the alcohol consumption distribution and relative risk functions on the estimated number of deaths attributable to alcohol consumption in the European Union in 2004.
BMC Med Res Methodol
PUBLISHED: 02-13-2013
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When calculating the number of deaths attributable to alcohol consumption (i.e., the number of deaths that would not have occurred if everyone was a lifetime abstainer), alcohol consumption is most often modelled using a capped exposure distribution so that the maximum average daily consumption is 150 grams of pure alcohol. However, the effect of capping the exposure distribution on the estimated number of alcohol-attributable deaths has yet to be systematically evaluated. Thus, the aim of this article is to estimate the number of alcohol-attributable deaths by means of a capped and an uncapped gamma distribution and capped and uncapped relative risk functions using data from the European Union (EU) for 2004.
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Gender differences in prevalence of substance use disorders among individuals with lifetime exposure to substances: results from a large representative sample.
Am J Addict
PUBLISHED: 02-13-2013
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Research regarding substance use and substance use disorders (SUDs) shows significant gender differences in prevalence of substance use and dependence. Though lifetime exposure to substances is higher among males, previous reports have not regarded gender differences in prevalence of SUDs among individuals formerly exposed to substances. In addition, though substance abuse is particularly important when exploring gender differences, previous reports have largely focused on rates of transition to substance dependence alone. In this study, we explored gender differences in prevalence of SUDs among individuals with lifetime exposure to substances using a single diagnostic category (abuse or dependence).
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Reductions in non-medical prescription opioid use among adults in Ontario, Canada: are recent policy interventions working?
Subst Abuse Treat Prev Policy
PUBLISHED: 02-12-2013
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Non-medical prescription opioid use (NMPOU) and prescription opioid (PO) related harms have become major substance use and public health problems in North America, the region with the worlds highest PO use levels. In Ontario, Canadas most populous province, NMPOU rates, PO-related treatment admissions and accidental mortality have risen sharply in recent years. A series of recent policy interventions from governmental and non-governmental entities to stem PO-related problems have been implemented since 2010.
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Phenibut dependence.
BMJ Case Rep
PUBLISHED: 02-09-2013
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Phenibut is a ?-aminobutyric acid (GABA) agonist designed and used as an anxiolytic in Russia. In Western countries, phenibut is not a registered medication but is available through online stores as a supplement. We present a case of a patient who used phenibut to self-medicate anxiety, insomnia and cravings for alcohol. While phenibut was helpful initially, the patient developed dependence including tolerance, significant withdrawal symptoms within 3-4 h of last use and failure to fulfil his roles at work and at home. He finally sought medical assistance in our addictions clinic. We have gradually, over the course of 9 weeks, substituted phenibut with baclofen, which has similar pharmacological properties, and then successfully tapered the patient off baclofen. This required approximately 10 mg of baclofen for each gram of phenibut.
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Alcohol use disorders and mortality: a systematic review and meta-analysis.
Addiction
PUBLISHED: 01-17-2013
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To conduct a systematic review and meta-analysis on all-cause mortality in people with alcohol use disorders.
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Cost of specialized addiction treatment of clients with fetal alcohol spectrum disorder in Canada.
BMC Public Health
PUBLISHED: 01-14-2013
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Individuals with Fetal Alcohol Spectrum Disorder (FASD) constitute a special population that may be at particularly high risk for substance use. The purpose of the current study was to estimate the utilization of specialized addiction treatment services (SATS) and the associated cost, as a part of the total cost of health care associated with FASD in Canada.
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Cost of fetal alcohol spectrum disorder diagnosis in Canada.
PLoS ONE
PUBLISHED: 01-01-2013
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Fetal Alcohol Spectrum Disorder (FASD) is underdiagnosed in Canada. The diagnosis of FASD is not simple and currently, the recommendation is that a comprehensive, multidisciplinary assessment of the individual be done. The purpose of this study was to estimate the annual cost of FASD diagnosis on Canadian society.
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Clear criteria based on absolute risk: reforming the basis of guidelines on low-risk drinking.
Drug Alcohol Rev
PUBLISHED: 12-14-2011
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The paper discusses the approach behind the Australian Guidelines to Reduce Health Risks from Drinking of 2009. The Guidelines involved a new approach to the central conundrum of low-risk drinking guidelines: how to set a guideline threshold on smooth risk curves.
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Different guidelines for different countries? On the scientific basis of low-risk drinking guidelines and their implications.
Drug Alcohol Rev
PUBLISHED: 12-12-2011
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The scientific evidence for low-risk drinking guidelines was examined in a narrative review focusing on three points: definition of exposure, the best way to select outcomes and risk relations and how to determine thresholds. With respect to exposure, at least two dimensions should be incorporated: average volume of alcohol consumption and patterns of irregular heavy drinking occasions. Mortality should be selected as the most severe outcome, and a disaggregated approach should be adopted incorporating the regional demographic and cause of death structure. Finally, our plea is for establishing a general threshold for acceptable risk on a societal level rather than ad hoc specific committees setting norms for specific risks. Acceptable thresholds will be different if the risk is to oneself or to others.
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Fetal alcohol spectrum disorder prevalence estimates in correctional systems: a systematic literature review.
Can J Public Health
PUBLISHED: 10-29-2011
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The objective of this study was to conduct a systematic search of the literature for studies that estimated the prevalence/incidence of Fetal Alcohol Spectrum Disorder (FASD) in correctional systems in different countries and, based on these data, to estimate a) the number of people with Fetal Alcohol Syndrome (FAS)/FASD within the criminal justice system population, and b) the relative risk of becoming imprisoned for individuals with FAS/FASD compared with those without FAS/FASD.
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Non-medical use of prescription opioids among Ontario adults: data from the 2008/2009 CAMH Monitor.
Can J Public Health
PUBLISHED: 10-29-2011
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There are indications that non-medical prescription opioid analgesics use (NMPOU) in the general population has increased in Canada in recent years; however, existing estimates have limitations. Thus our objectives are to determine prevalence and associated demographics of 1) prescription opioid analgesics (PO) use, 2) NMPOU, and 3) use of PO for intoxication purposes in the adult population in Ontario.
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Lower Risk Cannabis use Guidelines for Canada (LRCUG): a narrative review of evidence and recommendations.
Can J Public Health
PUBLISHED: 10-29-2011
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More than one in ten adults--and about one in three young adults--report past year cannabis use in Canada. While cannabis use is associated with a variety of health risks, current policy prohibits all use, rather than adopting a public health approach focusing on interventions to address specific risks and harms as do policies for alcohol. The objective of this paper was to develop Lower Risk Cannabis Use Guidelines (LRCUG) based on research evidence on the adverse health effects of cannabis and factors that appear to modify the risk of these harms.
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Heavy drinking occasions in relation to ischaemic heart disease mortality-- an 11-22 year follow-up of the 1984 and 1995 US National Alcohol Surveys.
Int J Epidemiol
PUBLISHED: 09-23-2011
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The relationship between alcohol consumption and ischaemic heart disease (IHD) risk is complex and several issues remain unresolved because many studies used rather crude exposure measures often based on one or two questions. The objective of this study was to investigate the association between heavy drinking occasions and IHD mortality while controlling for average daily alcohol intake and separating former drinkers from lifetime abstainers.
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Nonmedical prescription opioid use and mental health and pain comorbidities: a narrative review.
Can J Psychiatry
PUBLISHED: 09-01-2011
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In North America, the prevalence of nonmedical prescription opioid use (NMPOU), and morbidity and mortality related to prescription opioid analgesics (POAs) has risen sharply. Epidemiologic studies have suggested a high prevalence of mental health and pain comorbidities in NMPOU samples. Given the potential importance for interventions, a narrative review was conducted on studies reporting data on the co-occurrence of NMPOU with mental health problems and pain symptoms in general, treatment, or special populations.
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Racial and ethnic differences in all-cause mortality risk according to alcohol consumption patterns in the national alcohol surveys.
Am. J. Epidemiol.
PUBLISHED: 08-18-2011
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Previous studies have found J-shaped relations between volume of alcohol consumed and mortality risk in white Americans but not in African Americans, suggesting the need for studies in which race/ethnicity-defined subgroups are analyzed in separate comparable models. In the present study, the authors utilized mortality follow-up data (through 2006) on respondents from the 1984 and 1995 National Alcohol Surveys, including similar numbers of black, white, and Hispanic respondents by oversampling the minority groups. Cox proportional hazards models controlling for demographic, socioeconomic, mental health, and drug- and tobacco-use measures were used to estimate mortality risk from all causes. Findings indicated a protective effect of moderate alcohol drinking (2-30 drinks/month for women and 2-60 drinks/month for men) with no monthly ?5-drink days) relative to lifetime abstention for whites only. Elevated mortality risk relative to moderate drinking was found in former drinkers with lifetime alcohol problems. Moderate drinkers who consumed ?5 drinks in 1 day at least monthly were also found to have increased risk, suggesting the importance of identifying heavy-occasion drinking for mortality analyses. These differential results regarding lifetime abstainers may suggest bias from differential unmeasured confounding or unmeasured aspects of alcohol consumption pattern or may be due to genetic differences in the health impact of alcohol metabolism.
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Unrecorded alcohol consumption in Russia: toxic denaturants and disinfectants pose additional risks.
Interdiscip Toxicol
PUBLISHED: 08-15-2011
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In 2005, 30% of all alcohol consumption in Russia was unrecorded. This paper describes the chemical composition of unrecorded and low cost alcohol, including a toxicological evaluation. Alcohol products (n=22) from both recorded and unrecorded sources were obtained from three Russian cities (Saratov, Lipetsk and Irkutsk) and were chemically analyzed. Unrecorded alcohols included homemade samogons, medicinal alcohols and surrogate alcohols. Analysis included alcoholic strength, levels of volatile compounds (methanol, acetaldehyde, higher alcohols), ethyl carbamate, diethyl phthalate (DEP) and polyhexamethyleneguanidine hydrochloride (PHMG). Single samples showed contamination with DEP (275-1269 mg/l) and PHMG (515 mg/l) above levels of toxicological concern. Our detailed chemical analysis of Russian alcohols showed that the composition of vodka, samogon and medicinal alcohols generally did not raise major public health concerns other than for ethanol. It was shown, however, that concentration levels of DEP and PHMG in some surrogate alcohols make these samples unfit for human consumption as even moderate drinking would exceed acceptable daily intakes.
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Alcohol consumption and non-communicable diseases: epidemiology and policy implications.
Addiction
PUBLISHED: 08-09-2011
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This paper summarizes the relationships between different patterns of alcohol consumption and various on non-communicable disease (NCD) outcomes and estimates the percentage of NCD burden that is attributable to alcohol.
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JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.