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<i>Background:</i> Behavioral problems in adolescence have been shown to be associated with the presence of a positive family history of alcoholism (FH+), obstetric complications (OCs), and negative parenting practices. <i>Method:</i> This study tested the relation of these factors to aggression/delinquency and attention problems in an untreated population sample of 154 adolescents in Pomerania. Furthermore, we evaluated the predictive strength of a FH+, OCs and negative parenting styles in a prospective subsample of 127 adolescents using a hierarchical regression analysis. <i>Results:</i> Group comparisons between offspring with higher vs. lower values on aggression/delinquency revealed that only rejection by the parents was significantly more often reported by teenagers with higher measures on these behavioral problems. Offspring with higher values on attention problems had more OCs reported by the mother and also had more feelings of parental rejection compared to controls. The results of the hierarchical regression analysis showed that parental rejection was the only significant predictor for both aggression/delinquency, and attention problems measured 1 year after the initial assessment. <i>Conclusion:</i> We conclude that parental rejection is a major risk factor for both aggression/delinquency and attention problems. Reflecting the fact that these behavioral problems have been reported to be strongly associated with later substance misuse, the improvement of parenting practices should be considered in prevention and intervention programs.

<i>Objective:</i> Focussing on ever-smokers and comparing nicotine-dependent with nondependent subjects, we examined the characteristics, associations of nicotine dependence with other mental disorders as well as predictors of nicotine dependence. Never-smokers were not included in the reference group of the nondependent subjects, but were analyzed as a third group. <i>Methods:</i> Data of 1,636 never-smokers and 2,437 ever-smokers (i.e. 1,520 current smokers, 917 former smokers) were taken from the German Transitions in Alcohol Consumption and Smoking Study. Assessments were made using the Composite International Diagnostic Interview. <i>Results:</i> About a third of the ever-smokers met the criteria for nicotine dependence in some point in their lives. Nicotine-dependent smoking was significantly associated with various substance use disorders, affective disorders and anxiety disorders using nondependent smoking as a reference group. Comparing never-smokers and nondependent ever-smokers, significant associations were found for substance use disorders only. Smoking behavior variables, alcohol abuse or dependence and anxiety disorders but not sociodemographic variables and affective disorders were predictors for nicotine dependence. <i>Conclusion:</i> Nicotine-dependent smoking is distinct from smoking alone and nicotine-dependent smokers are a characteristically different subgroup within the smoking population.

The relations between the intake of alcohol and that of caffeinated beverages, as well as cigarette smoking, was examined in a group of chronic alcoholics in an Israeli treatment center. When data from the total sample was analyzed, relationships between alcohol and caffeinated beverages intake and between alcohol intake and smoking were observed. Caffeine use and smoking were also related. In addition, a subgroup of subjects with a family history of alcoholism revealed correlations between alcohol and caffeine consumption, between alcohol intake and smoking, as well as caffeine use and smoking. Subjects without a family history of alcoholism also showed relationships between alcohol and caffeine use and smoking. However, coffee intake and tobacco use was not related in this subgroup. The relevance of the findings to previous reports concerning alcohol drinking and smoking as well as the intake of coffee appear to be consistent with a notion of interaction between these respective behaviors occurring at a behavioral level rather than a genetic one.

Opiate users (n = 135) from southern England, Glasgow and Edinburgh were interviewed about opiate overdose (lifetime). Fifty-six percent had overdosed. The majority (66%) reported mixing opiates with at least one other drug (mainly alcohol and/or benzodiazepines) at their last overdose. Patients identified misjudgements of purity, mixing drugs and misjudgements of tolerance as causes of overdose. The sample was divided into groups: (1) 'no prescription', (2) prescribed 'diazepam only', (3) prescribed 'methadone only' and (4) prescribed 'methadone + diazepam'. The 'methadone + diazepam' group reported more lifetime and deliberate overdoses, the 'methadone only' group were more likely to have used several drugs at the time of their last overdose and the 'no prescription' group to have used only heroin. Drug users' overdose risk may vary as a result of their prescribed and non-prescribed drug use. Interventions should be developed and tailored according to clients' needs and current use patterns.

This paper takes an international perspective on the marketing of alcohol to young people by examining case studies of the marketing of alcohol in the UK and Poland. It is suggested that marketing is a powerful mechanism for attracting young consumers. The alcohol industry is an innovative industry able to use a wide variety of marketing tools to achieve success in the market-place. It is important to recognise that the marketing activities of the industry are becoming increasingly transnational and that policy response has to be equally transnational.

<i>Aims:</i> Within the guidelines of the research programme on medical prescription of narcotics for opioid addicts (PROVE), heroin, morphine, and methadone were prescribed to heavily opioid addicted individuals in Switzerland since 1994. This contribution analyses the course of dose levels during the treatment period. <i>Design: </i>Naturalistic description of consumed dosages per day and month. <i>Setting and Participants:</i> The study describes the dosages prescribed to all individuals who began outpatient treatment in the PROVE programme in Switzerland between 1994 and 1996. <i>Measurements:</i> Consumed amount of narcotics per day and the course of dosage of injectable heroin in different treatment regimes. <i>Findings:</i> Heroin was the most frequently prescribed narcotic. Of all consumption days, heroin had been applied in 77% as injection and in 9% in a smokeable form. The mean daily dosage was 474 mg for intravenous application and 993 mg for the smokeable form. Second most frequent was the prescription of oral methadone, in most cases in combination with heroin. The mean amount of daily consumption of oral methadone was 53 mg. There were dosage differences between treatment regimes. During the course of treatment the mean dosage for injectable heroin per day decreased significantly and, depending on the treatment regime, almost linearly. <i>Conclusions:</i> The significance of heroin dosages in heroin-assisted therapy for treatment outcome should be further explored, especially in the light of the markedly higher dosages in Switzerland compared to the UK. During the treatment period, dosages did not increase but generally decreased, indicating no further increase in tolerance.

From a total population of 10,766 Swedish 50- to 59-year-old women, 6,917 (64.2%) participated in the Women's Health in Lund Area (WHILA) study, and among them 6,623 (95.7%) answered the questions on alcohol consumption. One out of 4 women (26.0%) consumed no alcohol in an ordinary week (non-drinkers), 57.4% consumed not more than 83 g alcohol, 12.5% consumed 84–167 g and 4.2% consumed 168 g or more. The weekly drinkers had a median consumption of 40.0 g alcohol (range 2.5–1,036.0) and the main sort of alcohol was wine. Comparing the four drinking groups, most differences occurred between the non-drinking and the weekly drinking women. The non-drinkers had lower socio-demographic status, poorer health and more symptoms, especially physical symptoms. In a multivariate logistic regression analysis, most associations between non-drinking and lower socio-demographic status remained.

Smoking cocaine hydrochloride in the form of cocarettes is a method of cocaine use that has not been described in the scientific literature so far. Nonetheless it seems to be a somewhat common method of cocaine use in order to avoid the nasal irritation. Three case reports are presented in order to discuss the possibility.

Data on the prevalence of heroin addiction have considerable relevance in the field of public health as a means of evaluating measures aimed at improving the lives of the individuals concerned. The number of heroin addicts in Switzerland was estimated by six different methods based on various data sources. This resulted in an overall estimate for the reference year 1997 ranging from a minimum of 24,000 to a maximum of 35,000 heroin addicts. In the 1990s, the trend in the prevalence of heroin addiction was characterised by a rapid rise up to 1993/94 followed by a gradual decline. The increasing medicalisation (focus on treatment rather than on punishment) of Switzerland's heroin problem has therefore not translated into a clear downward trend in the estimated prevalence of heroin addiction; however, the data for the various sub-groups lend plausibility to the assumption that this population is more integrated, less conspicuous and receiving better medical care.

The purpose of this study was to establish the discriminant validity of alcohol use disorder (AUD) diagnoses within a population of well-functioning male heavy drinkers. A group of 57 subjects with a consumption of at least 28 alcoholic units (AU)/week was recruited from wine-tasting clubs. Within this group, a comparison was made between those individuals who met the criteria of AUD and those who did not. We compared the subjective and objective health status and drinking habits of both groups. No significant differences were found between the individuals with AUD and those without AUD, or between individuals with alcohol dependence and those without AUD, except for their drinking pattern. These findings raise doubt of the discriminant validity of AUD diagnoses in well-educated heavy wine drinkers.

<i>Aim:</i> To make quantitative estimates of the burden of disease attributable to alcohol in the year 2000 on a global basis. <i>Design:</i> Secondary data analysis. <i>Measurements:</i> Two dimensions of alcohol exposure were included: average volume of alcohol consumption and patterns of drinking. There were also two main outcome measures: mortality, i.e. the number of deaths, and disability-adjusted life years (DALYs), i.e. the number of years of life lost to premature mortality or to disability. All estimates were prepared separately by sex, age group and WHO region. <i>Findings:</i> Alcohol causes a considerable disease burden: 3.2% of the global deaths and 4.0% of the global DALYs in the year 2000 could be attributed to this exposure. There were marked differences by sex and region for both outcomes. In addition, there were differences by disease category and type of outcome; in particular, unintentional injuries contributed most to alcohol-attributable mortality burden while neuropsychiatric diseases contributed most to alcohol-attributable disease burden. <i>Discussion/Conclusions:</i> The underlying assumptions are discussed and reasons are given as to why the estimates should still be considered conservative despite the considerable burden attributable to alcohol globally.

This article will outline the main strands of the UK-based Alcohol, Drugs and the Family (ADF) research programme. This programme has examined the impact of substance misuse problems on children, spouses, and families, both in the UK and elsewhere, especially in urban Mexico City and in Australia amongst both urban and rural Aborigine populations. This article will outline the main theoretical perspective that we have developed from this work (the stress-strain-coping-support model). It will outline some of the key findings of this programme, and address some of the key universals that we have observed across various cultures. It will end by describing current research, including the testing of brief interventions being delivered through primary care to family members to enable them to cope better with the problems which family substance misuse causes.

The associations between maternal smoking and nicotine dependence and patterns of smoking and nicotine dependence in offspring were examined in a large community-based sample of adolescents. Data were derived from baseline and 4-year follow-up assessments of 938 respondents aged 14–17 years at the outset of the Early Developmental Stages of Psychopathology (EDSP) study, a prospective-longitudinal community study of adolescents and young adults and their parents respectively. Smoking and nicotine dependence in respondents were assessed using the Munich Composite International Diagnostic Interview (DSM-IV algorithms). Diagnostic information about smoking behavior in mothers was collected by independent direct diagnostic interviews with the mothers. In comparison to children of non- or occasionally smoking mothers, children of regularly smoking and nicotine-dependent mothers had higher probabilities of using tobacco as well as of developing nicotine dependence. For all ages under consideration, survival analyses revealed a higher cumulative lifetime risk of regular smoking and nicotine dependence among these children. Maternal smoking during pregnancy seems to represent an additional risk for these outcomes in children, specifically with regard to the risk of developing nicotine dependence. Associations were comparable for sons and daughters. Our findings show that maternal smoking predicts escalation of smoking, development of nicotine dependence, and stability of smoking behavior in children. Implications for specific intervention and prevention efforts are discussed.