Suchergebnisse

<B>Fragestellung:</B> Bisher gibt es für den deutschsprachigen Raum noch kein etabliertes Instrument, das ein umfassendes Screening des Substanzkonsums in allen verbreiteten Substanzkategorien erlaubt. Die Weltgesundheitsorganisation (WHO) hat einen standardisierten Fragebogen zur schnellen und einfachen Erfassung von Suchtmittelkonsum und seiner negativen Auswirkungen entwickelt, den »Alcohol, Smoking and Substance Involvement Screening Test« ((WHO ASSIST). Während der WHO ASSIST bereits in mehrere Sprachen übersetzt wurde (z. B. spanisch, portugiesisch), lag eine deutsche Version bislang nicht vor. </P><P> <B>Methodik:</B> Der Fragebogen wurde nach Vorgaben der WHO ins Deutsche übersetzt, und die Tauglichkeit der Übersetzung an Patienten aus der Allgemeinmedizin und einer Suchtstation praktisch überprüft. </P><P> <B>Ergebnisse:</B> Die Pilotuntersuchung zeigte, dass die Übersetzung grundsätzlich praktikabel ist. Anschließende Kurzbefragungen zur Verständlichkeit der Items erlaubten es, die Formulierungen an einigen Stellen weiter zu verbessern. </P><P> <B>Schlussfolgerungen:</B> Mit dem deutschen WHO ASSIST liegt nun ein Screening-Fragebogen zur parallelen Erfassung des Suchtmittelkonsums in allen wichtigen Substanzkategorien vor. Als nächster Schritt ist eine direkte Überprüfung der psychometrischen Eigenschaften der deutschen Version notwendig. Die Vorbefunde aus internationalen Studien lassen gute Reliabilitäts- und Validitätswerte erwarten.

This retrospective study aims to determine whether there is a difference in the additional consumption of alcohol between addicts treated with methadone or dihydrocodeine (DHC) and untreated addicts injecting heroin.<i></i>1,685 patients admitted for opioid withdrawal between 1991 and 1997 were reviewed. Cross-reference tables and multiple logistic regression analyses were carried out. 28% of patients take more than 40 g of alcohol daily (on average 176 g). We found that patients who are treated with methadone or DHC drink alcohol significantly more often daily than the heroin-dependent patients (p < 0.01). Using multiple regression analyses, the results were confirmed. Additionally, we found that co-abuse of alcohol was predicted by male gender, longer duration of drug use, additional daily consumption of tetrahydrocannabinol and daily consumption of benzodiazepines. Alcohol consumption by opioid-addicted patients treated with methadone or DHC presents a serious medical problem. Co-abuse of alcohol will receive more attention.

Introduction: The phenomenon of craving and attention bias towards drug cues is theorized to operate cooperatively, owing to the principles of associative learning. In this context, the conditioned response to drug-related stimuli activates reward mechanisms within the brain, consequently inducing craving and fostering the underlying mechanisms that contribute to relapse in individuals with substance use disorders. Multiple studies have assessed the relationship between attention to substance-related cues and subjective craving through electroencephalography (EEG), but their findings have yet to be synthesized and examined. This review summarizes the association between the amplitude of the P300 event-related potential (ERP) and substance use craving, compares discrepancies in results by type of substance, and discusses gaps in the literature to inform future research. Methods: A systematic search was conducted on Embase, Web of Science, CINAHL, and PsychINFO databases. Studies were published in English and included peer-reviewed human research investigating the relationship between EEG P300 ERP and self-reported substance use craving. The included study samples comprised of in treatment or non-treatment-seeking participants who use substances. The primary outcomes of interest were those derived from inferential statistics assessing P300 amplitude and substance use craving. Results: Ten studies were included in the final search and were organized by substance type: three alcohol, three cocaine, two tobacco, one heroin, and one cannabis. Results were mixed for alcohol and cocaine. Studies on tobacco, heroin, and cannabis use were congruent for associations between the P300 amplitude and craving. Conclusions: Overall findings are mixed between studies addressing the association of the EEG P300 amplitude and craving. These results should be considered in the context of the limited sample size, underpowered analyses, and methodological differences that potentially contribute to discrepancies in outcomes. Further research is required to assess the role of craving assessment, EEG methodology, and substance-related factors on the association between P300 amplitude and self-reported craving.

<i>Background/Aim:</i> Injection drug users (IDUs) have a high risk of acquiring an infection with the human immunodeficiency virus (HIV). To improve counseling and prevention, a better understanding of risk factors and predictors for an infection must be gained. This retrospective study has the aim to determine the risk factors for acquisition of HIV infection other than sharing of needles/syringes. <i>Methods:</i> The study population consisted of all patients admitted to the detoxification unit between 1991 and 1996 who met ICD-10 criteria for opioid dependency, who reported to share needles, and who agreed to have an antibody test. Possible risk factors were assessed by interview. Cross tables based on bivariate logistic regression were constructed to estimate the relative odds. Multiple logistic regression modeling procedures were used to adjust possible confounding factors. <i>Results:</i> A total of 1,049 out of 1,656 patients admitted were included into the study. 4.8% of the patients were HIV-1 seropositive. The prevalence was higher among older patients and among patients living with a significant other substance drug user with substance dependency, after a longer duration of drug use, and after coinfection with hepatitis B virus and/or hepatitis C virus (HCV). Using multiple logistic regression analyses and including all individually significant risk factors, we found only coinfection with HCV to remain significant. 92% of the HIV-infected patients were also HCV infected. In the group younger than 23 years of age, a total of 53.5% of the IDUs were still seronegative for HIV, hepatitis A and B virus, and HCV. <i>Conclusions:</i> Despite the high rate of HCV coinfection (92%) in HIV-infected patients, we found more than 50% of IDUs younger than 23 years to be neither infected with HCV nor with HIV. Early prevention strategies against infectious diseases should especially focus on young IDUs.