Abstract: Neuere Entwicklungen in der Epidemiologie und duchtpolitische Probleme im internationalen Umfeld bilden Herausforderugen für eine künftige schweizerische Suchtpolitik und für das System der Suchthilfe. Epidemiologisch sind es die Zunahme von Suchproblemen vor dem Hintergrund ungleicher Lebensperspektiven und Entwicklllngmölichkeiten. Mehrfachkonsum und Mehrfachahhängigkeit auf der Basis eines globalisierten Angebots und die Selbstverständlichkeit (“Normalisierung”) mit welcher vom Angebot Gebrauch gemacht wird. Auf Seiten der Politik sehen wir gegenläufige Tendenzen in manchen Bereichen. ein Auseinanderklaffen von Politik, Forschung und Praxis und ungelöste Probleme einer konsistenten Umsetzung von drängenden Fragen der Forschung und von Forschungsresultaten in eine effektive und kosteneffektive Praxis. Angesichts dieser Lage wird sich die Schweiz einer Reihe von offenen FrageIl stellen müssen.

Abstract: While there is evidence supporting the effectiveness of drug treatment in self help groups there are many points of divergence between the philosophies traditionally espoused by these groups and those advocated within hann reduction policies. In this paper we examine some of the differences between self help and hann reduction approaches. We argue that (in common with other treatment modalities) self help groups have altered and developed in response to changing community expectations and that this process should be expected to continue. We report on our ongoing exploration of research partnerships with self help group members focusing particularly upon research conducted in collaboration with self help groups in Victoria. We argue that research partnerships have advantages for both parties. These partnerships have the potential to better inform researchers of developments in the self help community (including the practices of active drug users). Research partnerships also encourage better understanding among self help group members of some of the potential problems that, as research has indicated, may be associated with certain self help group practices. We advocate such understanding as a potentially effective means of encouraging the appropriate development and refinement of self help group practices in line with harm reduction principals .

Abstract: The efficacy of clonidine, methadone, and guanfacine in rapid detoxification of heroin inpatients was assessed in a randomized controlled clinical trial. Signs and symptoms of abstinence and of side effects were analysed in 90 heroin addicts successfully completing a 12–day inpatient trial, all patients fit DSM-III criteria for opioid dependence, the age range being 18 to 36 years. All three drugs were effective in controlling abstinence; however, the course of abstinence was different in the methadone group as compared to the adrenergic agonists, the latter showing limitations in their ability to suppress withdrawal manifestations. While mean number of withdrawal signs and symptoms was significantly tower during days 2 to 5 in the methadone group (p < 0.01), adrenergic agonists were slightly more effective at the end of the trial. Incidence of side effects was closely related to the dose administered. Hypotensive action of adrenergic agonists was more marked in orthostatic position. The present results suggest that methadone is superior to adrenergic agonists. Between these drugs clonidine appears to be less effective than guanfacine in controlling some withdrawal manifestations, and causes more side effects, mainly of cardiovascular nature.