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Wittchen, H. - U., Perkonigg, A., & Reed, V. (1996). Comorbidity of mental disorders and substance use disorders. European addiction research, 2(1), 36–47.
Abstract: Recent major epidemiological surveys in general population samples throughout the world have demonstrated that substance use disorders are among the most frequent forms of mental disorders in the community, and are also frequently associated with other forms of mental disorders. This paper briefly reviews the concept of comorbidity and summarizes more recent data concerning the frequency of comorbidity of substance use disorders. The review is limited to studies in the general population using standardized diagnostic interviews. Specific emphasis is laid upon the most recent data from the National Comorbidity Survey, that specifically addressed comorbidity issues in detail. The clear majority of subjects with a definite substance use disorder according to the strict DSM-III-R definition has or has had at least one other comorbid mental disorder. Comorbidity rates between specific substance use disorders and other mental disorders will be compared and discussed in light of several other international epidemiological studies. Furthermore time sequences of substance use disorders and comorbid disorders are presented. Potential pathogenetic and clinical implications are addressed.
Keywords: addiction; AOD dependence; chemical addiction; behavioral and mental disorder
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Lechsteiner, K. J. (1996). Unruhe des Herzens. Ein Film über ethische Aspekte zu Sucht und Drogen aus christlicher Sicht. Drogenmagazin, 22(5; 10/1996), 27.
Keywords: addiction; AOD dependence; chemical addiction; ethics; spirituality and religion; Christianity; motion picture film
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Giger, M., & Gmür, R. (1996). Medizinprodukteverordnung und Wartungsvorschriften : neue Milchkuh? Schweizerische Ärztezeitung, 77(21; 22.05.1996), 867.
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Dobler-Mikola, A., & Schaaf, S. (1996). Spritzenautomaten in der Schweiz : erste Erfahrungen. Bulletin, (27; 15.07.1996), 3–4.
Keywords: harm reduction; needle distribution and exchange; Switzerland
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Schaaf, S. (1996). Spritzenautomaten : die Erfahrungen der Pionierjahre : Studie zu Spritzen- und Flashbox-Automaten. Spectra : Gesundheitsförderung und Prävention, 5(09/1996), 4.
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Spreyermann, C. (1996). Qualität mit Selbstevaluation entwickeln. Drogenmagazin, 22(4), 3–6.
Keywords: quality control
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QS-Info. (1996). Informationen zur Selbst Evaluation in der Kinder- und Jugendhilfe. QS-Info (Bundesministerium für Familie, Senioren, Frauen und Jugend, 1(09/1996).
Keywords: quality control
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Wodak, A., & Crofts, N. (1996). Once more unto the breach: controlling hepatitis C in injecting drug users. Addiction, 91(2), 181–184.
Keywords: health promotion
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Stark, K., Muller, R., Bienzle, U., & Guggenmoos-Holzmann, I. (1996). Frontloading: a risk factor for HIV and hepatitis C virus infection among injecting drug users in Berlin. Aids, 10, 311.317.
Abstract: Objective: To determine whether frontloading (i.e., syringe-mediated drug-sharing) is a risk factor for HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among injecting drug users (IDU). Design: Cross-sectional study. Data on sociodemographic and behavioural characteristics were obtained by a standardized questionnaire. Serum samples were tested for seromarkers for HIV, HBV and HCV. Setting and participants: IDU were recruited at ’low-threshold’ storefront agencies (out-of-treatment sample), and at a centre for long-term drug use treatment (in-treatment sample). Individuals were included in the study if they had injected drugs within the previous 3 months. Main outcome measures: Serological evidence for HIV, HBV, HCV exposure. Results: Of all IDU (n = 324), 84% had ever practised frontloading with non-sterile injecting equipment, and 46% had done so more than 100 times; 32% had front-loaded during the 6 months prior to the interview. The crude seroprevalence rates for HIV, HBV and HCV increased with the overall frequency of frontloading, and reached 22, 71 and 94%, respectively, among IDU who had frontloaded more than 100 times. After controlling for confounding effects by logistic regression, having practised front-loading more than 100 times was significantly associated with HIV infection [adjusted prevalence odds ratio (POR) 3.5; 95% confidence interval (CI), 1.4-9], and HCV infection (adjusted POR, 5.4; 95% CI, 2.3-12), but not with HBV infection. Another independent risk factor for all three virus infections was needle-sharing in prison. Conclusions: In communities where sterile injection equipment is readily available, and IDU have substantially reduced their overall levels of needle-sharing, the practice of frontloading appears to be a major risk factor for infections by blood-borne viruses among IDU. Prevention activities should specifically address this risk behaviour.
Keywords: health promotion
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Rhodes, T., Hunter, G. M., Stimson, G. V., Donoghoe, M. C., Noble, A., Parry, J., et al. (1996). Prevalence of markers for hepatitis B virus and HIV-1 among drug injectors in London : injecting careers, positivity and risk behaviour. Addiction, 91(10), 1457–1467.
Abstract: Concerns about the risks of HIV infection among drug injectors have eclipsed concerns about the prevalence and transmission of hepatitis, and in particular hepatitis B virus infection. Findings are reported from surveys undertaken with two separate community-recruited samples of drug injectors in London collected in 1992 (n = 505) and in 1993 (n = 507). Anonymized confirmed testing of saliva snows 51.5% of drug injectors in 1992 and 47.9% in 1993 to be antibody positive to the core antigen of hepatitis B virus (anti-HBc). Approximately half of the drug injectors confirmed as anti-HBc positive were unaware that they had been infected with hepatitis, Anti-HIV-1 prevalence was considerably lower at 7.0% in 1992 and 6.9% in 1993. Multivariate analyses showed anti-HBc positivity to be most likely among older injectors with longer injecting careers who had a history of having shared used needles and syringes. HIV-1 positivity was also associated with a history of having shared injecting equipment as well as with recent sharing (i.e. in the last 6 months). Unlike anti-HBc positivity, there were no associations between HIV-1 positivity and age or length of injecting career. Younger injectors with shorter injecting careers were more likely to report recent sharing of used injecting equipment than older injectors with longer injecting careers. We note the potential for continued transmission of HBV and HIV-1, particularly among younger injectors. We recommend an integrated strategy to maximize the health of drug injectors, of which HIV and HBV prevention is a part. There is a need to widen the availability of HBV vaccinations for HBV negative drug injectors and their sexual partners and for clear guidelines to drug injectors about the relative efficacy of bleach to disinfect injecting equipment of HBV and HIV.
Keywords: health promotion
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