Telephone counseling might be an effective primary care intervention for men who are not seeking treatment for their alcohol dependence or abuse, according to a new study.
Men benefited more from the short-term telephone counseling used in the study, which appears in the August issue of the journal Alcoholism: Clinical and Experimental Research.
Lead researcher Richard Brown, M.D., said that the study could empower time-strapped doctors to persuade reluctant alcoholism patients to seek treatment.
"The study shows that we shouldn't just give up on those alcohol-dependent patients who cannot or choose not to get treatment. If we can identify these folks in primary care waiting rooms and provide telephone counseling ??¦ we can start to help many of these patients," said Brown, of the University of Wisconsin School of Medicine and Public Health.
The researchers looked at nearly 900 men and women with alcohol abuse or dependence, recruiting study participants from primary care clinic waiting rooms in Madison and Milwaukee. The 445 people in the experimental group received up to six protocol-based phone interventions from counselors trained in a technique called motivational interviewing. The 452 members of the control group received a short pamphlet on healthy lifestyles.
Enrollment in the study was voluntary, and the researchers paid patients a small fee at each step; no participant earned more than $125. Members of the experimental group had assigned counselors who helped them identify their goals and examine how their alcohol use affected the achievement of those goals. Counselors gave feedback on the pitfalls and ramifications of alcohol use.
"Getting patients to participate in the counseling sessions was actually much easier than we thought it would be," Brown said. "Once they had established rapport with that counselor over the phone, many patients really looked forward to their sessions."
Of particular interest was the experimental treatment's effect on men with alcohol dependence, which unlike alcohol abuse results in changes in brain physiology. Alcohol-dependent men receiving the counseling reduced both their total alcohol consumption and "risky drinking days" over a three-month period, with risky drinking days declining the most, by 31.8 percent. Peers who received only the self-help literature cut back by 9.7 percent over the same period.
Women who received phone counseling reduced their drinking behaviors as well, but their improvements were not significantly different from those achieved by women in the control group.
Petros Levounis, M.D., director of the Addiction Institute of New York at St. Luke's and Roosevelt Hospitals, agreed with the study conclusions. "This is exactly the direction that we should be working toward. We can actually help our patients through the phone and provide support and counseling with different methods, not just with the more traditional one-to-one psychotherapy." Levounis, who was not involved with the study, said the prevalence of alcohol disorders makes screening and brief intervention in primary care settings necessary.
The authors noted that the study enrollment interview itself had an effect on drinking behaviors independent of the counseling intervention and said that patient tracking and follow-up posed a challenge. The researchers are currently studying the durability of treatment benefits over a 12-month period.
Brown RL, et al. Randomized controlled trial of a telephone and mail intervention for alcohol use disorders: three-month drinking outcomes. Alcoholism: Clinical and Experimental Research 31(8), 2007.
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
hbns
понедельник, 20 июня 2011 г.
воскресенье, 19 июня 2011 г.
The risks and benefits of drinking alcohol, Royal Society of Medicine conference. 30 Sept-1 Oct
The risks and benefits of drinking alcohol
Scientists, doctors and the media have taken two sides to the debate over the positive and negative effects of alcohol consumption. While excessive drinking can lead to a number of health problems, recent studies have revealed that a daily moderate intake of alcohol may decrease the risk of cardiovascular disease and diabetes and may help to ward of Alzheimer's disease and other types of dementia. Genetic variations and predisposition have major input into the effects on the individual. At the Drinking Alcohol: Risks & Benefits conference at the Royal Society of Medicine on 30 September - 1 October, speakers will discuss the benefits of moderate alcohol consumption, the health problems associated with drinking and the various external factors affecting our decision to drink in both the UK and Sweden.
The role of alcohol marketing
Professor Gerard Hastings, University of Strathclyde
Alcohol companies work hard to market their products to the public, with their efforts being increasingly focused on young people. Professor Hastings will discuss the impact alcohol marketing - mass media advertising, in particular - on individuals and the collective population.
Psychological benefits of alcohol
Dr Lars Hokan Nilsson, Uppsala University Hospital
The diagnosis of alcohol dependence is defined as a pattern of impaired control over substance abuse. The diagnosis of substance abuse, however, is defined as adverse consequences of drinking or use of drugs, but only in the absence of dependence. This paradox leads to the question: why do people engage in the self-destructive act of alcohol abuse? Many experts have emphasized the importance of socio-economic influences, but the results of some studies have disproved this link. Dr Nilsson, a chief consultant in addiction psychiatry, will investigate the biological argument for substance abuse and dependence. He will emphasise the brain's responses to drinking, the role of neurotransmitters and our own psychological expectations when deciding to drink. These findings are being used to identify and treat alcohol dependence and abuse.
Population drinking and resulting damage
Professor Thor Norstrom, Stockholm University
The development of a 'total consumption model,' associating population drinking with alcohol-related harm has been created from the Northern European drinking patterns and the relationship to chronic outcomes such as liver cirrhosis. Professor Norstrom will present the latest findings that more comprehensively represent geography and possible outcomes. The public health perspective of alcohol consumption is supported by his information that per capita intake has the most influence on alcohol-related harm, but a society's drinking culture and patterns can affect the impact of this harm on a population.
Cardiovascular benefits of alcohol
Professor Anders Waldenstrom
Epidemiological studies imply that alcohol beverages may have protective effects on coronary artery disease and stroke. These conclusions are drawn from death rates when comparing risks for coronary artery disease in people consuming small to moderate amounts of alcohol and those who don't drink at all.
Other related articles
Drinking Alcohol And Benefits
This relationship has been described as a J-shaped curve which means that the risk is highest for those that drink a lot, lower for those that drink moderately and higher again for those that abstain from drinking alcoholic beverages. A protective effect has been claimed for most types of alcoholic beverages and many possible mechanisms have been suggested. Professor Waldenstrom will talk in detail about the difficulties in interpreting published studies.
The Royal Society of Medicine
rsm.ac
Scientists, doctors and the media have taken two sides to the debate over the positive and negative effects of alcohol consumption. While excessive drinking can lead to a number of health problems, recent studies have revealed that a daily moderate intake of alcohol may decrease the risk of cardiovascular disease and diabetes and may help to ward of Alzheimer's disease and other types of dementia. Genetic variations and predisposition have major input into the effects on the individual. At the Drinking Alcohol: Risks & Benefits conference at the Royal Society of Medicine on 30 September - 1 October, speakers will discuss the benefits of moderate alcohol consumption, the health problems associated with drinking and the various external factors affecting our decision to drink in both the UK and Sweden.
The role of alcohol marketing
Professor Gerard Hastings, University of Strathclyde
Alcohol companies work hard to market their products to the public, with their efforts being increasingly focused on young people. Professor Hastings will discuss the impact alcohol marketing - mass media advertising, in particular - on individuals and the collective population.
Psychological benefits of alcohol
Dr Lars Hokan Nilsson, Uppsala University Hospital
The diagnosis of alcohol dependence is defined as a pattern of impaired control over substance abuse. The diagnosis of substance abuse, however, is defined as adverse consequences of drinking or use of drugs, but only in the absence of dependence. This paradox leads to the question: why do people engage in the self-destructive act of alcohol abuse? Many experts have emphasized the importance of socio-economic influences, but the results of some studies have disproved this link. Dr Nilsson, a chief consultant in addiction psychiatry, will investigate the biological argument for substance abuse and dependence. He will emphasise the brain's responses to drinking, the role of neurotransmitters and our own psychological expectations when deciding to drink. These findings are being used to identify and treat alcohol dependence and abuse.
Population drinking and resulting damage
Professor Thor Norstrom, Stockholm University
The development of a 'total consumption model,' associating population drinking with alcohol-related harm has been created from the Northern European drinking patterns and the relationship to chronic outcomes such as liver cirrhosis. Professor Norstrom will present the latest findings that more comprehensively represent geography and possible outcomes. The public health perspective of alcohol consumption is supported by his information that per capita intake has the most influence on alcohol-related harm, but a society's drinking culture and patterns can affect the impact of this harm on a population.
Cardiovascular benefits of alcohol
Professor Anders Waldenstrom
Epidemiological studies imply that alcohol beverages may have protective effects on coronary artery disease and stroke. These conclusions are drawn from death rates when comparing risks for coronary artery disease in people consuming small to moderate amounts of alcohol and those who don't drink at all.
Other related articles
Drinking Alcohol And Benefits
This relationship has been described as a J-shaped curve which means that the risk is highest for those that drink a lot, lower for those that drink moderately and higher again for those that abstain from drinking alcoholic beverages. A protective effect has been claimed for most types of alcoholic beverages and many possible mechanisms have been suggested. Professor Waldenstrom will talk in detail about the difficulties in interpreting published studies.
The Royal Society of Medicine
rsm.ac
суббота, 18 июня 2011 г.
How Strong Is Your Booze? True Strength Of Alcohol Revealed By New Portable Device
Both legitimate brewers and distillers and authorities on the track of illicit alcohol from home stills will soon have a helping hand. Measurement experts have unveiled a portable device to determine the strength of alcoholic drinks quickly and easily, almost anywhere. Published in the open access Chemistry Central Journal, the researchers show that their technique is just as accurate, and more sophisticated, than widely used lab-based methods.
Along with his colleagues, Dirk Lachenmeier of testing agency Chemisches und Veterin?¤runtersuchungsamt (CVUA) in Karlsruhe, Germany, decided to use a simple, patented multiple-beam infrared sensor combined with a flow-through cell for automated alcohol analysis. His team tested the device, which is portable to allow for on-site measurements, on a range of alcoholic samples.
Their tests on 260 different alcoholic drinks showed that the flow-through infrared device was much easier to handle than typical reference procedures, while time-consuming sample preparation steps such as distillation weren't necessary. Their sensor was equal to or better than current densimetric or Fourier transform infrared (FTIR) methods: repeatability, as determined in six different wine samples, was 0.05% vol and the relative standard deviation was below 0.2%. They also tested wines partway through the fermentation process, and unrecorded (non-commercial or illicit) alcohol samples, with good results. The test took less than a minute per drink.
"The device gives the opportunity for mobile on-site control in the context of labeling control of wine, beer and spirits, the process monitoring of fermentations, or the evaluation of unrecorded alcohols," says Lachenmeier. He adds that the device can also be used easily in developing country settings, with results that compare well to a more sophisticated lab set up.
Only beers and other sparkling drinks need more time-consuming preparation, to first remove the fizz, which can interfere with measurements.
The authors say that not only does unrecorded alcohol account for a quarter of all alcohol consumed worldwide, but in most cases, "not even the most basic chemical composition such as alcoholic strength is known for these beverages."
Ever since French chemist Gay-Lussac's work on alcohol-water mixtures, scientists have measured alcoholic strength by volume (% vol) using distillation and then a pycnometer to measure the liquid's density. Infrared spectroscopy is a more recent, popular method, but typically requires expensive equipment, and complicated calibration.
Source: BioMed Central Limited
Along with his colleagues, Dirk Lachenmeier of testing agency Chemisches und Veterin?¤runtersuchungsamt (CVUA) in Karlsruhe, Germany, decided to use a simple, patented multiple-beam infrared sensor combined with a flow-through cell for automated alcohol analysis. His team tested the device, which is portable to allow for on-site measurements, on a range of alcoholic samples.
Their tests on 260 different alcoholic drinks showed that the flow-through infrared device was much easier to handle than typical reference procedures, while time-consuming sample preparation steps such as distillation weren't necessary. Their sensor was equal to or better than current densimetric or Fourier transform infrared (FTIR) methods: repeatability, as determined in six different wine samples, was 0.05% vol and the relative standard deviation was below 0.2%. They also tested wines partway through the fermentation process, and unrecorded (non-commercial or illicit) alcohol samples, with good results. The test took less than a minute per drink.
"The device gives the opportunity for mobile on-site control in the context of labeling control of wine, beer and spirits, the process monitoring of fermentations, or the evaluation of unrecorded alcohols," says Lachenmeier. He adds that the device can also be used easily in developing country settings, with results that compare well to a more sophisticated lab set up.
Only beers and other sparkling drinks need more time-consuming preparation, to first remove the fizz, which can interfere with measurements.
The authors say that not only does unrecorded alcohol account for a quarter of all alcohol consumed worldwide, but in most cases, "not even the most basic chemical composition such as alcoholic strength is known for these beverages."
Ever since French chemist Gay-Lussac's work on alcohol-water mixtures, scientists have measured alcoholic strength by volume (% vol) using distillation and then a pycnometer to measure the liquid's density. Infrared spectroscopy is a more recent, popular method, but typically requires expensive equipment, and complicated calibration.
Source: BioMed Central Limited
пятница, 17 июня 2011 г.
Identification Of Distinctive Gene Expression In Brains Of Relapsing Heroin-Addicted Rats
A group of genes whose expression is significantly altered following exposure to drug paraphernalia after an enforced 'cold-turkey' period have been identified. Researchers writing in the open access journal BMC Neuroscience studied gene expression in the brains of heroin-addicted rats, identifying those genes that may be involved in precipitating a relapse.
Kara Kuntz-Melcavage, from Pennsylvania State University College of Medicine, USA, is part of a team of researchers who carried out the experiments. She said, "A number of gene expression studies have investigated changes induced by drug exposure, but few reports describe changes associated with the mental state that leads to relapse. We identified 66 genes involved in the relapse response, including some that are important for neuroplasticity, and through that role may impact learning and behavior".
Kuntz-Melcavage and her colleagues attached rats to a drug supply that for 3 hours each day delivered heroin into their jugular veins when they licked a particular empty spout. Over a two-week period, these animals were free to self-administer heroin, while control rats to whom they were linked received saline instead. One group of addicted rats and their yoked non-addicted partners were then kept without heroin for two weeks before being re-exposed to the spout, which no longer yielded drug infusions. After 90 minutes in this narcotic-associated environment, during which the addicted rats compulsively returned to lick the unrewarding empty spout, they and their yoked control mates were humanely killed and gene expression in their brains was studied. By comparing the gene expression in the drug-seeking animals with that in a second group of addicted rats re-exposed to the narcotic environment after only one day of abstinence, and with the saline-yoked controls, the researchers were able to identify genes involved in relapse behavior. According to Kuntz-Melcavage, "The session with the inactive spout served not only to provide an opportunity to observe drug-seeking behavior, but also mimicked a real-life situation in which environmental cues precipitate relapse behavior following an extended period of abstinence".
Speaking about the results of the study, Kuntz-Melcavage said, "As data accumulate, the existence of a single 'relapse gene' is looking increasingly unlikely - it is likely to be a constellation of different genes. Therefore, large scale views of gene expression, like this one, will prove very useful for guiding research into human drug-associated behavior".
Notes:
Gene expression changes following extinction testing in a heroin behavioral incubation model
Kara L Kuntz-Melcavage, Robert M Brucklacher, Patricia S Grigson, Willard M Freeman and Kent E Vrana
BMC Neuroscience (in press)
biomedcentral/bmcneurosci/
Source:
Graeme Baldwin
BioMed Central
Kara Kuntz-Melcavage, from Pennsylvania State University College of Medicine, USA, is part of a team of researchers who carried out the experiments. She said, "A number of gene expression studies have investigated changes induced by drug exposure, but few reports describe changes associated with the mental state that leads to relapse. We identified 66 genes involved in the relapse response, including some that are important for neuroplasticity, and through that role may impact learning and behavior".
Kuntz-Melcavage and her colleagues attached rats to a drug supply that for 3 hours each day delivered heroin into their jugular veins when they licked a particular empty spout. Over a two-week period, these animals were free to self-administer heroin, while control rats to whom they were linked received saline instead. One group of addicted rats and their yoked non-addicted partners were then kept without heroin for two weeks before being re-exposed to the spout, which no longer yielded drug infusions. After 90 minutes in this narcotic-associated environment, during which the addicted rats compulsively returned to lick the unrewarding empty spout, they and their yoked control mates were humanely killed and gene expression in their brains was studied. By comparing the gene expression in the drug-seeking animals with that in a second group of addicted rats re-exposed to the narcotic environment after only one day of abstinence, and with the saline-yoked controls, the researchers were able to identify genes involved in relapse behavior. According to Kuntz-Melcavage, "The session with the inactive spout served not only to provide an opportunity to observe drug-seeking behavior, but also mimicked a real-life situation in which environmental cues precipitate relapse behavior following an extended period of abstinence".
Speaking about the results of the study, Kuntz-Melcavage said, "As data accumulate, the existence of a single 'relapse gene' is looking increasingly unlikely - it is likely to be a constellation of different genes. Therefore, large scale views of gene expression, like this one, will prove very useful for guiding research into human drug-associated behavior".
Notes:
Gene expression changes following extinction testing in a heroin behavioral incubation model
Kara L Kuntz-Melcavage, Robert M Brucklacher, Patricia S Grigson, Willard M Freeman and Kent E Vrana
BMC Neuroscience (in press)
biomedcentral/bmcneurosci/
Source:
Graeme Baldwin
BioMed Central
четверг, 16 июня 2011 г.
National Institute On Drug Abuse To Highlight Latest Drug Abuse Research At Cincinnati Conference
The National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health, will convene a 2-day conference to explore how the latest scientific findings in drug abuse can fill the current gap between research and clinical treatment practices. The conference is part of NIDA's Blending Initiative, designed to stimulate engaging dialogue between those who work with substance abusers in communities with those engaged in the latest treatment research.
Targeting treatment professionals in the Ohio/Pennsylvania region, the Blending conference will equip participants with evidence based tools to use in their community-based practices, and will give treatment professionals an opportunity to share real-life challenges with researchers. The conference highlights NIDA's involvement as a crucial resource and partner for making the best drug addiction treatments available to those who need them.
What: Blending Science and Treatment: The Impact of Evidence-Based Practices on Individuals, Families, and Communities
When: Monday, June 2, 2008
9:00 a.m. - 5:30 p.m.
Tuesday, June 3, 2008
9:00 a.m. - 5:30 p.m.
Where: Duke Energy Center
525 Elm Street
Cincinnati, OH 45202
Who: Featured Speakers
Dr. Nora D. Volkow, Director, NIDA
Info: Topics that will be covered include, but are not limited to, the following:
- Addiction and the Brain
- Co-Occurring Psychiatric and Substance Use Disorders
- Addiction Treatments of the Future: The Role of Genetics
- Challenges in Determining, Implementing, and Sustaining Best Practices in Criminal Justice
- Community Reinforcement Approach and Family Training
For registration, please visit this link.
Interview opportunities with some of the world's top treatment researchers will be available. A full agenda and speaker list is available here.
Additional NIDA-related events open to media include a reception and screening of the HBO Emmy Award winning documentary, "Addiction,"which wasproduced in partnership with the Robert Wood Johnson Foundation, NIDA, and the National Institute on Alcohol Abuse and Alcoholism (NIAAA); and a student conversation at Walnut Hills High School where NIDA Director Dr. Volkow will engage students in a practical discussion on drug abuse and addiction.
The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at drugabuse..
National Institute on Drug Abuse
Targeting treatment professionals in the Ohio/Pennsylvania region, the Blending conference will equip participants with evidence based tools to use in their community-based practices, and will give treatment professionals an opportunity to share real-life challenges with researchers. The conference highlights NIDA's involvement as a crucial resource and partner for making the best drug addiction treatments available to those who need them.
What: Blending Science and Treatment: The Impact of Evidence-Based Practices on Individuals, Families, and Communities
When: Monday, June 2, 2008
9:00 a.m. - 5:30 p.m.
Tuesday, June 3, 2008
9:00 a.m. - 5:30 p.m.
Where: Duke Energy Center
525 Elm Street
Cincinnati, OH 45202
Who: Featured Speakers
Dr. Nora D. Volkow, Director, NIDA
Info: Topics that will be covered include, but are not limited to, the following:
- Addiction and the Brain
- Co-Occurring Psychiatric and Substance Use Disorders
- Addiction Treatments of the Future: The Role of Genetics
- Challenges in Determining, Implementing, and Sustaining Best Practices in Criminal Justice
- Community Reinforcement Approach and Family Training
For registration, please visit this link.
Interview opportunities with some of the world's top treatment researchers will be available. A full agenda and speaker list is available here.
Additional NIDA-related events open to media include a reception and screening of the HBO Emmy Award winning documentary, "Addiction,"which wasproduced in partnership with the Robert Wood Johnson Foundation, NIDA, and the National Institute on Alcohol Abuse and Alcoholism (NIAAA); and a student conversation at Walnut Hills High School where NIDA Director Dr. Volkow will engage students in a practical discussion on drug abuse and addiction.
The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at drugabuse..
National Institute on Drug Abuse
среда, 15 июня 2011 г.
Risk of death among homeless women
Homeless people are at high risk for illness and have higher death rates than the general population.
From the Women's Health Program, University Health Network (Cheung), the Inner City Health Research Unit, St. Michael's Hospital (Hwang), and the Department of Medicine, University of Toronto (Cheung, Hwang), Toronto, Ont.
Abstract
Background:
Homeless people are at high risk for illness and have higher death rates than the general population. Patterns of mortality among homeless men have been investigated, but less attention has been given to mortality rates among homeless women.
We report mortality rates and causes of death in a cohort of women who used homeless shelters in Toronto. We also compare our results with those of other published studies of homeless women and with data for women in the general population.
Methods:
A cohort of 1981 women not accompanied by dependent children who used homeless shelters in Toronto in 1995 was observed for death over a mean of 2.6 years. In addition, we analyzed data from published studies of mortality rates among homeless women in 6 other cities (Montreal, Copenhagen, Boston, New York, Philadelphia and Brighton, UK).
Results:
In Toronto, mortality rates were 515 per 100 000 person-years among homeless women 18-44 years of age and 438 per 100 000 person-years among those 45-64 years of age. Homeless women 18-44 years of age were 10 times more likely to die than women in the general population of Toronto.
In studies from a total of 7 cities, the risk of death among homeless women was greater than that among women in the general population by a factor of 4.6 to 31.2 in the younger age group and 1.0 to 2.0 in the older age group. In 6 of the 7 cities, the mortality rates among younger homeless women and younger homeless men were not significantly different.
In contrast, in 4 of the 6 cities, the mortality rates were significantly lower among older homeless women than among older homeless men.
Interpretation:
Excess mortality is far greater among homeless women under age 45 years than among older homeless women. Mortality rates among younger homeless women often approach or equal those of younger homeless men. Efforts to reduce deaths of homeless women should focus on those under age 45.
Homelessness is an important problem in the United States, Canada and the United Kingdom. Earlier studies have documented the high burden of illness among homeless people due to mental illness and addictions, medical conditions, tuberculosis and HIV infection, and traumatic injuries. These illnesses, in conjunction with severe poverty and often inadequate access to health care, lead to high mortality rates among homeless people.
Previous studies have focused on excess mortality observed among homeless people relative to their counterparts in the general population.
In Philadelphia, the mortality rate among homeless adults was 3.5 times higher than the rate in the general population. In a study of homeless people in Boston, mortality rates among men were 5.9, 3.0 and 1.6 times higher than those in the general population for people 18-24, 25-44 and 45-64 years of age respectively.
A study of people using homeless shelters in New York found age-adjusted death rates 2 to 3 times higher than those in the city's general population. Among men using homeless shelters in Toronto, mortality rates were 8.3, 3.7 and 2.3 times higher than rates among men in the general population aged 18-24, 25-44 and 45-64 years respectively.
Although a significant proportion of homeless people are women, relatively little attention has been focused on patterns of mortality in this subgroup. Among homeless people, single men, single women and women accompanied by children tend to have different health problems.
For example, the prevalence of substance abuse is lower among homeless single women than among homeless single men, but the rate of major depression is higher.
Such differences may have an effect on mortality rates. In this study, we focus on homeless single women, who tend to have more health problems than homeless women accompanied by children.
In the general population, mortality rates among younger women are one-third to one-half those among younger men. Low socioeconomic status is strongly associated with shorter life expectancy, but within every socioeconomic stratum women have a longer life expectancy than men do.
Whether this survival advantage is attenuated or lost altogether among homeless women is an important question, because the underlying mechanisms (e.g., addictions leading to drug overdose, or depression leading to suicide) might be amenable to targeted intervention.
We therefore conducted this study to determine whether homeless women lose the survival advantage associated with being female.
Our first objective was to determine mortality rates among women who use homeless shelters in Toronto. Our second objective was to analyze published data on mortality rates among homeless women compared with those among women in the general population and among homeless men.
To continue reading this report go to the Canadian Medical Association web site page:
cmaj.ca/cgi/content/full/170/8/1243
From the Women's Health Program, University Health Network (Cheung), the Inner City Health Research Unit, St. Michael's Hospital (Hwang), and the Department of Medicine, University of Toronto (Cheung, Hwang), Toronto, Ont.
Abstract
Background:
Homeless people are at high risk for illness and have higher death rates than the general population. Patterns of mortality among homeless men have been investigated, but less attention has been given to mortality rates among homeless women.
We report mortality rates and causes of death in a cohort of women who used homeless shelters in Toronto. We also compare our results with those of other published studies of homeless women and with data for women in the general population.
Methods:
A cohort of 1981 women not accompanied by dependent children who used homeless shelters in Toronto in 1995 was observed for death over a mean of 2.6 years. In addition, we analyzed data from published studies of mortality rates among homeless women in 6 other cities (Montreal, Copenhagen, Boston, New York, Philadelphia and Brighton, UK).
Results:
In Toronto, mortality rates were 515 per 100 000 person-years among homeless women 18-44 years of age and 438 per 100 000 person-years among those 45-64 years of age. Homeless women 18-44 years of age were 10 times more likely to die than women in the general population of Toronto.
In studies from a total of 7 cities, the risk of death among homeless women was greater than that among women in the general population by a factor of 4.6 to 31.2 in the younger age group and 1.0 to 2.0 in the older age group. In 6 of the 7 cities, the mortality rates among younger homeless women and younger homeless men were not significantly different.
In contrast, in 4 of the 6 cities, the mortality rates were significantly lower among older homeless women than among older homeless men.
Interpretation:
Excess mortality is far greater among homeless women under age 45 years than among older homeless women. Mortality rates among younger homeless women often approach or equal those of younger homeless men. Efforts to reduce deaths of homeless women should focus on those under age 45.
Homelessness is an important problem in the United States, Canada and the United Kingdom. Earlier studies have documented the high burden of illness among homeless people due to mental illness and addictions, medical conditions, tuberculosis and HIV infection, and traumatic injuries. These illnesses, in conjunction with severe poverty and often inadequate access to health care, lead to high mortality rates among homeless people.
Previous studies have focused on excess mortality observed among homeless people relative to their counterparts in the general population.
In Philadelphia, the mortality rate among homeless adults was 3.5 times higher than the rate in the general population. In a study of homeless people in Boston, mortality rates among men were 5.9, 3.0 and 1.6 times higher than those in the general population for people 18-24, 25-44 and 45-64 years of age respectively.
A study of people using homeless shelters in New York found age-adjusted death rates 2 to 3 times higher than those in the city's general population. Among men using homeless shelters in Toronto, mortality rates were 8.3, 3.7 and 2.3 times higher than rates among men in the general population aged 18-24, 25-44 and 45-64 years respectively.
Although a significant proportion of homeless people are women, relatively little attention has been focused on patterns of mortality in this subgroup. Among homeless people, single men, single women and women accompanied by children tend to have different health problems.
For example, the prevalence of substance abuse is lower among homeless single women than among homeless single men, but the rate of major depression is higher.
Such differences may have an effect on mortality rates. In this study, we focus on homeless single women, who tend to have more health problems than homeless women accompanied by children.
In the general population, mortality rates among younger women are one-third to one-half those among younger men. Low socioeconomic status is strongly associated with shorter life expectancy, but within every socioeconomic stratum women have a longer life expectancy than men do.
Whether this survival advantage is attenuated or lost altogether among homeless women is an important question, because the underlying mechanisms (e.g., addictions leading to drug overdose, or depression leading to suicide) might be amenable to targeted intervention.
We therefore conducted this study to determine whether homeless women lose the survival advantage associated with being female.
Our first objective was to determine mortality rates among women who use homeless shelters in Toronto. Our second objective was to analyze published data on mortality rates among homeless women compared with those among women in the general population and among homeless men.
To continue reading this report go to the Canadian Medical Association web site page:
cmaj.ca/cgi/content/full/170/8/1243
вторник, 14 июня 2011 г.
Release of detailed Canadian Addiction Survey improves understanding of substance use and abuse in Canada
Health Canada, the Canadian Executive Council on Addictions (CECA) and the Canadian Centre on Substance Abuse (CCSA) released detailed results of the Canadian Addiction Survey (CAS)-the first national survey devoted to alcohol and other drug use since 1994. CAS data is expected to guide program and policy development and inform the substance use and abuse research agenda for the next several years.
The 100-page detailed CAS report provides an in-depth national and province-by-province look at how Canadians use alcohol, cannabis and other drugs, and the impact these substances have on their lives.
The report also examines differences in rates of consumption and harm since the 1994 Canada's Alcohol and Other Drugs Survey (CADS) and the 1989 National Alcohol and Other Drugs Survey (NADS). Highlights of the CAS were released on November 24, 2004. The CAS reveals a rise in alcohol and cannabis use since 1994 with Canadians under the age of 25 accounting for much of the increase and problematic use. The detailed report also outlines self-reported harms that individuals attribute to their use of alcohol and drugs, including problems with friendships and social life, physical health, home life and marriage, work and studies, financial well-being, legal matters, housing, and learning.
"The CAS is the result of an impressive and effective partnership involving CECA, Health Canada and ourselves," said Michel Perron, CCSA's Chief Executive Officer. "We are very pleased that our collective efforts will help inform and assist decision-makers in their prevention and policy efforts." "The release of this report is the crucial next step in sharing the valuable CAS data with the research and treatment community to provide them with the additional clarity and understanding they need to validate or modify their work in the substance abuse and addictions field," said CECA president John Borody. "We hope that future detailed analyses will continue to build on this new understanding."
The full CAS data set will be made public in June 2005, providing Canadian researchers with further opportunities to conduct more detailed analyses from the rich data source. Some areas targeted for further exploration include health systems, treatment barriers and access; drinking, drugs and driving; psychosocial aspects of alcohol use; attitudes, beliefs and public opinion; detailed analysis of cannabis findings; youth and older adults.
The CAS was designed to provide a detailed assessment of how Canadians aged 15 years and older use alcohol and other drugs. The survey focused on the impact that alcohol and drug use has on physical, mental and social well-being.
The survey also questioned Canadians about their attitudes toward measures to control drug use, and on their beliefs about the availability of drugs and the risks associated with use. A total of 13,909 Canadians participated in the CAS, with a minimum of 1,000 in each province.
With Health Canada support, Yukon and the Northwest Territories are being surveyed separately with results anticipated in the summer of 2005.
The CAS is a collaboration of Health Canada, the Canadian Executive Council on Addictions (CECA)-which includes the Canadian Centre on Substance Abuse (CCSA), the Alberta Alcohol and Drug Abuse Commission (AADAC), the Addictions Foundation of Manitoba (AFM), the Centre for Addiction and Mental Health (CAMH), Prince Edward Island Provincial Health Services Authority, and the Kaiser Foundation/Centre for Addictions Research of BC (CAR-BC)-and the provinces of Nova Scotia, New Brunswick and British Columbia.
The Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms (both the highlights and detailed report) are available at ccsa.ca. Backgrounder: ccsa.ca/pdf/ccsa-bckgrd-20050323-e.pdf For further information, contact Enid Harrison Paul Duchesne Canadian Centre on Substance Abuse (CCSA) and Health Canada Canadian Executive Council on Addictions (CECA) (613) 954-4807 613) 235-4048 ext. 237; (613) 355-6894 (mobile) e-mail mailto:eharrisonccsa.ca
Health Canada
The 100-page detailed CAS report provides an in-depth national and province-by-province look at how Canadians use alcohol, cannabis and other drugs, and the impact these substances have on their lives.
The report also examines differences in rates of consumption and harm since the 1994 Canada's Alcohol and Other Drugs Survey (CADS) and the 1989 National Alcohol and Other Drugs Survey (NADS). Highlights of the CAS were released on November 24, 2004. The CAS reveals a rise in alcohol and cannabis use since 1994 with Canadians under the age of 25 accounting for much of the increase and problematic use. The detailed report also outlines self-reported harms that individuals attribute to their use of alcohol and drugs, including problems with friendships and social life, physical health, home life and marriage, work and studies, financial well-being, legal matters, housing, and learning.
"The CAS is the result of an impressive and effective partnership involving CECA, Health Canada and ourselves," said Michel Perron, CCSA's Chief Executive Officer. "We are very pleased that our collective efforts will help inform and assist decision-makers in their prevention and policy efforts." "The release of this report is the crucial next step in sharing the valuable CAS data with the research and treatment community to provide them with the additional clarity and understanding they need to validate or modify their work in the substance abuse and addictions field," said CECA president John Borody. "We hope that future detailed analyses will continue to build on this new understanding."
The full CAS data set will be made public in June 2005, providing Canadian researchers with further opportunities to conduct more detailed analyses from the rich data source. Some areas targeted for further exploration include health systems, treatment barriers and access; drinking, drugs and driving; psychosocial aspects of alcohol use; attitudes, beliefs and public opinion; detailed analysis of cannabis findings; youth and older adults.
The CAS was designed to provide a detailed assessment of how Canadians aged 15 years and older use alcohol and other drugs. The survey focused on the impact that alcohol and drug use has on physical, mental and social well-being.
The survey also questioned Canadians about their attitudes toward measures to control drug use, and on their beliefs about the availability of drugs and the risks associated with use. A total of 13,909 Canadians participated in the CAS, with a minimum of 1,000 in each province.
With Health Canada support, Yukon and the Northwest Territories are being surveyed separately with results anticipated in the summer of 2005.
The CAS is a collaboration of Health Canada, the Canadian Executive Council on Addictions (CECA)-which includes the Canadian Centre on Substance Abuse (CCSA), the Alberta Alcohol and Drug Abuse Commission (AADAC), the Addictions Foundation of Manitoba (AFM), the Centre for Addiction and Mental Health (CAMH), Prince Edward Island Provincial Health Services Authority, and the Kaiser Foundation/Centre for Addictions Research of BC (CAR-BC)-and the provinces of Nova Scotia, New Brunswick and British Columbia.
The Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms (both the highlights and detailed report) are available at ccsa.ca. Backgrounder: ccsa.ca/pdf/ccsa-bckgrd-20050323-e.pdf For further information, contact Enid Harrison Paul Duchesne Canadian Centre on Substance Abuse (CCSA) and Health Canada Canadian Executive Council on Addictions (CECA) (613) 954-4807 613) 235-4048 ext. 237; (613) 355-6894 (mobile) e-mail mailto:eharrisonccsa.ca
Health Canada
Подписаться на:
Комментарии (Atom)