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Biomedical subjects

A H Ghodse

Publications and source records attributed to A H Ghodse.

At least 19 recordsLinked to original sources
PubMed1992

Systems analysis of a drug dependency service in London: St George's Hospital.

Elements of a systems approach to analysing service delivery are outlined. A specific example--St George's Hospital Addiction Behaviour Department--is detailed. Dynamics of the system--from the client's perspective and the workers viewpoint--demonstrate some of the ways in which emotional conflict surrounding the task is handled. The conclusions focus on what might constitute adaptive resolution of systems dilemmas as well as highlighting the public-health concerns relating to AIDS which, we argue, compromise the primary task of an addiction service at the present time.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Cannabis and psychotic illness.

In-patients with psychotic symptoms and cannabis-positive urine analysis were assessed by PSE within one week of admission and again at one and six months. Concurrently admitted psychotic patients with drug-free urine analysis were controls. At one week the two groups differed significantly on only five PSE items: changed perception, thought insertion, non-verbal auditory hallucinations, delusions of control, and delusions of grandiose ability. One item (delayed sleep) differed at one month, and none at six months. The symptom cluster at one week is consistent with acute cannabis intoxication. Subjects and controls were mostly single, poorly educated, unemployed people with histories of psychotic disorders, and given major tranquillisers on admission. Compared with controls, subjects were younger, less likely to have psychiatric histories, more often male, Afro-Caribbeans with a history of convictions and compulsory admissions. The commonest diagnosis was schizophrenia. Use of the label 'cannabis-induced psychosis' may obscure a diagnosis of paranoid schizophrenia. A short-lived psychotic episode does occur in clear consciousness after cannabis intoxication, but chronic cannabis-induced psychosis was not found.

Adolescent↗
PubMed1991

Cannabis use in a large sample of acute psychiatric admissions.

A sample of 908 patients drawn from two London Psychiatric Hospitals is described in terms of age, sex, self-reported drug and alcohol history, drug urinalysis results and initial psychiatric diagnosis. Some (34.5%) of respondents admitted to using cannabis at least once in their lifetime and 13% of those tested had urines positive for cannabis on admission. Cannabis use is commoner in young males. These is a higher likelihood that an initial diagnosis of 'psychosis' will be made at admission if patients either report use of cannabis or present a urine sample positive for cannabis.

Adolescent↗
PubMed1990

An international survey of the educational activities of schools of nursing on psychoactive drugs.

A survey of the educational activities of schools of nursing on psychoactive drugs in 99 countries was carried out. All the schools that replied gave specific teaching and many also included the rational use of these drugs. The amount of time devoted to this teaching and the methods used varied greatly. Most schools felt that this topic needed more emphasis and many agreed that guidelines on teaching methods and approaches, as well as broad teaching aims and objectives, would be useful.

Curriculum↗
PubMed1989

Naloxone applied to conjunctiva as a test for physical opiate dependence.

Significant pupillary dilatation in response to conjunctivally applied naloxone was demonstrated with polaroid photography in 46 opiate addicts on maintenance methadone prescription. No pupillary response was seen to an identical procedure in 17 non-addict subjects who had been given an opiate premedication before elective surgery. This pupillary response to naloxone could be used as a test to identify the physically dependent opiate user.

Administration, Topical↗
PubMed1989

Undergraduate medical school training in psychoactive drugs and rational prescribing in the United Kingdom.

The present study examines the extent and form of teaching on psychoactive drugs and the rational prescribing of them given to undergraduate medical students in the United Kingdom. All the 21 schools which replied taught on psychoactive drugs. The average was 15.4 hours of formal teaching (lectures, seminars, tutorials). The teaching on psychoactive drugs compares favourably with the average of 4.2 hours teaching given on alcohol related problems and 3.5 hours on drug dependence. It emerged that there was a great deal of variation in the amount of teaching on psychoactive drugs and many schools felt their teaching on rational prescribing was inadequate. There is a need to promote better co-ordination between medical school departments and to identify the key concepts which all medical schools teach. These steps would help to ensure improved teaching on psychoactive drugs and rational prescribing.

Curriculum↗
PubMed1989

Types of opiate addiction and notification to the home office.

Hospitalised drug addicts were categorised according to the time lapse between onset of their opiate abuse and their first notification to the Home Office. Late notification correlated with a lower level of dependence, a more intermittent pattern of misuse, and a greater likelihood of alcohol abuse. It is postulated that there may be two types of addiction which lie along a continuum.

Adult↗
PubMed1989

An international survey of the educational activities of schools of pharmacy on psychoactive drugs.

A survey of the educational activities of schools of pharmacy on psychoactive drugs in 92 countries was carried out. All the schools which replied felt that there was a need for specific education on psychoactive drugs, and the majority felt that the rational use of such drugs should also be taught. Both the amount of teaching given and the methods used varied. This was particularly true for related subjects such as alternatives to psychoactive drug use. Almost a third of schools considered that they did not devote adequate time to psychoactive drugs and their rational use, and many would be grateful for specific educational guidelines in this area.

Curriculum↗
PubMed1987

Asthma in opiate addicts.

A case-note study of 2276 opiate addicts revealed that 112(5%) had a history of asthma and that in 31(1.4%) cases there appeared to be a definite temporal relationship between heroin abuse and the onset of asthma. This rarely-reported complication of heroin dependence has a higher incidence among female addicts (3.3%) than among male addicts (0.7%).

Adult↗
PubMed1987

Depression in solvent abusers.

Previous studies mention that some solvent abusers have a depressed mood. This study sets out to determine in a formal way whether solvent abusers are more depressed than a comparison group of non-solvent abusers. Forty-seven consecutive admissions (all with delinquent histories) to the secure unit of a regional assessment centre for adolescent boys, who fulfilled certain criteria, were assessed. They completed the General Health 28 item questionnaire (GHQ-28) and the Great Ormond Street (GOS) mood questionnaire. Thereafter, they were administered a semi-structured interview covering the following areas--solvent abuse data, educational data, demographic and family data, criminal history and other drug use data. Results showed that significantly more solvent abusers were depressed than non-solvent abusers as defined by GOS-mood scores of 25 or more (P less than 0.05). Also, mean GHQ-28 total scores (P less than 0.02), GHQ-28 depression subscale scores (P less than 0.02), and GOS-mood scores (P less than 0.05) were significantly higher in the solvent abuse group. In conclusion, solvent abusers are more depressed than a comparison non-solvent abusing group.

Adolescent↗
PubMed1987

Analysis of epidemiological data on agonist-antagonist analgesics.

Epidemiological information on the abuse of opioid agonist-antagonists is scanty. Most of the available information relates to pentazocine, the 'oldest' of this class of drugs, and it appears that a sporadic episode of its intravenous abuse in several cities in the United States, is subsiding: reformulation of pentazocine tablets to contain naloxone may have contributed to the decline in this abuse. Apart from a few reports of buprenorphine abuse, there are only occasional accounts of abuse of other drugs in this class. However, the lack of data does not necessarily mean that abuse does not occur and it is essential that epidemiologically sound investigations should be made to explore the existence and extent of any such problem. The interpretation of epidemiological data relating to agonist-antagonist abuse is discussed.

Buprenorphine↗
PubMed1987

Monitoring changing patterns of drug dependence in accident and emergency departments.

A survey was made of drug dependent individuals attending the Accident and Emergency Departments in Greater London in July 1982 and the results were compared with those of an identical survey in July 1975. There was a significant reduction in the number of incidents involving drug dependent patients, the majority of whom attended hospital after a drug overdose; the proportion of suicidal attempts increased significantly in 1982. Barbiturates were taken less frequently in 1982, but heroin and anxiolytics were taken more often. Possible reactions to these findings are discussed and the continuing role of the Accident and Emergency Departments in monitoring changing patterns of drug abuse in emphasised.

Accidents↗