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Biomedical subjects

J Strang

Publications and source records attributed to J Strang.

At least 145 records · Page 8Linked to original sources
PubMed1991

Should opiate addicts be involved in controlling their own detoxification? A comparison of fixed versus negotiable schedules.

This study compares the responses of opiate addicts at a London drug treatment centre to two outpatient methadone-based detoxification programmes. These involved either a fixed (non-negotiable) dose reduction schedule or a flexible, negotiable withdrawal schedule. In the negotiable condition, subjects were less likely to complete the detoxification programme and the mean reduction in dose achieved by the subjects in the negotiable condition was less than that in the fixed group. There was no difference between groups in programme retention at 6 weeks though subjects who remained in treatment in the negotiable group tended to extend their detoxification period beyond this point. The overall response of subjects in both groups was unsatisfactory. Only 13% of the subjects initially allocated to detoxification or 28% of those who actually started detoxification completed treatment; urine screening showed that heroin abuse was a continuing problem during treatment. The implications of these results for detoxification and drug treatment services are discussed.

Adult↗
PubMed1991

A comparison of the withdrawal responses of heroin and methadone addicts during detoxification.

This study compares the withdrawal responses of methadone and heroin addicts during a ten-day in-patient detoxification programme with methadone. Contrary to suggestions in the literature, the methadone group reported more severe withdrawal symptoms during both the acute withdrawal phase and the recovery phase. There were no differences between the two groups in onset or duration of symptoms. Whereas there may be reasons to favour methadone as a maintenance drug, its use may lead to difficulties during withdrawal.

Adult↗
PubMed1991

Self-detoxification by opiate addicts. A preliminary investigation.

A study of 50 opiate addicts attending a London service for treatment of drug dependence found that 47 subjects had previously made at least one attempt at self-detoxification. These subjects reported 212 previous attempts. Although 30 subjects reported having managed to complete at least one attempt, the success rate per episode was low (24%). One of the most commonly reported methods, used by 28 subjects, involved an abrupt cessation of opiates ('cold turkey'). Of the drugs used in their attempts at self-detoxification, benzodiazepines were reported by 24 subjects and opiates by 20. Practical strategies such as distraction and avoidance were also used. Self-help detoxification materials for opiate addicts might be useful.

Adult↗
PubMed1991

Past and present perspectives on cocaine in Britain.

Thanks to the Rolleston Report of 1926, the prescription of opiates and cocaine was allowed in the United Kingdom to physicians who treated addicted people. Until 1960 there were only a few cases per annum. However, this regulation strongly encouraged the immigration of addicts and in specialized clinics great amounts of cocaine were used. This changed speedily when one understood that this was not the right method, and the prescription of cocaine-injections disappeared in 1968. Afterwards began the illegal use of cocaine and greater and greater amounts were seized by Customs and police. The official number of cocaine-addicted people is however very low. At this time, the Police of the United Kingdom cannot yet decide if there is a beginning cocaine-epidemic or if cocaine should still be considered as a secondary drug.

Cocaine↗
PubMed1991

Chasing the dragon.

Explore the source record for details and available documents.

Administration, Inhalation↗
PubMed1990

Comparison of linear versus inverse exponential methadone reduction curves in the detoxification of opiate addicts.

A linear methadone detoxification procedure is compared with an inverse exponential reduction curve in a double-blind study. The inverse exponential curve resulted in withdrawal symptomatology which was significantly greater during the acute phase of the opiate withdrawal curve and was not significantly different during the recovery phase. There was no difference between groups in the time course of the withdrawal syndrome, in peak symptom severity, nor in patient compliance. Separate analyses for high-dose and for low-dose addicts show variation in the suitability of the two curves according to dose. The implications for future research and treatment of the opiate withdrawal syndrome are discussed.

Adult↗
PubMed1990

The Drug Advisory Service of England and Wales--the first 2 years.

An historical account is presented of the introduction and subsequent work of the Drug Advisory Service (DAS) of England and Wales since 1986. Data are presented from an analysis of the recommendations contained within the first 11 reports. The structural and operational strengths and weaknesses of the present approach are considered, and alternative approaches which might constitute constructive modifications or supplements to the present system are discussed.

Community Mental Health Services↗
PubMed1990

Screening for hepatitis B and vaccination of injecting drug users in NHS drug treatment services.

Hepatitis B vaccines are now available for people at high risk of infection. Injecting drug users are at particular risk. A UK national survey of statutory drug treatment facilities was conducted to assess what screening and vaccination procedures were offered to drug takers. Of the respondents 64% did not screen for hepatitis B and 71% did not offer vaccination to hepatitis B negative individuals. However, 63% respondents said they would advise vaccination for injecting drug users who continued to share. Fifty-eight per cent thought that the partners of hepatitis B positive clients should be screened and 50% thought that vaccination of partners was advisable. A policy of screening and vaccination for hepatitis B is recommended.

Hepatitis B↗
PubMed1990

Social and drug-taking behaviour of 'maintained' opiate addicts.

The roles of the prescribing of maintenance methadone and prescribing injectable drugs in the management of opiate addicts have become subjects of active debate since the advent of HIV. Data are presented on the social circumstances and drug-taking behaviour of 26 opiate addicts who had been receiving maintenance methadone (24 of whom had been receiving at least part of the prescription as injectible methadone ampoules.

Adult↗
PubMed1990

Crack and cocaine use in south London drug addicts: 1987-1989.

There has been great concern in recent years about the abuse of cocaine, particularly in its smokable form 'crack'. This paper presents data drawn from 441 patients seen by a South London Community Drug Team between 1987 and 1989. Only four (1%) cited cocaine abuse as the main drug problem. Heroin was the most common main drug. Detailed information was available on 355 of these subjects. During the study period 63 patients reported using cocaine and the proportion of subjects using cocaine increased from 13% to 29%. Within the sub-group of cocaine users, there was a marked increase in the use of smokable forms of cocaine from 15% in 1987 to 75% in 1989. In view of the increased dependence risk associated with smoking cocaine, this is seen as an ominous development.

Adult↗
PubMed1990

Lessons from an English opium eater: Thomas De Quincey reconsidered.

Thomas De Quincey published his autobiographical Confessions of an English Opium Eater in 1821. The publication both fascinated and outraged its 19th-century readers. Heated debate followed on such topics as: the causality of opiate use; self-inflicted suffering and responsibility; the impact of availability and environment; therapeutic addiction; controlled use; the emergence of dependence; tolerance; withdrawal techniques; hazards; the impact of advertising. Many of these topics remain subjects of debate and causes for concern today. We would be well advised to study the questions and debates of a century and a half ago.

England↗