A dialogue with the alcohol industry: prohibition or harm reduction.
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Biomedical subjects
Publications and source records attributed to N El-Guebaly.
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An overview is presented of the status of human saliva as a clinical monitoring medium in medicine and psychiatry. Despite the present controversy about the reliability of saliva lithium levels, an evaluation of the prospects of saliva for other pharmacokinetic estimations as well is recommended. The second part of the paper outlines the authors' attempt to expand the use of saliva monitoring in a depot neuroleptic clinic and a methadone maintenance program. This technique, well accepted by the patient populations, is found useful as a screening tool for drug use and compliance can be checked. It can also be indicated prior to the evaluation of the toxicity of prescribed medication as well as the assessment of drug interaction. On humanitarian, clinical and economical grounds, further investigation of the clinical applications of saliva in psychiatric practice is warranted.
The authors surveyed the reactions toward commitment of 61 respondents out of a sample of 100 patients who had been committed to hospital during a one year period. The patients reported little change in their life situation as a result of committal and most viewed committal quite neutrally. They generally felt uninformed of their rights and indicated little intent to appeal the commitments, but wished to be assured that their rights were being considered and protected. Most saw psychiatrists as the professional group best equipped to bring about a committal. The importance of consumer surveys in controversial areas such as this is underscored.
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In their review of the literature on the effects of parental alcoholism on the offspring of alcoholics, the authors focus on sample collection, criteria used for the diagnosis of parental alcoholism, and definitions of "emotional disturbances." Studies are grouped according to age of offspring; within each age group, the various approaches to the issue are described. The authors suggest a need for more carefully controlled studies using blind data collection and clear operational definitions. In addition, the "risk" status of offspring of alcoholics should be compared to that of children whose parents have other types of serious psychiatric disturbance. Although the literature has focused on the "casualties," the authors note that much could be learned from studies of the "successes"--those children who do not seem to be at increased risk for pychosocial illness despite the alcoholism of their parents.
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