ABSTRACT
OBJECTIVES: This comparative study investigated consumption patterns, comorbidity and treatment utilization of opioid addicts in six European cities (Athens, Essen, London, Padua, Stockholm, Zurich). SUBJECTS AND METHODS: Data were collected by structured face-to-face interviews. The representative sample comprises 599 addicts (100 patients per centre, 99 in London) at the start of a treatment episode. RESULTS: Patients were dependent on opioids for about 10 years. Regional differences were significant regarding the patients' drug consumption pattern and their method of heroin administration (up to a fourth of the patients in Essen, London and Zurich usually smoke heroin). Concomitant use of benzodiazepines, cannabis and alcohol was common in all regions with the German and English samples showing the highest level of polydrug use. The prevalence of major depression was high in all regions (50%). Stockholm and London patients worry most about their physical health. Differences in the amount of needle sharing and especially in the use of public health service were prominent between the sites. Opioid addiction was a long-term disorder associated with a high burden of comorbidity and social problems in all cities. CONCLUSION: The results of the study show significant interregional differences of opioid addicts which might require different treatment strategies in European countries to handle the problem.
Subject(s)
Alcoholism/epidemiology , Drug Users , Health Services/statistics & numerical data , Opioid-Related Disorders/epidemiology , Adult , Cocaine-Related Disorders/epidemiology , Comorbidity , Depressive Disorder, Major/epidemiology , Europe/epidemiology , Female , Humans , Male , Middle Aged , Needle SharingABSTRACT
BACKGROUND: There has been an increase of cannabis-related disorders in Germany during the last 10 years. According treatments are being established, however little is known about the treatment populations. METHODS: The population of an outpatient treatment program for diagnosis and therapy of cannabis-related disorders was investigated using a structured interview (based on EuropASI, SCID-I) regarding sociodemographic variables, history of addiction, consumption patterns, and psychiatric comorbidity. RESULTS: The 90 patients studied had a mean age of 27.5+/-6.6 years; 82% were male. They claimed averages of cannabis consumption for 11+/-7 years and current amount at 1.9 g per day. Alcohol problems were also common in this sample. High percentages were shown regarding unemployment, living alone, and problems with the law. Comorbid psychiatric disorders were diagnosed in 42% of patients. CONCLUSIONS: The patients were chronic users of cannabis with extensive psychosocial problems. Therapy of cannabis-related disorders should therefore include treatment for comorbidities and social care besides the treatment for addictive behavior.
Subject(s)
Alcoholism/epidemiology , Ambulatory Care/methods , Marijuana Abuse/diagnosis , Marijuana Abuse/epidemiology , Marijuana Abuse/therapy , Risk Assessment/methods , Adult , Alcoholism/diagnosis , Alcoholism/therapy , Comorbidity , Employment , Female , Humans , Male , Prevalence , Risk Factors , Socioeconomic Factors , Treatment OutcomeABSTRACT
A prospective clinical trial in couples was done to compare effectiveness and toxicity of gold and D-penicillamine (D-Pen.) in treatment of rheumatoid arthritis (r.A.). Respecting defined criteria 70 patients were put to couples according to a random list and were treated with gold or D-Pen. alternatively. Physical and laboratory indices of inflammatory activity were checked every 3 months, X-rays every 12 months. Dropouts (side effects, missing compliance, uneffectiveness) were replaced by the nextcoming fitting patient. Thirty-two of 147 totally recruited patients stopped treatment because of side effects, three because of unsatisfying efficiency. Forty-two patients shuned the necessary controls. The clinical course was better in 16 couples with gold, only in sex couples with D-Pen. Thirteen pairs showed no difference in this respect (p = 0.05). Looking to the laboratory parameters separately D-Pen. tends to be superior (p < 0.05), radiografic deterioration seems to be more seldom with gold (< 0.05). Side effects occur with both drugs in comparable frequency (15/44 with D-Pen., 17/52 with gold), but the complications with D-Pen. are more serious. Altogether this trial shows gold superior to D-Pen. in the long-term treatment of r.A.
Subject(s)
Arthritis, Rheumatoid/drug therapy , Gold/therapeutic use , Penicillamine/therapeutic use , Adult , Clinical Trials as Topic , Female , Gold/adverse effects , Humans , Male , Middle Aged , Penicillamine/adverse effects , Random AllocationABSTRACT
Haemofiltrate was administered into the duodenum of 5 ambulatory dogs through an implanted silastic catheter at a rate of 5-10 ml/min. None of the dogs presented signs of discomfort or suffered from regurgitation or diarrhoea. All 5 dogs had solid stools, enhanced diuresis and no change in body weight over a time period of 8 hours. Filtration rates between 5 and 10 ml/min were obtained in 7 dogs after connecting an Amicon in-line Ultrafilter with an external a.v. shunt. The intestinal recycling rate via the duodenal tube as a rule was 2 ml/min lower than the free flow ultrafiltration. Recirculation of autologous haemofiltrate in 5 uraemic dogs indicated unselective reabsorption of all electrolytes and small molecules. In 5 experiments with intestinal substitution of ultrafiltrate by a potassium-free Ringer's lactate solution, correction of acidosis and decrease in plasma potassium, creatinine and BUN was achieved.