A review of ecological effects and environmental fate of illicit drugs in aquatic ecosystems.

Although illicit drugs are detected in surface waters throughout the world, their environmental fate and ecological effects are not well understood. Many illicit drugs and their breakdown products have been detected in surface waters and temporal and spatial variability in use translates into "hot spots and hot moments" of occurrence. Illicit drug occurrence in regions of production and use and areas with insufficient wastewater treatment are not well studied and should be targeted for further study. Evidence suggests that illicit drugs may not be persistent, as their half-lives are relatively short, but may exhibit "pseudo-persistence" wherein continual use results in persistent occurrence. We reviewed the literature on the ecological effects of these compounds on aquatic organisms and although research is limited, a wide array of aquatic organisms, including bacteria, algae, invertebrates, and fishes, have receptors that make them potentially sensitive to these compounds. In summary, illicit drugs occur in surface waters and aquatic organisms may be affected by these compounds; research is needed that focuses on concentrations of illicit drugs in areas of production and high use, environmental fate of these compounds, and effects of these compounds on aquatic ecosystems at the concentrations that typically occur in the environment.

Substance misuse among health care workers: national survey of occupational physicians.

BACKGROUND: National Health Service (NHS) occupational health departments assist in the identification and assessment of substance-use disorders among health care workers (HCWs) and are involved in the management of an individual's return to work after treatment. AIMS: To determine the experience and training of NHS occupational health physicians (OHPs) in identifying substance misuse among HCWs. METHODS: A national, cross-sectional, postal-based questionnaire was administered to the Association of National Health Occupational Physicians membership. RESULTS: A total of 145/224 (65%) OHPs (55% male), with a mean age of 49 years (SD ± 9.1; range 28-76), who had worked in the NHS on average for 9.6 years took part. The majority of respondents were consultant grade (59%). Since taking up their NHS post, 26% had received no training in substance misuse. Of those who had undergone formal training, the mean duration received was 2.8 days for drugs and 3.5 days for alcohol. OHPs reported that they did not feel sufficiently trained in this area. Most (65%) did not routinely include standardized screening tools or deliver 'brief interventions' (78%), although many reported that they would routinely ask about substance use when there was no clear indication of use (42%). The majority did not feel they were adequately supported (54%) in this work, nor did they have adequate resources for these patients within their organization (68%). CONCLUSIONS: OHPs see HCWs with substance-use problems as part of their work, but the support provided is likely limited by insufficient training and inadequate support.

Spray droplet size, drift potential, and risks to nontarget organisms from aerially applied glyphosate for coca control in Colombia.

A wind tunnel atomization study was conducted to measure the emission droplet size spectra for water and Glyphos (a glyphosate formulation sold in Colombia) + Cosmo-flux sprays for aerial application to control coca and poppy crops in Colombia. The droplet size spectra were measured in a wind tunnel for an Accu-Flo nozzle (with 16 size 0.085 [2.16 mm] orifices), under appropriate simulated aircraft speeds (up to 333 km/h), using a laser diffraction instrument covering a dynamic size range for droplets of 0.5 to 3,500 microm. The spray drift potential of the glyphosate was modeled using the AGDISP spray application and drift model, using input parameters representative of those occurring in Colombia for typical aerial application operations. The droplet size spectra for tank mixes containing glyphosate and Cosmo-Flux were considerably finer than water and became finer with higher aircraft speeds. The tank mix with 44% glyphosate had a D(v0.5) of 128 microm, while the value at the 4.9% glyphosate rate was 140 microm. These are classified as very fine to fine sprays. Despite being relatively fine, modeling showed that the droplets would not evaporate as rapidly as most similarly sized agricultural sprays because the nonvolatile proportion of the tank mix (active and inert adjuvant ingredients) was large. Thus, longer range drift is small and most drift that does occur will deposit relatively close to the application area. Drift will only occur downwind and, with winds of velocity less than the modeled maximum of 9 km/h, the drift distance would be substantially reduced. Spray drift potential might be additionally reduced through various practices such as the selection of nozzles, tank mix adjuvants, aircraft speeds, and spray pressures that would produce coarser sprays. Species sensitivity distributions to glyphosate were constructed for plants and amphibians. Based on modeled drift and 5th centile concentrations, appropriate no-spray buffer zones (distance from the end of the spray boom as recorded electronically +/-5%) for protection of sensitive plants were 50-120 m for coca spray scenarios and considerably lower for poppy spray scenarios. The equivalent buffer zone for amphibia was 5 m. The low toxicity of glyphosate to humans suggests that these aerial applications are not a concern for human health.

Coca (Erythroxylum coca) Control is Affected by Glyphosate Formulations and Adjuvants.

The aerial spray program for the eradication of coca in Colombia uses Glyphos, a local formulation of glyphosate tank-mixed with an adjuvant product, Cosmo-Flux. There are some potential risks to amphibians from direct overspraying of shallow waters. In order to evaluate potential alternative mixtures, a field experiment was conducted at the Center of National Training of Police Operations in Tolima province, Colombia. Plants of coca were established with irrigation and grown to 75 cm tall. A randomized split-plot design experiment was laid out and sprayed with a range of glyphosate formulations and different adjuvants using an experimental ground sprayer. Assessments were made of plant vigor, height, and above-ground standing crop (fresh weight) 3 wk after application. Resprouting of plants was assessed at 9 wk after treatment. Unformulated glyphosate applied as the product Rodeo gave poorer control of coca than two formulated products, Roundup Biactive (from Europe) and Colombian Glyphos. In general, these products performed well without added adjuvants, giving control similar to that of the eradication mixture with Cosmo-Flux. There was some evidence that addition of the adjuvant Silwet L-77 and to a lesser extent Mixture B (from the United Kingdom) gave more rapid herbicide symptoms. There were also indications that glyphosate rates of less than 3.69 kg acid equivalents (a.e.)/ha could give control in the range of 95%. Depending on the environmental risk requirements, the experiment indicates that, should other spray mixtures be required, there are potential alternatives. These would require extensive field testing to cover different environmental conditions, different coca varieties, and particularly aerial application, prior to a recommendation. Should the glyphosate product require changing, Roundup Biactive may be considered. Should the adjuvant require changing, then on the basis of this research, Silwet L-77 and Mixture B would be good candidates for further evaluation.

Regional differences in time to pregnancy among fertile women from five Colombian regions with different use of glyphosate.

The objective of this study was to test whether there was an association between the use of glyphosate when applied by aerial spray for the eradication of illicit crops (cocaine and poppy) and time to pregnancy (TTP) among fertile women. A retrospective cohort study (with an ecological exposure index) of first pregnancies was undertaken in 2592 fertile Colombian women from 5 regions with different uses of glyphosate. Women were interviewed regarding potential reproductive, lifestyle, and work history predictors of TTP, which was measured in months. Fecundability odds ratios (fOR) were estimated using a discrete time analogue of Cox's proportional hazard model. There were differences in TTP between regions. In the final multivariate model, the main predictor was the region adjusted by irregular relationship with partner, maternal age at first pregnancy, and, marginally, coffee consumption and self-perception of water pollution. Boyaca, a region with traditional crops and. recently, illicit crops without glyphosate eradication spraying (manual eradication), displayed minimal risk and was the reference region. Other regions, including Sierra Nevada (control area, organic agriculture), Putumayo and Narino (illicit crops and intensive eradication spray program), and Valle del Cauca, demonstrated greater risk of longer TTP, with the highest risk for Valle del Cauca (fOR 0.15, 95% CI 0.12, 0.18), a sugar-cane region with a history of use of glyphosate and others chemicals for more than 30 yr. The reduced fecundability in some regions was not associated with the use of glyphosate for eradication spraying. The observed ecological differences remain unexplained and may be produced by varying exposures to environmental factors, history of contraceptive programs in the region, or psychological distress. Future studies examining these or other possible causes are needed.

Biomonitoring of genotoxic risk in agricultural workers from five colombian regions: association to occupational exposure to glyphosate.

In order to assess possible human effects associated with glyphosate formulations used in the Colombian aerial spray program for control of illicit crops, a cytogenetic biomonitoring study was carried out in subjects from five Colombian regions, characterized by different exposure to glyphosate and other pesticides. Women of reproductive age (137 persons 15-49 yr old) and their spouses (137 persons) were interviewed to obtain data on current health status, history, lifestyle, including past and current occupational exposure to pesticides, and factors including those known to be associated with increased frequency of micronuclei (MN). In regions where glyphosate was being sprayed, blood samples were taken prior to spraying (indicative of baseline exposure), 5 d after spraying, and 4 mo after spraying. Lymphocytes were cultured and a cytokinesis-block micronucleus cytome assay was applied to evaluate chromosomal damage and cytotoxicity. Compared with Santa Marta, where organic coffee is grown without pesticides, the baseline frequency of binucleated cells with micronuclei (BNMN) was significantly greater in subjects from the other four regions. The highest frequency of BNMN was in Boyaca, where no aerial eradication spraying of glyphosate was conducted, and in Valle del Cauca, where glyphosate was used for maturation of sugar cane. Region, gender, and older age (> or =35 yr) were the only variables associated with the frequency of BNMN measured before spraying. A significant increase in frequency of BNMN between first and second sampling was observed in Narino, Putumayo, and Valle immediately (<5 d) after spraying. In the post-spray sample, those who reported direct contact with the eradication spray showed a higher quantitative frequency of BNMN compared to those without glyphosate exposure. The increase in frequency of BNMN observed immediately after the glyphosate spraying was not consistent with the rates of application used in the regions and there was no association between self-reported direct contact with eradication sprays and frequency of BNMN. Four months after spraying, a statistically significant decrease in the mean frequency of BNMN compared with the second sampling was observed in Narino, but not in Putumayo and Valle del Cauca. Overall, data suggest that genotoxic damage associated with glyphosate spraying for control of illicit crops as evidenced by MN test is small and appears to be transient. Evidence indicates that the genotoxic risk potentially associated with exposure to glyphosate in the areas where the herbicide is applied for coca and poppy eradication is low.

On the relationship between farmland biodiversity and land-use intensity in Europe.

Worldwide agriculture is one of the main drivers of biodiversity decline. Effective conservation strategies depend on the type of relationship between biodiversity and land-use intensity, but to date the shape of this relationship is unknown. We linked plant species richness with nitrogen (N) input as an indicator of land-use intensity on 130 grasslands and 141 arable fields in six European countries. Using Poisson regression, we found that plant species richness was significantly negatively related to N input on both field types after the effects of confounding environmental factors had been accounted for. Subsequent analyses showed that exponentially declining relationships provided a better fit than linear or unimodal relationships and that this was largely the result of the response of rare species (relative cover less than 1%). Our results indicate that conservation benefits are disproportionally more costly on high-intensity than on low-intensity farmland. For example, reducing N inputs from 75 to 0 and 400 to 60kgha-1yr-1 resulted in about the same estimated species gain for arable plants. Conservation initiatives are most (cost-)effective if they are preferentially implemented in extensively farmed areas that still support high levels of biodiversity.

Toxins in transgenic crop byproducts may affect headwater stream ecosystems.

Corn (Zea mays L.) that has been genetically engineered to produce the Cry1Ab protein (Bt corn) is resistant to lepidopteran pests. Bt corn is widely planted in the midwestern United States, often adjacent to headwater streams. We show that corn byproducts, such as pollen and detritus, enter headwater streams and are subject to storage, consumption, and transport to downstream water bodies. Laboratory feeding trials showed that consumption of Bt corn byproducts reduced growth and increased mortality of nontarget stream insects. Stream insects are important prey for aquatic and riparian predators, and widespread planting of Bt crops has unexpected ecosystem-scale consequences.

Mixed biodiversity benefits of agri-environment schemes in five European countries.

Agri-environment schemes are an increasingly important tool for the maintenance and restoration of farmland biodiversity in Europe but their ecological effects are poorly known. Scheme design is partly based on non-ecological considerations and poses important restrictions on evaluation studies. We describe a robust approach to evaluate agri-environment schemes and use it to evaluate the biodiversity effects of agri-environment schemes in five European countries. We compared species density of vascular plants, birds, bees, grasshoppers and crickets, and spiders on 202 paired fields, one with an agri-environment scheme, the other conventionally managed. In all countries, agri-environment schemes had marginal to moderately positive effects on biodiversity. However, uncommon species benefited in only two of five countries and species listed in Red Data Books rarely benefited from agri-environment schemes. Scheme objectives may need to differentiate between biodiversity of common species that can be enhanced with relatively simple modifications in farming practices and diversity or abundance of endangered species which require more elaborate conservation measures.

A double-blind randomized placebo-controlled trial of lofexidine in alcohol withdrawal: lofexidine is not a useful adjunct to chlordiazepoxide.

Lofexidine is an alpha-adrenoceptor agonist which has proved useful in opiate withdrawal and which, through its attenuation of noradrenergic activity, might be a valuable adjunct in the management of alcohol withdrawal. The objective of this study was to compare the clinical effectiveness and patient retention with adjunctive lofexidine versus placebo in the treatment of alcohol withdrawal under chlordiazepoxide cover. This was done in a prospective double-blind randomized placebo-controlled trial with 72 alcohol-dependent adults referred and admitted for in-patient alcohol detoxification. The adjunctive lofexidine group experienced significantly more severe withdrawal symptoms, greater hypotensive problems, more adverse effects, and no better rates of retention in treatment. Lofexidine provides no discernible benefit as an adjunctive medication (to chlordiazepoxide) in alcohol detoxification and, on the basis of our study, appears to be contra-indicated.

Microsatellite analysis of the inbreeding grass weed Barren Brome (Anisantha sterilis) reveals genetic diversity at the within- and between-farm scales.

Nine microsatellites were used to screen 131 samples of Barren Brome (Anisantha sterilis: synonym Bromus sterilis) collected from within the fields of three English farms [from Oxfordshire (Oxon), Leicestershire (Leics) and Wiltshire (Wilts)] and eight seeds taken from samples of each of 10 farms across England, UK. Most individuals (approximately 97%) were homozygous. Polymorphism occurred at all nine loci in all three farms sampled at the field scale, and at most loci for nine of the other 10 farm samples. Between three and 11 alleles were found per locus. Gene diversity (D = 1 - summation operator p(i)2) ranged from 0.088 to 0.760. Polymorphism occurred among individuals within and among fields, and farms. Some alleles were found in only one farm. On the basis of the alleles at all nine loci in the 211 sampled plants, a total of 92 (44%) different genotypes was identified. Clustering analysis using the unweighted pair group method with arithmetic averages (UPGMA) for the combined Oxon, Wilts and Leics samples did not cluster them into their respective farms. Similarly, a phenogram of samples from all 10 farms showed considerable mixing of individuals with respect to farm origins. Identification of genotypes on field plans showed evidence of both spatial localization and mixing. Previous reports have suggested that A. sterilis is strictly inbreeding with little intrapopulation variation at the genetic level. Our data reveal that A. sterilis exists as numerous separate and genetically different lines, which are maintained by inbreeding but which very occasionally outcross. Possible explanations for this pattern of high genetic diversity are discussed.

Application of a quality of life measure, the life situation survey (LSS), to alcohol-dependent subjects in relapse and remission.

BACKGROUND: Recent studies have shown that quality of life (QOL) is improved significantly when subjects do not relapse to heavy drinking, and QOL deteriorates significantly on prolonged relapse. This article further investigates these relationships using a QOL index, the Life Situation Survey (LSS). METHODS: Eighty-two DSM-IV alcohol-dependent subjects admitted for alcohol detoxification were studied at baseline and 12 week follow-up. Sociodemographic data were collected, and severity of alcohol dependence (SADQ) and General Health Questionnaire (GHQ-12) were baseline indices only. The main outcome measure, the LSS, was administered at both time points. RESULTS: Two subjects were lost to follow-up and one died during the study period. Thus, the relapse/ nonrelapse analysis related to 79 subjects. Fifty subjects (63%) had relapsed to heavy drinking at 3 months follow-up. There was a significant correlation between LSS and GHQ-12 scores. Significant changes occurred in total LSS scores as a result of relapse and nonrelapse. The improvement in LSS scores associated with nonrelapse was larger than the deterioration that accompanied relapse. In those subjects who did not relapse to heavy drinking, the mean follow-up score remained in the poor/borderline LSS range. Remission from heavy drinking was accompanied by significant improvements in appetite, sleep, and self-esteem. Relapse to heavy drinking coincided with a significant deterioration in mood/affect, public support, and work/life role scores. CONCLUSION: QOL as assessed by the LSS in recently detoxified alcoholics is impaired significantly. In the nonrelapse group, there was a significant improvement in LSS scores after 3 months. Relapse was accompanied by a smaller deterioration in LSS scores. The LSS can play an important role in monitoring the clinical care and progress of alcohol-dependent subjects.

Quality of life measures and outcome in alcohol-dependent men and women.

A sample of 82 (41 men 41 women) DSM IV alcohol-dependent inpatients admitted for detoxification was studied at baseline and followed-up 12 weeks thereafter. The following questionnaires were administered 4-5 days after admission for detoxification: Socio-demographic information, Severity of Alcohol Dependence Questionnaire (SADQ), Alcohol Problems Questionnaire (APQ), Rotterdam Symptoms Checklist (RSCL), Life Situation Survey (LSS), Beck Depression Inventory (BDI), General Health Questionnaire (GHQ 12), and Nottingham Health Profile (NHP). All indices other than socio-demographic data, the SADQ, and APQ were administered at 12-week follow-up. After controlling for confounding factors at baseline, women were more likely to be in a higher social class, prescribed anti-depressants during the previous 12 months, drink fewer units of alcohol in a typical week, and have a higher level of psychiatric caseness scores (GHQ-12). A total of 80 subjects (97%) were successfully followed-up. Difference between gender did not significantly impact upon any of the 12-week outcome measures. There was no significant difference in the study relapse rates or time taken to relapse between men and women. The only significant total sample change was a reduction in the amount of alcohol consumed in a typical week. This was significantly related to changes in the following Quality of Life (QoL) measures, NHP emotional reaction sub-scores, LSS, and BDI scores.

Outcome after in-patient detoxification for alcohol dependence: a naturalistic comparison of 7 versus 28 days stay.

Research has tended to show that the gains of residential rehabilitation are short-term and cost-inefficient. This study compares the outcomes of two samples, one group staying at a non-statutory sector alcohol detoxification unit for < or =7 days (short stay: SS) with a second group also admitted for detoxification but who stayed at the Unit for a further 8-21 days (long stay: LS). Allocation was not at random: the longer stay was either at the request of the client, referring or treatment agency itself and then had to be approved by an external funding agency. Sixty-four DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) alcohol-dependent subjects were studied. Baseline data included socio-demographic information, illicit drug use during the past 12 months, severity of alcohol dependence, alcohol problems, physical/psychological symptoms, depression and indices of quality of life. At baseline, LS subjects reported more recreational cannabis use than SS subjects. Sixty-two (97%) subjects were re-interviewed 12 weeks after baseline assessment. During follow-up, equal proportions of each group relapsed (> or =21 units/7 day period fo males; > or =14 units/7day period for females). There was a trend for SS clients to have consumed less alcohol in total than the LS clients. The trend was towards improvement in the study measurements for the SS group, though none of the changes was significant. In the LS group, all variables tended towards a deterioration in health status. The longer stay did not appear to confer any extra benefit to the LS group. Cannabis use and illicit drug use at baseline, while commoner in the LS group, did not predict drinking or social adjustment in the follow-up period in this sample and thus could not be used to explain the lack of a better outcome in the LS group.

Levels of gamma-aminobutyric acid-benzodiazepine receptors in abstinent, alcohol-dependent women: preliminary findings from an 123I-iomazenil single photon emission tomography study.

BACKGROUND: Although alcohol dependence in women is an increasing problem, little is known about the effects of alcohol on the female brain. Evidence from a few structural and functional neuroimaging studies suggests that the female brain may be more susceptible than the male brain to the harmful effects of alcohol. However, no in vivo studies of the neuropharmacology of alcohol dependence in women have been carried out. The aim of this preliminary study was to test the hypothesis that alcohol dependence in women is associated with greater reduction in gamma-aminobutyric acid (GABA)-benzodiazepine receptor levels than in men with an equivalent drinking history. METHODS: We used single photon emission tomography and 123I-iomazenil to label the central GABA-benzodiazepine receptor and to compare semiquantified levels in 9 abstinent alcohol-dependent and 13 control women. These groups were further compared with equivalent male groups from a previous study. RESULTS: There was a trend toward a reduction in GABA-benzodiazepine receptor levels in alcohol-dependent women, but this did not reach significance. These lower levels were seen primarily in the cerebellum, occipital lobes, and parietal cortex (left > right). This was in marked contrast with the pattern of reduction seen in the previous study of male dependence, where significant reductions were seen primarily in the frontal cortex. CONCLUSIONS: Due to the semiquantitative analysis performed and the relatively small number of subjects in this study, which resulted in a nonsignificant trend, we can only comment on the differences in the pattern of lower levels of GABA-benzodiazepine receptors seen in alcohol dependence in men and women. Although we are not able to ascertain whether the female brain is more susceptible to the effects of alcohol, it appears that alcohol has a differential effect on the central GABA-benzodiazepine receptors in men and women. Recent animal evidence supports this hypothesis. Future studies should explore whether other neuropharmacological differences exist between men and women in alcohol dependence that could have implications for pharmacotherapy.

Measurement of quality of life in alcohol-dependent subjects by a cancer symptoms checklist.

There are few studies of Quality of Life measures (QoL) in alcohol-misusing patients. The present study addresses this deficiency. The sample consisted of 60 (39 men, 21 women) alcohol dependent subjects defined by DSM-IV criteria (American Psychiatric Association, 1994). At baseline (4-5 days after admission and detoxification) sociodemographic data were collected, and three questionnaires were administered: the Rotterdam Symptoms Checklist (RSCL), the Severity of Alcohol Dependence Questionnaire (SADQ), and Alcohol Problems Questionnaire (APQ). QoL scores for dependent alcoholics both for physical and psychological measures were significantly worse (higher) than those reported for a variety of cancer patients. Psychological symptom scores were higher than physical symptoms at baseline. Correlations of RSCL scores to both SADQ and APQ were greater for RSCL physical compared to psychological symptom scores. The subjects were followed up at 12 weeks when the RSCL was re-administered and relapse status ascertained. Fifty-eight (97%) subjects were successfully contacted at 12 weeks of whom 36 (62%) had relapsed. After a repeated measures ANOVA psychological and physical symptom subscores were statistically significantly improved as a result of not relapsing to heavy drinking. There was no significant change in scores in the relapse group when baseline and week 12 scores were compared. The RSCL measure is a useful QoL assessment tool in alcohol-dependent subjects.