Coffee consumption and cigarette smoking are strongly associated, but whether this association is causal remains unclear. We sought to: 1) determine whether coffee consumption causally influences cigarette smoking, 2) estimate the magnitude of any association, and 3) explore potential mechanisms. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
This paper estimates how far monthly changes in prevalence of cigarette smoking, motivation to quit and attempts to stop smoking have been associated with changes in prevalence of high-risk drinking, and motivation and attempts to reduce alcohol consumption in England. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Editorial. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
According to recent statistics from NHS Digital, there were an estimated 1.1 million hospital admissions where alcohol was the primary or secondary issue in 2015-16. In the UK, it is estimated that 24% of adults drink in a hazardous or harmful way, while around 9% of men and 4% of women show signs of alcohol dependence.
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There is evidence that low risk drinking is possible during the course of alcohol treatment and can be maintained following treatment. Our aim was to identify characteristics associated with low risk drinking during treatment in a large sample of individuals as they received treatment for alcohol dependence. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
To adapt the four-dimensional Gambling Motives Questionnaire-Revised (GMQ-R) to measure the motivation for engaging in electronic gaming, and to validate the internal structure and investigate the criterion validity of the new Electronic Gaming Motives Questionnaire (EGMQ). Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
The aims were to (1) estimate the prevalence of alcohol and drug use disorders in prisoners on reception to prison, and (2) estimate and test sources of between study heterogeneity across 10 countries. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Premises licensed for the sale and consumption of alcohol can contribute to levels of assault-related injury through poor operational practices that, if addressed, could reduce violence. We tested the real-world effectiveness of an intervention in Wales, designed to change premises operation, whether any intervention effect changed over time, the effect of intervention dose and cost effectiveness of the intervention. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Substance use and binge drinking during early adolescence are associated with neurocognitive abnormalities, mental health problems and an increased risk for future addiction. The trial aims to evaluate the protective effects of an evidence-based substance use prevention program on the onset of alcohol and drug use in adolescence, as well as on cognitive, mental health and addiction outcomes over 5 years. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
The aim of this study is to develop a model for screening excessive gambling practices based on the gambling behaviours observed on French gambling websites, coupled with a clinical validation.
Open Access Article
Practice Pointer. What you need to know
Addiction to exercise might form part of a broader eating disorder or may occur in isolation
Inability to stop or reduce exercising, for example in response to an injury, may indicate addiction
Treatment broadly follows the principles of treating other addictions, for example cognitive behavioural therapy and exercise reprogramming
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Cannabis is a well-established environmental risk factor for psychosis.1 More frequent users and those who start at a younger age are at greater risk2 and the mean age of onset of psychosis among cannabis users is about 3 years younger than among non-users.3 In Europe and North America, about a third of patients with first-episode psychosis report regular cannabis use and about one-half of those quit after diagnosis and treatment.4 Former cannabis users with psychosis have fewer positive symptoms5 and lower rates of relapse6 than continued users.
Schoeler et al aimed to examine the role of different patterns of cannabis use in the likelihood of relapse after the initial episode of psychosis....To read the full article, log in using your NHS OpenAthens details.
Efforts to move towards integrated care have been met with increased interest and enthusiasm in recent years given the potential to improve care and population health while containing costs. However, there is a need to better understand community-based integrated care approaches for youth with mental health and/or addiction concerns to guide future implementation efforts and develop a set of standards for key components. The objectives of this scoping review are to: (1) identify the populations, settings, service providers, interventions, infrastructure and care coordination methods that have been included in integrated care for youth with mental health and/or addiction needs and (2) identify constructs that have been measured and evaluated (eg, outcomes, engagement) in the context of youth integrated care.
Open Access Article
Alcohol drinking is associated with ill health but less is known about its contribution to overall functioning. We aimed to examine whether alcohol drinking predicts self-reported mental and physical functioning 5-7 years later.
Open Access Article
In the UK, a significant proportion of male remand prisoners have alcohol problems. Alcohol Brief Interventions (ABIs) are an effective component of a population-level approach to harmful and hazardous drinking. ABIs have been shown to reduce the aggregate level of alcohol consumed and therefore reduce harm to the individual and to others. However, in relation to remand prisoners, there is no evidence as to how effective ABIs could be. The aims of this study are therefore to explore the feasibility and acceptability of an ABI for adult male remand prisoners and to develop an ABI for this group to be piloted in a future trial.
Open Access Article
The aim of this study was to systematically summarize knowledge on the association between exposure to interpersonal trauma and addictive behaviors. Extant reviews on this association focused on a restricted range of substance-related addictions, and/or used a narrative instead of a systematic approach.
To examine the risk to heroin users of also using gabapentin or pregabalin (gabapentoids). Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Varenicline was compared with transdermal nicotine (NRT) for smokers with current substance use disorders (SUD) for effects on 3-month smoking abstinence (primary outcome) and, secondarily, on 3 and 6 month abstinence while adjusting for medication adherence, and on additional smoking and substance use outcomes. Moderation by major depressive disorder history (MDD) and adherence were investigated. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
However, a continuing issue of concern is the study also showed that people with HIV who injected drugs, or who had a low CD4 cell count (a marker for immune system health) had not seen much improvement in life expectancy.
As the substantial global health burden associated with alcohol use disorders continues to rise1 and treatment rates remain comparatively low,2 improving treatment engagement and broadening treatment options are crucial. Abstinence from alcohol use is the most widely accepted primary treatment goal and indicator of clinical trial efficacy,3 but it might limit treatment options and deter individuals from seeking treatment. Reduced drinking is a viable alternative—it might be more appealing to service users, offers the potential to expand treatment options, and could be used as a primary outcome in clinical trials. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Alcohol dependence is often untreated. Although abstinence is often the aim of treatment, many drinkers prefer drinking reduction goals. Therefore, if supported by evidence of benefit, drinking reduction goals could broaden the appeal of treatment. Regulatory agencies are considering non-abstinent outcomes as efficacy indicators in clinical trials, including reduction in WHO drinking risk levels—very high, high, moderate, and low—defined in terms of mean ethanol consumption (in grams) per day. We aimed to study the relationship between reductions in WHO drinking risk levels and subsequent reduction in the risk of alcohol dependence. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Editorial. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Letter. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Journal of Consulting and Clinical Psychology85.5 (May 2017): 459-470.
Objective: Young-adult American veterans are at risk for problematic alcohol use. However, they are unlikely to seek care and may drop out from lengthy, multicomponent treatments when they do get care. This randomized controlled trial tested a very brief alcohol intervention delivered over the Internet to reach the population of young-adult veterans to help reduce their drinking. To read the full article, log in using your NHS OpenAthens details.
Journal of Consulting and Clinical Psychology85.5 (May 2017): 447-458.
Objective: This study tested mediating processes hypothesized to explain the therapeutic benefit of an efficacious motivational interview (MI). The constructs of interest were motivation to change, cognitive dissonance about current drinking, self-efficacy for change, perceived young adult drinking norms, future drinking intentions, and the use of protective behavioral strategies. To read the full article, log in using your NHS OpenAthens details.
. Letter. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Conclusions: Adolescents aged 15-16 years, especially male adolescents, are the most prone to the development of Internet addiction, whereas adolescents aged 11-12 years show the lowest level of Internet addiction.
Lack of non-injectable naloxone formulations has impeded widespread take-home provision for the prevention of heroin/opioid overdose deaths. For non-injectable formulations that are finally being investigated, rapid onset of action and sufficient bioavailability will be vital. We present analysis of data from a study of concentrated naloxone nasal spray formulations. Our aims are: to assess 1) pharmacokinetic properties and 2) suitability for overdose reversal in terms of naloxone absorption within 30 minutes post-dosing. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Login using your SSOTP NHS Athens for full text. SSSFT - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Scientists at the University of York have shown that the risk of developing psychosis, such as hallucinations, from cannabis use is small compared to the number of total users.
REC-CONNECT is a city-wide collaboration developed to help those in recovery from alcohol and drug problems access activities and services in their local areas by forging relationships with the people at the very heart of those communities, who will be known as "community connectors".
The community connectors will help the service users access activities or groups that they might previously have dismissed - despite their interest - due to lack of confidence, concern about stigma or knowledge of how to get involved. These could include anything from fishing clubs to local libraries and knitting groups to cafes.
The opportunity to swim and use gyms to improve their health can play a key role in someone’s recovery, so over 60 service users a month from Aspire Drug and Alcohol Service are accessing fitness facilities at over 10 locations across the borough, thanks to a reduced rate corporate membership with DCLT.
Individuals with substance use disorders are at high risk of hospital readmission. This study examined whether follow-up services received within 14 days of discharge from an inpatient hospital stay or residential detoxification reduced 90-day readmissions among Medicaid enrollees whose index admission included a substance use disorder diagnosis. Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
East Riding Partnership (ERP) Addiction service, which involves Humber NHS Foundation Trust, has started a new training programme for service users and carers aimed at preventing drug-related deaths.
Psychiatric Rehabilitation Journal40.1 (Mar 2017): 94-102.
Objective: Cognitive remediation therapy (CRT) is reported to improve neurocognitive and substance use disorder (SUD) outcomes in residential treatments. This National Institute of Drug Abuse funded pilot study reports on CRT as an augmentation to outpatient treatment for SUD. To read the full article, log in using your NHS OpenAthens details.
As part of Derbyshire Recovery Partnership, we will be providing a combined service for adults that will offer a range of treatments and support all ‘under one roof’. People requiring both drug and alcohol support will no longer need to be re-referred or transferred between services. One phone call will be all it takes to request either service.
The BeReady programme at Reaseheath College welcomed experts from Cheshire and Wirral Partnership NHS Foundation Trust (CWP) to talk to more than 600 students about substance misuse.
The reinforcement learning theory of drug addiction has been influential for decades.1 Under this framework, drugs trigger dopamine (DA) release and exert their reinforcing effects through the mesolimbic pathway.1 This model can account for compulsive drug-seeking behaviors in addiction. However, many empirical findings remain unaddressed. In particular, accumulating evidence suggests that DA, delivered by either addictive drugs2 or by pharmacological treatments, such as the nicotine replacement therapy,3 is not sufficient to reduce craving. Craving persists even after compulsive drug-taking behavior stops,3 suggesting that craving and drug-seeking behavior are 2 distinct processes, despite the fact that they are often homogenized in laboratory settings......Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
In this image-based meta-analysis of neuroimaging studies, striatal activation during reward anticipation was decreased among individuals with addiction compared with those in control groups. During reward outcome, substance-addicted individuals showed increased activation in the ventral striatum, whereas gambling-addicted individuals showed decreased activation in the dorsal striatum, compared with controls. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Feature. Could drug laws be to blame for drug users’ deaths? Some families think so and are determined to influence policy. To read the full article, log in using your NHS OpenAthens details
The relationship between cannabis and psychosis and schizophrenia has tested the field of addiction for decades, and in some ways serves as measure of our ability to provide a credible contribution to public health. As cannabis is used widely, many people are interested in the risks the drug poses to mental health. This paper focuses upon a seminal study examining this, the trajectory of subsequent research findings and what this has meant for understanding and communicating risk factor information. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
In April 2017 we reviewed the evidence for corticosteroid treatment for people with severe alcohol-related hepatitis and changed recommendation 1.3.3.1.
Adfam and Cruse Bereavement Care have launched of the new Bereavement through Alcohol and Drugs (BEAD) website, a vital source of information, support and hope for anyone who has lost a loved one through drug or alcohol use.
Nearly one-third of individuals in treatment for substance use disorders endorse at-risk levels of compulsive sexual behaviours (CSBs). Untreated sexual compulsivity may facilitate relapse for treatment-seeking men. Previous research and theory suggest that CSBs are maintained by efforts to escape or alter negative affect (e.g., depression and anxiety). However, this hypothesis has not been examined within a sample of men in treatment for substance use disorders. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Smoking is an important risk factor for mental health-related problems. Numerous studies have supported a bi-directional association between cigarette smoking and depression. Despite the advances in understanding the comorbidity between both problems, the most effective psychological treatment that simultaneously targets smoking and depressive symptomatology remains unclear. The objective of this study is to assess the effectiveness of a cognitive-behavioral intervention for smoking cessation with components of behavioral activation for managing depressed mood.
There has been a great deal of evidence showing high novelty seeking (NS) is a risk factor for the development of substance use disorders (SUDs). However, the possible causal role of NS in SUDs is unconfirmed. The aim of this study was to examine the associations between NS at age 16 and SUDs from age 18 to 35 years, net of a series of covariate factors.Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
To understand processes placing individuals at risk for stimulant (amphetamine and cocaine) use disorder. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Unintended pregnancy rates are high among women with substance use disorders (SUDs) in Massachussets, which could be partly explained by lower use of and adherence to contraception. We aimed to test: (1) the association of SUD with prescription contraceptive use, contraceptive method selection, and adherence; (2) whether practices participating in the Patient-Centered Medical Home Initiative (PCMHI) had better contraceptive use and adherence for patients with SUD; (3) for differences in the association of SUD with adherence by type of contraceptive used. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
There is inconsistent evidence that alcohol-specific coping is a mechanism of change in cognitive-behavioral therapy (CBT) for alcohol use disorder (AUD). Our primary aim was to test whether baseline dependence severity moderates the mediational effect of CBT on drinking outcomes via coping. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Commentary to: Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Alcohol dependence is more prevalent in men than in women. The evidence for how prenatal and adult androgens influence alcohol dependence is limited. We investigated the effects of prenatal and adult androgen activity on alcohol dependence. Moreover, we studied how the behaviours of pregnant women affect their children's prenatal androgen load. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Editorial. Pathological gambling is a serious health problem that has attracted plenty of political and media attention over the years, but no national agreement has yet been reached on NHS involvement.
A 2014 paper for the Royal College of Psychiatrists on the need for NHS treatment of problem gamblers described the illness as a “hidden addiction.” Its manifestations and indeed presence in society were not as apparent to the general population or health professionals at the time and it consequently remained underdiagnosed and untreated. To read the full article, log in using your NHS OpenAthens details
Journal of Consulting and Clinical Psychology85.4 (Apr 2017): 309-322.
Objective: Behavioral couples therapy (BCT) is more efficacious than individually-based therapy (IBT) for substance and relationship outcomes among substance use disorder patients. This study compared BCT with IBT for drug-abusing women. To read the full article, log in using your NHS OpenAthens details.
ABSTRACT FROM: Schoeler T, Petros N, Di Forti M, et al. Effects of continuation, frequency, and type of cannabis use on relapse in the first 2 years after onset of psychosis: an observational study. Lancet Psychiatry 2016;3:947–53.
Cannabis is a well-established environmental risk factor for psychosis.1 More frequent users and those who start at a younger age are at greater risk2 and the mean age of onset of psychosis among cannabis users is about 3 years younger than among non-users.3 In Europe and North America, about a third of patients with first-episode psychosis report regular cannabis use and about one-half of those quit after diagnosis and treatment.4 Former cannabis users with psychosis have fewer positive symptoms5 and lower rates of relapse6 than continued users. To read the full article, log in using your NHS OpenAthens details.
To examine whether genetic influences on the development of alcohol use disorders (AUD) among men during emerging adulthood through mid-adulthood are stable or dynamic. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Risky single occasion drinking (RSOD) by young people is a serious public health issue, yet little is known about the specific circumstances of risky drinking occasions. This study examined the independent effects of event- and individual-specific variables on RSOD. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Journal Scan. Intelligent teenagers are more likely to drink alcohol and use cannabis than their less academically gifted peers but are less likely to smoke, new study results suggest. To read the full article, log in using your NHS OpenAthens details
Implications for practice and research
In an emergency department (ED) setting, a 1-hour motivational interviewing session involving personalised risk feedback can yield meaningful reductions in hazardous alcohol use and risky sexual behaviour.
Research is needed to evaluate this intervention with racial, ethnic and sexual minority patients and test its effectiveness when delivered by clinical rather than research staff.
Additional innovation is needed to develop integrated brief intervention protocols for addressing a larger range of health risks and to increase the feasibility of implementing such protocols in all appropriate settings. To read the full article, log in using your NHS OpenAthens details
Substance use disorders are associated commonly with comorbid physical illness. There are fewer data on dental disease in these conditions, in spite of high rates of dry mouth (xerostomia), as well as the associated indirect or life-style effects such as poverty and lack of access to care. We compared the oral health of people with substance use disorders (SUDs) with non-using controls. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Limited information is available regarding links between specific substance use disorders (SUDs) and suicide mortality; however, the preliminary evidence that is available suggests that suicide risk associated with SUDs may differ for men and women. This study aimed to estimate associations between SUDs and suicide for men and women receiving Veterans Health Administration (VHA) care. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
To test whether binge drinking, the density of familial alcoholism (FHD), and their interaction are associated with an altered developmental trajectory of impulsive choice across adolescence, and whether more lifetime drinks is associated with a greater change in impulsive choice across age. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Low-risk alcohol drinking guidelines require a scientific basis that extends beyond individual or group judgements of risk. Lifetime mortality risks, judged against established thresholds for acceptable risk, may provide such a basis for guidelines. Therefore, the aim of this study was to estimate alcohol mortality risks for seven European countries based on different average daily alcohol consumption amounts. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
The time post-release from prison involves elevated mortality, especially overdose deaths. Variations in overdose mortality both by time since release from prison and time of release has not been sufficiently investigated. Our aims were to estimate and compare overdose death rates at time intervals after prison release and to estimate the effect on overdose death rates over calendar time. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Public Health England announces new funding to expand Mentor UK’s ADEPIS resource into more schools and community settings.
The programme helps equip young people with the life skills and resilience to deal with the challenges they face with alcohol and drugs.
Psychology of Addictive Behaviors31.2 (Mar 2017): 171-179.
Alcohol dependence is characterized by conflict between approach and avoidance motivational orientations for alcohol that operate in automatic and controlled processes. This article describes the first study to investigate the predictive validity of these motivational orientations for relapse to drinking after discharge from alcohol detoxification treatment in alcohol-dependent patients. To read the full article, log in using your NHS OpenAthens details.
Psychological Services (Mar 13, 2017).
Comorbid alcohol and drug use disorders are treatable and have substantial effects on outcomes and health care utilization in people with schizophrenia. While these substance use disorders (SUDs) are thought to be common in patients with schizophrenia, it has been difficult to characterize prevalence and treatment utilization of this population, since administrative data and medical records may not identify patients with schizophrenia who have an SUD diagnosis. In this study, we used an in-person, population-based survey of 801 individuals with schizophrenia who were in treatment within the Veterans Health Administration (VHA) to inform service delivery for patients with these problems. To read the full article, log in using your NHS OpenAthens details.
Whether a diagnosis of a mental disorder contributes to the risk of poorer correctional outcomes is controversial. This study aimed to clarify the extent to which mental and substance use disorders individually and in combination contribute to correctional outcomes in order to determine optimal treatment and promote public safety.
Methods: Differences were examined between four groups of federal offenders in Canada (N=715): those with a mental disorder only, those with a substance use disorder only, those with co-occurring mental and substance use disorders, and those with no disorder. : Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Alcohol Brief Intervention (ABI) uses a motivational counselling approach to support individuals to reduce excessive alcohol consumption. There is growing evidence on ABI’s use within various health care settings, although how they work and which components enhance success is largely unknown. This paper reports on the qualitative part of a mixed methods study. It explores enablers and barriers associated with alcohol reduction following an ABI. It focuses on alcohol’s place within participants’ lives and their personal perspectives on reducing consumption. There are a number of randomised controlled trials in this field though few ABI studies have addressed the experiences of hazardous/harmful drinkers. This study examines factors associated with alcohol reduction in harmful/hazardous drinkers following ABI.
Research has shown that internet interventions can be effective for dependent users of various substances. However, less is known about the effects of these interventions on users of opioids, cocaine, and amphetamines than for other substances. We aimed to investigate the effectiveness of internet interventions in decreasing the usage of these types of substances. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Two thirds of GPs in Ireland support planned initiatives to provide wider availability of naloxone in the community for treating opiate addiction and overdose, a survey has found. To read the full article, log in using your NHS OpenAthens details
The primary purpose of this study is to evaluate the relative effectiveness of 2 of the best developed and most promising forms of therapy for problem gambling, namely face-to-face motivational interviewing (MI) combined with a self-instruction booklet (W) and follow-up telephone booster sessions (B; MI+W+B) and face-to-face cognitive–behavioural therapy (CBT). Open Access Article
REC-CONNECT is a city-wide collaboration developed to help those in recovery from alcohol and drug problems access activities and services in their local areas by forging relationships with the people at the very heart of those communities, who will be known as "community connectors".
The community connectors will help the service users access activities or groups that they might previously have dismissed - despite their interest - due to lack of confidence, concern about stigma or knowledge of how to get involved. These could include anything from fishing clubs to local libraries and knitting groups to cafes.
There is insufficient randomized controlled trial evidence to draw conclusions regarding the benefits or harms of antipsychotic medications for cocaine dependence.
Moderate-quality evidence showed that fewer people with cocaine dependence receiving an antipsychotic drug withdrew from treatment when compared with placebo (on average, 411 versus 547 withdrew per 1000 people), implying some benefit of antipsychotic drugs. However, this is a surrogate outcome and withdrawal from a trial can be for reasons other than lack of effectiveness or adverse effects.
The department has developed a special appeals mechanism, called the special category mechanism (SCM), for those with chronic hepatitis C infection (stage 1). The SCM is a significant new element of the infected blood reforms and the government is consulting on the details of it and proposals for ensuring the scheme remains within its budget.
The profiles provide information to monitor the services and initiatives that have been put in place to prevent and reduce the harmful impact of alcohol.
This study examined whether a co-occurring substance use disorder contributed to disparities in receipt of Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) specialty care or psychotherapy. Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.