Communication alcohol

In the middle years of the 1980s some of the new statutory services for problem drug takers started calling themselves Community Drug Teams (CDTs). This title reflected the similarity between their aspirations and those of other Community Teams, particularly Community Alcohol Teams (CATs) which had developed during the previous few years. It is too early to provide a comprehensive description and evaluation of these services this chapter looks at three very different examples in order to provide a snapshot of their organisation, philosophy, and operation. 

Source T.Stockwell and S.Clement (1986) Community Alcohol Teams, A... 

Clement, S. (1987) An Evaluation of the Salford Community Alcohol Team, Report to Salford Health Authority and DHSS. 

The activity of the ingredients may be different. When iodophors and alcohol are tested after topical application (handwashing and prep testing), the initial reduction is approximately 2 log. Depending on product, application and protocol, the results may vary 0.5 log [57-61 G. Mulberry, Hilltop Biolabs, personal communication]. Alcohol can be more complicated. Many European countries use alcohol for handwashing and propping. 

Although the polysulfur macrocycles became more interesting to the scientific community after Pedersen s report of the crown compounds (see Chap. 1), examples of such structures may be found in the literature dating back some time. The first report of a macrocyclic polysulfide appears to be that by Ray who found in 1920 that when 1,2-dimercaptoethane and 1,2-dibromoethane were heated with alcoholic potassium hydrogen sulfide as shown in Eq. (6.2), triethylene trisulfide (2) and a substance presumed to be triethylene tetrasulfide (3) could be isolated. 

In 1980, Katsuki and Sharpless communicated that the epoxidation of a variety of allylic alcohols was achieved in exceptionally high enantioselectivity with a catalyst derived from titanium(IV) isopropoxide and chiral diethyl tartrate. This seminal contribution described an asymmetric catalytic system that not only provided the product epoxide in remarkable enantioselectivity, but showed the immediate generality of the reaction by examining 5 of the 8 possible substitution patterns of allylic alcohols all of which were epoxidized in >90% ee. Shortly thereafter. Sharpless and others began to illustrate the... 

Walker, K.A.M. Tetrahedron Lett., 1977, 4475. See the references in this paper for other methods of converting alcohols to sulfides. See also Cleary, D.G. Synth. Commun., 1989,... 

The 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES), based on interviews with a national probability household sample of nearly 43,000 adults age 18 years and older, showed the 1-year prevalence of DSM-IV alcohol use disorder to be 7.4% (i.e., 3.0% with alcohol abuse and 4.4% with alcohol dependence) (Grant et al. 1994). Findings from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a community-based survey of nearly 43,000 individuals conducted in 2001—2002 (Grant... 

As evidence accumulates showing that a number of medications are efficacious for the treatment of co-occurring psychopathology and/or the prevention of relapse in alcoholic patients, the therapeutic options available to physicians in treating these patients will increase. As these developments unfold, it is crucial that efforts be directed to enhancing the acceptability of pharmacotherapy to the alcoholism treatment community as a standard ingredient in alcoholism rehabilitation. 

Anton RF, Pettinati H, Zweben A, et al A multi-site dose ranging study of nalmefene in the treatment of alcohol dependence. J Clin Psychopharmacol 24 421 28, 2004 Aragon CM, Stotland LM, Amit Z Studies on ethanol-brain catalase interaction evidence for central ethanol oxidation. Alcohol Clin Exp Res 15 165-169, 1991 Arizzi MN, Correa M, Betz AJ, et al Behavioral effects of intraventricular injections of low doses of ethanol, acetaldehyde, and acetate in rats studies with low and high rate operant schedules. Behav Brain Res 147 203—210, 2003 Azrin NH, Sisson RW, Meyers R, et al Alcoholism treatment by disulfiram and community reinforcement therapy. J Behav Ther Exp Psychiatry 13 105—112, 1982 Babor TF, Kranzler HR, Lauerman RL Social drinking as a health and psychosocial risk factor Anstie s limit revisited, in Recent Developments in Alcoholism, Vol 5. Edited by Galanter M. New York, Plenum, 1987, pp 373 02... 

A number of psychosocial treatments for alcohol and other substance use disorders exist and are widely used. In this chapter, we discuss six of these psychotherapies as they are applied to alcohol, cocaine, and opioid dependence brief interventions, motivational enhancement therapy, cognitive-behavioral therapy, behavioral treatments (including contingency management and community reinforcement approaches), behavioral marital therapy, and 12-step facilitation. We also describe studies that examined the efficacy of a medication in combination with one or more of the six psychotherapies. In the second section of the chapter, we highlight research that directly studied the interaction between psychosocial and pharmacological treatments. 

Anton RF, Pettinati H, Zwehen A, et al A multi-site dose ranging smdy of nalmefene in the treatment of alcohol dependence. J Clin Psychopharmacol 24 421 28, 2004 Azrin NH Improvements in the community reinforcement approach to alcoholism. Behav Res Ther 14 339-348, 1976... 

Azrin NH, Sisson RW, Meyers R, et al Alcoholism treatment by disulfiram and community reinforcement therapy. J Behav Ther Exp Psy 13 105-112, 1982 Bickel WK, Amass L, Higgins ST, et al Effects of adding behavioral treatment to opioid detoxification with buprenorphine. J Consult Clin Psychol 65 803—810, 1997 Bien TH, Miller WR, Tonigan JS Brief interventions for alcohol prohlems a review. Addiction 88 315-335, 1993... 

Fleming MF, Barry KL, Manwell LB, et al Brief physician advice for problem alcohol drinkers a randomized controlled trial in community-based primary care practices. J Am Med Assoc 277 1029-1043, 1997 Goldstein MF, Deren S, Sung-Yeon K, et al Evaluation of an alternative program for MMTP drop-outs impact on treatment re-entry. Drug Alcohol Depend 66 181-187, 2002... 

Higgins ST, Sigmon SC, Wong CJ, et al Community reinforcement therapy for cocaine-dependent outpatients. Arch Gen Psychiatry 60 1043—1052, 2003 Hopkins JS, Garbutt JC, Poole CL, et al Naltrexone and acamprosate meta-analysis of two medical treatments for alcoholism. Presented at the 25th annual meeting of the Research Society on Alcoholism, San Francisco, CA, June 28—July 3, 2002... 

Schottenfeld RS, Chawarski MC, Pakes JR, et al Methadone versus buprenorphine with contingency management or performance feedback for cocaine and opioid dependence. Am J Psychiatry 162 340-349, 2003 Smith JE, Meyers RJ, Delaney HD Community reinforcement approach with homeless alcohol-dependent individuals. J Consult Clin Psychol 66 341-348, 1998... 

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