REPORT TO THE SOCIETY FOR THE STUDY OF ADDICTION

Professor Golla has recently retired from the post of Director of the Burden Neurological Institute so the time seems appropriate to review the work on alcohol carried out with the support of the Society's Monthly Bulletin Research Fund.     

SECOND-LINE AND 'ALTERNATIVE' TREATMENTS FOR ALCOHOL WITHDRAWAL: ALPHA-AGONISTS, BETA-BLOCKERS, ANTICONVULSANTS, ACUPUNCTURE AND NEURO-ELECTRIC THERAPY

Drugs which reduce autonomic overactivity but have no sedativeeffects can be useful in alcohol withdrawal, either as the solepharmacological intervention or in conjunction with sedativedrugs. They may reduce sedative requirements, but their lackof anticonvulsant and anti-delirium effect can be a disadvantage.Beta-blockers are more effective than alpha-2 agonists. Non-sedativeanticonvulsants are of questionable value. Acupuncture and neuro-electrictherapy, though often popular with patients and therapists,appear to be no more than impressive placebos in this context.Non-specific treatment effects can be very prominent in withdrawal.Support, information, reassurance and good nursing can reducethe need for specific pharmacological or psychological interventions.     

A drug eruption due to acebutolol with combined lichenoid and lupus erythematosus features

Many drugs have been implicated in the genesis of eruptions resembling lichen planus (Gange & Wilson Jones, 1978; Almeyda & Baker, 1970) and lupus erythemarosus (Raferty & Denman, 1973; Tuffanelli, 1972).
We report the development of both the above in the same patient during treatment with a beta blocking agent. On withdrawal of the drug the lesions resolved.     

Letting the Client Speak: drug misusers and the process of help seeking

This is the third report on a study of 150 drug misusers new to treatment at three London drug treatment agencies: a Drug Treatment Clinic, a Therapeutic Community and a Drug Crisis Centre. The focus here is on the clients’perceptions of the help seeking process, and particularly on their reasons for coming to services and their fears about treatment. Analysis of responses revealed an underlying structure to the‘reasons’and‘fears’. There were significant between-agency differences, and differences between those who injected drugs and those who did not. The importance of mood disturbance in the help-seeking process is discussed. The implications of the findings for the development of strategies and the provision of earlier and more appropriate treatment are examined.     

Influence of the Youth Tutor upon teachers'' perception of some maladjusted behaviour

SUMMARY There has been a long-standing interest in attempting to link home and school (Central Advisory Council 1967) and the recognition of the importance of the child's home background upon his educational achievement has grown (Douglas et al. 1972, Wedge & Prosser 1973). It would seem that in practice however, the main school-home contact has been the Education Welfare Officer (Pritchard 1973). While Plowden stressed the potential of the Education Welfare Officer it is known that there are difficulties in realizing this because of shortcomings in the Education Welfare Officer's training and status (Pritchard 1974, Local Government Training Board 1974). In the United States home and school have been brought together by the long-established School Cotmsellor or School Social Worker (Clegg & Megson 1970). It has been found however, that even in the United States their role has been diffuse, depending upon variations in local policy and there has been little examination of their work (Know et al. 1974). IN the United Kingdom social work has grown (Lyons 1973) as local education authorities have made various efforts to orientate schools towards the community; one such method was the Central Lancashire Family and Community Project (Marshall & Rose 1975). The project centred upon the work of School Social Workers, and their work in reducing maladaptive behaviour was encouraging. Another such scheme was introduced by the West Riding County Council who appointed Youth Tutors to some of their secondary schools. The Youth Tutors' work varied greatly as different emphasis was placed upon their work, though they generally acted in a counselling role and sought to involve the home and commvmity with the school and also attempted t o establish more extracurricular activities (Sedgwick 1975). It is with this development that the present study is concerned. We attempted to discover something of the Youth Tutors' influence, if any, upon the teachers' perception of children's behaviour in school. We wished to determine whether there would be any variation in the perception of teachers who came from schools which had a Youth Tutor and those which had not. We focused upon teachers' views of the origin of the behaviour and what action they might take in response to such children.     

Short report: treatment of gastric ulcer with lansoprazole or ranitidine: a multicentre clinical trial

We studied the effectiveness of lansoprazole and ranitidine in promoting gastric ulcer healing in a multicentre double-blind trial, by comparing the proportion of healed ulcers after 4 and 8 weeks of treatment. One hundred and fifty-eight patients were randomly given either ranitidine (150 mg each morning and at bedtime) or lansoprazole (30 mg each morning and placebo at bedtime). One hundred and twenty-eight patients completed the trial (62 taking lansoprazole, 66 taking ranitidine). Fifty-one (80%) of those treated with lansoprazole and forty-two (62%) of those treated with ranitidine had healed ulcers at 4 weeks (P < 0.05). Sixty-one (98%) patients who received lansoprazole and 57 (86%) who received ranitidine had healed ulcers at 8 weeks (P < 0.05). The observed differences were not significant in the intention-to-treat analysis. No serious adverse event was reported with lansoprazole.