Welcome to the Spring/Summer 2002 issue of SMH.

In this issue we examine two recent surveys of drug use in the United Kingdom, a call for primary care

physicians to become more involved in treating addicts, and the applicability of the self-medication hypothesis to nicotine addiction, We also include a listing of upcoming meetings in the addictions field.

London (Reuters, April 21, 2002) - More than half of all young people in Britain and 28 percent of the whole population -- about 13 million people -- have taken illegal drugs, increasing pressure for reform of narcotic laws, The Observer reported in a special issue titled "Drugs Uncovered".

An ICM poll for the newspaper found that 51 percent of the nation's 16 to 24-year-olds had taken banned drugs, while five million people regularly used cannabis, and more than two million regularly took ecstasy, amphetamines and cocaine.

"We are not surprised. The threat of criminal sanctions is simply not stopping large numbers of young people experimenting with drugs," Roger Howard, chief executive of the charity Drugscope, told The Observer.

The issue of drugs has become a hot political topic in Britain in recent months. A pilot scheme in south London, sees officers overlooking cannabis users and concentrating instead on dealers in destructive drugs such as heroin and cocaine. The experiment, which began last July, has been heralded as a success.

Last October the government announced it would reassess its traditional tough line on drugs. Home Secretary David Blunkett said he intended to relax the law on cannabis by making possession no longer an arrestable offence. Some senior politicians and Britain's former chief inspector of prisons have even called for some, if not all, drugs to be legalised and made available on prescription.

The ICM poll was based on a survey carried out in February and March of 1,075 people aged over 16.

The full report of the survey and related articles in

The Observer can be found at:

Some of the addict accounts in the reports illustrate the role of self-medication in addiction. For instance, the history of heroin addict Giles in "Can You Kick It?":

The Observers survey reinforces the findings of the charity Alcohol Concern which reported last year in its State of the Nation report that

For more information on Alcohol Concerns report on The State of the Nation see

Washington, D.C., U.S. (Nicotine and Tobacco Research) A new study shows that people who have difficulties paying attention may smoke to sharpen their focus, according to a study by researchers at the Center for the Advancement of Health.

The leader of the research team Dr. Caryn Lerman, of the University of Pennsylvania Cancer Center, points out that patients with attention defecit/hyperactivity disorder have a well-documented tendency to smoke. The researchers found that tobacco's stimulating effects help hyperactive people to manage their symptoms and allow them to be more focused. The more severe a smoker's attention problems, the more likely they are to use tobacco as a form of "self-medication." Some chronic smokers were also found to use tobacco to relieve symptoms of depression.

As a result of the study's findings, Dr. Lerman suggested that simple screening procedures could be used to identify smokers entering cessation programs who may have more difficulty quitting smoking, and to tailor treatments to address their specific needs for symptom management alternatives to nicotine.

Santa Monica, Cal., U.S. (Rand Newsletter) Empirical evidence regarding the causal nature of the relationship between emotional distress and tobacco use in male and female adolescents provides support for both the distress-to-use (self-medication) and the use-to-distress
hypotheses. Using a cross-lagged model with 3 waves of data from 2,961 adolescents followed into young adulthood, the authors tested the hypothesis that this relationship changes over time. As hypothesized, emotional distress in Grade 10 was associated with increased smoking in Grade 12 for both boys and girls. Smoking in Grade 12 was in turn associated with increased emotional distress in young adulthood. The addition of 3 third factors (rebelliousness, deviance, and family problems) to the model did not
alter the results. Results suggest that the relationship between tobacco use and emotional distress is a dynamic one in which distress initially leads to use but then becomes exacerbated by it over time.

Maria Orlando, Phyllis L. Ellickson, Kimberly Jinnett. The Temporal Relationship Between Emotional Distress and Cigarette Smoking During Adolescence and Young Adulthood. Journal of Consulting and Clinical Psychology, vol. 69, no. 6, 2001.

A copy of this paper (identified as RAND Document #RP-997) can be requested free from The RAND Corporation at their website,