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Introduction and Aims: Although alcohol is often used in an attempt to alleviate negative affect, alcohol oftentimes exacerbates depressive symptoms. Therefore the relationship between alcohol and affect, and the role of motives for drinking remain unclear. The present study hypothesised that placebo alcohol would blunt affective responding and that desire to drink would increase in individuals who expected alcohol to help them cope after a negative experience. The present study also explored whether motives and reasons for drinking altered after a negative experience., Design and Methods: Participants (36 first-year psychology students and 41 community members) were randomly assigned to one of four experimental groups, being soft drink or placebo alcohol, neutral or negative mood induction., Results: Two repeated measures analyses indicated that placebo alcohol did not significantly blunt affective responding after the negative mood induction. T-tests showed that desire to drink did not significantly increase post negative mood induction for participants who endorsed coping motives for drinking. However, interestingly coping-depression and enhancement motives decreased after negative mood induction, and participants misattributed the majority of their mood to other life events., Discussion and Conclusions: The findings indicate that motives for drinking are amendable with prior learning, providing support for expectancy challenge procedures. The study also provides some evidence for alcohol's effect on emotional lability., (© 2012 Australasian Professional Society on Alcohol and other Drugs.)

Issues: Comorbidity between anxiety and substance use disorders is common, yet it is poorly understood and poorly treated., Approach: Narrative literature review. PsycINFO and Medline databases were searched for clinical trials of anxiety and substance use disorders using clinical queries for 2005-2009., Key Findings: There are few well-conducted treatment outcome trials for comorbid anxiety and substance use disorders. Some recent (2005-2009) outcome literature has focused on specific mechanisms (anxiety sensitivity and tension reduction alcohol expectancies) that may underlie comorbidity between anxiety and substance use disorders and may lead to more targeted intervention. IMPLICATIONS AND CONCLUSION: The research base for understanding and treating comorbid anxiety and substance use disorders needs to be broadened. In particular research is needed with a focus on: (i) specifying particular comorbid relationships between anxiety and substance use disorders; (ii) the mechanisms that may underlie and maintain those relationships; and (iii) well-conducted evaluations of treatments that target those mechanisms.

A meta-analysis of randomized and controlled evaluations of the efficacy of smoking cessation interventions compared 146 estimates of the difference in abstinence rates between treated and control conditions (effect sizes) from 85 publications. Simple advice to quit and other brief intervention techniques, nicotine chewing gum and behavioural techniques were all found to be significantly better than relevant control conditions in promoting abstinence, although the results were not homogeneous. In five studies of acupuncture compared with control, consistent results were found showing no benefit for acupuncture.

The first Australian national census of clients of drug and alcohol treatment agencies was undertaken to document the characteristics of clients attending these facilities. Of the agencies surveyed nationwide, 431 (85.2%) completed and returned census forms describing demographic and drug use details of their clients. A total of 6175 clients were reported to have received services (beyond methadone maintenance alone) in the responding agencies on the census day. Ninety percent of the clients seen were substance users, and 10% of clients were relatives or friends of a substance user. The mean age of the clients was 34 years and two-thirds were male. The majority were Australian born, with 10% described as Aborigines or Torres Strait Islanders. The majority of the clients were not in paid employment. Fifty-five percent of all clients received treatments services on a non-residential basis. The most frequent presenting drug problem reported was alcohol, followed by opiates and tobacco. Thirty-three percent of the substance users were reported to have injected illicit drugs in the past 12 months.

Drug and alcohol agencies across Australia were asked to describe the services they offer to opiate users. Of the 284 agencies identified as providing treatment, 229 (81%) responded. A standard assessment procedure was used in 72% of agencies. Eighty (35%) agencies offered detoxification and had assisted 7883 clients with detoxification in the 12 months prior to March 1990. Methadone maintenance was offered in 20% of agencies with 5234 clients currently receiving this treatment. Daily doses of methadone in the range of 40-80 mg were described for most (51%) clients receiving methadone and concurrent counselling was provided in 45% of cases. Standard psychosocial interventions were provided by 60% of agencies. Out-patient or non-residential settings were most common (36%), with residential therapeutic communities being the setting for 21% of programmes. Supportive counselling was the most commonly used individual approach, and cognitive-behavioural or 12-step approaches were the most commonly used group approaches. Brief support or referral to Nar-Anon were the most popular family interventions. Procedures aimed at reducing the risk of HIV were in place at 85% of agencies. These findings are discussed in light of research evidence. Briefly, there is a diversity of treatment options available from different treatment agencies which is not reflected within the agencies, little aftercare is offered despite high rates of relapse, and doses of methadone are lower than has been found to be optimal.