Thesis (Ph. D.)--West Virginia University, 2005. / Title from document title page. Document formatted into pages; contains vi, 101 p. : ill. Includes abstract. Includes bibliographical references (p. 94-101).

Thesis (Ph.D.)--Victoria University of Wellington, 2009. / Includes bibliographical references.

Thesis (M.Soc.Sc.)--University of Hong Kong, 1988. / Also available in print.

Thesis (M.S.)--West Virginia University, 2006. / Title from document title page. Document formatted into pages; contains xi, 191 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 179-191).

Thesis (Ph. D.)--University of Glasgow, 1997. / Includes bibliographical references. Print version also available.

Ph.D.

In an effort to shift away from the narrow medical model of drug treatment the Advisory Council on the Misuse of Drugs (ACMD), in 1982, introduced the idea of the 'problem drug user' (PDU) and recommended a multi-disciplinary approach in order to meet the increasingly evident multiple and complex problems presented by dependent drug users. However, despite the development of a series of drug strategies (HM Government, 1995; 1998; 2002; 2008; 2010) and vast increases in funding, dependent drug users are still struggling to receive the services they require to address their diverse problems (Neale, 2008; Buchanan, 2010). Through an analysis of in-depth interviews with dependent drug users and their keyworkers this thesis seeks to explain these deficiencies. The author argues that the broad umbrella of drug policy that has adopted a framework of risk-based strategies to regulate and control drugs and drug users has focused on the social and economic costs associated with problem drug use, particularly in relation to the belief that much acquisitive crime is drug-related. Hence, the focus has not been on the problems that drug users have but on the problems they cause. The medical model that has dominated the treatment of addiction has been reinforced, therefore, not only because 'drug addiction' has been described as a chronic and relapsing condition (NTA, 2002), but also because of the wider social control objectives (crime reduction, in particular) that this approach delivers (Lind et al., 2005; Gossop, 2005; Millar et al., 2008). The author examines the implications of these drug policy directions on the treatment journeys of dependent drug users. Firstly, the author demonstrates how the confluence of the health and crime reduction agendas has led to the paradoxical perception of drug users as being 'sick-but-deviant' that has served to exacerbate their stigmatised identities. Secondly, the author suggests that the closer alignment between the drug treatment workforce and the criminal justice system has led to the isolation of drug treatment from wider health and social care services. Together, these two consequences of drug policies have created further barriers to service access and successful recovery, thereby providing an explanation for the unmet need of dependent drug users attending treatment services.

Class of 2012 Abstract / Objectives: To evaluate the literature with respect to drug-drug interactions of the hydroxymethylglutaryl CoA reductase inhibitors atorvastatin, fluvastatin, lovastatin, pitavastitin, pravastatin, simvastatin, and rosuvastatin with warfarin. Methods: This descriptive retrospective study identified articles reporting on each drug-drug interaction from the online databases PubMed (1970 – February 2012) and the drug compendia Micromedex and Facts & Comparisons. The studies included in this investigation were primary literature reports, written in English with human subjects. All studies included were evaluated using the van Roon 5-point quality of evidence scale developed in the Netherlands to assess drug-drug interactions. This scale rates the study type from lowest to highest quality, from zero to four. Case-reports were evaluated using the Drug Interaction Probability Scale (DIPS). The DIPS tool uses 10 questions to evaluate the probability that an adverse event is caused by a drug-drug interaction. Results: Twenty studies met the inclusion criteria. One study involved atorvastatin, four for fluvastatin, three for lovastatin, 2 for pitavastatin, 1 for pravastatin, 5 for rosuvastatin, and 6 for simvastatin. The mean van Roon quality of evidence score was 2.1+/- 0.74, the mean score for atorvastatin, pitavastatin, and pravastatin was 3, with the mean score of fluvastatin, lovastatin, rosuvastatin, and simvastatin was 2. 70% of the literature reviewed were case-reports or letters. Conclusions: The studies and reports supporting HMG-CoA reductase inhibitors and warfarin drug-drug interactions are most commonly case-reports and are of low quality and quantity.

Class of 2015 Abstract / Objectives: To determine the quality of evidence in the literature reporting the potential effect of QT prolongation and cardiovascular interactions of amiodarone with fluoroquinolones and macrolides. Methods: A thorough database search was conducted utilizing PubMed, Embase, Micromedex, and Facts and Comparison. Studies were eligible if they involved human subjects, original submission in English, and focusing on any drugs within the macrolide class along with amiodarone or any drugs within the fluoroquinolone class along with amiodarone was included. Drug-drug interactions (DDI) within the literature were evaluated using one of two tools: (1) van Roon to assess the quality of randomized controlled studies, and (2) the Drug Interaction Probability Scale (DIPS) to assess case reports. Results: Five case reports were included for evaluation. None of the patients within the case reports were less than 65 years old. Four of the five case reports included ciprofloxacin as part of the proposed drug interaction with amiodarone. The range of DIPS scores were 4-7 with a median score of 6. Conclusions: The evidence purporting this drug-drug interaction is of poor quality and low quantity. Additional studies of high quality must be conducted on the subject of this DDI to provide clinicians the ability to make more informed clinical decisions.

Class of 2008 Abstract / Objectives: The purpose of this study is to compare the critical drug-drug interaction alerting software at the Department of Veteran Affairs with Hansten and Horn's drug analysis and management (DIAM) and Micromedex®. Methods: The Department of Veterans Affairs supplied a list of drug-drug interacting (DDI) pairs. Each pair was labled as significant or critical. The critical interactions were included in the study (n=1018). Two researchers inputed the interactions into Micromedex and looked up the interactions in Hansten and Horn's drug interactions analysis and management (DIAM). A Kappa statistic was used to calculate the agreement between the 2 researchers. Results: The researchers differed in the number of interactions found to be "contraindicated" or "major" in Micromedex and "avoid" or "usually aviod" in DIAM (researcher 1= 683, 330, respectively; researcher 2= 672,176, respectively) with a Kappa of 0.9 for Micromedex and 0.57 for DIAM. Conclusions: Our study suggests that there is a difference between the VA drug interaction alerting system, Micromedex ® and DIAM in regards to the way they list interactions and their method of rating the level of severity of the interactions. Also, there may be a difference in the way each researcher interprets the information.