Pharmacists' and technicians' perceptions and attitudes toward dispensing buprenorphine/ naloxone to patients with opioid dependence.

OBJECTIVE: To assess the perceptions and attitudes of pharmacists and pharmacy technicians involved in an office-based opioid dependence treatment program using buprenorphine/naloxone. DESIGN: Cross-sectional attitudinal assessment. SETTING: Community, outpatient hospital, and clinic pharmacies. PARTICIPANTS: Pharmacists and technicians participating in a clinical trial of opioid dependence treatment using buprenorphine/naloxone. INTERVENTION: Written and telephone surveys followed by interviews with open-ended items. MAIN OUTCOME MEASURES: Attitudes and perceptions regarding opioid-dependent patients and use of buprenorphine/naloxone for treatment of opioid dependence. RESULTS: Pharmacies in seven states (New York, Virginia, Illinois, Florida, Texas, California, and Washington) participated in the clinical trial. A total of 40 pharmacists and pharmacy technicians responded to the initial written survey, representing 27 of the 32 pharmacies (84%). Follow-up interviews were obtained from one individual at 30 of those pharmacies (93.8%). Most pharmacy personnel (77.5%) involved with this study were not more concerned about theft or break-ins and would be willing to participate in opioid dependence treatment as the medication became available commercially (70%). The majority of respondents (85%) indicated that patients did not cause problems at their pharmacies. Compared with their experiences in administering other narcotic medications, most respondents did not express increased concern regarding prescription forgery (75%) or diversion (80%) of buprenorphine/naloxone. CONCLUSION: The majority of respondents expressed positive attitudes and perceptions regarding patients treated for opioid dependence with buprenorphine/naloxone.

Effects of alcohol and cigarette use on cognition in middle-aged adults.

In this retrospective cohort study we examined the independent and interactive effects of drinking and smoking on cognition in a sample of 3361 males, ages 31 to 49, with varying lifetime histories of alcohol and cigarette use. Dependent variables were neuropsychological measures of global and specific cognitive abilities. Comparison of the ability scores of seven groups, defined by their drinking and smoking histories, explained only 5.4% of the multivariate variance in cognitive ability and less than 2% in any individual cognitive measure. Regression analyses for current drinkers and smokers showed only a single significant, but negligible, effect of pack-years of smoking on a measure of global cognitive ability. Differences in cognitive function in groups defined by intensity of alcohol and cigarette use revealed no significant effect for drinking and a significant, but very small, effect for smoking.