***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Objective : To evaluate an experimental heroin maintenance programme . Design : R and omised trial . Setting : Outpatient clinic in Geneva , Switzerl and . Subjects : Heroin addicts recruited from the community who were socially marginalised and in poor health and had failed in at least two previous drug treatments . Intervention : Patients in the experimental programme ( n=27 ) received intravenous heroin and other health and psychosocial services .  Control patients ( n=24 ) received any other conventional drug treatment ( usually methadone maintenance ) . Main outcome measures : Self reported drug use , health status ( SF-36 ) , and social functioning . Results : 25 experimental patients completed 6 months in the programme , receiving a median of 480 mg of heroin daily . One experimental subject and 10 control subjects still used street heroin daily at follow up ( difference 44 % ; 95 % confidence interval 16 % to 71 % ) . Health status scores that improved significantly more in experimental subjects were mental health ( 0.58 SD ; 0.07 to 1.10 ) , role limitations due to emotional problems ( 0.95 SD ; 0.11 to 1.79 ) , and social functioning ( 0.65 SD ; 0.03 to 1.26 ) . Experimental subjects also significantly reduced their illegal income and drug expenses and committed fewer drug and property related offences . There were no benefits in terms of work , housing situation , somatic health status , and use of other drugs . Unexpectedly , only nine ( 38 % ) control subjects entered the heroin maintenance programme at follow up . Conclusions : A heroin maintenance programme is a feasible and clinical ly effective treatment for heroin users who fail in conventional drug treatment programmes . Even in this population , however , another attempt at methadone maintenance may be successful and help the patient to stop using injectable opioids INTRODUCTION Numerous investigations have shown that premature discharge against medical advice from alcohol detoxification treatment is associated with poor outcome . The aim of the present study was to assess the risk of different possible influencing factors . PATIENTS AND METHOD 168 in- patients admitted for detoxification treatment were included in the study . All patients were detoxified using clome-thiazole and /or carbamazepine in individual , symptom-triggered dosages . Possible influencing factors were recorded using a st and ardised interview . RESULTS Cox regression revealed a lower risk of premature discharge being significantly asso-ciated with few preceding withdrawals , intoxication at admission and treatment with clomethiazole . Kaplan-Meier survival statistics showed a significantly lower risk only for being treated with clomethiazole ( premature discharge until day 7 : chi2=25.07 ; p<0.001 ; premature discharge until day 14 : chi2=5.19 ; p=0.023 ) . Other included demographic factors like daily intake of ethanol before admission , duration of alcohol dependence , age or smoking status were not associated with the risk of premature discharge . DISCUSSION The present findings show that pharmacotherapy with clomethiazole may positively influence the risk of premature discharge . This might be a consequence of the psychoactive properties of the drug which leads to positive reinforcement Because of a controversial view on the role of smoking in the recovery process of alcoholism , outcome data obtained for alcoholics who had been included in a long-term clinical trial with a putative anticraving drug were analyzed . To avoid unknown interactions between the drug under study and smoking behavior , only placebo-treated patients were evaluated in this investigation . After 12 months of rehabilitation , there was no significant difference regarding abstinence rate between 48 smoking alcoholics ( who reported that they smoked 32 cigarettes on average per day ) and 15 nonsmoking alcoholics ( 33 % vs. 20 % ) . However , smokers tended to be abstinent longer than nonsmokers ( 173 vs. 114 days ; P= .092 ) . This possible advantage might be related to nicotinic effects on central dopamine systems in smokers , as indicated by higher growth hormone secretion after apomorphine stimulation obtained in smokers , compared with findings for nonsmokers ( area under the curve during chronic intoxication : 2253 vs. 1247 microg/min/l ; P= .019 ) . Multivariate regression analysis revealed a decreasing effect of ethanol blood level ( P= .006 ) and the number of fullfilled International Classification of Diseases , 10th edition ( ICD-10 ) criteria of the alcohol dependence syndrome ( P= .012 ) on stimulated growth hormone secretion . In contrast , the reported number of smoked cigarettes per day had an increasing effect ( P= .034 ) , accounting for 6 % of the variance of growth hormone secretion . However , differences in outcome could also be explained by other clinical features as smokers , compared with nonsmokers , were more frequently males ( 78.3 % vs. 60.7 % ) and younger when studied at index episode ( mean age 44.45 vs. 48.21 years ; P= .054 ) , reported higher ethanol consumption in the month before hospital admission ( 262 g vs. 192 g ; P= .044 ) , and met more criteria for the ICD-10 alcohol dependence syndrome ( 6.6 vs. 6.0 ; P= .047 ) . Therefore , it can not be stringently inferred from our data that a possible advantage of smoking for alcoholism recovery is causally related to the effects of nicotine on cerebral systems or human behavior , as our findings had not been based on a r and omized design Background : To investigate the improvement in quality of life ( QoL ) of alcohol-dependent patients during a 3-week inpatient withdrawal programme  , and to identify the sociodemographic , clinical and alcohol-related variables associated with baseline QoL on admission and with improvement of QoL during residential treatment . Methods : This prospect i ve , observational study included 414 alcohol-dependent patients , hospitalised for a period of 3 weeks .  QoL was measured on admission and at discharge using the French version of the Medical Outcome Study SF-36 . The mean scores for each dimension and for the Physical and Mental Component Summary scores were calculated . Results : The mean scores per dimension and the mean Physical and Mental Component Summary scores were significantly lower on admission than at discharge ; the lowest scores being observed for social functioning and role limitations due to emotional problems . At discharge , the mean scores per dimension were similar to those observed in the French general population . Female gender , age > 45 years , living alone , working as a labourer or employee , somatic comorbidity , and the existence of at least five criteria for alcohol dependence according to the DSM-IV classification were associated with a low Physical Component Summary score on admission ; psychiatric comorbidity , the presence of at least five DSM-IV dependence criteria , smoking and suicidality were associated with a low Mental Component Summary score on admission . The increase in Physical and Mental Component Summary scores during hospitalisation was more marked when the initial scores were low . Apart from the initial score , the greatest improvement in Physical Component Summary score was seen in patients with a high alcohol intake and in those without a somatic comorbidity ; the increase in Mental Component Summary score was greatest in patients without psychotic symptoms and in those who abused or were dependent on illegal drugs . Conclusion : QoL improvement after a residential treatment was related to low QoL scores at admission . Improvement in physical component of QoL was related to baseline alcohol intake and good somatic status . Improvement in mental component of QoL was related to other drugs abuse/dependence This study examined the association between stopping smoking at 1 year after  substance use treatment intake and long-term substance use outcomes . Nine years of prospect i ve data from 1185 adults ( 39 % female ) in substance use treatment at a private health care setting were analyzed by multivariate logistic generalized estimating equation models . At 1 year , 14.1 % of 716 participants who smoked cigarettes at intake reported stopping smoking , and 10.7 % of the 469 non-smokers at intake reported smoking . After adjusting for sociodemographics , substance use severity and diagnosis at intake , length of stay in treatment , and substance use status at 1 year , those who stopped smoking at 1 year were more likely to be past-year abstinent from drugs , or in past-year remission of drugs and alcohol combined , at follow-ups than those who continued to smoke ( OR=2.4 , 95 % CI : 1.2 - 4.7 and OR=1.6 , 95 % CI : 1.1 - 2.4 , respectively ) . Stopping smoking at 1 year also predicted past-year alcohol abstinence through 9 years after intake among those with drug-only dependence ( OR=2.4 , 95 % CI : 1.2 - 4.5 ) . We found no association between past-year alcohol abstinence and change in smoking status at 1 year for those with alcohol dependence or other substance use diagnoses when controlling for alcohol use status at 1 year . Stopping smoking during the first year after substance use treatment intake predicted better long-term substance use outcomes through 9 years after intake . Findings support promoting smoking cessation among smoking clients in substance use treatment Smoking is highly prevalent ( 85%-98 % ) in methadone maintenance treatment ( MMT ) patients .  Methadone has been shown to increase cigarette smoking in a dose-dependent manner , whereas smoking/nicotine has been shown to increase methadone self-administration and reinforcing properties . The objective of this study was to evaluate methadone-nicotine interactions in MMT patients during trough and peak methadone effect conditions . Subjective effects of nicotine ( administered by cigarette smoking , 4 mg of nicotine gum and placebo gum ) and methadone and their combination were assessed in 40 regularly smoking , stabilized MMT patients using a r and omized , placebo-controlled , within-subject study design . Subjects responded to a battery of subjective assessment s before and after nicotine administration both before methadone administration ( cycles 1 and 2 ) and 3 hours after methadone administration ( cycles 3 and 4 ) . There was a main effect of methadone on the decrease of opioid withdrawal scores ( P < 0.001 ) , and cigarette smoking enhanced this effect ( day × methadone interaction , P = 0.031 ) . Both nicotine and methadone had main effects on the decrease of nicotine withdrawal scores ( P < 0.001 and P = 0.001 , respectively ) ; this was associated with the cigarette day ( day × nicotine interaction , P = 0.003 , and day × methadone interaction , P = 0.004 ) . Nicotine plasma levels were highest on the cigarette smoking day ( P < 0.001 ) . Methadone and nicotine shared main effects on the increase of ratings of euphoria and drug liking and on the decrease of restlessness , irritability , and depression . The overall results may help to explain high smoking rates in the MMT population and may account for reports of increased positive effects of methadone when the drugs are taken together BACKGROUND A r and omised controlled trial of substance misuse indicated that many patients who use methadone  have respiratory symptoms and /or are prescribed respiratory medications . There is little research in this area . AIMS To determine the prevalence of respiratory disease and prescriptions among drug misusers . METHODS This historical cohort study of  drug misusers  and matched controls analysed routinely collected primary care data . The prevalence of common chronic respiratory diseases , class and number of respiratory medications were examined . RESULTS The cohort of 18,570 patients ( 9,285 per group ) was mostly male ( 64 % , n=11,890 ) and aged 31 - 59 years ( 76 % , n=14,060 ) . After adjusting for age , gender , deprivation and smoking status , the results showed that more drug misusers than controls had a diagnosis of asthma or chronic obstructive pulmonary disease ( 17.1 % vs. 10.9 % ; adjusted odds ratio ( OR ) 1.61 , 95 % confidence interval ( CI ) 1.46 to 1.77 , and 2.4 % vs. 0.8 % ; OR 1.86 , 95 % CI 1.42 to 2.44 , respectively ) and were prescribed more chronic respiratory medications : short-acting β(2)-agonists ( 16.4 % vs. 7.9 % ; OR 2.00 , 95 % CI 1.80 to 2.22 ) , long-acting β(2)-agonists ( 1 % vs. 0.4 % ; OR 1.93 , 95 % CI 1.29 to 2.89 ) , and inhaled corticosteroids ( 10.6 % vs. 7.6 % ; OR 1.49 , 95 % CI 1.33 to 1.67 ) . All differences were statistically significant ( p<0.001 ) . CONCLUSIONS Drug misusers have a significantly higher prevalence of respiratory diseases and respiratory prescriptions than matched controls . Further work is needed to determine the reasons for this The frequencies of structural chromosomal aberrations were analyzed in peripheral blood lymphocytes of 31 chronic alcoholics at the beginning of an intensive outpatient treatment program at a neuropsychiatric clinic and were compared with 31 controls matched for gender , age , smoking habits , and nondrinkers . A statistically significant difference was observed in the level of chromosomal aberrations in 
    Output:
    
Smoking rates among people in addiction treatment  are more than double those of people with similar demographic characteristics .
Smoking rates are also higher in people being treated for opiate dependence compared with people being treated for alcohol use disorder