Japan's Dependence Research Articles

Four cases of alcoholic liver cirrhosis in alcohol-dependent patients treated with nalmefene

Traditionally, abstinence has been regarded as the only appropriate goal in the treatment of alcohol dependence in Japan. Recently, harm reduction by reducing alcohol consumption, which has been used as a treatment approach in Europe, has gained recognition in Japan. The 2018 guideline for the treatment of alcohol dependence in Japan recommends abstinence as the primary goal, but reduction of alcohol consumption is described as an appropriate treatment goal in some patients. Nalmefene is an opioid modulator that is used to reduce alcohol consumption in patients with alcohol dependence. Here, we report the clinical course of alcoholic liver cirrhosis in alcohol-dependent patients who were treated with nalmefene for three months. Their alcohol consumption was reduced, which led to an improvement in liver function. Nalmefene provides a clinical benefit, constitutes a potential pharmacological treatment paradigm in terms of the treatment goal and dosing regimen, and addresses an unmet medical need in patients with alcohol dependence who need to reduce their alcohol consumption.

How Grief, Funerals, and Poverty Affect Bereaved Health, Productivity, and Medical Dependence in Japan

Grief has been shown to weaken bereaved persons' health, but measurements of their lost time and medical expense remain rare. Funerals traditionally managed and assuaged grief through ritual expression, approval, and social support. Research suggests that satisfying funeral participation reduces grief, while poverty exacerbates it. We hypothesized that: (1) psycho-physical symptoms of grief, (2) abbreviation/dissatisfaction in the funeral, and (3) poverty, correlate with decreased productivity and increased medical and social services use. We collected data from 165 mourning families about their grief, funerals, and subsequent medical conditions. (1) Deeper grief after bereavement in Japan correlated with more physical problems, more down time, and more medical dependency. (2) Low satisfaction with funerals correlated with higher hospital, pharmacy, and counseling costs. (3) Low income families lost more time, while declining incomes showed increased pharmaceutical costs. This suggests that satisfying funerals and income safeguards may reduce costs of low productivity and increased public services dependency.

Replenishing the Soil: Food, Fertiliser and Soil Science in Occupied Japan (1945-52)

Abstract Environmental scientists and activists in the early twenty-first century have identified productive, healthy soils as a key factor in feeding a rapidly increasing global population and mitigating climate change. This article argues that serious food shortages in Japan following its defeat in 1945 caused the fertility of its soils to become a pressing issue for the Allied Occupation (1945-52) and one seen as central to the success of democratisation. The prospect of famine in the cities in 1946 and 1947 and associated political unrest justified urgent imports of food from the US, causing much resentment among its allies, who questioned the seriousness of the food supply crisis in Japan. The Occupation's Natural Resources Section worked to reduce Japan's dependence on food imports by surveying Japan's soils and recommending their rapid augmentation with chemical fertilisers, the manufacture of which had practically ceased during the war. The US imported nitrogenous fertiliser to supplement inadequate domestic output and provided phosphate ore (for superphosphate fertiliser) from Florida, in addition to encouraging Japanese mining operations on Angaur Island, formerly part of the Japanese empire. The latter generated conflicts with the natives of the island, the local US naval command and the Australian government. Such tensions demonstrate the many and varied facets of the 'fertiliser problem', which was seen as pivotal to food supply and economic recovery. Major imports of agricultural commodities from the US after 1952 reflected its Cold War alliance with Japan. Likewise, significant transfers of technology contributed to a steep increase in the use of agricultural chemicals, causing the fertiliser problem to become a pressing environmental one by the 1990s.

Comparison of two train-the-pharmacist programs for supporting tobacco-nicotine dependence in Japan

Comparison of two train-the-pharmacist programs for supporting tobacco-nicotine dependence in Japan

Revision of labelling related to drug dependence in Japan

Revision of labelling related to drug dependence in Japan

The Pharmacist as Gatekeeper of Prescription Drug Abuse: Return to "Community Scientists"

The non-medical use or abuse of prescription drugs, including benzodiazepines, is a growing health problem in Japan. An association between prescription drug overdose and suicide risk has also been reported. The Japanese Ministry of Health, Labour and Welfare has expected pharmacists to act as "gatekeepers", facilitating early identification of individuals at high risk of prescription drug abuse including overdose, supplying medication counseling to patients, and helping to introduce these patients to appropriate medical care. Prescription drugs such as benzodiazepines are widely used in psychiatry. However, these drugs are prescribed not only by psychiatrists but also by other healthcare professionals including primary care physicians. Moreover, in recent years, the dispensing of prescriptions has moved rapidly from inside to outside hospitals, with prescription drugs being dispensed mainly at community pharmacies. Although all healthcare professionals including hospital pharmacists can play a role in preventing prescription drug abuse, the role of the community pharmacist is vital in addressing this problem. Formerly, community pharmacists were recognized as "community scientists", low-threshold accessible healthcare advisors. Now, community pharmacists should return to the role of community scientists to prevent prescription drug abuse. This article begins by reviewing the current situation of prescription drug abuse and dependence in Japan. The role of pharmacists as gatekeepers in preventing prescription drug abuse is then examined. Finally, this article discusses the effect of intervention in the form of gatekeeper training for community pharmacists.

OR11-4 * LONG TERM OUTPATIENT DETOXIFICATION TREATMENT OF OPIOID DEPENDENCE BY BUPRENORPHINE SUPPOSITORY: CASE REPORT

There are very few cases of opioid abuse and dependence in Japan and use of opioid in the opioid dependence treatment is prohibited by the old-fashioned Japanese narcotics control law. There are few options of medical treatment for opioid dependence available in Japan. Although we used low dosage buprenorphine injection on inpatient detoxification treatment for heroin dependence for ten years, we have not prescribed opioid agonist and antagonist for outpatient treatment of opioid dependence. The relapse rete was high. A patient was referred from U.S. addiction treatment agency last year. He had three years opioid abuse history. He was treated by buprenorphine film for three months. After the patient arrived in Japan, he used buprenorphine film he brought from U.S. and buprenorphine suppository. In the first 3 weeks, the patient use buprenorphine film and tapered buprenorphine from 1.0 mg/day to 0.25 mg /day. In the next 7 weeks, he used buprenorphine suppository 0.2mg/day. In the last 3 days of tenth week, he withdrew from buprenorphine. He returned to US in the 13th week. His drug use was monitored by frequent urinary test and he kept clean in Japan. Buprenorphine suppository was effective substitute of sublingual buprenorphine, in small dosage.

Acceptance of Controlled Drinking Among Treatment Specialists of Alcohol Dependence in Japan

This study evaluated the acceptance of controlled drinking (CD) goals among physicians specializing in the treatment of alcohol dependence (AD) in Japan. A mailed questionnaire survey was sent to physician members of the Japanese Society of Alcohol-Related Problems (n = 232) who were specialists in the treatment of AD in Japan. The evaluated items included the acceptance of CD goals, the definition of CD, the reasons for accepting or rejecting CD and the patient factors used to make treatment-goal decisions. CD as an interim goal on the way toward abstinence was accepted by about two-thirds of the specialists, while CD as a final goal was accepted by about one-third of specialists. Specialists supported harm-free drinking and a satisfactory quality of life, rather than alcohol consumption limits, as the definition of CD. Of note, a significantly higher percentage of specialists who rejected CD, compared with those who accepted CD, supported the disease model of AD as grounds for their decision. Specialists who accepted CD relied mostly on factors such as the severity of dependence, attitude toward CD and abstinence, and the level of psychological dependence and social stability, when making treatment-goal decisions. CD was accepted as an interim goal by two-thirds and as a final goal by one-third of Japanese physician specialists. Despite differences in drinking cultures and treatment circumstances, great similarities were found between this study and those conducted in Europe and North America with regard to the reasoning of treatment providers and the use of patient characteristics to make treatment-goal decisions.

Awareness and treatment of alcohol dependence in Japan: results from internet-based surveys in persons, family, physicians and society.

Aims: To understand current awareness of, and views on, treatment of alcohol dependence in Japan. Methods: (a) Nationwide internet-based survey of 520 individuals, consisting of 52 diagnosed alcohol-dependent (AD) persons, 154 potentially alcohol-dependent (ADP) persons, 104 family members and 106 friends/colleagues of AD persons, and 104 general individuals, derived from a consumer panel where the response rate was 64.3%. We enquired into awareness about the treatment of alcohol dependence and patient pathways through the healthcare network. (b) Nationwide internet-based survey of physicians (response rate 10.1% (2395/23,695) to ask 200 physicians about their management of alcohol use disorders). Results: We deduced that 10% of alcohol-dependent Japanese persons had ever been diagnosed with alcohol dependence, with only 3% ever treated. Regarding putative treatment goals, 20–25% of the AD and ADP persons would prefer to attempt to abstain, while 60–75% preferred ‘reduced drinking.’ A half of the responding physicians considered abstinence as the primary treatment goal in alcohol dependence, while 76% considered reduced drinking as an acceptable goal. Conclusion: AD and ADP persons in Japan have low ‘disease awareness’ defined as ‘understanding of signs, symptoms and consequences of alcohol use disorders,’ which is in line with the overseas situation. The Japanese drinking culture and stigma toward alcohol dependence may contribute to such low disease awareness and current challenging treatment environment. While abstinence remains the preferred treatment goal among physicians, reduced drinking seems to be an acceptable alternative treatment goal to many persons and physicians in Japan.

Critical Juncture and Nuclear-Power Dependence in Japan: A Historical Institutionalist Analysis

The institution of nuclear power in Japan appears to be drifting; nevertheless it persists. For the past 60 years, conservative politicians, technologists, and electric companies have acted in concert, for different reasons, to achieve a full nuclear fuel cycle: specifically technology for reprocessing and uranium enrichment. Their pursuit has eroded the bottom-line spirit of peaceful use; to be sure, it has been excessively ambitious for Japan’s status as a non-nuclear-weapon state. The mastering of the full nuclear fuel cycle has resulted in a competency trap, excluding or delaying development of alternatives to nuclear power. Furthermore, this situation has heightened nuclear power’s sunk costs. The critical conjuncture of the March 11, 2011 incident has had a limited impact only. Anti-nuclear activists, the weakest concerned actor, try to dramatize their movement for “exit from nuclear,” but they have failed to bring about electoral changes.

Family Dysfunction Differentially Affects Alcohol and Methamphetamine Dependence: A View from the Addiction Severity Index in Japan

We investigated the differential influence of family dysfunction on alcohol and methamphetamine dependence in Japan using the Addiction Severity Index (ASI), a useful instrument that multilaterally measures the severity of substance dependence. The participants in this study were 321 male patients with alcohol dependence and 68 male patients with methamphetamine dependence. We conducted semi-structured interviews with each patient using the ASI, which is designed to assess problem severity in seven functional domains: Medical, Employment/Support, Alcohol use, Drug use, Legal, Family/Social relationships, and Psychiatric. In patients with alcohol dependence, bad relationships with parents, brothers and sisters, and friends in their lives were related to current severe psychiatric problems. Bad relationships with brothers and sisters and partners in their lives were related to current severe employment/support problems, and bad relationships with partners in their lives were related to current severe family/social problems. The current severity of psychiatric problems was related to the current severity of drug use and family/social problems in patients with alcohol dependence. Patients with methamphetamine dependence had difficulty developing good relationships with their father. Furthermore, the current severity of psychiatric problems was related to the current severity of medical, employment/support, and family/social problems in patients with methamphetamine dependence. The results of this study suggest that family dysfunction differentially affects alcohol and methamphetamine dependence. Additionally, family relationships may be particularly related to psychiatric problems in these patients, although the ASI was developed to independently evaluate each of seven problem areas.

The history and current state of drug abuse in Japan

Drug abuse in Japan began after World War II and has been characterized by three epidemics of methamphetamine abuse; in addition, solvent abuse has been prominent for a long time. Since 1995, with the beginning of the third epidemic of methamphetamine abuse, drug abuse or dependence in Japan changed, with a marked decrease in solvent abuse, stabilization of methamphetamine abuse, an increase in the abuse of such drugs as cannabis or 3,4-methylenedioxymethamphetamine (which do not have high potential of causing drug-induced psychosis), and the emergence of designer drugs. Furthermore, the abuse of medical drugs such as Ritalin became a major issue in 2007. These changes reveal an increase in the abuse of drugs that do not as easily produce a psychotic state, underlain with a shift from personal conduct that leads to arrest to conduct that does not. Japan, therefore, needs to deal with drug abuse and dependence using not only a medical model, but also a criminal model as well.

Dental caries prevalence as evidence for agriculture and subsistence variation during the Yayoi period in prehistoric Japan: Biocultural interpretations of an economy in transition

The Yayoi period represents the earliest point of agricultural dependence in Japan, dating from approximately 2500 BP to AD 300. Yayoi period people consumed wet-rice as a primary subsistence base. This article uses dental caries prevalence to interpret the biocultural implications of agriculture among these people by testing the following hypotheses: 1) Yayoi period agriculturalists had greater frequencies of carious teeth than Jomon period foragers, 2) regional variation in carious tooth frequencies will be observed among Yayoi period agriculturalists, while 3) variation in carious tooth frequencies will be observed between male and female agriculturalists. Statistically significant differences in carious teeth were observed between the agriculturalists from Southern Honshu and all other samples. These differences suggest greater reliance on cariogenic plants among farmers from Southern Honshu and are consistent with an agricultural economy. The people of the Yayoi period from Tanegashima Island and Northern Kyushu did not have significantly different carious tooth frequencies compared to Jomon period foragers. This suggests that rice alone was not a more cariogenic dietary substance than those consumed by Jomon period foragers but a cariogenic food nonetheless. Dietary heterogeneity between the prehistoric people of the Yayoi period from Southern Honshu and those from Northern Kyushu and Tanegashima Island is also inferred from these differences. Significantly greater frequencies of carious teeth among older aged Yayoi period females compared with males suggest dietary differences between the sexes.

The serotonin-2A receptor polymorphism and clinical symptoms in mood disorders, schizophrenia and alcohol dependence in Japan.

In the past, there have been many epidemiological and genetic studies of mood disorders, schizophrenia, and alcohol dependence, and in this study, the human serotonin 2A receptor (5-HTR2A) polymorphism was examined in 80 patients with mood disorders, 50 patients with schizophrenia and 41 patients with alcohol dependence. 5-HTR is related to affectivity, regulation, and pharmacologic effects of antidepressant, anti-anxiety and antipsychotic medications. The polymorphism in 5-HTR2A (102T/C, -1438 A/G) was identified by the polymerase chain reaction (PCR), followed by restriction fragment length polymorphism (RFLP). The results suggest that 5-HTR2A (102T/C, -1438G/A) polymorphism might not be associated with susceptibility to schizophrenia or mood disorders, and it might not be a risk factor contributing to alcohol dependency. We found that the 102T/C polymorphism was in linkage disequilibrium with the -1438G/A polymorphism in psychosis (mood disorder, schizophrenia, and alcohol dependence) and in health controls. Further studies are needed to determine whether or not the novel serotonin receptor (5-HTR) polymorphism reflects the pathogenesis of schizophrenia, mood disorders, and alcohol dependence.

A Survey on Nursing Care for the Patients with Drug Dependence in Japan : The Factor Analysis of Nursing Care and the Relating Factors

A Survey on Nursing Care for the Patients with Drug Dependence in Japan : The Factor Analysis of Nursing Care and the Relating Factors

NEDO Activities to Promote the Introduction of New Energy

Under the Law Concerning the Promotion of the Use of New Energy, “New Energy” can be defined as important new energy which has not yet been widely used due to economic constraints, but which introduction is necessary in order to reduce Japan's dependence on oil.NEDO conducts trial introduction of new energy and energy conservation systems with end users in order to verify the effectiveness of the systems and to establish the fundamentals of fullscale introduction, thus strengthening and expanding the introduction of new energy and energy conservation.In addition to. NEDO subsidizes project operators who promote the introduction of new energy and energy conservation to accelerate promotion, in addition to providing information, guidance, and support for dissemination to obtain understanding and recognition for such energy policies.

Epidemiological studies of tobacco smoking and dependence in Japan

In this study, we attempted to determine the prevalence of tobacco or nicotine dependence in current smokers in Japan and to assess the relationship between alcoholism and tobacco or nicotine dependence. The subjects consisted of 246 alcohol-dependent and 1,111 non-alcohol-dependent individuals. We used a questionnaire, consisting of items obtained from the World Health Organization’s The ICD–10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines (ICD–10) and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM–IV) criteria for tobacco or nicotine dependence. The prevalence of tobacco dependence diagnosed according to the ICD–10 criteria was 23.9% among all subjects. The prevalence of tobacco dependence diagnosed according to the ICD–10 criteria was higher in alcohol-dependent individuals (58.1%) than in nondrinkers or social drinkers (12.8%). Alcohol-dependent subjects consumed significantly more nicotine per day than did nondrinkers or social drinkers. The prevalence of nicotine physical dependence diagnosed by using DSM–IV criteria for nicotine withdrawal was 2.4% in alcohol-dependent individuals, whereas only 0.3% of nondrinkers or social drinkers exhibited nicotine physical dependence. These results indicate to us that the potential for nicotine physical dependence is not much stronger than that reported among current smokers.

The Current Situation of the Japanese Nonferrous Mining Industry

In the long term, worldwide consumption of nonferrous metals is steadily rising as a result of improvements in economic growth accompanied by an increasing population. In particular, consumption in Asia is following a trend of rapid growth which is expected to far exceed the world average. Under the current state of overseas ore dependence in Japan, to secure the stable supply of mineral resources is one of the key issues facing the Japanese nonferrous metals industry. We are encouraging those responsible in the Japanese mining industry to positively conduct overseas exploration activities, in order to locate promising deposits, strengthen international competitiveness and expand their contribution to the international mining sector.

How Japan–US Economic Interdependence Changed from 1985 to 1990: Some Findings from Price-adjusted MITI Intercountry Input–Output Tables

This paper consists of two parts. First, constant-price Japan–US intercountry input–output (IO) tables are compiled, based on Japan–US IO tables of the Ministry of International Trade and Industry (MITI) for 1985 and 1990, and the relative producer prices of both countries, which are estimated by the ‘peeling off’ method from OECD purchasing power parity data. Second, a factor decomposition analysis is carried out to show changes in Japan–US economic interdependence between 1985 and 1990. The Leontief inverse matrices of intercountry IO tables are decomposed into three matrices, which reflect domestic repercussion effects, spillover effects to the other country and feedback effects of own final demand from the other country. Then, a traditional decomposition analysis of changes in production for both countries is applied to see how both countries' economic interdependence changed. It is found that Japan–US economic interdependence moved from a pattern of Japan's dependence on the US to an almost equally interdependent pattern, although the degree of dependence was still higher in Japan in 1990. At the same time, there are significant industrial structural changes in the relationship between both countries, as a result of the significant appreciation of the yen relative to the dollar from 1985 to 1990.

‘Trouble Must Follow’: Australia's Ban on Iron Ore Exports to Japan in 1938

Despite the attention that has been given to the role of economic sanctions in Japan's decision to launch the Pacific war, Australia's decision to ban iron ore exports to Japan has been given little attention, even though this was one of the earliest economic sanctions imposed onimperial Japan in the 1930s. To a degree this neglect can be traced to a preoccupation with the actions and objectives of the great powers and a failure to consider the opportunities available to small nations to take significant initiatives. The following article traces the origins of the iron ore embargo back to 1934 when Essington Lewis, the Managing Director of the Broken Hill Proprietary Company Ltd (BHP), Australia's iron and steel monopoly, visited Japan and subsequently advocated the development of an Australian armaments industry to counter probable Japanese aggression in the Pacific. In Japan Lewis crossed paths with J. G. Latham, the Minister for External Affairs, who was leading the Australian government's Eastern Mission. Latham returned to Australia with conclusions that differed fundamentally from those of Lewis, who came up with a plan to take advantage of Japan's dependence on imports of iron ore and other iron products to finance investment in Australian armaments manufacturing. In explaining this outcome the article discusses interactions between a number of conflicts: between Latham and Lewis; between the British Treasury and the Foreign Office; and between the Japanese army and navy. In London the Treasury wanted to focus on the European theatre, while also holding down military spending in order to achieve balanced budgets. The Treasury believed that the way to best defend British commercial interests in Asia was to appease Japan. On the other hand, the Foreign Office was committed to the protection of British interests in the Far East by a more forceful diplomacy, although it was only willing to counten-ance behavior short of military action. Consistent with Latham's recommendations to his government, the emerging consensus in London was that while a settlement in China would help to safeguard British interests there, as long as the Japanese were bound up in their war in China they were less likely to attack British colonies in Southeast Asia and the Pacific. In 1936 this orientation was challenged by a shift in the balance of power in Tokyo away from the army and in favor of the navy. Although priority continued to be placed on winning the war in China and guarding against an attack from the Soviet Union, now the navy's plan for southward expansion was given more careful consideration and credibility.