摘要:

The experience with methadone maintenance treatment by two major New York City methadone maintenance treatment programs using the Dole-Nyswander philosophy is reviewed. After more than 56,000 person-years in treatment over a 10-year period of time, a unit of medical experience exemplified by these two programs is evident. There was a high degree of patient acceptance, a small amount of recognized residual illicit drug abuse, and steeply reduced criminal activities of those patients who remained in treatment. A wide variety of other methadone treatment programs are recognized. Many use methadone differently from those in the present study. The treatment results reported herein may represent a standard by which narcotic (methadone and other) treatment programs can be assessed.

ISSN:0095-2990    

DOI:10.3109/00952997609077192

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor

摘要:

Highly disparate research techniques have been employed to develop estimates of the extent of opiate use. Exclusive reliance upon public health and law enforcement statistics has been supplemented in recent years with data generated by survey research‘incidence and prevalence’epidemiological methods. State agencies attempting to measure the extent of opiate use as a requirement for the receipt of federal categorical grant formula funds utilize multiple indicators: opiate treatment, arrest, incarceration, serum hepatitis, narcotics overdose death, and survey data. To address the question of undetected opiate use in a major southwestern city, the authors have undertaken a study measuring the extent of law enforcement recognition of the addictive status of a random sample of patients selected from the city's two municipally operated methadone treatment programs. The results indicate that over one-half of the sample was unknown to the police as addicts. Descriptive attributes of the unknown group were identified through appropriate statistical analyses. These findings are comparable to those of a similar study conducted in 1973 in a major eastern city.‘Official drug statistics are like an iceberg—or, more precisely, an aerial view of that iceberg when the shadow of the information-gathering mechanism distorts what little reality a photograph might reveal’[1].

ISSN:0095-2990    

DOI:10.3109/00952997609077193

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor

摘要:

This study reports 1 year follow-up data of 96 patients who received methadone at selected community pharmacies instead of traditional program dispensaries.Outcomes are comparable to those reported for traditional programs. Security measures were not a problem. The results indicate that most patients can begin methadone maintenance at a pharmacy without a period of stabilization at a program unit. Of several factors studied, arrest record, both preceding and during treatment, based on official police data was the single factor significantly associated with employment and continuation in methadone treatment. Community pharmacy dispensing of methadone is a useful means of operating a methadone treatment program.

ISSN:0095-2990    

DOI:10.3109/00952997609077194

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor

摘要:

Recent public concern over illicit methadone use has generated considerable interest among both treatment authorities and researchers. Unfortunately, many professional studies on the topic have done little to clear up certain misconceptions surrounding methadone use. In building upon earlier empirical work, the authors sought to explore the role of methadone within the context of addict career experiences as a whole. Interviews revealed considerable differentiation in types of experiences and purposes for use with respect to a variety of demographic and drug career attributes. The findings suggest the need for some rethinking about prevailing conceptions of‘the problem’of illicit methadone use.

ISSN:0095-2990    

DOI:10.3109/00952997609077195

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor

摘要:

There is a growing concern with the rapid pace of physical and psychosocial deterioration of methadone patients who abuse alcohol. The need for a sample method for determining the extent of the problem, as well as the presence of an alcohol problem in individual patients, led the authors to test the validity of the Michigan Alcoholism Screen Test (MAST) in a small urban methadone maintenance clinic (N= 125). The MAST was administered to every patient by their counselors, and the nursing staff was asked to independently rate each patient according to Keller's definition of alcoholism. The authors compared the patients' MAST scores with the global ratings of the nursing staff. Forty-six percent (n= 58) of the patients scored in the alcoholism range of the MAST questionnaire, while 34% (n= 43) of the patients were diagnosed as alcoholics by the nursing staff. There was 75% (n= 94) agreement between the MAST findings and the nurses' global ratings (p<. 001). The authors suggest that the MAST could be an effective screening tool in the area of alcohol abuse in methadone clinics. Going beyond the data, the authors recommend reexamination by psychiatrists of their peripheral role in the treatment of these difficult and multihandicapped patients.

ISSN:0095-2990    

DOI:10.3109/00952997609077196

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor

摘要:

Drug abusers have historically tended to abuse more than one drug. However, over the past 5 years there has been an increasing tendency to combine narcotics, alcohol, sedatives, and/or stimulants. The statistical increase of such abuse in the United States is documented by national surveys and the findings of drug treatment programs and detoxification centers. To clarify the confusion about such terms as‘polydrug abuse’and‘multidrug abuse,’these terms are defined. A classification of multiple drug abuse is presented which demonstrates recent increases in each of four categories.

ISSN:0095-2990    

DOI:10.3109/00952997609077197

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor

摘要:

Several basic psychological hypotheses about multiple drug abuse are examined, i.e., social determinants, the effect of availability on extent of abuse, that drug abuse is a symptom rather than a disease, the relationship of social class to psychopathology, the lack of specificity of psychodynamics or psychopathology to drug choice, and the use of drugs to facilitate or obliterate concern with assertion, relieve neurosis, or provide homeostasis. There is a need for a variety of comprehensive, directive treatment approaches from which an individual treatment plan can be chosen. Such plans must consider which of the complex factors that can lead to multiple drug abuse are most prominent and can be remedied in each case.

ISSN:0095-2990    

DOI:10.3109/00952997609077198

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor

摘要:

In a study of client variables related to length of stay in two types of drug-free day treatment programs, results varied according to program structure and sex of the clients. In the more loosely structured Youth Centers, in which the programs differed from center to center and the populations were heterogenous, there were no clear-cut results. However, within the more tightly structured Ambulatory Treatment Units, the programs and the populations were more homogeneous, and the results showed a significant pattern related to length of stay, but for males only.

ISSN:0095-2990    

DOI:10.3109/00952997609077199

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor

摘要:

Clinicians should be skilled in work with their ethnic peers before attempting cross-cultural treatment. Acquiring cross-cultural sensitivity involves regression to childlike openness for new values, attitudes, and behaviors. Members of the ethnic group can orient the clinician by discussion, suggested readings, and invitations to their homes and ritual events. Work should begin slowly, with regular consultation from ethnic peers of the patient. Special transference issues involve parent-child transactions and the‘Messianic countertransference.’Clinicians must maintain their primary commitment to the patient and to the patient's social resources, rather than to an institution not responsible to the patient population.

ISSN:0095-2990    

DOI:10.3109/00952997609077200

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor

摘要:

The‘agent,’‘host,’and‘environment’of drug dependence are examined relative to their potential as effective foci of efforts in the areas of primary secondary and tertiary prevention. Factors associated with the agent and the host are shown to be of extremely limited value when it comes to the primary prevention of drug dependence. Results of prior rewards are reviewed and they serve as the basis for the conclusion that the manipulation of environmental factors holds the greatest promise relative to the primary prevention of drug dependence.

ISSN:0095-2990    

DOI:10.3109/00952997609077201

出版商:Taylor&Francis    

年代:1976

数据来源: Taylor