摘要:

4,657 out of a total APA membership of 28,000 expressed a particular interest in alcoholism and substance abuse. 1,705 of these responded to a questionnaire studying their attitudes and practices. Most of these do part-time work in the field with 9.9% being subspecialists. Self-report responses indicated that psychiatrists have incorporated a disease concept, abstinence orientation, utilized AA, education, supportive therapy, and a range of other modalities, think of addictions as treatable psychiatric disorders, and very infrequently use maintenance minor tranquilizers. Most became interested because of community need. However, 41.4%

ISSN:0095-2990    

DOI:10.3109/00952998609007389

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

A contemporary approach to the family treatment of substance abuse is presented. This approach involves developing a method for establishing and maintaining a substance-free state, a workable system of family therapy, sufficient attention to the family after substance abuse has stopped, and an individualized, integrated approach which takes into consideration a variety of family factors.

ISSN:0095-2990    

DOI:10.3109/00952998609007390

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

In contrast to early psychodymamic formulations of addictions which stressed pleasure seeking or self-destruction, a modern psychodynamic perspective places greater emphasis on understanding addicts' disturbances in regulating their internal emotional life and adjustment to external reality. Effective treatment rests on providing interventions and responses that appropriately respond to addicts deficits in regulating affects and behavior. Treatment modalities must keep needs for comfort, control, and safety as the highest priorities, especially initially, in considering the choice of treatment or combination of treatments which are adopted or prescribed. The concept of a primary care therapist is advanced in which a single clinician takes responsibility for holding patients to other interventions and for monitoring which elements or combinations are most helpful. Benefits, pitfalls, limitations, and risks are considered for individual psychotherapy, self-help groups (i.e., AA and NA), and group psychotherapy. The role of psychopharmacologic approaches are considered as they pertain to psychotherapy.

ISSN:0095-2990    

DOI:10.3109/00952998609007391

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

In the past 15 years there has been an explosion of data on the multivariate nature of drug dependence. The complex relationship between addictive disorders and psychopathology has been better clarified. Certain Axis I and II diagnoses in DSM-III appear to occur more commonly in alcohol-and drug-dependent patients than in the general population, suggesting that they may serve as risk factors for the development of addictive disorders. Psychopathological symptoms also result during periods of chronic intoxication and may persist as secondary psychiatric disorders even in the absence of continued substance use. Behavioral research in human and animal models has begun to yield insights into the nature of dependence disorders and the importance of brain mechanisms of reinforcement to the addiction process. Inevitably, neural scientists are beginning to delineate the commonalities and differences in drug reinforcement across drug class. The research has begun to suggest pharmacological approaches to the treatment of drug dependence and withdrawal. This paper provides an overview of research on the psychobiology of drug dependence with implications for the clinician.

ISSN:0095-2990    

DOI:10.3109/00952998609007392

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

Recent research has produced encouraging preliminary data on general pharmacological treatments for cocaine abuse as well as on pharmacotherapies specific for cocaine abusers with Axis 1 psychiatric disorders. Pharmacotherapy trials with antidepressants, lithium, and stimulants in chronic cocaine abusers as well as recent clinical, diagnostic, and pre-clinical studies will be reviewed. Symptom presentation, severity of abuse, and phase of recovery are discussed as potential guides in treatment selection.

ISSN:0095-2990    

DOI:10.3109/00952998609007393

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

Substance abuse in pregnancy places both mother and infant at extremely high risk. There is little information, however, about the impact of changing patterns of drug use and improvements in medical technology on pregnancy outcome. The Family Center Program utilizes a team approach to provide counseling, support, and education as well as complete medical care for substance-abusing pregnant women. We reviewed the records of women seen in the Family Center Program from 1981 to 1983 to evaluate the effect of intervention on pregnancy outcome. Complications, including prematurity, growth retardation, intrauterine fetal demise, and neonatal abstinence, were common, although early prenatal care and frequent visits appear to reduce the risk of low birth weight infants. Uncorrected perinatal mortality was 11/163 (67/1,000). Compared to earlier experience in this program, few women delivered with no prenatal care. Thus a program designed specifically for the needs of these women is successful in increasing the number seeking prenatal care and appears to improve pregnancy outcome. Despite this, serious problems are common and further improvement seems unlikely unless such women can be maintained in a stable, drug-free environment during their pregnancies.

ISSN:0095-2990    

DOI:10.3109/00952998609007394

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

Toxicology studies were performed on a subset of highway fatalities in Alabama. Results of those tests were analyzed for the years 1980 through 1984. It was found that 63% of driver fatalities tested had some level of blood alcohol concentration. From a smaller subset of the fatalities, it was found that almost 17% tested positively for marijuana. More than 5% of fatalities had some level of drugs (either illicit or prescription) in their blood stream. A statistical significant association was found between diazepam (tranquilizer) and low alcohol blood concentration. Another important finding is that for Alabama, marijuana is a problem drug of young drivers.

ISSN:0095-2990    

DOI:10.3109/00952998609007395

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

The occurrence of alcohol problems in opiate addicts on methadone maintenance presents a serious challenge for treatment. Dually addicted patients have a higher incidence of medical and psychiatric complications, consume large amounts of staff and treatment resources, and often exit treatment through administrative detoxification. Yet, little is known about differences in psychopathology between this group and other opioid addicts. This paper summarizes data for 166 male opioid addicts receiving methadone treatment. Alcohol problems were identified, and the relationship between dual addiction and psychopathology was explored. In the first phase of the study the MMPI and Brief MAST (Michigan Alcoholism Screening Test) were administered to 91 subjects. Comparison of Brief MAST scores with program counselors' judgments of the presence or absence of an alcohol problem showed a significant relationship. Cluster analysis of MMPI scores generated three groups. The clusters had significantly different mean MAST scores with the normal cluster having the least indication of alcohol problems, the neurotic cluster intermediate, and the schizoid cluster the greatest indication of problematic alcohol consumption. The second phase of the study with another 75 subjects replicated the relationship between cluster membership and MAST score. The Addiction Severity Index (ASI) was also administered to these subjects, and high correlations between Brief MAST and ASI alcohol problem measures were found. Within-treatment outcome data on a number of measures were then collected for 1 year. Problem drinking severity was negatively related to employment status and positively related to number of random urinalyses indicating illicit drug use. Implications of these findings for refining treatment strategies are discussed.

ISSN:0095-2990    

DOI:10.3109/00952998609007396

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

Hangover following consumption of alcohol includes many disagreeable signs and symptoms that are suggestive of sympathetic overactivity. We performed a randomized, double-blind, crossover controlled study to assess the effect of beta blockade in preventing the symptoms of hangover. Ten subjects were randomized to receive 160 mg of a long-acting preparation of propranolol or a placebo and then participated in a controlled drinking situation. Patients were then evaluated for symptoms and signs of hangover. The results showed that although beta blockade was achieved, there was no clinically important reduction in symptoms of hangover. We conclude that propranolol does not prevent the symptoms of hangover.

ISSN:0095-2990    

DOI:10.3109/00952998609007397

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

Following an extensive initial evaluation, 35 couples with alcoholic husbands decided to participate in couples therapy (acceptors) and 28 couples did not (rejectors). A significant discriminant function indicated that acceptors were characterized by husbands with more education, better marital adjustment, full-time employment, and larger number of alcohol-related arrests. Acceptors also had sought more outpatient help in the past year. Rejectors were characterized by wives with better marital

ISSN:0095-2990    

DOI:10.3109/00952998609007398

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor