摘要:

Objective:This study assessed the impact of social ties on substance abuse treatment outcome. Two models which predict alternative hypotheses were evaluated. 1) Based on the self-medication model, it was hypothesized that social support would aid in coping with painful affect and decrease the need for drugs. 2) Based on a social learning model, it was hypothesized that drug use in the social network would threaten abstinence due to modeling and conditioning effects.Method:Seventy methadone maintenance patients were given baseline measures of mood, stress, social support, and drug use in the network and followed prospectively for 3 months with weekly urine drug screens.Results:Social support was correlated with positive affect (r=. 59,p<. 001), and stress with negative affect (r=. 46,p<. 001), but no measures of social support, affect, or stress correlated with the proportion of drug positive urines. However, patients with at least one drug user among the closest significant others had 63±38% positive urines versus 35±36% positive among those without a drug-using significant other (t=–3.2,p<. 002).Conclusions:Substance use in the social network had a substantial negative impact on treatment outcome. Consistent with the social learning model and the traditional‘persons, places, and things,’this suggests interventions should get drug-using significant others into treatment and teach patients coping skills to reduce their negative influence.

ISSN:0095-2990    

DOI:10.3109/00952999309001617

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

A procedure is outlined for comparing dependence potential and acute toxicity across a broad range of abused psychoactive substances. Tentative results, based on an extensive literature review of 20 substances, suggested that the margin of safety (“therapeutic index”) varied dramatically between substances. Intravenous heroin appeared to have the greatest risk of dependence and acute lethality; oral psilocybin appeared to have the least. Hazards due to behavioral deficits, perceptual distortion, or chronic illness were not factored into the assessments.

ISSN:0095-2990    

DOI:10.3109/00952999309001618

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

Levels of social competence and maladaptive behaviors were examined among 184 male and 85 female treatment-seeking cocaine abusers. Social competence was assessed based on indices of functioning at work and in relationships, maladaptive behaviors included severity of drug and legal problems, and difficulties in interpersonal relationships. Consistent with developmental interpretations, results indicated that addicts with comorbid depression had higher social competence than those with comorbid antisocial personality disorders. In contrast with research on other psychiatric groups, female addicts had lower social competence than males; however, they also had lower levels of maladaptive behaviors. Findings are discussed in terms of implications for preventive interventions and treatment for drug abusers.

ISSN:0095-2990    

DOI:10.3109/00952999309001619

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

Patterns of HIV infection and IV drug use in 697 Essex and Hudson Counties, New Jersey, 1986–1987 Medical Examiner (ME) cases, aged 15–59 years, were examined. All cases had toxicology tests for drugs and had been autopsied. Postmortem stored sera were blind-tested and confirmed for the presence of HIV-1-antibody by the New Jersey Department of Health. All cases and IV drug users were dichotomized according to the presence/absence of HIV-1-antibody and were then analyzed for differences in demographic and postmortem characteristics. Subjects were predominantly Black men aged 30–44 years; the 119 HIV(+) cases were even more likely to be Black or Hispanic and in the 30–44 age group. Evidence of IV drug use and HIV(+) status were very highly correlated; 86 of 181 IV drug users were HIV(+). There was a low rate of suicide among HIV(+) cases and IV drug users. Only 3 of 63 suicide victims were HIV(+), and they were the only IV drug users whose manner of death was certified as suicide. Cases with toxicology findings of both heroin and cocaine were most likely to be HIV(+), followed in order by those with heroin or cocaine alone present. Cocaine alone was the illicit drug most often present in toxicology tests on all cases. Among IV drug users, heroin with cocaine was most often present.

ISSN:0095-2990    

DOI:10.3109/00952999309001620

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

Two thousand thirty-three hospital emergency room (ER) patients who were current, active injecting drug users (IDUs) were voluntary participants in a pretest, posttest research project which utilized a nursing model, the Personalized Nursing LIGHT Model, as a counseling approach to decrease high-risk AIDS behaviors. The LIGHT Model works by directly improving well-being and thereby indirectly decreasing high-risk behaviors associated with AIDS. Addicts from an urban ER in each of three cities (Detroit, Michigan; Brooklyn, New York; and Baltimore, Maryland) were treated with teams consisting of nurses and indigenous outreach workers. Posttest data were gathered on 995 of the clients who received the Personalized Nursing LIGHT Model teaching and counseling intervention. In a posttest at least 3 months after the initial interview, these IDUs reported a significant increase in well-being, t(530) =−11.77;p<. 001, and significant reductions in frequency of IV heroin use, z =−18.4;p<. 001, IV cocaine use, z =−16.0;p<. 001, and IV speedball use, z =−14.3;p<. 001, as well as significant decreases in sharing of cookers (a type of drug-using equipment), z =−13.8;p<. 001, and other high-risk behaviors associated with AIDS acquisition and transmission. At a second posttest, at least 6 months after the initial interview, these results were unchanged.

ISSN:0095-2990    

DOI:10.3109/00952999309001621

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

In preparation for an exercise program in eocaine abusers maintained abstinent in a hospital setting (average 98.4 days), we measured resting serum creatine kinase (CK). Surprisingly, many were elevated. Further tests confirmed the observation. We measured 19 long abstinent cocaine abusers, 22 abstinent abusers of other substances, and a later group of 26 long abstinent cocaine abusers. While none of the other substance abusers showed elevated serum CK levels, 53 and 31% of the abstinent cocaine groups did (p=. 000082 and. 00041, respectively). All CK elevations were muscle derived; repeated sampling demonstrated stability. Cocaine abusers' CK showed a bimodal distribution: the lower bell curve approximated controls and the higher bell curve centered above normal range, at 400 U/L. Demographics did not influence the results. With complementary findings of impaired spatial motor performance, these persistent CK elevations suggest that a large minority of cocaine abusers maintain tendencies to coarse motor control and impulsive movements, and perhaps hyperactivity.

ISSN:0095-2990    

DOI:10.3109/00952999309001622

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

Clinical impressions and data from a limited number of studies suggest that membership in certain groups such as Alcoholics Anonymous may promote well-being and abstinence from alcohol and drugs. The present study examines measures of religiosity and drug/alcohol consumption in an inpatient psychiatric population in order to test the possible association between these variables. One hundred sixty-eight adult admissions to a private psychiatric hospital were asked to complete the Religious Involvement Questionnaire (RIQ), a self-report instrument containing validated measures of intrinsic and extrinsic religiosity. Responses of general adult psychiatric patients (N= 103) were compared with those of patients admitted to a chemical dependence unit (N= 65). Correlations between alcohol/drug use and RIQ responses were measured for the entire sample. Patients admitted for chemical dependence were significantly less likely than general adult psychiatry patients to avoid certain food/music/drink because of their religion, and were less likely to help with the running of their church. Measures of alcohol, hallucinogen, and prescription drug consumption had significant negative correlations with religiosity scores. Chemically dependent patients differ from psychiatric patients with other diagnoses on measures of religiosity. Religious belief and involvement may be clinically relevant variables in the treatment outcome of chemically dependent patients.

ISSN:0095-2990    

DOI:10.3109/00952999309001623

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

The morbidity risks for alcoholism in the first-degree relatives of a cohort of male cocaine addicts with or without alcoholism comorbidity were studied. Of the 71 patients who participated in our study, 40 (56.3%) had a history of alcoholism and 37 (59.1%) a history of opioid abuse. Twenty-two patients (30.1 %) also met criteria for a lifetime diagnosis of a major psychiatric disorder. Significant increases in morbidity risks for alcoholism were found among male relatives of cocaine addicts with comorbid alcohol dependence when compared with relatives of cocaine addicts with no alcohol comorbidity. Among fathers, risks were. 69 vs. 32 (z= 2.98,p<. 003). Among brothers, risks were. 38 vs. 15 (z= 2.35,p<. 03). Significantly increased risks were also observed in male relatives when probands with a psychiatric diagnosis were excluded from the analyses. Among female relatives, increases in morbidity risks were found but they failed to reach statistical significance. Two interpretations are consistent with these findings. One of these interpretations is that alcoholism is a disorder distinct from other addictions and has its own mode of transmission. The second interpretation is that the transmission of substance use disorders lacks specificity and that the substances selected are influenced by sociocultural or biological factors.

ISSN:0095-2990    

DOI:10.3109/00952999309001624

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

Three hundred and eight subjects were screened over the phone for admission to an inpatient alcohol treatment research unit. Using a structured interview, the prospective patients were asked questions regarding demographics, drinking history, previous treatments, physical health, family history, and a detailed history of past and present substance use. Drug use was studied as regular use versus no use or brief experimental use of five drug categories: cannabinoids, stimulants, sedatives, opiates, and hallucinogens. Fifty-one percent of the men and 48% of the women reported regular use of one or more of the drugs in addition to alcohol. For women, the amount of alcohol intake was positively correlated with use of stimulants (r=. 32,p=. 001), cannabinoids (r=. 24,p=. 019), sedatives (r=. 30,p=. 003), and hallucinogens (r=. 30,p=. 003). For men, correlations between the amount of alcohol intake and drug use were weaker but significant for stimulants (r=. 21,p=. 002), opiates (r=. 15,p=. 028), and hallucinogens (r=. 15,p=. 029). Women with alcoholic mothers displayed higher alcohol intake than women with nonalcoholic mothers (p=. 02) and also showed more frequent use of most drugs. Although men with alcoholic fathers also showed greater alcohol intake compared to men with nonalcoholic fathers, the two groups did not differ in drug use. Younger subjects of both sexes were more likely to use cannabinoids, stimulants, opiates, and hallucinogens. Alcohol and sedative use was relatively constant across all age groups.

ISSN:0095-2990    

DOI:10.3109/00952999309001625

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

One hundred thirty-five individuals seeking help for an alcohol or drug problem from a family physician completed a self-report questionnaire. Eighty-six percent of respondents reported having experienced alcohol-related blackouts. Blackouts were found to be most strongly related to severity of alcohol problems. They were not clearly early-stage nor middle-stage indicators of alcohol problems and were not associated with a variety of neuropsychological indicators.

ISSN:0095-2990    

DOI:10.3109/00952999309001626

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor