摘要:

ABSTRACTDespite the widespread use of psychotherapy as treatment for cocaine abuse, the effectiveness of psychotherapy has not been explored through clinical trials. Forty-two outpatients who met DSM-III criteria for cocaine abuse were randomly assigned to one of two forms of purely psychotherapeutic treatments of cocain abuse, either relapse prevention (RPT) or interpersonal psychotherapy (IPT). Subjects assigned to relapse prevention were more likely than subjects in IPT to attain three or more continuous weeks of abstinence (57 versus 33%), be classified as recovered at the point of treatment termination (43 versus 19%), and complete treatment (67 versus 38%). Whereas these differences did not reach statistical significance, significant differences by treatment group did emerge when subjects were stratified by severity of substance use: Among the subgroup of more severe users, subjects who received RPT were significantly more likely to achieve abstinence (54 versus 9%) and be classified as recovered (54 versus 0%). Among the subgroups of subjects with lower severity of substance abuse, outcome was comparable for both treatment types. Comparison of results from this investigation with historical controls from a structurally similar pharmacotherapy trial suggests that purely psychotherapeutic treatments may be both viable and effective approaches for many ambulatory cocaine abusers.

ISSN:0095-2990    

DOI:10.3109/00952999109027549

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

ABSTRACTA variety of promising pharmcotherapies, psychotherapies, and other treatments for cocaine abuse have recently been developed, many of which may facilitate the initiation of abstinence in cocaine abusers. This paper describes specific interventions and therapeutic strategies used in the treatment of cocaine abuse, adapted from Marlatt's theory of relapse prevention. These strategies extend Marlatt's primarily psychoeducational approach to address the unique difficulties presented in the treatment of cocaine abuse, which may include wide variations in patients' severity of abuse, available psychosocial resources, and coexistent psychopathology. This approach attempts to integrate relapse prevention techniques into a psychotherapeutic, rather than a purely psychoeducational approach, in order to enhance its effectiveness with cocaine abusers.

ISSN:0095-2990    

DOI:10.3109/00952999109027550

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The Problem Opium addiction was prevalent in the United States from the early 1800s to the early 1900s, when about 250,000 opiate-dependent persons lived in the United States [1]. After the Narcotic Act of 1914, opium addiction essentially disappeared from the United States until it reappeared among Indochinese refugees during the last decade [2]. This paper reports on the demographic characteristics and opium use patterns in a group of Asian opium addicts presenting voluntarily for assessment and treatment.

ISSN:0095-2990    

DOI:10.3109/00952999109027551

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

ABSTRACTThe behavioral circumstances related to opiate drug use were examined during a 90-day outpatient methadone detoxification. Seventy-one subjects (55 male and 16 female) were followed from the day of intake to treatment termination. Data were collected by means of a weekly structured interview. Questions were asked about each occasion of opiate use in the previous week with respect to time, source, cost, social circumstance, etc. Monitored urine samples were tested x3/week to verify verbal reports. The study demonstrated beneficial effects of the detoxification treatment by showing dramatic decreases in rates and amounts of opiate drug use during treatment. The study also identified race (p<. 0008;t= -3.522; beta = -0.366), gender (p<. 0243;t= 2.305; beta = 0.222), and the number of opiate use episodes/week at baseline (p<. 0013;t= -3.364; beta = -0.338) as significant and independent predictors of treatment outcome. Current duration of regular and continuous opiate use was also found to be marginally significant. The overall regression was highly significant (p<. 0001;F= 9.176;df= 4,66). A second regression analysis with race, age, and gender excluded as independent variables was conducted in order to derive indices which were related to behavioral and environmental characteristics versus global physical/cultural identification. With race and gender removed, the overall regression was still highly significant, although less than a fifth of the variance was accounted for. The number of opiate use episodes/week at baseline and the total number of drug-related stimulus cue exposures at baseline were found to be independently significant variables in the analysis. Knowledge of the impact of such behavioral factors on the treatment process may enable us to better understand the role of environmental contributors to opiate use. Such information may also help us to direct our limited resources and to better focus our treatment interventions.

ISSN:0095-2990    

DOI:10.3109/00952999109027552

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

ABSTRACTThe study of the dexamethasone suppression test (DST) in 374 chronic psychiatric patients with concurrent substance dependence, including alcohol, found 97% of nonsuppression associated with affective disorders. The incidence of nonsuppression was 38.5% in major depressive disorder and 27.7% in bipolar affective disorder. This study found no apparent connection between the incidence of nonsuppression and any particular drug group. Predex amethasone plasma concentrations were higher in affective disorders than in other diagnoses. It is concluded that the DST may be of value as part of the clinical approach to the diagnosis of major depressive disorders in a substance-abusing population.

ISSN:0095-2990    

DOI:10.3109/00952999109027553

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

ABSTRACTA study comparing abrupt and gradual opiate detoxification which identified the efficacy by means of computer-assisted pupilometry and rating of withdrawal distress is presented. This paper concentrates on the efficacies of these two detoxification modes with regard to the identical results after successful opiate detoxification treatment. The findings of the present investigation support the hypothesis that withdrawal distress returns to a normal level after rapid naloxone withdrawal treatment within 6 days. Similar results can be seen for inpatient methadone withdrawal after 3 weeks of treatment. These results indicate that by rapid detoxification therapy, the time of withdrawal can be effectively shortened. Considering the low dropout rate and the high degree of acceptance during rapid detoxification, the rapid detoxification regimen is an effective and economic alternative to gradual withdrawal treatments.

ISSN:0095-2990    

DOI:10.3109/00952999109027554

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

ABSTRACTIn a group of 71 inpatient schizophrenics with no other concurrent psychiatric diagnosis except for dependence on one drug, we ascertained the subjective effect their drug of abuse had on their psychiatric symptoms 2 weeks prior to hospitalization. Psychiatric symptoms were assessed by means of the Hopkins Symptom Checklist (Revised) (SCL-90R). Cocaine addicts, but not alcoholics, reported aggravation more often than improvement of symptoms. Alcoholics reported alcohol-induced symptom improvement with a similar frequency as alcohol-induced symptom aggravation.

ISSN:0095-2990    

DOI:10.3109/00952999109027555

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

ABSTRACTWith lifetime prevalence estimates of substance abuse among schizophrenics as high as 47.01 %, there is an increasing awareness of the importance of this dual diagnosis and the global deficiencies in our knowledge about this comorbid condition. Patients with substance abuse disorders and schizophrenia are problematic from a clinical, economic, and health care systems perspective. The lack of systematic research into phenomenology, etiology, and treatment approaches (both psychotherapeutic and psychopharmacologic) has hindered the development of an adequate strategy to care for the needs of these patients. Thus, these patients place a significant burden on the mental health delivery system through chronic disability, social dysfunction, frequent rehospitalizations, and poor overall treatment compliance. The authors critically review the contemporary literature relevant to concurrent substance abuse and schizophrenia, highlight major deficiencies in our knowledge, and call for research to reduce the individual, economic, and social costs of this condition.

ISSN:0095-2990    

DOI:10.3109/00952999109027556

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

ABSTRACTRisk-taking behaviors were studied in this assessment of 345 intravenous drug users from Baltimore, El Paso, and Denver. Over 50% reported injecting drugs daily and 70% shared needles with others, averaging 6.3 partners. In addition, 86% had shared a“cooker”and nearly 50% injected in a“shooting gallery.”More than half of the males sampled had two or more sex partners, including 18% with five or more. Females averaged 19 sex partners in the preceding 6 months, with 22% reporting sex with five or more. Two-thirds of the total sample never used a condom, while only 6% always used this form of protection. On the other end of this risk continuum were those subjects who did not share needles or always cleaned their needles with an effective agent, had no sexual relations or always used a condom. Subjects following such practices could be considered low risk if they adopted safe behaviors in other associated areas of their lives. However, in an analysis of total risk, it was found that only 14 subjects (4%) practiced safe needle use and safe sex. Despite these findings, some encouraging results were seen. In an analysis of risk according to location, Baltimore subjects were significantly less at risk according to number of needle-sharing partners, borrowing needles, sharing a“cooker,”injection in a“shooting gallery,”cleaning needles, use of disinfectants, number of sexual partners, and use of condoms than either their cohorts in El Paso or Denver. Street outreach to modity risk behaviors among IVDUs began in Baltimore approximately 2 years prior to funding in El Paso and Denver. These results suggest that there may be a potential to moderate risk through intervention.

ISSN:0095-2990    

DOI:10.3109/00952999109027557

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

ABSTRACTWe compared retention in treatment and psychological reactions during drug abuse treatment by 22 HIV-antibody positive, physically asymptomatic cocaine addicts to 22 matched HIV-seronegative cocaine addicts. All subjects participated in an outpatient clinical research project. There were no significant differences between groups in sociodemographics and psychiatric symptom scores on entrance or cocaine use except for route of administration (x2= 11.59,df=2,p<. 005). There were no significant differences among groups regarding being informed of serostatus and beginning treatment. There was a trend (p=. 079) for more seropositives to complete treatment. Using end-point analysis to compare 11 seropositive subjects who completed a minimum of 2 weeks of treatment to a matched seronegative comparison groups, there were no significant differences in mood states except for“anger/hostility”(interaction of group time;F= 2.24,df= 13/260,p<. 05). Informing drug abusers in treatment regarding positive HIV-serostatus was not associated with a lower treatment-retention rate or adverse psychological reactions when counseling regarding HIV issues was integrated with drug abuse treatment.

ISSN:0095-2990    

DOI:10.3109/00952999109027558

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor