摘要:

Next to Blacks, Mexican-Americans are the largest ethnic minority group among the visible opioid addict population in the United States. Although commonly grouped together with Puerto Ricans and other Spanish-speaking peoples under the rubric“Hispanic,”Mexican-Americans have a unique culture and ethnohistory. In this report we review the clinical and research literature and present new data from studies of Mexican-American opioid users in San Antonio. Mexican-American addicts tend to use fewer classes of illicit drugs and are less likely to use stimulants and psychedelics than Whites or Blacks. Onset of daily opioid use occurs at an early age, typically around 20, yet first voluntary admission to treatment usually occurs later than it does for other ethnic groups. Mexican-American addicts tend to be arrested more frequently and spend significantly more years in correctional institutions, but there is also evidence that they spend more time voluntarily abstinent and employed during their careers. The duration of the career is prolonged, however, and typically exceeds 20 years. Mexican-Americans prefer individual to group treatment, and are especially unlikely to participate in traditional therapeutic communities and group psychotherapies. The Mexican-American client is the least likely to complete treatment without adverse termination. The literature seems unanimous in calling for more treatment of Mexican-American addicts by Mexican-American therapists, but we found little empirical outcome data which demonstrated that ethnic matching of therapist and client brings better results.

ISSN:0095-2990    

DOI:10.3109/00952998409001475

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor

摘要:

Although they developed from different backgrounds, therapeutic communities and methadone maintenance programs became major treatments of heroin abuse in the 1970s. Research published in the last 5 years demonstrates that therapeutic communities are associated with long-lasting improvements in functioning for the few drug abusers who stay in treatment at least 3 months. A principal limitation of this modality is that few patients remain in treatment long enough to acquire the changed values that produce long-lasting effects. Research on methadone maintenance continues to show that this treatment produces immediate decreases in criminality and drug abuse; however, patients who taper off of maintenance are prone to relapse. The aspects of treatment that appear to prevent relapse include minimizing withdrawal symptoms during tapering and providing support during and after completing maintenance. The strengths of these two treatment modalities can be combined to enable narcotic addicts to taper off of methadone maintenance in a therapeutic community and remain drug-free. Several other clinical, administrative, and research collaborations could be beneficial, pooling the medical/technical expertise of maintenance programs with the intensity of therapeutic community treatment.We studied 108 heroin-dependent patients who had been“stabilized”on methadone, i.e., had no change in methadone dose for at least 2 weeks. With respect to their methadone detoxification regimen, 65 of the study patients preferred physician regulation and 43 study patients preferred self-regulation. Half of each group was randomly assigned to self- or physician regulation. Twenty-five of the 108 patients reached abstinence following a regimen which lasted 22 weeks; there was no statistically significant difference in proportion of subjects reaching abstinence from any of the four study groups. We observed no differences in treatment retention, symptom severity, frequency of urines positive for morphine or quinine, or psychosocial functioning. Study subjects preferring self-regulation had statistically significant increases in the number of dose raises. We conclude that there is no evidence to support the belief that physician regulation is superior to self-regulation in opioid detoxification regimens.

ISSN:0095-2990    

DOI:10.3109/00952998409001476

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor

摘要:

We studied 108 heroindependent patients who had been“stabilized”on methadone, i.e., had no change in methadone dose for at least 2 weeks. With respect to their methadone detoxification regimen, 65 of the study patients preferred physician reg- ulation and 43 study patients preferred self-regulation. Half of each group was randomly assigned to self- or physician regulation. Twenty-five of the 108 patients reached abstinence following a regimen which lasted 22 weeks; there was no statistically significant difference in proportion of subjects reaching abstinence from any of the four study groups. We observed no differences in treatment retention, symptom severity, frequency of urines positive for morphine or quinine, or psycho- social functioning. Study subjects preferring self-regulation had statistically signif- icant increases in the number of dose raises. We conclude that there is no evidence to support the belief that physician regulation is superior to self-regulation in opioid detoxification regimens.

ISSN:0095-2990    

DOI:10.3109/00952998409001477

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor

摘要:

This project analyzed the impact of state regulation and control measures on per capita apparent distilled spirits consumption using a 25-year period, 1955-1980. The project was an effort to determine if statistically significant associations between regulation of spirits and per capita consumption could be found for the 48 states of the continental United States. A series of regression models was employed to obtain estimates of the effects of a set of independent variables, including (1) alcoholic beverage control laws, (2) price and price-related variables, and (3) social/cultural control variables on apparent distilled spirits consumption. Most previous studies of the relationship of restrictions on spirits availability have led to a belief that control efforts have little or no impact on per capita consumption. This study was undertaken with the expectation of similar findings. What was found instead was that certain laws and regulations do seem to play a significant role in holding down distilled spirits consumption. The regression models developed predict a decrease of about two drinks per month per person if the state was to shift its regulatory laws (including the price of liquor, which is not always subject to regulation) from being relatively loose to being relatively strict. This decrease in drinking would cut down the level of consumption in the median state by nearly one-fourth.

ISSN:0095-2990    

DOI:10.3109/00952998409001478

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor

摘要:

While recent literature on individual and family therapy has increasingly focused on the nature and use of paradoxical styles of intervention, little has been published concerning the use of paradox in alcoholism counseling. Alcoholism represents a type of problem that can lend itself to the use of such interventions. This paper first reviews the nature of paradoxical styles of intervention in relation to alcoholism. It then presents three developmentally determined paradoxical dynamics: intensification, paradoxical shifting, and differentiation. These are defined and examples from case studies are given for each. Therapists working with alcoholics are encouraged to consider the use of these patterns of response with their clients.

ISSN:0095-2990    

DOI:10.3109/00952998409001479

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor

摘要:

In an effort to assess alcoholism service needs, the social indicators technique was employed. Data on 15 relevant indicators were collected. A three-step analysis was performed. First, cluster/multiple discriminant analyses were conducted to obtain scores reflecting the clustering of cases. Second, factor analysis was employed to derive scores spanning the space covered by the 15 variables. Third, results of both strategies were combined to obtain an overall need index score for each area.

ISSN:0095-2990    

DOI:10.3109/00952998409001480

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor

摘要:

Having validated the Munich Alcoholism Test in three different countries (Germany, Spain, and Ecuador), it was determined that five of the 31 items of the test were very consistent in revealing similarities among these three alcoholic populations.

ISSN:0095-2990    

DOI:10.3109/00952998409001481

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor

摘要:

The decision to recommend alcoholism treatment for convicted drinking drivers is examined for a treatment program in Western New York. A total of 2,061 client files were abstracted for these analyses. The Mortimer-Filkins score and the blood alcohol concentration at the time of arrest were the two best discriminating variables in the decision to recommend treatment in these analyses. When these scores were high, additional information was not needed. However, when these scores were in the low or midranges, other variables became crucial to the decision-making process. Further investigation of variables not available in these analyses is needed to determine the decision-making process for clients with low or midrange Mortimer-Filkins and BAC scores.

ISSN:0095-2990    

DOI:10.3109/00952998409001482

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor

摘要:

A group of 15 patients being treated for anorexia nervosa were diagnostically examined for alcoholism. Using Landeen's diagnostic questionnaire, it was found that 33% scored“likely”and another 27% scored“uncertain”for alcoholism with the rest“unlikely.”This is a significantly higher rate than for the general population where 8.2% of those over the age of 14 are reported as problem drinkers including alcoholics. 67% of the subjects also reported drinking problems among relatives which is comparable to any group of diagnosed alcoholics. It is speculated that anorexia nervosa can be an addictive process with similarities to other addictions including alcoholism.

ISSN:0095-2990    

DOI:10.3109/00952998409001483

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor

摘要:

Family structure is related to adolescents' drinking behavior differently for Blacks than Whites. Black adolescents were more likely to be heavy alcohol users when both natural parents were present, but the opposite was true for the whites. Only when non-White adolescents were in families with both parents, and the father had at least a high school education, did they drink near the rate of White adolescents. There was support of social learning theory.

ISSN:0095-2990    

DOI:10.3109/00952998409001484

出版商:Taylor&Francis    

年代:1984

数据来源: Taylor