摘要:

This study was designed to assess gender differences in high-risk sex behaviors related to the transmission of HIV among injection drug users (IDUs) and crack smokers. Using a standard national survey instrument, 593 verified drug users were questioned about their sexual activities and drug use in the 30-day period prior to the interview. High-risk sex behaviors included nonuse of condoms, exchanging sex for drugs or money, sex with an IDU, and sex with more than one partner. Results showed that IDUs who engaged in needle risk practices were more likely to report nonuse of condoms than IDUs who practiced safer needle use. African-American ethnicity was a more powerful determinant of exchanging sex than smoking crack cocaine. Sex with more than one partner in the previous 30 day was reported by 11% of married males and 15% of married females. Independently, marital status was found to be a marker for high-risk sex behaviors, in particular, sex with an IDU and nonuse of condoms, behaviors reported more often by married than unmarried respondents. Needle risk, more common among females than males, was associated with sex with an IDU. Approximately one-fourth of the injectors reporting sex with only non-IDUs also reported needle risk, sex with more than one partner, and nonuse of condoms. These findings show the dual threat drug injectors face for HIV infection, through sex and needle risk behaviors, and the pivotal role IDUs play in the heterosexual transmission of HIV to noninjectors.

ISSN:0095-2990    

DOI:10.3109/00952999509002708

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Although advocacy and coordination are recognized as important aspects of the addictions treatment process, little research has been done in these areas. The present study examined advocacy and coordination at two programs where the mandate was assessment, referral, and case management. Both programs spent a similar proportion of client-related effort on advocacy and/or coordination (about 25% of contact time, accounting for about half of contacts made regarding clients). The majority of advocacy and coordination contacts were with other agencies about clients (the remainder with family and friends of clients). A framework for advocacy and coordination was developed that allowed contacts to be categorized into mutually exclusive advocacy or coordination activities. Advocacy was defined as any activity undertaken to obtain something for clients; coordination involved the giving or receiving of information regarding specific clients. Sources of variability in the provision of advocacy and coordination were found between the programs that could be attributed to differences between the systems within which the programs operated, as well as differences in program clientele. In terms of client characteristics, it was found that females were more likely than males to receive advocacy; those over 65 years were most likely to receive both advocacy and coordination; those who were referred by school or employer or by corrections were most likely to receive coordination; those with no prior treatment were most likely to receive advocacy; and self-referrals and those who had had prior treatment were most likely to receive neither advocacy nor coordination. Receiving advocacy or coordination was not found to reduce the need by clients for other case management services, such as supportive counseling. The findings are discussed in terms of the need for knowledge regarding highly variable aspects of treatment such as advocacy and coordination. New research approaches (as taken in the present study) are needed to begin to examine the contribution of these types of flexible and ancillary interventions to the recovery process.

ISSN:0095-2990    

DOI:10.3109/00952999509002709

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

To determine the reliability of serial naloxone challenges, five heroin addicts stabilized on methadone were given 0.2 mg naloxone intravenously on three consecutive days. Two-factor ANOVA revealed that the between-subjects effect accounted for at least 63% of the variance in each of the dependent measures, and the effect of challenge number for at most 22%. Withdrawal tended to be slightly more severe for the first challenge. Intraclass correlation coefficients were calculated for the area-under-the-curve of the change from baseline: subject-rated (.74) and observer-rated (.71) withdrawal, pulse (.88), systolic blood pressure (.58), diastolic blood pressure (.85), and skin temperature (.63).

ISSN:0095-2990    

DOI:10.3109/00952999509002710

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

We conducted a double-blind, randomized clinical trial of mazindol (n= 37) for the prevention of relapse to cocaine abuse in methadone-maintained patients who were in the“action”stage of change, i.e., had a history of cocaine dependence but who had been abstinent for at least 2 weeks prior to entry into the study. Eight-one percent of subjects completed the 12-week course of treatment. Overall, cocaine use during the study was comparatively low–17% of the urine screens submitted were positive for cocaine metabolite. Differences between the mazindol and placebo groups of rates of relapse, number of days to relapse, and cocaine use did not reach statistical significance, but were in the direction of a treatment effect. Results suggest that stage of abstinence initiation may be a potentially useful category to employ as an independent variable in future pharmacotherapy trials for the treatment of cocaine addiction in this patient population.

ISSN:0095-2990    

DOI:10.3109/00952999509002711

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

The Expected Treatment Outcome Scales was developed to gather information on clients who abuse drugs or alcohol, to assess their severity of illness, and to evaluate the effectiveness of drug treatment in nonrandomized clinical studies. The scale is based upon a multiattribute value model reflecting the opinions of an expert panel. The experts identified 25 variables, or predictors of relapse, from which 48 questions were constructed. Answers to the questions are individually scored. These scores are summed to produce an overall Expected Treatment Outcome score. This paper focuses on the development and preliminary validation of the Expected Treatment Outcome Scale. Results of our analysis show a correlation of. 89 between the experts' average ratings of hypothetical clients and scores based on our scale. This finding suggests that the Expected Treatment Outcome Scale has face validity and accurately simulates the experts' judgments regarding treatment outcome. Further research is necessary to assess the reliability as well as the concurrent and predictive validity of our instrument.

ISSN:0095-2990    

DOI:10.3109/00952999509002712

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Gender differences in risk and protective factors for substance use/abuse in early adulthood were studied. Comprehensive systematic data on African-American males (N= 318) and females (N= 322), from birth to 7 years of age, were available from the National Collaborative Perinatal Study. These subjects were retrieved for assessment at average age 24. There are more differences between males and females than there are similarities in regard to the early childhood variables that predict substance use in early adulthood. However, high activity and intensity of response during infancy (measured at 8 months of age) was found to predict later substance use for both males and females. This type of behavior is considered by us to be a trait of temperament and to suggest the possibility of a genetic predisposition. More risk factors were found for female than for males. The risk factors for females were primarily of two types: 1) Related to experiences with mother and with the family environment; and 2) Poor levels of intellectual functioning and academic performance, and abnormal mental status.

ISSN:0095-2990    

DOI:10.3109/00952999509002713

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

An open clinical trial was conducted to compare the effects of rapid (1-day) admission with slow (14-day) admission to methadone maintenance on pretreatment attrition, retention during treatment, and other outcomes. One hundred eighty-six illicit opioid users eligible for methadone maintenance were randomly assigned to rapid admission or slow admission, with 93 subjects assigned to each group. The random assignment produced two groups that were similar on 22 personal variables. All subjects admitted to treatment were followed for 1 year. Follow-up interviews were obtained with 155 (98%) of the 158 subjects admitted to treatment. During the period from initial contact to medication, only 4% of the rapid admission subjects but 26% of the slow admission subjects dropped out. The risk of dropout during slow admission was 6 times that during rapid admission. A higher percentage of rapid admission subjects, 43%, than of slow admission subjects, 39%, remained continuously in treatment for 1 year, but the difference was not significant. The two subgroups that remained in treatment for 1 year did about equally well on measures of illicit drug use and social performance. The findings indicate that pretreatment attrition can be markedly reduced by prompt medication, and that prompt medication does not adversely affect retention during treatment or other outcomes.

ISSN:0095-2990    

DOI:10.3109/00952999509002714

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

In the past decade, ambulatory medical detoxification for alcohol withdrawal has become increasingly utilized due to pressures to contain cost of treatment and research demonstrating its effectiveness. The research that describes this area spans the last 15 years. This article reviews the available literature on ambulatory detoxification and attempts to summarize and synthesize what is known about this area in order to make ambulatory medical detoxification readily reproducible in clinical practice. Finally, this article concludes with an analysis of the advantages and disadvantages of outpatient alcohol detoxification as compared to inpatient treatment.

ISSN:0095-2990    

DOI:10.3109/00952999509002715

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

This study examined the accuracy of the Diagnostic Interview Schedule (DIS) for indicating alcohol use disorder in a sample of patients hospitalized for depression. The Michigan Alcoholism Screening Test (MAST), with its established validity, was considered a good criterion against which to evaluate the DIS, and preferable to the clinician-assigned diagnosis in this regard. The rates of alcoholism in the sample were 31, 33, and 22.5% as yielded by the DIS, MAST, and physician's diagnosis of alcohol disorder, respectively. (The lower rate for physician's diagnosis may be due to the physician's not applying this diagnosis to recovered or currently abstinent alcohol patients.) Using the MAST's standard cutoff of five points as indicative of alcoholism, agreement with the DIS occurred in 91% of the cases, corresponding to a product moment coefficient of. 79. It was concluded that the DIS alcoholism scale could be used, with reasonable confidence in its validity, for assessing alcoholism in psychiatric settings.

ISSN:0095-2990    

DOI:10.3109/00952999509002716

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

The present study examines the association between breath alcohol concentration (BAC) at arrest and problem drinking for a sample of 1,283 male DWI offenders in the US Army. The results indicated a moderate but statistically significant association between BAC at arrest and DSM-III diagnosis. BAC's ability to indicate problem drinking was also compared with the diagnostic ability of three well-known, paper-and-pencil instruments designed for that purpose. BAC performed as well in identifying problems with alcohol as did the MAST, the MacAndrew Scale of the MMPI, and the Vaillant.

ISSN:0095-2990    

DOI:10.3109/00952999509002717

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor