摘要:

AbstractAMSAODD's Third National Forum on AIDS and Chemical Dependency presented a session about the theory and practicality of combining pharmacologic and nonpharmacologic treatment modalities to maximize the social, psychological, and physical health of patients. Synthesizing methadone maintenance for opioid dependence with abstinence modalities for cocaine dependence and alcoholism was discussed. Chronic adequate methadone treatment allows normalization of neuroendocrine function, is associated with normal natural killer-cell activity, and has proven efficacious in retaining patients in chemical dependence treatment, and thus decreasing the risk for transmission of HIV infection. Individualization of treatment is then exemplified by four clinical vignettes that were discussed by a panel of experts.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472188

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractMuch of what is accepted as conventional chemical dependence treatment is not supported by rigorous clinical studies. However, the considerable supportive literature and data on methadone treatment has not ensured this treatment modality's acceptance by the medical and/or chemical dependence treatment community. The now obvious connection between AIDS and intravenous drug use demands an objective assessment of and inclusive approach to this problem. The need for effective treatment-both multimodal and acceptable to the addict—is discussed. Data are presented describing the characteristics of a successful methadone program that supports long-term treatment and adequate individual dosing. The disparity between the data and general attitudes toward methadone treatment is discussed. The variable quality among methadone treatment programs is also addressed. urging improved quality of care throughout the modality. It is suggested that quality of life issues are perhaps more important than the drug-free state. Some observations on recoveryoriented methadone treatment are made. A definition of abstinence that provides for appropriate use of licit psychoactive drugs is proposed.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472189

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractHIV infection creates difficulties for patients and staff in drug abuse treatment programs. This article reviews significant problems and coping strategies, drawing on experience in a drug abuse treatment program where a third of the patients are HIV infected. Patient-related problems include denial, anger, depression, and isolation. The coping strategies that patients use can exacerbate their illness. Effective coping strategies may involve the development of mutual-support groups and public education. Staff-related problems include the fear of infection, protecting confidentiality, the need to develop new treatment goals. and recognizing the limitations of drug abuse treatment. To lessen the fears of infection, programs can exercise clear body substance precautions, conduct frequent inservice training, and hold periodic updates for staff. To adequately protect confidentiality, programs can keep up with rapidly changing laws and guidelines. To modify treatment goals, programs can alter admission standards for HIV-infected patients, change treatment methods to minimize the impact of occasional relapses, develop medical referral networks, and give special consideration to counselors who treat HIV-infected patients. To cope with the limitations of drug abuse treatment, programs can support counseling staff in coping with emotionally stressful clinical problems and to avoid burnout.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472190

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472191

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor