摘要:

AbstractThis paper discusses the possible role of neurological dysfunction in the frequent treatment-resistance of dual diagnosis patients. Through case vignettes, the complex treatment process of three dual diagnosis patients is presented. Each case demonstrates how in addition to both psychiatric and substance abuse problems, the patients also experienced neurological difficulties that made treatment even more complicated. The authors suggest that treatment providers should carefully screen for neurological disorders among this patient population. Attending to such comorbid difficulties in addition to patients' psychiatric and substance abuse problems may sometimes play a pivotal role in enabling patients to attain abstinence. The authors also speculate concerning the role of neurological dysfunction in the etiology of the dual diagnosis syndrome in at least a subgroup of dual diagnosis patients.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524383

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractThe diagnosis of depression has been viewed as an important factor in the treatment response for those who have alcohol and other drug dependence. The objective of the study was to examine the prevalence of a lifetime history of major depression in inpatients with a substance use disorder in addictions treatment. An evaluation study of 6,355 patients was conducted in inpatient and outpatient addictions treatment programs from 41 sites. Subjects were required to have a substance use disorder and to be evaluated for a lifetime diagnosis of major depression according to DSM-III-R criteria. The rate of a lifetime diagnosis of major depression was 43.7%. The most common diagnosis was alcohol dependence, followed by cocaine dependence, and cannabis dependence). Depression was associated in significantly greater numbers with diagnoses involving drugs other than alcohol, in females greater than in males, with number and frequency of use, and in inpatient programs more than outpatient programs. The rates for continuous abstinence at one year did not differ between those with and without a lifetime history of depression.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524384

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractMen and women in recovery from addiction were compared on levels of depression, guilt, and shame. The measurement of guilt included subscales of Survivor Guilt, Separation Guilt. Omnipotent Responsibility Guilt, Trait Guilt, State Guilt, and Adaptive Guilt. The sample included 75 men and 33 women in treatment in a residential treatment community. It was found that women were significantly higher than men in depression. The recovering subjects were compared to nonaddicted subjects and estahlished norms, and it was found that the recovering people were higher on depression, shame, and the subscales of maladaptive guilt. Both men and women in recovery were significantly lower than norms in adaptive guilt.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524385

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractThis study examines gender differences in 16 social and psychological problems among substance abusers and nonsubstance abusers in a community population to determine whether such differences are simply a reflection of differences between men and women in the general population. Data were gathered from 119 respondents using the Addiction Severity Index. Loglinear analysis suggests that problems typically attributed to“being a female substance abuser”may be due to the effect of gender or substance abuse alone. Only two problems significantly distinguish female substance abusers from the other comparison groups: psychiatric hospitalizations and relatives with substance abuse. However, women in the overall sample were more troubled by family problems, had more parents with psychiatric problems, and received more outpatient psychiatric treatment. Problems associated with substance abuse, not gender, include divorce, problems controlling violence, and parents with substance abuse problems. These findings suggest that substance-abusing women experience a“double whammy”because they incur both the problems of women and the problems of substance abusers. Disaggregating gender and substance abuse effects has implications for treatment-matching and relapse prevention, specifically for suggesting strategies that address the special vulnerabilities of substance-abusing women.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524386

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractAs many as one-half to three-fourths of homeless persons have diagnoses of alcohol or other drug dependence. Rates of alcohol and other drug use disorders, and the social costs associated with untreated substance disorder, are higher among homeless than nonhomeless persons. Despite the high level of need for treatment, relatively few substance-abusing homeless individuals receive treatment for their drug problems, suggesting difficulties in accessing treatment. This study addresses access by focusing on the select group of homeless drug users who have overcome barriers to enter the substance abuse treatment system in California and by examining differences between these homeless treatment clients and nonhomeless drug-using clients. Major findings from bivariate and logistic regression analyses performed on 187 homeless and 1,820 nonhomeless treatment clients are that homeless clients were more likely than nonhomeless clients to have a primary drug problem of cocaine/crack and to be injecting methamphetamine and other amphetamines, and that they were no less likely to complete their treatment program. An implication of this study is that homeless persons with primary drug problems appear to have no less commitment to achieving treatment goals than their nonhomeless counterparts.†This study was facilitated by a RAND Drug Policy Research Center postdoctoral fellowship to the first author funded by the General Mills Foundation and the Ford Foundation. The authors would like to thank the California Department of Alcohol and Drug Programs, the UCLA Drug Abuse Research Center, and Carol Edwards and C. Peter Rydell of RAND Corporation.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524387

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractThere is growing interest in a number of medications with proven clinical efficacy or potential for treating substance abuse. At the same time, many treatment programs make little, if any, use of pharmacotherapy. The reasons for this circumstance are not clear. An exploratory survey using focus groups and telephone interviews with medical personnel and administrators from 38 programs and three professional associations suggests that program staff perceive a variety of drawbacks to pharmacotherapy, which may help account for the lack of more widespread use of this treatment modality.†The research reported in this article was supported by the U.S. Department of Health and Human Services, National Institute on Drug Abuse, contract number 271-90-2200. Opinions stated in the article are those of the author and do not necessarily represent the position or policies of the U.S. Department of Health and Human Services.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524388

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractThis paper presents the rationale for and description of the empirical curriculum development process in Project Towards No Drug Abuse (Project TND), which is a five-year grant funded by the National Institute on Drug Abuse. First, the target population is described, continuation high-school youths who are at high risk for drug abuse. The rationale for developing a classroom-based curriculum tailored for them is also provided. Second, a brief description is provided of state-of-the-art generic social influences drug abuse prevention programming, which has been found to be the most effective among young adolescents. There is a the need to consider other prevention activities, particularly those that include motivational variables, to maximize prevention efforts among higher-risk youths. Third, five types of curriculum development studies are discussed that led to a curriculum that is being implemented with continuation high-school students at schools in five counties in southern California. Finally, the contents of the final curriculum product is provided, which consists of motivation, skills-training, and decision-making components.†This research was supported by grant DA07601 from the National Institute on Drug Abuse.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524389

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractFlunitrazepam (Rohypnol) is a benzodiazepine sedative-hypnotic that has generated significant media attention in the United States because of its abuse and its association with“date rape.”A field investigation was conducted in south Texas to ascertain the nature and consequences of the abuse of flunitrazepam. In semistructured interviews, 66 subjects identified as flunitrazepam users were asked about their use of alcohol and other drugs and their sexual behaviors. Many subjects identified the drugs they had used as“roches”and gave descriptions of tablets of other benzodiazepines that were not consistent with flunitrazepam. Almost all subjects used other drugs, primarily alcohol and marijuana. Adverse consequences included amnesia, discoordination, automobile accidents, sexual assault, and respiratory depression or arrest. A significant proportion of the subjects reported that continued use was unappealing to them. The abuse of sedative-hypnotics in southeast Texas involves several benzodiazepines and is not limited to flunitrazepam.†This research was funded in part by a grant from Hoffmann-La Roche Pharmaceuticals to the Haight Ashbury Free Clinics. The research team also appreciates the assistance of Jane Maxwell, Research Director, Texas Commission on Alcohol and Drug Abuse, Austin, Texas; Avelardo Valdez, Ph.D., Director, Hispanic Research Center, University of Texas at San Antonio; and James Hall, Executive Director, Up Front Drug Information, Miami, Florida.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524390

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractSemistructured interviews were carried out with 20 illicit users of ketamine in Scotland. Participants had used a wide range of illegal drugs. Scottish drug agencies reported limited contact with ketamine users; however, subjects were knowledgeable regarding the licit purpose of ketamine, its effects, and its legal status. Ketamine was usually obtained through diversion from legitimate sources. Three participants reported extensive use, indicating the potential for psychological dependence. A standard dose of ketamine was typically 1/8 g, usually taken intranasally. Participants reported the ketamine experience as being extremely intense and dissociative, usually lasting for approximately one hour. All participants reported using ketamine in a carefully preplanned setting, emphasizing comfort, security, and familiarity. Participants identified potential problems arising from using ketamine in a public place, or in unfamiliar surroundings, and also suggested that novice users may encounter problems through lack of knowledge concerning the intense nature of the experience. Accurate information concerning the effects and nature of ketamine as well as the importance of set and setting should be made available. However, publicizing the drug should be avoided as widespread interest could cause greater problems than currently exist.†This research was funded by Chief Scientist Office, Scottish Office Home and Health Department. The views expressed in this report are those of the authors and not necessarily those of Chief Scientist Office.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524391

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractSniffing of volatile organic solvents containing toluene, such as acrylic paints, glues, adhesives, paint thinners, varnishes and shoe polishes, has become increasingly frequent in recent years. Renal tubular acidosis is one of a number of human complications reported in the offspring of mothers inhaling toluene during pregnancy. This article reports a case of a premature newborn with renal tubular acidosis probably due to maternal sniffing of paint containing toluene. Characteristics of this condition are described as well as its medical management. With increasing frequency of maternal glue and paint sniffing, more cases of newborn renal tubular acidosis will likely appear. Physicians should be prepared to manage neonatal tubular acidosis that may accompany maternal toluene sniffing in order to lessen newborn morbidity and/or mortality.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10524392

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor