摘要:

AbstractFive expert discourses on addiction purport to explain the phenomenon of the semantics of addiction. An assessment of the burgeoning use of this term by the lay public, however, reveals a plethora of socially contextualized and culturally mediated meanings related to addiction that are generally not considered by expert models. Addiction has meanings that index the loss of self-control and individual responsibility, as well as political and moral meanings and meanings that index social modes of consumption, the range and limits of normative behavior, and the constitution of deviance. The category of addiction interacts with other socially produced categories, including“drugs”and“desires,”and implies an unfolding history linked to specific cultural conventions of what is proper. This paper briefly reviews expert debates over the meanings of addiction and explores the semantics of how this term is used in both popular discourse and among those who use substances associated with physical addiction. In addition, some, of the more interesting theoretical issues this discussion brings to light are highlighted, with the intent to identify issues warranting future research that will broaden the study of addiction.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472483

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractThe addictive nature of nicotine appears to depend on a number of psychobiological factors. This study explores the psychoactive effects of nicotine in relationship to the particular dysphoric aspects of Attention Deficit Disorder as a coincident factor in nicotine dependence and resistance to treatment. The psychological and behavioral effects of nicotine directly correspond to reduction in symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) and the neurochemical effects of nicotine are qualitatively similar to stimulant medications used to treat ADHD. Aspects of the treatment of nicotine or other addictions in such comorbid situations are discussed in the context of self-medication.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472484

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractDespite numerous research studies demonstrating the efficacy of methadone maintenance treatment (MMT) in general and the value of retention in particular, the increasing defunding of this modality has compromised its potential. From 1990 to 1995 the lead author conducted a longitudinal research project to determine the impact of the cost of treatment on 233 San Francisco Bay Area study participants seeking, enrolled in, or defunded from MMT. This paper reports on selected findings from that study. Using variables of drug use, crime, gender and HIV risk, qualitative and quantitative results comparing those seeking treatment with those enrolled in treatment indicated that MMT functioned as a harm-reduction tool. When clients were defunded, however, drug use, crime and HIV risk increased and harm was maximized.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472485

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractChanging paradigms of health care and increasing knowledge of opioid addiction continue to influence the attitudes of the health profession toward methadone maintenance treatment (MMT) This approach has again reached the forefront of attention because of its significant role in reducing HIV transmission associated with intravenous drug use. In spite of the well-documented benefits of MMT, patients continue to detoxify from methadone for a variety of reasons both overt and covert. Variable outcomes and generally poor long-term abstinence rates result. At present uncertainty still exists surrounding who should attempt detoxification, when or how this should be done, or whether in fact detoxification should be attempted at all. This article describes and examines factors that are positively and negatively associated with detoxification outcome. Evidence for the interrelationship of two notably significant determinants, affective states and protracted withdrawal, are presented and discussed as they relate to theories of relapse and outcome.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472486

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractThe goal of this study was to identify factors associated with six- and 12-month retention in methadone maintenance treatment programs (MMTPs) in Massachusetts and Connecticut. Data was obtained from 674 participants, clinic records, and clinic staff. Ethnographic and logistic regression analyses were conducted. Overall, 69% and 48% of the clients remained in treatment at six months and 12 months, respectively. The MMTPs were categorized as either a 12-Step, case management, or primary care model. Factors independently associated with retention in treatment at six months were each one-year increase in age of client (OR 1.05), injecting at three months (OR 0.47), and enrollment in the primary care model (OR 2.10). The same factors were associated with 12-month retention in treatment. To retain clients in MMTPs—which should, in turn, help reduce drug use and prevent HIV transmission among IDUs—younger IDUs and clients still injecting at three months after entering drug treatment may need additional services from the staff, or alternative treatment regimens. MMTP directors should consider differences between these programs and, if appropriate, make changes to increase retention in treatment.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472487

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractThis paper investigates the supposedly psychedelicBufotoad and the allegedly psychedelic drug bufotenine, which is contained in the skin and glands of this toad. TheBufotoad has held a place in human mythologies and medicines worldwide since archaic times. Used by ancient peoples for a variety of purposes, its most spectacular effects, according to lore, involve magical and shamanic or occult uses for casting spells and for divination. In the Middle Ages, theBufotoad was celebrated as a panacea and persecuted as a powerful poison. More recently, in the 1960s theBufotoad was resurrected as a countercultural icon, with people purportedly licking or smoking the secretions to get high. Bufotenine has been at the center of a scientific debate since its discovery in 1893. This paper examines the extensive literature surrounding theBufotoad and bufotenine, and untangles many of the myths and the misinformation that continue to vex both science and popular reporting. Finally, to promote further investigation, a comprehensive bibliography is provided that charts the history of theBufotoad and bufotenine.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472488

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractThis article presents an initial evaluation of a community-based substance abuse treatment program for probationers described in a previous issue of theJournnl of Psychoactive Drugs[27(1): 39–47]. Posurealmenl outcomes for 492 probationers remanded to a six-month residential facility were assessed. Based on official stale records, 9% of the probationers were rearrested in the six months following discharge from treatment. Those who graduated from the program were significantly less likely to be rearrested during the follow-up interval than were program expulsions and transfers to other programs. Also, program graduates who auended a specialized residential aftercare program were more likely to remain drug-free and be employed after treatment than were those who did nol attend the specialized aftercare program. Collectively, results suggest that lower rearrest rates may be associated with the provision of residental treatment to substance-abusing probationers.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472489

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractBeginning therapists sometimes make mistakes when working with substance abusers in groups. This article discusses ten common errors that the author has observed. Five center on the therapist's approach and five center on the nuts and bolts of group leadership. Suggestions are offered for how to avoid them.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472490

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractThe authors conducted an open-label trial of pemoline, a dopaminergic CNS stimulant, for the treatment of cocaine addiction in methadone-maintained patients. Ten patients who met DSM-111-R criteria for cocaine dependence participated in an eight-week study. Findings showed that 50% of patients were discontinued from the study due to complaints of side-effects. Patients who completed treatment submitted 79% positive urine toxicology screens over the course of the study. Patients who dropped out tended to submit fewer cocaine-positive urine screens than treatment completers. In view of suggestions that dopaminergic agents in the treatment of addictions may be enhanced when combined with serotonergic agents, a single-case study of pemoline plus fenfluramine is also reported. Except for one urine sample, all of this patient's urine screens were positive for cocaine. Although findings from these studies do not support the effectiveness of pemoline for the treatment of cocaine abuse in methadone-maintained patients, conclusions must be qualified by the lack of a control group.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472491

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor

摘要:

AbstractCocaine dependence continues to be a major public health problem and efforts to develop pharmacotherapies have been disappointing. Chronic cocaine use is believed to cause catecholamine depletion and similarities exist between cocaine withdrawal and major depression. Tyrosine is the dietary precursor to catecholamines and has yielded positive results in small trials of its antidepressant efficacy. Tyrosine 2 g every 8 hours was administered on an open-label basis to 49 cocaine-dependent individuals, as an adjunct to intensive outpatient drug abuse counseling. Retention in treatment at 90 days was compared to data from a control group of 80 subjects who had received 10 mg of imipramine per day in an earlier trial. Median retention was 17 days in both groups. No side effects were reported by the subjects receiving tyrosine. These results do not support the utility of tyrosine in the treatment of cocaine dependence.

ISSN:0279-1072    

DOI:10.1080/02791072.1996.10472492

出版商:Taylor&Francis Group    

年代:1996

数据来源: Taylor