摘要:

Multiple neurotransmitters in the mesocorticolimbic system that are involved in alcohol's rewarding effects mediate its abuse liability. Abuse liability may be even more pronounced among biologic or early onset alcoholics—characterized by high familial loading and antisocial behaviors—because they may possess abnormalities of serotonin (5-HT) and perhaps &mgr;-opioid function within the mesocorticolimbic system. Therefore, medications such as ondansetron and naltrexone, which target the 5-HT3and &mgr;-opioid receptor systems, respectively, may each be beneficial for treating early onset alcoholism. Additionally, it would be tempting to hypothesize that the combination of ondansetron and naltrexone may be additive or synergistic in treating early onset alcoholism. The authors' first study showed that ondansetron (1, 4, and 16 &mgr;g/kg twice daily) was more efficacious than placebo in treating early onset alcoholism. In a second smaller preliminary study, the authors found that the combination of ondansetron 4 &mgr;g/kg twice daily + naltrexone 25 mg twice daily, compared with placebo, appeared to act synergistically at improving the drinking outcomes of early onset alcoholics. That study did not, however, test the independent effects of ondansetron and naltrexone. The authors concluded that while ondansetron is effective at treating early onset alcoholism, its combination with naltrexone might be associated with greater treatment benefits. Further studies testing the factorial combinations of ondansetron and naltrexone are needed to establish synergism, or at least additivity, of effects in treating early onset alcoholism.

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectivesDual diagnosis patients are difficult to treat because of their noncompliance with follow-up care. The authors believed that the ability to contact these patients after acute psychiatric treatment may be an important first step toward engaging them into treatment. This study examined the factors that are associated with the ability to contact dual diagnosis patients by phone after discharge from a psychiatric emergency room.MethodsThe authors reviewed 6 months of psychiatric emergency room evaluations, collecting data on all dually diagnosed patients. Starting 2 weeks after discharge from their psychiatric emergency room, they called each patient by telephone.ResultsThe authors found that male patients or those with a psychotic diagnosis were much harder to locate by telephone.ConclusionsMore intensive effort is required to be able to contact and engage this vulnerable population into treatment.

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveTreatment of substance use disorders in physicians has become a highly specialized clinical practice. The recognition of comorbid psychiatric disorders for physicians with substance use disorders has been slower to evolve than with the general field of addiction treatment and service research. This study examines the role of psychiatric comorbidity for physicians with substance use disorders along a number of dimensions.MethodsSeventy-three (73) subjects were assessed on initial clinical characteristics, treatment experiences, and post-treatment functioning variables.Results and ConclusionsThe percentage of physicians suffering from comorbid psychiatric disorders was 60.3%. These physicians scored higher on indices of psychiatric severity but not on indices of substance use severity. Treatment experiences were similar. The physicians with psychiatric comorbidity were equivalent to those with substance use disorders alone on most follow-up measures but continued to report higher levels of psychologic distress. Future research and clinical initiatives are recommended.

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectivesThe goal of this study was to assess the characteristics and treatment success rate (outcome) among Iranian opioid addicts.MethodsThe data were gathered (using DSM-IV criteria) from 437 opioid addicts seeking treatment in 1998.ResultsThe subjects' mean age was 35.6 years, and 72.8% were married. Of these subjects, 34.1% listed secondary school, 25.9% listed primary school, and 23.6% listed high school as their level of education. Of these subjects, 26.1% were unemployed, 24.5% were laborers, and 22.4% were drivers. About 49.4% reported opium, 31.8% reported heroin, 12.4% reported cooked dross, and 6.4% reported other opioids as the substance currently used. Of the 437 addicts, the majority (54%) did not complete the detoxification phase, 35% had experienced abstinence at least for 3 months, and 11% relapsed before 3 months of abstinence were completed. The relation was statistically significant between outcome and type of opioid used and also between dose of opioid used and outcome.ConclusionsThe most commonly used opioids were opium, heroin, and cooked dross. During the last few years, some demographic characteristics of Iranian addicts have changed. Cultural attitudes toward drug use are quite likely to affect types and amount of use and also treatment outcome. These findings can be considered when planning preventive and therapeutic programs.

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID