摘要:

This paper describes the historical background of the Consensus Standards for Postgraduate Medical Fellowships in Alcoholism and Drug Abuse, developed for the American Academy of Psychiatrists in Alcoholism and Addictions and the Association for Medical Education and Research in Substance Abuse. These standards were prepared by a National Advisory Committee of the Center for Medical Fellowships in Alcoholism and Drag Abuse, which includes 23 leading figures in academic medical training in the addiction field. The standards define general information, facilities and resources, the educational program, and the specific knowledge and skills appropriate to fellowship training. The standards were designed to provide a model for optimal training for residency affiliated fellowships to be used by faculty, trainees, and organizations setting training standards.

ISSN:0095-2990    

DOI:10.3109/00952999108992805

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Crack is a potent form of cocaine which results in rapid and striking stimulant effects when smoked. This paper reviews epidemiological research on the extent of use as well as reports of adverse effects. Crack is used by a small minority of adult and student populations but by a large proportion of cocaine users and heavy drug-using groups. Use does not appear to be increasing in general populations, but there are no trend studies for high-risk groups. Crack users tend to be young, heavy polydrug users, many of whom have serious drug abuse problems. The adverse reactions to crack are similar to those of cocaine and include effects on offspring, neurological and psychiatric problems, as well as pulmonary and cardiac abnormalities. However, two adverse reactions unique to crack have been reported. One relates to lung infiltrates and bronchospasm. The other involves neurological symptoms among children living in crack smoke-filled rooms. There is a need for improved treatment and preventive programs for crack use.

ISSN:0095-2990    

DOI:10.3109/00952999108992806

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

ISSN:0095-2990    

DOI:10.3109/00952999108992807

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

To assess how injection practices may have changed during the course of the AIDS epidemic, active intravenous drug users (IVDUs) recruited from the community were asked to report year of first injection as well as specific details about the first 3 months after initial injection: frequencies of injection, using sterile needles, sharing needles and other equipment. For the analysis, the users were sorted into successive cohorts of initiation (by year of first injection), and tests for trends were completed using Mantel-Haenszel statistics. Among the 421 IVDUs who reported first injection between 1982 and 1987, the use of new sterile needles to self-administer drugs increased (p<. 05) along with its corollary behavior (i.e., using equipment one is sure that no one else had used before). Conversely, there was a decrease in the proportion of those who always used equipment previously used by another IVDU (p<. 05) and a decrease in the number of needle-sharing partners (p<. 01). Over the 6 years, heroin as first drug decreased and cocaine increased (p<. 01). Although these data are from a cross-sectional interview study, they suggest a shift toward lower risk practices among new IVDUs between 1982 and 1987. The shift from heroin to cocaine is compatible with other evidence on the cocaine epidemic.

ISSN:0095-2990    

DOI:10.3109/00952999108992808

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

A total of 189 consecutive new women patients were surveyed at an adult psychiatric outpatient clinic which did not have a specific program for the treatment of alcoholics. Twenty-seven patients (14%) reported a history of heavy alcohol consumption measured by scores of 10 or more on the Michigan Alcoholism Screening Test (MAST), but only 16 had a diagnosis of alcohol abuse or alcohol dependence made by a clinician. Those with a self-reported history of physical and/or sexual abuse had significantly higher scores on the MAST than those with no such history. When the first abuse occurred before the age of 18 years and there was no recent reported abuse, the association of abuse and high MAST scores persisted, suggesting that early physical or sexual abuse may be associated with current levels of alcohol use.

ISSN:0095-2990    

DOI:10.3109/00952999108992809

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

This study provides data about the extent of alcohol use disorders among general adult psychiatric inpatients. The accuracy of alcohol use disorder diagnoses given by the lay-administered Diagnostic Interview Schedule (DIS) and by staff psychiatrists, as compared to each other, was investigated. From consecutive admissions to a private psychiatric hospital, 55 patients with alcohol use disorders were identified by trained research assistants using the DIS (n= 162). A comparison of DIS diagnoses to clinicians' diagnoses revealed that 66 patients (40.7 % of all admissions) were given an alcohol diagnosis by the DISorclinician, 35 patients (21.6%) by DISandclinician, 20 (12.3%) by DIS only, and 11 (6.8%) by clinician only. The two diagnostic approaches were also compared using several accuracy measures (sensitivity and specificity ratios, percentage of agreement, and kappa). With psychiatrists' diagnoses as reference, the DIS sensitivity ratio was 76 and specificity ratio 83. There were 12.3% false positive and 6.8% false negative diagnoses assigned by the DIS. Kappa was. 56 and percentage of agreement 80.9%. Recomputing accuracy measures for the psychiatrist, using the DIS as the reference, clinician assessment sensitivity was 64 and specificity 90. Compared to each other, the DIS“overdiagnosed”and the staff psychiatrists“underdiagnosed”by about 1 in 20 cases. Among those alcohol use diagnoses upon which both clinician and DIS agreed, alcohol abuse was the predominant diagnosis. Among all patients with an alcohol diagnosis, the main nonsubstance abuse diagnoses (as assigned by the clinician) were: major depressive, dysthymic, bipolar, schizophrenic, and personality disorders.

ISSN:0095-2990    

DOI:10.3109/00952999108992810

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

This study examines the overall and relative contributions of a variety of family environment measures to a child's alcohol, marijuana and other drug use, delinquent activity, and dysfunctional methods of coping with problems. The family environment variables tapped aspects of parental behaviors and attitudes, parenting styles, and family harmony and cohesion. Data were collected as part of a prospective, longitudinal study that examined the acquisition and maintenance of a variety of behaviors. Data were gleaned at two points in time, spanning 3-year intervals, from subjects ranging in age from early to late adolescence. In general, alcohol use among the younger subjects was more strongly determined by the use and attitudes of the same sex parent. In contrast, among older subjects, father's alcohol use was important to the offspring's use. While models predicting illicit drug use and the extent of problems related to alcohol and marijuana use fared least well, it was generally found that hostility and lack of warmth on the part of the parents contributed most to these outcomes in subjects. Finally, hostility displayed by both parents helped to determine the incidence of delinquency among sons and the use of dysfunctional coping methods among sons and daughters.

ISSN:0095-2990    

DOI:10.3109/00952999108992811

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Female substance abusers' attributions about the stability and globality of positive and negative life events were used as predictors of successful completion of a halfway-house treatment program. Instead of the typical beneficial effects associated with a self-serving attributional style, subjects who attributed their own recent negative life events to global (wide influence on life) and stable (always present) causes were more likely to successfully complete the treatment program. Subjects who perceived the cause of their first substance abuse (whether alcohol or another drug of abuse) as global and likely to affect substance abuse in the future also were more successful in completing the program. Not surprisingly, subjects who indicated that the cause of their quitting substance abuse was likely to lead them to stay off their drug of abuse in the future were more successful in completing the program. Finally, the amount and helpfulness of social support provided by a subject's AA sponsor were both significantly correlated with program completion. These results are interpreted as consistent with the program's Alcoholics Anonymous philosophical orientation.

ISSN:0095-2990    

DOI:10.3109/00952999108992812

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

A summary is presented of available information regarding the special characteristics and needs of hearing-impaired alcoholics and drug addicts. The various obstacles to this population receiving treatment are seen to be made even more formidable by apparent minimal adherence in the chemical dependency field to the legal mandate that agencies and institutions that receive federal funding must provide services that are accessible to disabled persons. The Illinois Task Force on Substance Abuse Among the Hearing Impaired was established to examine the needs of this population in Illinois. The results of a needs assessment conducted by the Task Force are summarized. The conclusion is reached that the minimal accessibility of hearing-impaired individuals to substance abuse treatment reported in the literature extends to Illinois as well. The concerns of agencies in attempting to meet the needs of this population are cited. Specific recommendations are made to changes in programming intended to improve the level of substance abuse services accessible to hearing-impaired individuals.

ISSN:0095-2990    

DOI:10.3109/00952999108992813

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

ISSN:0095-2990    

DOI:10.3109/00952999108992814

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor