摘要:

Cocaine is becoming a major drug of abuse among the general population and among opiate addicts. Reports from the early 1970s found that most abusers were older Black males with some antisocial characteristics. Cocaine abuse at that time was reported by about 17% of opiate addicts seeking treatment and by 7 to 11% of ex-addicts on methadone maintenance. However, that rate increased dramatically during the 1970s, and in our 1980 study of 533 addicts we found that 74% of opiate addicts applying for treatment used cocaine. It was the second most abused nonopioid drug after marijuana, surpassing alcohol intoxication. Although the mean number of days of abuse over the previous 30 days was substantially lower among the addicts on our methadone maintenance program (x = 1.4 days,n= 120) than among the addicts applying for treatment (x = 9 days,n= 204), the following associations with cocaine abuse were consistent in both subsamples. Cocaine abuse was more frequent among Blacks. It was associated with a variety of antisocial indices including Research Diagnostic Criteria antisocial personality disorder, number of arrests, and legal, family, employment, and drug abuse problems as assessed by the Addiction Severity Index and the Social Adjustment Scale. Several differences emerged between Black and White cocaine-abusing addicts, the most interesting being an increased rate of anxiety disorders among White cocaine abusers. Based on these associations, we offer several guidelines for treating cocaine abuse in opiate addicts.

ISSN:0095-2990    

DOI:10.3109/00952998609083739

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

A group of 30 hospitalized cocaine abusers were studied, along with 124 hospitalized patients who were dependent upon opiates or central nervous system depressants. DSM-III diagnoses, family history data, demographic characteristics, and measures of current depressive symptomatology were compared in the two groups. Nineteen (63%) of the cocaine abusers met criteria for an Axis I diagnosis other than substance abuse; sixteen (53%) had affective disorder. These figures reflected a significantly higher prevalence rate of affective disorder among the cocaine abusers than among the opiate and depressant abusers. In addition, a significantly higher rate of affective disorder was found in the first degree relatives of the cocaine abusers when compared to the other group. Since these findings suggest that a substantial number of cocaine abusers may be suffering from other psychiatric disorders, careful diagnostic evaluation is indicated in this population.

ISSN:0095-2990    

DOI:10.3109/00952998609083740

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

The Moos Community Oriented Program Environment Scale (COPES) was administered to 482 adolescent clients and 291 drug counselors in 30 outpatient and 27 residential drug treatment programs. Both clients and staff of residential programs were found to rate their programs more positively than did clients and staff of outpatient programs in the following specific ways: (1)“encourage and provide more support”; (2)“provide more practical help,”such as training; (3)“more concern with clients' personal problems”; and (4)“encourage clients to argue, express anger, and display aggressive behavior.”The only COPES factor on which the outpatient programs were perceived as superior to residential programs was“spontaneity”(“The program encourages clients to act openly and to express their feelings openly”). Across both types of programs, staff perceived the programs significantly more positively than did clients. The male staff ratings were the most positive of the ratings of the four subgroups. Female clients rated the program environments more positively than did male clients, but female staff did not rate the program environments more positively relative to male staff. Since the female staff ratings tend to be somewhat more similar to the ratings of the clients, both male and female, than did the male staff ratings, it might seem reasonable to hypothesize that the female staff ratings are more valid than the male staff ratings.

ISSN:0095-2990    

DOI:10.3109/00952998609083741

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

The Moos Community Oriented Program Environment Scale (COPES) was administered to 244 adolescent clients and 131 drug counselors in 30“drug-free”outpatient drug treatment programs. Four of the COPES factor scores were found to predict significantly to treatment outcome (as measured by reduction in drug use): client ratings of“Spontaneiety,”and staff ratings of“Personal Problem Orientation,”“Practical Problem Orientation,”and“Order and Organization.”The more positive the ratings of the program environments, the greater the reduction in client-reported drug use from admission to discharge. The“discrepancies”(differences) between staff and client perceptions of the programs on two of the COPES factors (“Autonomy”and“Staff Control”) were also found to predict significantly to treatment outcome (as measured by reduction in drug use). The greater the discrepancy, the less successful was the treatment outcome. In the programs in which the clients tended to perceive the staff as less encouraging of client autonomy and as exercising more control over the clients relative to the staffs perceptions of these relationships, the clients tended to have less successful treatment outcomes. One possible interpretation of this finding might be that in the programs which have client populations that are more poorly motivated and more resistant to treatment, the clients will not only tend to have poorer treatment outcomes but will also perceive the program environment more negatively and thus will tend to disagree more with the staff's perceptions of the program.

ISSN:0095-2990    

DOI:10.3109/00952998609083742

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

Subjects (n= 108) who volunteered to participate in a study in which they expected to smoke marijuana were asked, as part of a screening procedure, to rate the harmfulness of a number of illicit drugs including marijuana. Subjects were separated into three groups according to their reported history of use of marijuana. The three groups were: (1) naive users (at least 1 but no more than 25 incidences of use in a lifetime), (2) light users (1 to 3 incidences of use per week), and (3) heavy users (at least 5 incidences of use per week). Groups did not differ in terms of their perceived harmfulness of any of the drugs. Cluster analyses of the results for each group and for the total group indicated three distinct clusters: the drugs perceived to be the most harmful were heroin, morphine, and LSD; drugs perceived to be less harmful were cocaine, amphetamines, barbiturates, and nicotine; and the drugs perceived to be the least harmful were caffeine and marijuana, with marijuana being judged the least harmful of all the drugs.

ISSN:0095-2990    

DOI:10.3109/00952998609083743

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

Subjective responses to intravenous heroin and cocaine administration were investigated by questionnaire in a population of 40 male and 29 female confirmed heroin addicts. Responses of males and females were very similar for the heroin rush, ranking pleasure, relaxation, satisfaction, warmth, and thirst highest among 20 feelings surveyed and ranking feelings like sexual orgasm low, only fifteenth out of 20. Responses of males and females for the cocaine rush were similar in that both ranked excitement, pleasure, thirst, strength, and anxiety very high, in the top six responses, and both rated feelings like sexual orgasm relatively low, rank 9 for males and 15 for females. However, male and female responses for cocaine differed in that males ranked power very high, rank 2; and females ranked power relatively low, rank 10; but ranked satisfaction, rank 5; warmth, rank 5; and relaxation, rank 12; much higher than males who ranked them 15, 16, and 17, respectively. Despite the fact that sexual feelings were infrequently identified with rushes, the results best supported an interpretation that the population was largely inorgasmic without drugs, but found attractive orgasmic pleasure in heroin and cocaine. Males and females perceived the cocaine rush differently, but the reason for these differences is uncertain.

ISSN:0095-2990    

DOI:10.3109/00952998609083744

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

We compared the maternal and birth characteristics of 87 first-year dropouts with 103 active participants of a pediatric clinic which provides long-term follow-up care to offspring exposedin uteroto substance abuse mothers. The age, ethnicity, and marital status of the mother; the type of drug used during pregnancy; and the length, gender, number, and type of addiction problems of the newborn were not significantly different between the two groups. However, the dropouts differed significantly from the active participants in many other aspects. More dropout mothers received no prenatal care and did not have children at home at the time of the present birth. More of them were smokers; had gonorrhea, heart, and kidney problems; and had infections complicating their pregnancy. The dropout newborns were found to have lower birthweight and shorter gestation. These clinical parameters defined a suboptimal group of mothers and children requiring more attention and care. The findings also alert investigators of long-term follow-up studies to be aware of basic differences between nonparticipants and participants.

ISSN:0095-2990    

DOI:10.3109/00952998609083745

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

Prior research had shown that alcohol and drug abuse treatments were effective and that the results of treatments could be predicted from pretreatment information regarding the patient's employment, family, and especially psychiatric problems. However, this research had been conducted entirely with adult male service veterans, largely from lower socioeconomic strata. Three treatment centers were included in the present study to examine these conclusions with other populations containing adolescents, females, and patients from higher socioeconomic strata. Data from the Addiction Severity Index was collected at treatment admission and again at independent follow-up, 6 months later. Results confirmed prior observations. Both alcohol and drug abuse treatments showed substantial improvements in the chemical use problems of their patients and in the important areas of employment, criminal behavior, family relations, and psychological health. As in earlier reports, a global measure of the nature and extent of pretreatment psychiatric problems was the single best predictor of treatment response for both alcoholics and drug-dependent samples.

ISSN:0095-2990    

DOI:10.3109/00952998609083746

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

Blood alcohol levels (BALs) were determined for all homicide victims in Erie County, New York, between 1973 and August 1984. These data were compared with similar data for Los Angeles (L.A.) County, California. The overall percentage of victims with blood alcohol levels of 0.01g% or more was lower in Erie County compared to L.A. County. However, when race and sex were examined as variables in this context, there were interesting differences between the two counties. For instance, there was a higher percentage of Black victims with positive BALS relative to negative BALs in L.A. County, but a higher percentage of White victims with positive BALs relative to negative BALs in Erie County. In Erie County there was a higher percentage of female victims with positive compared to negative BALS, whereas in L.A. County less than half the female victims had positive BALs.

ISSN:0095-2990    

DOI:10.3109/00952998609083747

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor

摘要:

To investigate the construct validity of a proposed 10-factor alcoholism diagnostic profile, a principal components analysis was performed on the responses of 1,535 alcoholic inpatients to a questionnaire designed to assess functioning in a number of life areas. A total of 16 components, explaining 50% of the total variance, were retained for rotation and interpretation. On this basis it is recommended that consideration be given to additional factor areas in the proposed profile. It is suggested that factor profiles from the proposed model might be of use in formulating predictions regarding treatment completion. To evaluate the likelihood of this suggestion, a stepwise discriminant analysis was performed using scale scores for the 16 components and the additional variable of age in an attempt to differentiate between treatment completers and premature discharges in the sample. The discriminant function which resulted contained 12 of the 17 variables available and served to correctly identify 62.5% of the premature discharges. Cautions are expressed regarding generalizations from the results of both analyses. It is concluded that evidence was obtained for both the construct validity of the factors in the proposed model and of the potential clinical use of the resultant profiles. Although substantial research and development is required, the proposed model seems to offer numerous advantages over the diagnostic approaches currently available.

ISSN:0095-2990    

DOI:10.3109/00952998609083748

出版商:Taylor&Francis    

年代:1986

数据来源: Taylor