ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The role of impulsivity in substance abuse has recently received increased attention from both researchers and clinicians. Although past studies and treatment primarily focused on compulsive aspects of substance use associated with craving, it is becoming apparent that impulsivity is also a factor in the initiation and maintenance of substance use disorders. This article presents data from the authors' group and others showing that individuals with substance abuse have higher impulsivity than non–substance-using populations and that impulsivity has a negative impact on substance abuse treatment. Other data are presented showing that children and adolescents who have the highest rates of later substance abuse also have increased impulsivity. Finally, evidence that drugs of abuse can increase impulsivity as measured in the human behavioral laboratory are presented. These results support impulsivity as being both a risk factor and a consequence of substance abuse. In light of these findings, the authors discuss pharmacologic and behavioral methods of decreasing the effect of impulsivity on substance abuse treatment.

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectivesIn the United States, outpatient acupuncture treatment of patients with drug and alcohol addictions has been provided for more than 20 years. Although positive effects were shown in control studies, the effectiveness of acupuncture treatment in drug addiction is not well-established and is still disputed. During the past few years, interest in acupuncture treatment has increased in Germany. It is occasionally provided in inpatient and outpatient settings for detoxification purposes.MethodsThis longitudinal study evaluates a low-threshold outpatient acupuncture treatment project in Hamburg. During 8 months of documentation, 159 patients were included in the study—96% of all the patients being treated. The majority participated in only a few acupuncture visits. After 2 weeks, half of the patients had already finished treatment. This study focused on 30 patients who participated in at least four follow-up assessments during the treatment.ResultsThe results show a significant decrease of withdrawal symptoms, a slight improvement of the physical and mental state, and a reduction of alcohol and cocaine consumption.ConclusionsBecause of the great number of patients who dropped out soon after the beginning of acupuncture treatment, the sample size is rather low. Therefore, this study only shows preliminary results regarding the efficiency of acupuncture treatment of patients with drug and alcohol addictions. However, there is some evidence that acupuncture might be an effective form of therapy, especially for patients with problematic cocaine use.

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThis article describes a two-group outcome study designed to evaluate the feasibility and potential efficacy of cognitive–behavioral therapy (CBT) in conjunction with pharmacotherapy for dually diagnosed patients (bipolar disorder and substance use disorder).MethodsForty-six randomly assigned outpatients received up to 12 weeks of medication monitoring (MM) plus individual CBT (MM + CBT) or MM only.ResultsSixty percent of subjects in the MM + CBT group completed treatment compared with 33% of subjects in the MM group (P< 0.08), with session attendance significantly higher in the MM + CBT group (P< 0.01). The two groups did not differ in substance use outcomes during treatment, but there was some indication of greater improvement in the MM + CBT group with regard to outcomes related to medication compliance and mood symptoms.ConclusionsThis article documents a preliminary attempt to develop and evaluate a new, integrated treatment approach for patients with bipolar disorder who have coexisting substance abuse, and to address effectively those aspects of bipolar disorder that are not impacted by medication alone.

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectivesThis study assessed the effect of a 4-mg/d sublingual dosage of buprenorphine in the maintenance treatment of Iranian patients with opioid dependency by comparison with a 1-mg/d dosage over a 24-week treatment period. As a secondary objective, results were determined concurrently for patients treated with a 2-mg/d dosage.MethodsPatients were randomized to three dosage groups. The participants included 420 consecutive patients (407 men and 13 women) with opioid dependency who met the criteria for opioid dependence of theDiagnostic and Statistical Manual of Mental Disorders, 4th edition, and were seeking treatment. Patients received a 1-, 2-, or 4-mg/d dosage of buprenorphine and were treated in an outpatient clinic (in Shiraz, Iran, with a population of approximately 1.5 million), including a 1-hour weekly clinical counseling session. Measurements included Addiction Severity Index, retention in treatment, and illegal opioid use as determined by random urine toxicology.ResultsThe mean age was 36.3 years (SD, 11.3; range, 16–72). Overall, 237 (56.4%) of the patients completed the 24-week study. Completion rates by dosage group were 45.7% for the 1-mg group, 55.7% for the 2-mg group, and 62.9% for the 4-mg group (&khgr;2= 14.0,df= 2,P< 0.001). No sex difference was observed (&khgr;2= 0.04,df= 1,P= 0.84).ConclusionsThe results support the efficacy and safety of buprenorphine for opioid dependence and suggest that an adequate dosage of buprenorphine is strongly recommended for Iranian patients with opioid dependence to increase their success rate.

ISSN:1531-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveSoon after termination of withdrawal, many detoxified heroin addiction patients experience affective instability (i.e., depression, dysphoria, anxiety), insomnia, and craving for opiates. Previously, the authors have described these symptoms as the syndrome of anhedonia (SA). The search for novel pharmacologic agents able to optimize treatment of this syndrome is an important component in the prevention of future relapses and stabilization of remissions. This study examines the new pharmacologic treatment of SA. The choice of antidepressants as possible medication for SA is based on the fact that depressive symptoms are the most prominent features of SA. The authors compare the effect of the selective serotonin reuptake inhibitor citalopram on SA with the tricyclic antidepressant amitriptyline and placebo.MethodsImmediately after detoxification, 73 heroin addiction patients were randomly assigned to one of three groups: 26 patients received 20 mg/d citalopram during 3 weeks; 24 patients received 75 mg/d amitriptyline; and 23 patients received placebo.ResultsThe results of the randomized, single-blind, placebo-controlled study showed that both medications, citalopram and amitriptyline, are more effective than placebo in treatment of SA. However, patients in the amitriptyline group reported a statistically greater number of side effects in comparison with patients in the two other groups.ConclusionCitalopram significantly reduces the severity of SA in patients with heroin addiction.

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