Yih-Ing Hser

Bio: Yih-Ing Hser is an academic researcher from University of California, Los Angeles. The author has contributed to research in topics: Substance abuse & Methadone maintenance. The author has an hindex of 59, co-authored 250 publications receiving 12996 citations. Previous affiliations of Yih-Ing Hser include China Medical University (PRC) & University of California, Berkeley.

A 33-year follow-up of narcotics addicts.

Abstract: Background This study examined longitudinal patterns of heroin use, other substance use, health, mental health, employment, criminal involvement, and mortality among heroin addicts Methods The sample was composed of 581 male heroin addicts admitted to the California Civil Addict Program (CAP) during the years 1962 through 1964; CAP was a compulsory drug treatment program for heroin-dependent criminal offenders This 33-year follow-up study updates information previously obtained from admission records and 2 face-to-face interviews conducted in 1974-1975 and 1985-1986; in 1996-1997, at the latest follow-up, 284 were dead and 242 were interviewed Results In 1996-1997, the mean age of the 242 interviewed subjects was 574 years Age, disability, years since first heroin use, and heavy alcohol use were significant correlates of mortality Of the 242 interviewed subjects, 207% tested positive for heroin (with additional 95% urine refusal and 140% incarceration, for whom urinalyses were unavailable), 669% reported tobacco use, 221% were daily alcohol drinkers, and many reported illicit drug use (eg, past-year heroin use was 405%; marijuana, 355%; cocaine, 194%; crack, 103%; amphetamine, 116%) The group also reported high rates of health problems, mental health problems, and criminal justice system involvement Long-term heroin abstinence was associated with less criminality, morbidity, psychological distress, and higher employment Conclusions While the number of deaths increased steadily over time, heroin use patterns were remarkably stable for the group as a whole For some, heroin addiction has been a lifelong condition associated with severe health and social consequences

Treatment of Drug Abuse

Abstract: The major drug-treatment modalities-methadone maintenance, therapeutic communities, outpatient drug-free programs, and some criminal justice system-based treatments such as civil commitment-have all been shown to be successful by most outcome criteria. Programs with flexible policies, goals, and philosophies produce better results than inflexible programs, especially when they adopt combinations of treatment components that are suited to individual clients' problems and needs. Patients' lengths of time in treatment are highly correlated with positive outcomes, but dropout rates are high for most modalities. Clients entering treatment under legal coercion do as well by most outcome criteria as volunteer clients and may stay in treatment longer. The evidence on treatment effectiveness suggests a social policy of expanded treatment capacities and options and increased attention to adequate implementation of treatment programs.

Drug treatment outcomes for adolescents with comorbid mental and substance use disorders.

Abstract: This study compared the pretreatment characteristics and posttreatment outcomes of substance-abusing adolescents with and without comorbid mental disorders in the Drug Abuse Treatment Outcome Studies for Adolescents. Subjects (N = 992) were sampled from 23 adolescent drug treatment programs across three modalities (residential, short-term inpatient, outpatient drug-free). Nearly two thirds (64%) of the sample had at least one comorbid mental disorder, most often conduct disorder. Comorbid youth were more likely to be drug or alcohol dependent and had more problems with family, school, and criminal involvement. Although comorbid youth reduced their drug use and other problem behaviors after treatment, they were more likely to use marijuana and hallucinogens, and to engage in illegal acts in the 12 months after treatment, as compared with the noncomorbid adolescents. Integrated treatment protocols need to be implemented within drug treatment programs in order to improve the outcomes of adolescents with comorbid substance use and mental disorders.

Treatment retention among patients randomized to buprenorphine/naloxone compared to methadone in a multi-site trial.

Abstract: Aims To examine patient and medication characteristics associated with retention and continued illicit opioid use in methadone (MET) versus buprenorphine/naloxone (BUP) treatment for opioid dependence.

The Life Course Perspective on Drug Use: A Conceptual Framework for Understanding Drug Use Trajectories

Abstract: This article discusses the life course perspective on drug use, including conceptual and analytic issues involved in developing the life course framework to explain how drug use trajectories develop during an individual's lifetime and how this knowledge can guide new research and approaches to management of drug dependence. Central concepts include trajectories marked by transitions and social capital and turning points influencing changes. The life course perspective offers an organizing framework for classifying varying drug use trajectories, identifying critical events and factors contributing to the persistence or change in drug use, analytically ordering events that occur during the life span, and determining contributory relationships.

Making Good: How Ex-Convicts Reform and Rebuild Their Lives

Abstract: Can hardened criminals really reform? "Making Good" provides resounding proof that the answer is yes. This book provides a fascinating narrative analysis of the lives of repeat offenders who, by all statistical measures, should have continued on the criminal path but instead have created lives of productivity and purpose. This examination of the phenomenology of "making good" includes an encyclopedic review of the literature on personal reform as well as a practical guide to the use of narratives in offender counseling and rehabilitation.The author's research shows that criminals who desist from crime have constructed powerful narratives that aided them in making sense of their pasts, finding fulfillment in productive behaviors, and feeling in control of their future. Borrowing from the field of narrative psychology, Maruna argues that to truly understand offenders, we must understand the stories that they tell - and that in turn this story-making process has the capacity to transform lives. "Making Good" challenges some of the cherished assumptions of various therapy models for offenders and supports new paradigms for offender rehabilitation. This groundbreaking book is a must read for criminologists, forensic psychologists, lawyers, rehabilitation counselors, or anyone interested in the generative process of change.

Guidelines for the Primary Prevention of Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

Abstract: The aim of this updated statement is to provide comprehensive and timely evidence-based recommendations on the prevention of stroke among individuals who have not previously experienced a stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches to atherosclerotic disease of the cervicocephalic circulation, and antithrombotic treatments for preventing thrombotic and thromboembolic stroke. Further recommendations are provided for genetic and pharmacogenetic testing and for the prevention of stroke in a variety of other specific circumstances, including sickle cell disease and patent foramen ovale.