Showing papers in "Addiction Research & Theory in 2008"
TL;DR: An acceptance based treatment for self-stigma in individuals in treatment for substance use disorder and initial outcomes showed medium to large effects across a number of variables at post-treatment.
Abstract: Little is known about the assessment and treatment of self-stigma in substance abusing populations. This article describes the development of an acceptance based treatment (Acceptance and Commitment Therapy - ACT) for self-stigma in individuals in treatment for substance use disorder. We report initial outcomes from a study with 88 participants in a residential treatment program. The treatment involves 6 h of a group workshop focused on mindfulness, acceptance, and values work in relation to self-stigma. Preliminary outcomes showed medium to large effects across a number of variables at post-treatment. Results were as expected with one potential process of change, experiential avoidance, but results with other potential mediators were mixed.
286 citations
TL;DR: In this paper, the authors explore whether compulsive buying may be conceived of as a behavioural addiction and identify compulsive buyers' potential ability to regulate mood, using a screened SVM test.
Abstract: This article seeks to explore whether compulsive buying may be conceived of as a behavioural addiction and to identify compulsive buying's potential ability to regulate mood. Utilising a screened s...
116 citations
TL;DR: Logistic regression analyses show that previous treatment, unemployment/institutionalization and having an unstable living situation are the strongest predictors of who is in treatment, followed by age, alcohol dependence and frequency of drinking.
Abstract: In the study “Women and Men in Swedish Alcohol and Drug Treatment,” it is possible to compare alcohol consumption and problems among respondents in the general population with those in clients ente ...
96 citations
TL;DR: In this article, an action theoretical perspective of addiction is introduced, and a composite case scenario is used to understand individual and joint addiction processes over time and within the context of other life processes.
Abstract: This article introduces an action theoretical perspective of addiction. The view that addiction resides solely within the individual continues to foster significant limitations across addiction theorizing, research, and treatment. Exclusive focus on an individual neurobiological level of analysis precludes important additional layers of understanding, for example, the roles of individual and joint human actions, the socially constituting processes of addiction, and the role of gender. Our perspective is that a neurobiological view on addiction is insufficient without consideration of goals, intentionality, relationships, and meaning. Using a composite case scenario, we offer an action theoretical framework for understanding individual and joint addiction processes over time and within the context of other life processes. This integrative framework considers manifest behaviors, internal and communicative processes, and the social meaning of addiction. This article offers a practical application of the theo...
86 citations
TL;DR: In this article, the role of the general tendency to ruminate as a predictor of problem drinking (alcohol abuse) in clinical and community samples was explored, and it was found that depression, rumination and alcohol use were significantly higher for problem drinkers than for social drinkers.
Abstract: The present study explored the role of the general tendency to ruminate as a predictor of problem drinking (alcohol abuse) in clinical and community samples. A sample of 36 patients with a diagnosis of problem drinking and 37 social drinkers from the general population were compared on the following measures: Beck Depression Inventory (BDI), Ruminative Responses Scale (RRS) and Quantity Frequency Scale (QFS). Mann-Whitney U-tests, and logistic and hierarchical regression analyses were performed on the data. Mann-Whitney U-tests revealed that depression, rumination and alcohol use were significantly higher for problem drinkers than for social drinkers. The logistic regression analysis indicated that rumination was an independent predictor of classification as a problem drinker over and above depression. Finally, the hierarchical regression analysis on the combined samples showed that rumination independently predicted alcohol use. These results highlight the potential relevance of targeting the general ten...
65 citations
TL;DR: The authors assessed the recovery process in problem gamblers who had recovered for at least 6 months without formal treatment from those who had had recovered with the assistance of formal treatment and found that the treated recovered gamblers generally had a more severe gambling problem than did the untreated gamblers.
Abstract: Understanding the process by which problem gamblers recover without formal treatment may improve both formal treatments and assist those who wish to modify their gambling behavior without seeking treatment. Study 1 assessed the recovery process in problem gamblers who had recovered for at least 6 months without formal treatment from those who had recovered with the assistance of formal treatment. The treated recovered gamblers generally had a more severe gambling problem than did untreated recovered gamblers, as indicated by a long problem gambling career and more gambling-related negative consequences (e.g., family, health). Study 2 compared two samples of untreated gamblers, those who had recovered without treatment with a comparable sample of active gamblers who also had never received treatment. The active, untreated gamblers had higher lifetime rates of anxiety and personality disorder. Recovered gamblers may match the behaviorally conditioned problem gamblers as described in Blaszczynski's Pathways ...
57 citations
TL;DR: In this paper, the authors explored the moderating role of coping in the relationship between sensitivity to both reward and punishment, and drinking behavior, and found that sensitivity to reward, avoidant and emotion-focused coping strategies were positively related to drinking behavior.
Abstract: In an effort to further understand the role of individual differences in alcohol use, recent research has focused on sensitivity to punishment and reward and the relationship which these predispositions have to substance use. Likewise, considerable research interest has been invested in investigating the role of coping strategies in predicting alcohol use. The current study aimed to expand this research by exploring the moderating role of coping in the relationship between sensitivity to both reward and punishment, and drinking behaviour. A total of 161 participants (55 males; 106 females) completed self-report measures assessing sensitivity to reward and punishment, coping strategies and drinking behaviour. Regression analyses revealed that sensitivity to reward, avoidant and emotion-focused coping strategies were positively related to drinking behaviour. Additionally, emotion-focused strategies were found to moderate the relationship between both sensitivity to reward and punishment, and alcohol use, while avoidant strategies moderated the relationship between sensitivity to reward and drinking. These results suggest a relationship between reward sensitivity and coping in determining alcohol use.
54 citations
TL;DR: In this paper, the authors found that adults with substance use disorders (SUD) often have experienced multiple psychological traumas and suffer from posttraumatic stress disorder (PTSD) and complex PTSD impairments (e.g., dissociation, affect dysregulation).
Abstract: Adults with substance use disorders (SUD) often have experienced multiple psychological traumas and suffer from posttraumatic stress disorder (PTSD) and complex PTSD impairments (e.g., dissociation, affect dysregulation). Among adult addiction treatment outpatients with self-reported trauma histories, 50% had PTSD alone, 41% had comorbid PTSD and complex PTSD, and 4% had complex PTSD alone. Compared to PTSD alone, comorbid PTSD/complex PTSD was associated with a history of childhood sexual trauma, sexual retraumatization in adulthood, and more severe PTSD and depression symptoms. Patients with alcohol-related SUDs were at increased risk for PTSD, while those with cocaine or opiate SUDs had a reduced risk of comorbid PTSD/complex PTSD. Gender and ethnicity were unrelated to PTSD or complex PTSD except that women were at lower risk than men for PTSD alone. Complex PTSD may warrant clinical and research evaluation, particularly for patients with histories of childhood sexual trauma and retraumatization.
51 citations
TL;DR: In this paper, context-specific frameworks that constrain what can be presented as rational when considering psychoactive substances are conceptualised as context specific frameworks, and the implications of this for Australian discourse are discussed.
Abstract: Discourses are conceptualised as context-specific frameworks that constrain what can be presented as rational when considering psychoactive substances. Given the implications of this for Australian...
49 citations
TL;DR: In this article, the use of ketamine in clubbing contexts has been the focus of British media attention, but little quantitative or qualitative data is available on its use amongst those young people participa...
Abstract: Whilst ketamine use in clubbing contexts has recently been the focus of British media attention, little quantitative or qualitative data is available on its use amongst those young people participa...
49 citations
TL;DR: Ketamine has become embedded in a distinctively working class youth dance scene, is accessible in terms of supply and cost, shared among groups of friends and results in a stimulating yet liberating experience beyond that of ecstasy.
Abstract: From the late 1990s onward, ketamine use among young persons in Hong Kong grew rapidly becoming the drug of choice. This article examines ketamine's attraction in Hong Kong, and in so doing aims to uncover the cultural meaning of ketamine use. The analysis explores the emergence and shifts in meanings and experiences of those who initiate and continue to use ketamine. The data stems from a comparative study of the social setting of club drug use in Hong Kong, San Francisco and Rotterdam. We draw from 100 in-depth interviews to examine the experiences of young persons who have used drugs in dance venues in Hong Kong. Our findings indicate that ketamine has become embedded in a distinctively working class youth dance scene, is accessible in terms of supply and cost, shared among groups of friends and results in a stimulating yet liberating experience beyond that of ecstasy.
TL;DR: In this article, the authors examine the content of online forum discussions of ketamine use in light of theories of Beck's risk society and find that online ketamine users are very knowledgeable about the harmful effects of the drug.
Abstract: This article qualitatively examines the content of online forum discussions of ketamine use in light of theories of Beck's risk society. Based on 59 discussions from a reputable harm reduction website, the study finds that online ketamine users are very knowledgeable about the harmful effects of the drug. They view risk and harm as stemming from: (1) the direct physical effects of ketamine; (2) the environment of use; and (3) the economic, social and legal consequence resulting from use. Moreover, they believe that the harmful consequences of use can be mitigated through controlled and safe use practices. These methods of mitigation include practices that ensure the purity of the drug, use in controlled environments with trusted individuals, and limiting the amount and frequency of use. Ultimately, the study finds that online discussions provide a rich exemplar of Beck's theory of contested definitions of risk and harm.
TL;DR: The revised edition of the RCQ[TV] offers researchers and clinicians a shorter and improved measurement of stage of change in the alcohol treatment population and provides evidence of improved construct validity for the revised edition.
Abstract: The UK Alcohol Treatment Trial provided an opportunity to examine the factor structure of the Readiness to Change Questionnaire–Treatment Version (RCQ[TV]) in a large sample (N = 742) of individuals in treatment for alcohol problems who were given the RCQ[TV] at baseline, 3-months and 12-months follow-up. Confirmatory factor analysis of the previously reported factor structure (5 items for each of Precontemplation, Contemplation and Action scales) resulted in a relatively poor fit to the data. Removal of one item from each of the scales resulted in a 12-item instrument for which goodness-of-fit indices were improved, without loss of internal consistency of the three scales, on all three measurement occasions. Inspection of relationships between stage allocation by the new instrument and negative alcohol outcome expectancies provided evidence of improved construct validity for the revised edition of the RCQ[TV]. There was also a strong relationship between stage allocation at 3-months follow-up and outcome...
TL;DR: The results show a close relationship between the cessation of illegal drug use and individuals’ ability to obtain paid employment, and show that abstaining from drug use is unlikely to be successful on its own.
Abstract: The aim of this article is to identify which aspects of drug treatment are most closely associated with recovering drug users’ ability to obtain paid employment. Based on a cohort study of 1033 ind...
TL;DR: The failure to properly conceptualize the constructs of problem and pathological gambling in epidemiological studies has been identified as a serious methodological problem as mentioned in this paper, leading to serious methodological problems in the use of epidemiological instruments.
Abstract: Current instruments used in epidemiological studies suffer serious methodological problems, one being the failure to properly conceptualize the constructs of problem and pathological gambling The
TL;DR: The authors explored the role of changing images of drug use in rap music from the 1970s to the 1990s and found that from 1979 to 1997, songs with references to drugs increased over 6-fold; those exhibiting positive attitudes and consequences rose substantially and that references to particular drug types changed significantly.
Abstract: This article explores the role of changing images of drug use in rap music from the 1970s to the 1990s. A sample of 341 rap music lyrics were coded for drug mentions, behaviours and contexts; drug attitudes and consequences; and music genres. The results show that from 1979–1997, songs with references to drugs increased over 6-fold; those exhibiting positive attitudes and consequences rose substantially and that references to particular drug types changed significantly. In addition, there were significant changes in the social context of drug use such as increased references to using drugs to signify glamour, wealth and sociability. The article examines potential explanations of the increasing focus on drug use rap music which includes the rise of the drug war; changes in the drug use habits of rappers and listeners; rise of gangsta rap and other rap music genres, and changing social images of drugs in American society.
TL;DR: For instance, it is quite true that man lives by bread alone when there is no bread as discussed by the authors. But what happens to man's desire when there are plenty of bread and when his belly is chronically filled?
Abstract: “It is quite true that man lives by bread alone–when there is no bread. But what happens to man's desire when there is plenty of bread and when his belly is chronically filled? At once other (and ‘...
TL;DR: Data indicate that, in order to reduce the potential for an explosive HIV epidemic among Canadian street youth, further interventions are urgently needed to address the high level of syringe sharing among street-involved youth.
Abstract: Syringe sharing continues to play an integral part in HIV epidemics involving injection drug users around the world. We examined the prevalence of syringe sharing among Canadian street youth enrolled in a prospective cohort study known as the At-Risk Youth Study (ARYS), and used logistic regression to examine factors associated with syringe sharing. Among 509 participants, 154 (30%) had injected drugs in the last 6 months and of those 44 (29%) injectors had shared a syringe in the previous 6 months. In logistic regression, being female (adjusted odds ratio [AOR] = 2.31, [95%CI: 1.01–5.28]), binge drug use (AOR = 2.11 [95%CI: 0.99–4.51]) and injection cocaine use (AOR = 2.43 [95%CI: 1.05–5.60]) remained associated with syringe sharing. These data indicate that, in order to reduce the potential for an explosive HIV epidemic among this population, further interventions are urgently needed to address the high level of syringe sharing among street-involved youth.
TL;DR: In this article, it is suggested that an important cultural image of intoxication in some Western societies appears to be "intoxication as ecstasy", intoxication as escape from the everyday into a "wild" and "natural" state.
Abstract: In this article, it is suggested that an important cultural image of intoxication in some Western societies appears to be ‘intoxication as ecstasy’, intoxication as escape from the everyday into a ‘wild’ and ‘natural’ state. The purpose of this article is to discuss this cultural image and its link to gendered ideas about sexuality and, on the basis of this discussion, to develop a hypothesis for further testing. The hypothesis developed proposes that women–via the cultural linking of their sexuality to biological processes of reproduction–are placed closer to nature than men. This makes women's drinking and intoxication seem more dangerous than men's, because drinking and intoxication would seem to make women come even closer to nature. It is suggested that women's ‘dual licentiousness’ threatens the distinction between nature and culture.
TL;DR: Psychonautics refers both to a methodology for describing and explaining the subjective effects of drugs, and to a long established research paradigm in which intellectuals have taken drugs to expl... as mentioned in this paper.
Abstract: Psychonautics refers both to a methodology for describing and explaining the subjective effects of drugs, and to a long established research paradigm in which intellectuals have taken drugs to expl...
TL;DR: Results suggested that having made choices under the influence of alcohol leading to a negative outcome was significantly more prevalent among those with high-discount rates compared to others, also when controlling for alcohol consumption, age, gender and impulsivity.
Abstract: This study addresses whether discounting of future rewards may have an impact on alcohol consumption and propensity to alcohol-related harms, by applying survey data among young people whose drinking career hardly may have affected their time preferences. Analyses from a school survey among 17,000, over 13–17 year olds in Norway showed that discount rates were positively associated with drinking frequency and intoxication frequency when age, gender, impulsivity and disposable income were controlled for. Moreover, the results suggested that having made choices under the influence of alcohol leading to a negative outcome (deliberate self-harm, drunk-driving, vandalism or use of narcotics) was significantly more prevalent among those with high-discount rates compared to others, also when controlling for alcohol consumption, age, gender and impulsivity. The results are discussed in relation to the potential role of discounting in pathways to addictive behaviour.
TL;DR: Additional professional education and training is recommended to familiarize counselors with standardized craving instruments and exposure interventions that hold promise to ameliorate craving.
Abstract: A four-page paper survey was mailed to 500 randomly-selected substance abuse treatment agencies listed in a national directory to evaluate how often specific methods are employed to assess and treat craving in American substance abuse agencies. Of 426 eligible agencies, 149 (35%), located in 41 states, returned 152 usable replies. Although counselors regularly assessed craving during intake evaluations, they rarely used published self-report questionnaires. Almost one-half of respondents made craving a target of treatment with at least a majority (and sometimes all) of their clients, and only 5% of respondents reported never making craving a target of treatment. A variety of interventions are employed to address craving, including coping skills training, encouraging clients to avoid/leave situations where craving occurs, and providing clients with education about craving. We recommend additional professional education and training to familiarize counselors with standardized craving instruments and exposur...
TL;DR: Perceptions of drinking practices, especially of “alcohol abuse”, have shifted with the change in average alcohol consumption, and the higher general consumption the more drinking is allow before it is perceived as abuse.
Abstract: The aims of this study is to demonstrate how perceptions of the concept of “alcohol abuse” have changed over time and to delineate variations among sub-groups of the Norwegian population. An initial survey was conducted in 1964 in 10 Norwegian cities. Follow-up surveys were conducted in 1989 and 2006 based on national, representative samples. From these samples presumably comparable sub-samples have been selected. The respondents characterised 18 different drinking situations as “abuse”, “not abuse” or “doubt”. The 18 drinking situations were constructed based on combinations of three degrees of drinking frequencies, three degrees of intoxication and two degrees of sociability. The different combinations were presented to the respondents on cards, and in a random order. Norwegians’ perceptions of alcohol consumption have undergone major changes, particularly with respect to perceptions of what constitutes “alcohol abuse”. In general, views have become more liberal and permissive. A shift in perceptions si...
TL;DR: The authors examined the multiple and contradictory understandings that participants of a free party (rave) scene in the South West of England drew upon when talking about ketamine, and the role of these understandings in identity and consumption practices.
Abstract: This article examines the multiple and contradictory understandings that participants of a free party (rave) scene in the South West of England drew upon when talking about ketamine, and the role of these understandings in identity and consumption practices. The data is drawn from 19 semi-structured interviews and one focus group conducted in two phases over a period of 17 months with participants associated with a particular sound system. The data was analysed using discourse analysis, identifying three interpretative repertoires namely ‘communality and sociality’; ‘ketamine as alien invader’; and ‘rights and pleasures of extreme intoxication’. Different understandings of ketamine were used to articulate a contradictory set of values about the free party scene, and drawn upon to negotiate the heterogeneity of this scene. This also entailed the negotiation of wider neo-liberal discourses around individual rights and freedoms to consume, and individual regulation and responsibility for these freedoms.
TL;DR: A role for posttrauma symptom-specific alcohol expectancies as a potential link between sexual assault and alcohol consumption is supported and no support was found for symptom- specific expectancies to moderate between assault and drinking.
Abstract: Risk of alcohol use problems is an important clinical concern for women who have been sexually assaulted and experience PTSD symptoms. This study explored this risk by testing a factor structure of an alcohol expectancy questionnaire that assesses beliefs about alcohol's effects on posttraumatic stress symptoms (P-AEQ). Symptom-specific expectancy scores were then tested as predictors of alcohol consumption. Subjects were 96 female undergraduate women who reported being forced to have sex, 68 who experienced pressure to have sex, and 149 who denied any forced or pressured sex. Alternative factor models were tested using Confirmatory Factor Analysis. A four-factor model reflecting posttraumatic stress symptom domains (Intrusions, Avoidance, Arousal, and Numbing) was found. The numbing factor was correlated with drinking among assaulted women; however, no support was found for symptom-specific expectancies to moderate between assault and drinking. Findings supported a role for posttrauma symptom-specific al...
TL;DR: The letter was the more cost-effective intervention when taking into account changes in health service use and savings to the drugs bill, and Savings to the District Health Authority would be a minimum of £4.9 million per annum.
Abstract: Previous findings have indicated that a letter from a patient's General Practitioner (GP) and a short GP consultation leads to reduced intake among long-term benzodiazepine (BZD) users. To compare the cost-effectiveness and potential cost savings of these two brief interventions. Economic evaluation conducted alongside a prospective randomised controlled trial from the perspective of the NHS. A total of 273 long-term BZD users (=>6 mos) at seven general practices and regarded by their GPs as suitable to take part in the study within the Newcastle and North Tyneside District Health Authority were identified from repeat prescription computer records. Patients were randomised to usual GP care + assessment only or the offer of a short consultation (12 mins approx) with the patient's GP (or practice pharmacist/practice nurse) or a letter signed by the GP advising gradual reduction in BZD intake. Economic measures taken were: costs of intervention; savings (costs) of changes in health service use from before to after intervention; savings to the NHS from reductions in drug use and dispensing costs; total costs of brief intervention; simulations of savings (costs) extrapolated to the District Health Authority. The letter was the more cost-effective intervention when taking into account changes in health service use and savings to the drugs bill. If all GPs in Newcastle and North Tyneside screened long-term BZD users on their lists and sent the letter studied here to those considered suitable to receive it, it is estimated that savings to the District Health Authority would be a minimum of £4.9 million per annum. Routine implementation of the letter intervention in general practice throughout the UK would result in large financial gains to the NHS. These savings represent a conservative estimate of savings to the public sector, as wider savings to the social care system may also be expected as a result of the policy.
TL;DR: In this paper, an ethnographical study carried out among an opiate consumer community in Barcelona (Spain) and analyses the meanings that those consumers build and handle around the substances that they consume, emphasizing the point of view of the consumers in their understanding of drugs and the type of relationships that they maintain between themselves and with their social environment.
Abstract: This article reports on the ethnographical study carried out among an opiate consumer community in Barcelona (Spain) and analyses the meanings that those consumers build and handle around the substances that they consume. Our approach emphasises the point of view of the consumers in their understanding of drugs and the type of relationships that they maintain between themselves and with their social environment.
TL;DR: This article investigated whether scores on the Alcohol Related Aggression Questionnaire (ARAQ) were predictable from the independent influences of personality and intra-sexual competition as a predictor of the scores.
Abstract: The current study investigated whether scores on the Alcohol Related Aggression Questionnaire (ARAQ) were predictable from the independent influences of personality and intra-sexual competition as ...
TL;DR: Cannabis-only initiation between 18 and 23 years was most likely among those from non-manual backgrounds who had left school later and were in full time education at 18, and Initiation of other drug(s) between18 and 23 showed some evidence of this ‘student effect’.
Abstract: Among a west of Scotland cohort surveyed at ages 15 (1987), 18, 23 and 30, lifetime prevalence (ever use) of any drugs rose from 9% at 15 to 58% at 23, thereafter increasing little; past year (‘current’) use peaked at age 23 (35%). Cannabis-only rates increased most between ages 15 and 18; ‘hard’ drug use increased steadily with age. There was considerable transitory use, particularly among cannabis-only users and those initiating later. Neither initiation nor use of cannabis only or other drug(s) was raised among those of lower background social class. However, cannabis-only initiation between 18 and 23 years was most likely among those from non-manual backgrounds who had left school later and were in full time education at 18. Initiation of other drug(s) between 18 and 23 also showed some evidence of this ‘student effect’. Measures which fail to distinguish different types of drug use, or the use of broad age bands, may obscure such relationships.
TL;DR: The utility of targeting intervention intensity to the level of substance use is supported and the relationships of initial substance use problem severity and HIV status to efficacy are explored.
Abstract: This article evaluates the efficacy of a 14-session social-cognitive behavioral intervention on problem drinking (and where applicable, drug use) among urban HIV-infected and uninfected mothers, in comparison to a single-session social/motivational intervention, and explores the relationships of initial substance use problem severity and HIV status to efficacy. A randomized controlled trial design was used. Participants (N = 118) were mothers with problem drinking, both HIV-infected (55%) and uninfected, and primarily from racial/ethnic minority and low socioeconomic status backgrounds. Participants were interviewed five times over 18 months. Both intervention arms yielded reductions in alcohol and drug use frequency, alcohol quantity, and alcohol/drug problems, with moderate effect sizes. Those with greater initial substance use maintained reductions over a longer period of time in response to the more intensive social-cognitive intervention. Treatment efficacy did not vary by HIV status. The utility of ...