Showing papers in "American Journal of Drug and Alcohol Abuse in 1978"
TL;DR: The chronic relapsing nature of heroin addiction can be explained from a family systems viewpoint, part of a family pattern involving a complex homeostatic system of interlocking feedback mechanisms that serve to maintain the addiction and consequently the overall family stability.
Abstract: The chronic relapsing nature of heroin addiction can be explained from a family systems viewpoint The addiction cycle is part of a family pattern involving a complex homeostatic system of interloc
113 citations
TL;DR: It was found that it usually took 3 to 5 weeks for this effect to occur, and the possible relationship between drug craving and participation in the naltrexone program is discussed.
Abstract: The level of heroin craving was monitored in patients receiving naltrexone on a regular basis. Meetings and interviews conducted twice weekly attested to a pattern of craving reduction in most but not all the addicts. It was also found that it usually took 3 to 5 weeks for this effect to occur. The possible relationship between drug craving and participation in the naltrexone program is discussed.
41 citations
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TL;DR: The research literature on alcoholism in women is reviewed, with suggestions for treatment and future research suggested, and certain recurring characteristics among alcoholic women are listed.
Abstract: Alcoholism, the most prevalent form of drug dependence, has become a problem for large numbers of women. The research literature on alcoholism in women is reviewed, with suggestions for treatment and future research. The greater stigma placed upon female intoxication has made it difficult to obtain reliable data and has contributed to the tendency to ignore the problem altogether. Furthermore, the greater stigma has resulted in guilt because the woman alcoholic is likely to share society's opinion of herself, and this stigma/guilt/shame factor is viewed by the authors as one of the main difficulties in recovery. Certain recurring characteristics among alcoholic women are listed, and the impact on children is briefly discussed. Treatment suggestions include offering women alternatives during rehabilitation.
36 citations
TL;DR: A woman, previously addicted to other drugs, who became dependent on carisoprodol, and was diagnosed with central nervous system effects comparable to those of meprobamate.
Abstract: Although known to have central nervous system effects comparable to those of meprobamate, carisoprodol has not previously been reported to be a dependence-producing drug. This case report is of a woman, previously addicted to other drugs, who became dependent on carisoprodol.
31 citations
TL;DR: South American Indians have used coca leaf as a remedy for thousands of years and its effects are distinct from those of cocaine, which is but one of a number of active compounds in the leaf.
Abstract: South American Indians have used coca leaf as a remedy for thousands of years. Coca might be useful as a treatment for gastrointestinal ailments and motion sickness, as a fast-acting antidepressant medication, as a substitute stimulant for coffee in certain cases, and as an adjunct in programs of weight reduction and physical fitness. In leaf form, coca does not produce toxicity or dependence. Its effects are distinct from those of cocaine, which is but one of a number of active compounds in the leaf. Coca can be administered as a chewing gum containing a whole extract of the leaf, including alkaloids, natural flavors, and several nutrients. Legal mechanisms exist for importing, distributing, and dispensing coca, and experimentation with it by interested physicians would be valuable.
30 citations
TL;DR: The purpose of this paper will be to provide as complete and current a bibliographic listing as possible of the reports which have emerged in the area up through early 1978.
Abstract: Increasing interest in family factors in the genesis and maintenance of nonalcoholic drug misuse and dependence has resulted in the generation of a large number of publications, particularly since 1973. In addition, a growing number of investigators working in drug abuse areas which have not primarily been family focused, have begun to include more relevant family information in their research efforts. Thus the overall size of the body of literature has increased exponentially. In fact, at least 14 attempts to review or list this literature have been published to date. However, these have limitations, either because they are no longer up-to-date or because they only address circumscribed aspects of the field. The purpose of this paper will be to provide as complete and current a bibliographic listing as possible of the reports which have emerged in the area up through early 1978.
28 citations
TL;DR: The adolescent smoker (aged 14 to 17 years) shows little difference from the non-smoker in terms of scores on the Cattell 16 personality factor inventory, and there is no evidence of tension, extroversion, or reversal of sexually-biased personality characteristics.
Abstract: The adolescent smoker (aged 14 to 17 years) shows little difference from the non-smoker in terms of scores on the Cattell 16 personality factor inventory. In particular, there is no evidence of tension, extroversion, or reversal of sexually-biased personality characteristics. The sexual promiscuity of the adolescent smoker is probably related more to liberal attitudes and a propensity for risk-taking behavior than to uncertainty regarding sexuality. In this age group the decision to start smoking regularly may depend more on the influence of parents and friends than on an inherent personality structure.
27 citations
TL;DR: Determination of temporal sequence in the use of these substances revealed that in 68% regular alcohol abuse preceded narcotic use, and alcohol abusers who were in a methadone maintenance treatment program were significantly younger than those who did not use narcotics, including methamphetamine.
Abstract: Evidence exists that alcohol abuse frequently coexists with narcotic addiction and methadone maintenance treatment, and it is the major factor in the development of cirrhosis and liver failure. This study of patients hospitalized for alcohol detoxification compares the quantity of alcohol consumed by alcohol abusers, addicted to narcotics or in a methadone maintenance treatment program, to that consumed by patients not involved with narcotic addiction. Mean daily alcohol consumption was not significantly different in either group using narcotics, including methadone, or in the subgroup of methadone maintenance patients, from the amount consumed by nonnarcotic abusers. Determination of temporal sequence in the use of these substances revealed that in 68% regular alcohol abuse preceded narcotic use. Alcohol abuse reportedly began after entering a methadone maintenance treatment program in 29% of our patients. Alcohol abusers who were in a methadone maintenance treatment program were significantly younger than those who did not use narcotics, including methadone. Time interval according to the patients' estimates, from onset of regular alcohol consumption to heavy drinking, was not significantly different in the two groups.
26 citations
TL;DR: A small, nonsignificant correlation is found between monthly mean heroin dose and monthly number of heroin overdose deaths over a 5-year period, which contradicts findings of previous studies in Washington, D.C. and Atlanta, conducted over shorter periods of time, in which high positive correlations were found.
Abstract: Disagreement over the mechanism of death in so-called heroin overdose has been noted in the medical literature for more than a decade We studied the relationship between the potency of street heroin and the frequency of heroin overdose deaths in San Antonio in order to test the "pharmacologic overdose" hypothesis We found a small, nonsignificant correlation (r=+13) between monthly mean heroin dose and monthly number of heroin overdose deaths over a 5-year period This low correlation contradicts findings of previous studies in Washington, DC and Atlanta, conducted over shorter periods of time, in which high positive correlations were found The low correlation does not support the pharmacologic overdose hypothesis Since there were confounding variables, the data do not refute the hypothesis These variables include the use of alcohol and other depressants, hidden suicide, and reduced opioid drug tolerance due to institutional treatment
26 citations
TL;DR: It is suggested that rather than relying mainly upon pretreatment status for prediction, two promising areas should be examined in future studies: (1) the patient's early response to the treatment and to the therapist, and (2) the patients' environment posttreatment that should be altered to consolidate and perpetuate the gains made during treatment.
Abstract: Our ability to predict the outcome of psychological treatments, particularly for drug dependence, is examined by (1) new data on a VA sample, (2) a review of studies predicting the outcome of drug abuse treatment, and (3) a review of predicting the outcome of psychotherapy for other types of patients. For (1), the direct predictions of 13 staff members' ratings of the outcome of treatment correlated. 27 with the outcome. Although staff predictions improved when grosser predictions were examined, the results are disappointing given the level of discrimination required and the modest levels of prediction attained. For (2), prediction success with drug abuse patients in other studies were also disappointing and the bases for predictions often did not hold up on crossvalidation. For (3), direct predictions in the Penn Psychotherapy Study were similar to the VA sample in level of success. Other studies produced insignificant or similarly low levels of prediction success. In our discussion we suggest that rathe...
25 citations
TL;DR: A significant drop in opioid and nonopioid (but not marijuana) drug use generally occurred upon entry into other, post-DARP treatments, and that beneficial effects of treatment tended to continue beyond the end of treatment.
Abstract: The present study was based on follow-up data on 1,409 persons interviewed 4 to 6 years after admission to drug treatments in the Drug Abuse Reporting Program (DARP). The admissions to DARP occurred in 1969-1971, and for most persons the follow-up data included 3 or more years after termination of DARP treatment. The focus of this study was on illicit drug use of former DARP clients, taking into account if and when they reentered drug treatment after termination of DARP treatment. The results showed that a significant drop in opioid and nonopioid (but not marijuana) drug use generally occurred upon entry into other, post-DARP treatments, and that these beneficial effects of treatment tended to continue beyond the end of treatment. Overall, 42% of the sample had no further drug treatment during the first 3 years after DARP, and almost half (42%) of this group used no opioid or nonopioid drugs at all during this time. Comparisons between DARP treatment groups also indicated that therapeutic community client...
TL;DR: The results indicated that use of alcohol and non-opioid drugs (particularly marijuana) tended to be correlated, but that this was not true of opioid drugs.
Abstract: The present study was based on follow-up data on 1409 persons interviewed 4 to 6 years after admission to drug treatment in the Drug Abuse Reporting Program (DARP) The admissions to DARP occurred in 1969-1971, and for most persons the follow-up data included 3 or more years after termination of DARP treatment The study focused on variations in alcohol consumption associated with post-DARP drug use and treatment status The results indicated that use of alcohol and non-opioid drugs (particularly marijuana) tended to be correlated, but that this was not true of opioid drugs For a small segment of the sample, evidence suggested that substitution of use may have occurred between alcohol and opioid drugs Also, persons with post-DARP drug treatment tended to use less alcohol than persons without treatment Interpretations and implications of these findings are discussed
TL;DR: When length of stay on non-PCP users and occasional and chronic users were compared, it was found that chronic users remain in treatment longest.
Abstract: Little data exists relative to ongoing treatment of adolescent phencyclidine (PCP) abusers. This paper presents data gathered on a cohort of 87 residents in an adolescent social rehabilitation program. Approximately 50% of this cohort were either chronic or occasional PCP users. Both groups were found to be regular users of other drugs. Demographic characteristics are described, as are behaviors and symptoms reflective of various emotional and behavioral problems. When length of stay on non-PCP users and occasional and chronic users were compared, it was found that chronic users remain in treatment longest. No PCP-induced psychosis was found. Symptoms of depression, anxiety, aggitation, and other reported psychological effects of PCP were seen. Considerations for treatment are briefly discussed.
TL;DR: Small differences are apparent, but not enough to warrant a rejection of the null hypothesis that there is no difference between male and female drug abuse clients in length of time spent in treatment and successful outcome of that treatment.
Abstract: This paper examines the null hypothesis that there is no difference between male and female drug abuse clients in length of time spent in treatment and successful outcome of that treatment The hypothesis is tested by means of multiple classification analysis on a random sample of 20,264 clients who were discharged from federally-funded drug abuse programs in 1975 Upon controlling for the effects of demographic client characteristics, treatment history, and drug usage, the authors conclude that the null hypothesis is sustained Small differences are apparent, especially with respect to the length of time spent by clients in drug-free modality and day-care environment and in detoxification modality and hospital environment, and with respect to treatment success for clients in drug-free environment and hospital environment However, these differences are not sufficient to warrant a rejection of the null hypothesis
TL;DR: The Don't-Drink-and Drive Program (3-D) is a classroom and behind-the-wheel, 3-day curriculum designed for court-referred drinking drivers, mostly first offenders, most of whom will in all probability continue to drink.
Abstract: The Don't-Drink-and Drive Program (3-D) is a classroom and behind-the-wheel, 3-day curriculum designed for court-referred drinking drivers, mostly first offenders. The curriculum is not an abstinence program but designed for the so-called social drinker, most of whom will in all probability continue to drink. The 1-year driving record of 876 3-D graduates was compared with 802 drivers exposed only to the usual court procedures of probation and fine. It was found that the "no-treatment"groups had 78% more alcohol-related violations, 23% more moving violations, 40% more suspensions of licence, and 34% more accidents. The importance of quasi-experimental designs in accident research is discussed.
TL;DR: The research examines variables related to self-destructive or self-endangering behaviors, such as accidental overdoses, arrests for driving under the influence, and auto accidents in which the subject was the driver to indicate a suicide attempt rate at least 12 times greater than expected for the general population.
Abstract: This paper examines the relationship between drug abuse and suicide. It attempts to assess the extent of suicidal thoughts or behaviors among a group of drug abusers. The research examines variables related to self-destructive or self-endangering behaviors, such as accidental overdoses, arrests for driving under the influence, and auto accidents in which the subject was the driver. These data were examined in relation to reports of suicidal thoughts and actual suicide attempts. The results indicate a suicide attempt rate at least 12 times greater than expected for the general population. The results also indicate significant correlations between suicidal thoughts and suicide attempts, suicidal thoughts and nonsuicidal overdoses, and arrests for driving under the influece of drugs or alcohol and nonsuicidal overdoses. The implications of these results along with the role of depression as discussed.
TL;DR: Overall, the three groups reported little difference in side effects, and the regimen with the least number of patients reporting side effects daily was that of Group B, regardless of dose or dosage regimen.
Abstract: In a controlled double-blind clinical study, 42 patients reported side effects and severity of side effects to naltrexone on three different first-day doses and maintenance dosage regimens. Initiating doses of 25, 100, and 150 mg were administered. The maintenance regimens involved 350 mg of naltrexone per week for 4 weeks with drug administration in Group A, five times weekly; in Group B, three times weekly; and in Group C, twice weekly. All three groups received identical doses for the last dosage administered each week. The first-day doses produced no significant quantitative difference in side effects. Overall, the three groups reported little difference in side effects. Nonetheless, the regimen with the least number of patients reporting side effects daily was that of Group B. In no case, regardless of dose or dosage regimen, did any patient have side effects of such a nature as to require termination of their participation in the study.
TL;DR: Overall, the decline in both rate of arrest and number of patients arrested was significant, but this was due to the decrease in drug-related arrests, which play a dominant role in the criminality of the suburban patients in this study.
Abstract: In a suburban methadone program, using official police records, a study was made of patients' arrest records before and after methadone treatment. Eighty patients were willing to allow the researchers to secure their arrest records. These 80 patients were similar to the total clinic population of 226 in terms of demographic variables, arrest records, and addiction history. For these 80 patients both the rate of arrest and the number of patients arrested declined in association with entering methadone maintenance treatment. The decline was statistically significant for drug-related offenses but not for nondrug-related offenses. Overall, the decline in both rate of arrest and number of patients arrested was significant, but this was due to the decrease in drug-related arrests. Drug-related arrests play a dominant role in the criminality of the suburban patients in this study. Because of this, the reduction in drug-related arrests is more significant for this group of patients than it would have been for an inner-city patient population.
TL;DR: Cardiovascular disease, violence, violence (homicide, suicide, accidental), cirrhosis, carcionomas, and acute intoxication were the leading causes of death.
Abstract: This is a study of alcoholic mortality in which time, cause, and age at death were variables of critical interest. Five cohorts of 100 members each were followed 12, 11, 9, 6, and 4 years. A total of 133 cases were located as deceased. The overall case fatality rate (CFR) was 0371. Higher CFR's were observed in years 1 to 6. Cardiovascular disease, violence (homocide, suicide, accidental), cirrhosis, carcinomas, and acute intoxication were the leading causes of death. Violent deaths were more prevalent in younger admission age groups. The cardiovascular/other ratio increased in older admission age groups.
TL;DR: A profile of 1,117 family therapists who are providing treatment to families of recovering drug abusers reveals extensive information about the education, training, personal background, caseload characteristics, and theoretical orientations of these individuals.
Abstract: This paper presents a profile of 1,117 family therapists who are providing treatment to families of recovering drug abusers. The data was part of a national survey of the current status of family therapy in the drug-abuse field. The results reveal extensive information about the education, training, personal background, caseload characteristics, and theoretical orientations of these individuals.
TL;DR: Pattern of crime as measured by official arrest statistics do not appear stable over time for the treatment cohorts, and certain groups remain at high risk of arrest and/or confiction.
Abstract: Patient samples from methadone maintenance and detoxification programs are examined for their patterns of criminal activity before, during, and after treatment. Demographic, sociological, and criminal history variables are tested for their ability to account for changes in arrest patterns over time. While the number of arrestees decline after entering treatment, certain groups remain at high risk of arrest and/or conviction. Patterns of crime as measured by official arrest statistics do not appear stable over time for the treatment cohorts.
TL;DR: There were no significant differences between these two groups on their prescores, indicating that heroin and nonheroin patients were quite similar at time of intake, however, at discharge significant differences were found in terms of Tense and Thoughtful from the Mood Scale and Somatization, Obsessive/Compulsiveness, Interpersonal Sensitivity, Depression, and Anxiety from the Symptom Checklist.
Abstract: Differences between heroin and nonheroin users were determined at intake and discharge from an inpatient rehabilitation program. Background data as well as attitudes toward drug-related concepts, mood, and symptoms were gathered from 65 male veterans. Data were analyzed by analysis of variance and covariance comparing heroin and nonheroin users at intake and discharge. There were no significant differences between these two groups on their prescores, indicating that heroin and nonheroin patients were quite similar at time of intake. However, at discharge significant differences were found in terms of Tense and Thoughtful from the Mood Scale and Somatization, Obsessive/Compulsiveness, Interpersonal Sensitivity, Depression, and Anxiety from the Symptom Checklist. The heroin subjects had consistently more positive ratings than the nonheroin subjects following treatment.
TL;DR: Results indicated that physicians, psychologists, and social workers favored a "therapeutic" approach to the problem, while nurses and nursing assistants advocated "punitive" measures.
Abstract: Previous studies at this VA hospital had indicated considerable evidence of “serious problem drinking” among the psychiatric patients. Mailed questionnaires to 344 treatment staff members assessed their attitudes toward and recommended approach to this problem as a function of job classification and personal drinking patterns. Results indicated that physicians, psychologists, and social workers favored a “therapeutic” approach to theproblem, while nurses and nursing assistants advocated “punitive” measures. Interestingly, staff members who reported light or moderate personal drinking recommended additional therapy for these patients, while staff members who reported personal abstinence or heavy drinking generally suggested punitive actions.
TL;DR: An examination of some semographic, social, and work-related correlates of employment status during each period revealed that factors such as ethnicity, educational attainment, marital status, alcohol use, previous employment, and attitudes toward work were all important in relation to patients' employment status at one or more of the four periods.
Abstract: The employment patterns of 342 male methadone maintenance patients who remained in treatment for at least 1 year are examined. Four periods in the patients' lives are considered: (1) the period before addiction, (2) the period of addiction, (3) the time of entry into the treatment program, and (4) the first treatment year. Although more than three-quarters of the patients were employed regularly during the period before addiction, only about one-quarter were employed while addicted. At entry into the program 15% were employed, and 25% worked regularly during the first treatment year. An examination of some demographic, social, and work-related correlates of employment status during each period revealed that factors such as ethnicity, educational attainment, marital status, alcohol use, previous employment, and attitudes toward work were all important in relation to patients' employment status at one or more of the four periods. The treatment program had only a moderate impact on patients' attitudes toward...
TL;DR: It is suggested that a generalized feeling of optimism and motivation surrounds the completer, while the dropout seems to lack such drive.
Abstract: One hundred sixty-one male veterans with a history of drug abuse were administered a battery of background questions as well as self-concept measures prior to entering a Substance Abuse Unit at the VA Hospital in Miami. Significant interaction effects were found when a 2 2 analysis of variance was run using heroin/nonheroin as one factor and completer/dropout as the other. Nonheroin drug abusers who subsequently completed treatment entered the program with the lowest self-concepts, highest ideals (with respect to the self), and were most often high school dropouts. Nonheroin drug abusers who eventually dropped out of treatment entered with relatively high self-concepts, low ideals, and were more often high school graduates. On the other hand, heroin users showed the opposite trend. Heroin users who eventually completed treatment began with higher self-concepts, lower ideals, and more education than the heroin users who became dropouts. It is suggested that a generalized feeling of optimism and motivation ...
TL;DR: It is argued that chemical dependency treatment centers are a valuable resource in the education of medical students, as well as other professionls, if used with a view to their assets and limitations.
Abstract: Physicians can play a significant role in chemical dependency, including early identification and intervention, referral to treatment resources, patient and community education, and responsible prescribing practices. Some medical schools have begun to provide instruction in the psychology, pharmacology, and physical pathology of chemical dependency; yet surveys indicate that few offer supervised clinical experience with chemically dependent patients.At the University of Minnesota Medical School, chemical dependency treatment centers are used to provide supervised clinical tutorials for all second year students as part of a coordinated chemical dependency curriculum. The authors describe the development, goals, organization, instructional approaches, and assessment of these tutorials. It is argued that chemical dependency treatment centers are a valuable resource in the education of medical students, as well as other professionals, if used with a view to their assets and limitations.
TL;DR: While ethnicity per se contributed little to the discrimination of problem from nonproblem drinkers, several other variables provided an overall correct classification (discrimination) rate of 79.73%.
Abstract: Five hundred and ninety-two Anglo, Mexican American, and American Indian students from nine selected 2-year colleges in the Southwest were given a self-administered questionnaire with items related to problem drinking (dependent variable) and various social psychological and demographic information (independent variables). Analyses included discriminant analysis, chi square, and eta. While ethnicity per se contributed little to the discrimination of problem from nonproblem drinkers, several other variables provided an overall correct classification (discrimination) rate of 79.73%. These variables were, in order of discriminating power: neighborhood people drink, veteran status, live life differently, close friend with drinking problem, drink because acquaintances drink, and age. It is hypothesized that the psychological principle of individual differences, and the significance of some other study variables, may have overshadowed any ethnic effect. Measurement problems in this area are discussed as well as...