Showing papers in "American Journal of Drug and Alcohol Abuse in 1979"
TL;DR: A discussion of women addicts as mothers: the woman addict most often wants "out" of the heroin life when her children and her role as mother--her last remaining option--are in jeopardy.
Abstract: This paper is devoted to a discussion of women addicts as mothers. Women who are addicted while pregnant begin their careers as mothers with extreme guilt and a sense of initial failure. Heroin becomes a mechanism for coping with the routine difficulties of childraising. Children can also act as a controlling force on their mother's addiction if she has the option to perform her mothering duties in an otherwise “normal” fashion. If the woman is being supported adequately and can be available for her children, it is possible to combine addiction and mothering. Often, however, the woman has to work outside the home (usually in criminal pursuits) and the general chaos of her life greatly impinges on her ability to fulfill her mothering duties. Children are occasionally mistreated, sometimes neglected physically, and often neglected psychologically by a mother who is frequently absent. Addicted mothers feel extreme guilt and remorse over this neglect, and often take stock of their situation when their role as...
91 citations
TL;DR: The results show friends' use of alcohol and marijuana and participation in drug/street culture out-of-school activities have strong direct effects on personal drug involvement for the Black and Puerto Rican junior high school males and females who were studied.
Abstract: The present study examines a causal model explaining inner city youths' drug involvement using environmental variables which previously have been investigated singly or in various combinations and shown to influence drug use: the availability of drugs in the neighborhood and at school, a view of the neighborhood as tough, the esteem given to drug using, gang-involved persons by peers, friends' substance use, and participation in drug/street culture spare-time activities. The results show friends' use of alcohol and marijuana and participation in drug/street culture out-of-school activities have strong direct effects on personal drug involvement for the Black and Puerto Rican junior high school males and females who were studied; further, friends' use of alcohol and marijuana and the status peers give to drug using, gang-involved persons have respectable indirect effects on drug involvement for the four groups. In addition to these common features, a number of differences in the factors relating to drug in...
70 citations
TL;DR: Magnitude of reductions was uniform across race and legal status, varied by age, but increased systematically by time in program, confirming long-term positive change in criminal behavior associated with length of stay in the therapeutic community.
Abstract: Two hundred and two male dropouts, mainly heroin abusers averaging 3 to 6 years out of treatment, were sampled from the 1970-1971 Phoenix House admissions by race and time in program ( 2 years). Criminal justice arrest records were compared between three pre- and all posttreatment years. Percent and rate of arrest declined significantly in followup. Magnitude of reductions was uniform across race and legal status, varied by age, but increased systematically by time in program. Results replicated and extended earlier findings, confirming long-term positive change in criminal behavior associated with length of stay in the therapeutic community.
43 citations
TL;DR: The effects of several schedules of payment on duration and patterns of compliance with a naltrexone regimen were examined and the issue of using extrinsic reinforcers such as monetary payment to enhance compliance is discussed and additional procedures are suggested.
Abstract: The effects of several schedules of payment on duration and patterns of compliance with a naltrexone regimen were examined. Patients were paid under contingencies based on either number of doses ingested or on a fixed time schedule. Reinforcement schedules based on number of doses ingested produced more consistent treatment-oriented behavior than a time-based schedule. Covariation between behavior and alternating contingencies (A-B-A) indicated that the schedules served as one determinant of the pattern of attendance. Both types of schedules contributed to increased duration of treatment compared to previous noncontingent payment. The issue of using extrinsic reinforcers such as monetary payment to enhance compliance is discussed and additional procedures are suggested.
42 citations
TL;DR: An analysis of all deaths occurring over a 79-month period in patients enrolled in methadone maintenance revealed an overall mortality rate of 20/1,000, highlighting the persistent risk associated with heroin addiction and the role of alcoholism in the production of excessive mortality.
Abstract: An analysis of all deaths occulting over a 79-month period in patients enrolled in methadone maintenance (MM) revealed an overall mortality rate of 20/1,000. Over a similar period 510 persons were discharged from MM. Follow-up able to be performed in 80% revealed at least 22 deaths to have occurred subsequent to discharge. Survival curves calculated on the basis of these data indicate that even under the best possible assumption, age adjusted mortality rates of heroin addicts are not only above the national mean but are one and a half times that of the population in the community surrounding the clinic. None of the deaths could be directly attributed to methadone. Alcohol was prominent in 60% of all deaths, being responsible for 89% of medical deaths and present in 35% of violent deaths. These findings emphasize the persistent risk associated with heroin addiction as well as the role of alcoholism in the production of excessive mortality.
41 citations
TL;DR: The results suggest the possibility that PCP abuse might be associated with neuropsychological disturbance which persists for considerable time after PCP use ceases, and the deficits in PCP users occurred despite negative medical-neurological history.
Abstract: The performance of sober (average length of abstinence = 27 months) phencyclidine (PCP) abusers on neuropsychological measures of organicity was compared to that of polydrug users who were not experienced with PCP, and to controls who were not alcohol or drug abusers. Six of 12 PCP users, five of 12 polydrug users, and none of the controls showed neuropsychological impairments. The deficits in PCP users occurred despite negative medical-neurological history, and even though the PCP group abused othei drugs previously associated with neuropsychological impairment less than the polydrug group. Deficiencies in abstracting and in perceptual-motor integrative abilities were noted. The results suggest the possibility that PCP abuse might be associated with neuropsychological disturbance which persists for considerable time after PCP use ceases.
33 citations
TL;DR: It is concluded that romantic/kinship units and liasons of female addicts are an important focus for research, policy, and therapeutic interest.
Abstract: Heroin use histories and related institutional involvements were obtained from 30 female heroin addicts. Presence of intimate (vs casual) companions at first heroin use strongly differentiated subsequent high vs low consumption patterns. Intimate others were precipitants in 60% of all treatment episodes; the duration of such episodes was nearly double that for self-precipitated admissions. Concurrent familial determinants were indicated in virtually all accounts of current consumption patterns. It is concluded that romantic/kinship units and liaisons of female addicts are an important focus for research, policy, and therapeutic interest.
31 citations
TL;DR: Analysis of drug use among Vietnam veterans and a comparison group of non-Vietnam veterans, included in a 1975 national survey, was used to test two hypotheses, which indicated Vietnam veterans were in a higher risk group for drug abuse because they were younger and mostly male and demographic factors were often important variables in accounting for the incidence of drug abuse in a population.
Abstract: Analysis of drug use among Vietnam veterans (N = 105) and a comparison group of non-Vietnam veterans (N = 2,966), included in a 1975 national survey, was used to test two hypotheses. The first was that Vietnam veterans would have higher levels of current drug abuse involvement. The second was that after controlling for demographic differences between these groups, Vietnam veterans would not have substantially higher levels of current drug abuse. These hypotheses were based on independent research findings which indicated (1) Vietnam veterans were in a higher risk group for drug abuse because they were younger and mostly male, (2) Vietnam veterans had high rates of remission from drug abuse shortly after return to the United States, and (3) demographic factors were often important variables in accounting for the incidence of drug abuse in a population. The data for the study were collected in structured, face-to-face, household interviews. The drug abuse involvement index in the study included 12 groups of...
29 citations
TL;DR: Heavier alcohol use among the deaf correlated significantly with reported frequency of driving after having drunk too much, age of having had the first drink, ever having been drunk, feeling guilt over drinkingToo much, and others criticizing the respondent for drinking behavior.
Abstract: Thirty-nine White deaf persons functioning normally within the general hearing community were surveyed on a variety of factors concerning their use of alcohol, and compared to the data from two comparable hearing samples reported previously in the literature. No significant differences were found between the deaf and hearing samples on patterns of drinking or other parameters of alcohol use. Heavier alcohol use among the deaf correlated significantly with reported frequency of driving after having drunk too much, age of having had the first drink, ever having been drunk, feeling guilt over drinking too much, and others criticizing the respondent for drinking behavior. Heavier use also tended to be correlated with attendance at an all-deaf school. Implications of the findings of similar drinking patterns for the deaf and the hearing are discussed in terms of the lack of specific rehabilitation facilities for the deaf, along with possible reasons for the lack of use by deaf clients of alcohol rehabilitation agencies in the community.
28 citations
TL;DR: The findings indicate that better neonatal outcomes are associated with the mother's joining the program relatively early in pregnancy and coming in relatively often for prenatal care.
Abstract: This study reports pregnancy outcomes for 105 addicted women enrolled in New York Medical College's Pregnant Addicts and Addicted Mothers Program. Three classes of variables are examined: prenatal care variables, obstetrical outcomes, and neonatal outcomes. As a first step, percentage distributions are shown for all variables within each class. With respect to the second and third classes, comparisons are made when possible to findings reported elsewhere on heroin-addicted, methadone-maintained, and drug-free populations. Zero-order correlations are then shown for the prenatal care variables versus the neonatal outcomes. It is found that the mother's number of prenatal medical visits correlates significantly with the neonate's gestational age at birth and birth weight, and that her methadone dose at time of delivery correlates significantly with the neonate's withdrawal status. The effect of the prenatal care variables on the two key neonatal outcomes-gestational age at birth and birth weight-is then exam...
27 citations
TL;DR: Analyses of the MAC Scale scores of male substance abusers evidence the presence of two fundamentally different, age-independent characterological types within unselected runs of male alcohol and drug abusers.
Abstract: Analyses of the MAC Scale scores of male substance abusers evidence the presence ot two fundamentally different, age-independent characterological types within unselected runs of male alcohol and drug abusers. Examination of those items which best accomplish this discrimination indicates that the members of the majority type (approximately 85%, on average, over several studies) have disorders of character, while the members of the minority type (approximately 15%, on average, over several studies), are introverted neurotics. Since both types are also present, but in roughly opposite proportions, in the self-depictions of the members of unselected runs of nonsubstance-abusing male psychiatric outpatients, it is evident that neither type is comprised only of substance abusers.
TL;DR: A survey of 123 Al-Anon wives in the Washington, D.C. area revealed that these women delayed an average of more than 7 years after the first occurrence of problem drinking before finally seeking help.
Abstract: A survey of 123 Al-Anon wives in the Washington, D.C. area revealed that these women delayed an average of more than 7 years after the first occurrence of problem drinking before finally seeking he...
TL;DR: An exhaustive test-retest reliability study was made of the intake interview used by Abraxas' residential drug program, and it was concluded that considerable self-reported information can be obtained from court-stipulated clients within a few days after admission.
Abstract: An exhaustive test-retest reliability study was made of the intake interview used by Abraxas' residential drug program. The study is notable in that (1) 143 wide-ranging questionnaire variables were examined, (2) all tested clients were under court pressure, and (3) the second interview was given after an average of 8 months in treatment. Reliability coefficients for 50% of the 143 items were found to be greater than or equal to .70, 83 were greater than or equal to .50, and the lowest coefficient recorded was .24. Although the clients tended to suppress some sensitive material in the first interview, it was concluded that considerable self-reported information can be obtained from court-stipulated clients within a few days after admission.
TL;DR: The author attempts to clarify two largely different uses of term, Therapeutic Community, by describing a movement which originated in psychiatry in the United Kingdom at the end of World War II and the more recent developments in the treatment of substance abuse.
Abstract: The author attempts to clarify two largely different uses of term, Therapeutic Community (TC) By "old" TC he describes a movement which originated in psychiatry in the United Kingdom at the end of World War II This was an attempt to establish a democratic system in hospitals where the domination of the doctors was replaced by open communication of content and feeling, information sharing, shared decision making, and problem solving shared as far as possible with all patients and staff Daily meetings of all patients and staff formed the nucleus of this process In recent years developments in the areas of systems theory, learning theory, and organization development have contributed to a better understanding of social organization and change The "new" TCs derive from the more recent developments in the treatment of substance abuse Central to this movement is Synanon and its many modification which use the clients' peer group to solve their own problems, largely eliminating mental health professionals Linked with these "new" TCs is the development of Asklepieion units in prisons, which use Synanon "games" along with transactional analysis An attempt is made to distinguish the methodologies used in TCs, "old" and "new"
TL;DR: Results suggested significant increases in symptom severity within the 1978 sample in all comparison areas, especially psychological status, suggesting the possibility that therapeutic approaches which were previously effective may no longer be meeting the more extensive needs of the current population.
Abstract: Considerable anecdotal evidence at this hopsital had suggested that the present population of drug abuse patients was qualitatively different from the population for which the original treatment program had been designed. In order to assess these suspected differences, samples of drug abuse clients from 1972 and 1978 were compared in terms of pattern of abuse, previous treatments, means of support, family background, and psychological status. Results suggested significant increases in symptom severity within the 1978 sample in all comparison areas, especially psychological status. The authors consider the possibility that therapeutic approaches which were previously effective may no longer be meeting the more extensive needs of the current population.
TL;DR: During the spring of 1977 a survey was taken of drug analysis results for over 17,500 urine samples from Los Angeles County probationers and methadone clinic enrollees to determine the frequency of diazepam (Valium).
Abstract: During the spring of 1977 a survey was taken of drug analysis results for over 17,500 urine samples from Los Angeles County probationers and over 8,500 urine samples from Los Angeles County methadone clinic enrollees to determine the frequency of diazepam (Valium) use. The probation department specimens were found to contain diazepam less frequently than the methadone clinic specimens as a group. There were, however, wide variations in use frequency between the seven methadone clinics.
TL;DR: This preliminary report from an epidemiological study of heroin addiction in Tucson, Arizona, 1956-1976, examines the status of heroin addicts 20 years after they have been identified as narcotics abusers, focusing on the maturation hypothesis which holds that heroin addicts tend to cease use of narcotics spontaneously by age forty.
Abstract: This preliminary report from an epidemiological study of heroin addiction in Tucson, Arizona, 1956-1976, examines the status of heroin addicts 20 years after they have been identified as narcotics abusers, focusing on the maturation hypothesis which holds that heroin addicts tend to cease use of narcotics spontaneously by age forty.A cohort of 51 subjects was identified from Public Records of Court Appearances for narcotic offenses during a 36-month period (1955-1957), located and, where possible, interviewed. Records from a minimum of two agencies (law enforcement, corrections, treatment, welfare) were used to establish current status of the individual with reference to the use of narcotics and/or other drugs. Demographic, ethnic, socioeconomic makeup of the sample, as well as criminal involvement and treatment episodes, is included.After 20 years, one individual is drug-free or abstinent. Twenty-three are considered still addicted to heroin, 16 of these are in prison; seven are addicted to methadone or ...
TL;DR: The frequency of use of amphetamine was relatively high followed by phentermine, ephedrine, and methamphetamine, which may warrant testing for these drugs on a more routine basis in drug monitoring programs.
Abstract: A survey was done on over 10,000 urine samples from the Los Angeles County Probation Department and methadone maintenance programs to determine the frequency of use of eight sympathomimetic amine drugs including amphetamine, methamphetamine, ephedrine, mephentermine, phendimetrazine, β-phenethylamine, phenmetrazine, and phentermine. As expected, the frequency of use of amphetamine was relatively high followed by phentermine, ephedrine, and methamphetamine. The extensive use of ephedrine and phentermine may warrant testing for these drugs on a more routine basis in drug monitoring programs.
TL;DR: The MAST appears to be a valid instrument for use under New Zealand conditions, but the ability to discriminate between alcoholics and problem drinkers would be an added advantage.
Abstract: The Michigan Alcoholism Screening Test (MAST) has been validated on a wide range of American drinkers. In this study the MAST was administered to four groups of New Zealand males: 100 hospitalized alcoholics, 100 psychiatric inpatients, 70 convicted drinking drivers, and 55 social drinkers. All the diagnosed alcoholics scored in the test's alcoholic range, as did 83% of the drinking drivers. Seventy-six percent of psychiatric patients and 89% of social drinkers scored below 5. The MAST appears to be a valid instrument for use under New Zealand conditions, but the ability to discriminate between alcoholics and problem drinkers would be an added advantage.
TL;DR: Age-matched samples of Vietnam veterans and veterans who did not serve in Vietnam were surveyed at the time that they applied for treatment of heroin addiction, and Vietnam veterans were more likely to have begun using heroin during their military service and to say that their service experiences had affected their use of drugs.
Abstract: Age-matched samples of Vietnam veterans and veterans who did not serve in Vietnam were surveyed at the time that they applied for treatment of heroin addiction. Vietnam veterans were more likely to...
TL;DR: Preliminary findings in the treatment of Puerto Rican women are presented to serve as an initial research effort, to encourage further areas of study, and to contribute valuable information for those who currently treat ethnic populations.
Abstract: This paper presents an overview of Puerto Rican history, its traditional effect on Puerto Rican women, and its applicability in treating the Puerto Rican female drug user. The paper focuses on items of historical and cultural significance and includes data gathered from selected interviews of Puerto Rican females in treatment. What has been compiled here is a description of characteristics, traits, and attributes that distinguish Puerto Ricans from other ethnic groups and those traits traditionally attributed to their women. It takes into consideration such things as the role of the family, religious implications, "machismo" behavior exhibited by males upon females, attitudinal differences between mainland and island females, and changes undergone during migration. There currently exists a paucity of literature concerning the treatment of Puerto Ricans in general and even less exists with regard to Puerto Rican women. This paper, therefore, purports only to present preliminary findings in this area. Its intent is to serve as an initial research effort, to encourage further areas of study, and to contribute valuable information for those who currently treat ethnic populations.
TL;DR: The BDI-5 proved to be an efficient method for screening for depression in these samples, and thus might be useful in clinical or research settings when a very brief method is needed.
Abstract: Samples of heroin-addicted veterans in treatment at a VA drug clinic, ex-addict and nonaddict Vietnam veterans followed-up after return to the United States, and male suicide attempters who were no...
TL;DR: The overall evaluation of DARP treatments by former clients was generally favorable and was highest for the DARP therapeutic community.
Abstract: A national sample of drug treatment clients admitted to the Drug Abuse Treatment Program (DARP) during 1969--1972 was followed approximately 5 years after admission. Subjective evaluations of treatment were compared for clients in methadone maintenance, therapeutic community, outpatient drug-free, and outpatient detoxification treatment programs, as well as a comparison group of clients who completed intake but received no treatment. These evaluations were also analyzed in relation to client background and treatment performance measures and post-treatment outcomes. The overall evaluation of DARP treatments by former clients was generally favorable and was highest for the DARP therapeutic community. Over two-thirds of the combined treatment sample indicated satisfaction with the treatment they received and a willingness to recommend it to others. Favorable evaluation was also positively related to during-treatment performance and tenure in DARP treatment as well as to behavioral outcomes after leaving treatment.
TL;DR: Upper and lower limits have been determined for the temperature of freshly voided urine sample, which provides a basis for monitoring urine collection in a drug abuse treatment program in a manner that does not invade privacy.
Abstract: Upper and lower limits have been determined for the temperature of freshly voided urine When specified procedures are followed, more than 99% of measurements lie between 325 and 367°C This provides a basis for monitoring urine collection in a drug abuse treatment program in a manner that does not invade privacy The method is not foolproof, but it provides sufficient control if there are no penalties for illicit drug use so that there is no strong incentive to turn in a fraudulent urine sample
TL;DR: A study was undertaken to determine the frequency of alcohol use and the amount consumed by methadone maintenance patients, and it appears that those who participated were typical of the group selected for study.
Abstract: A study was undertaken to determine the frequency of alcohol use and the amount consumed by methadone maintenance patients. In four clinics of the Beth Israel Medical Center Methadone Maintenance Treatment Program, every fifth patient from an alphabetical clinic list was selected for interview. Among the 101 patients who were interviewed, mean alcohol consumption was 1.2 ounces per day. Among those who drank, there was a continuum in terms of amount consumed. Forty-three percent had totally abstained from alcohol during the prior 3 months, and an additional 30% drank one or less ounces per day. Independently obtained staff rankings generally approximated interview results, and thus supported the reliability of the interview. Since staff rankings for participants and nonparticipants in the interview were similar, it appears that those who participated were typical of the group selected for study.
TL;DR: A cognitive social learning model of the maintenance of problem drinking is presented and it is concluded that the model provides a useful theoretical framework in which to conceptualize the development, maintenance and treatment of drinking problems.
Abstract: A cognitive social learning model of the maintenance of problem drinking is presented. Basic constructs involving social skills acquisition, experienced cognitive control, and self-efficacy expectations as they relate to alcoholism are discussed. It is concluded that the model provides a useful theoretical framework in which to conceptualize the development, maintenance, and treatment of drinking problems. A number of specific suggestions are made for further research which test various hypotheses generated by this model.
TL;DR: Results from a random household survey of the Boston Standard Metropolitan Statistical Area show a consistent and relatively strong association of adults' use of coffee, tobacco, alcohol, tranquilizers, and marijuana with their perceptions of present friends' use.
Abstract: Results from a random household survey of the Boston Standard Metropolitan Statistical Area show a consistent and relatively strong association of adults' use of coffee, tobacco, alcohol, tranquilizers, and marijuana with their perceptions of present friends' use. Associations with parents' and past adolescent friends' use are much weaker. The results support efforts to explain illicit drug use with general theories of behavior acquisition and cast doubt on the utility of deviance theories.
TL;DR: The low base rate suggests that veterans do not rely on a VA ER for the treatment of acute drug reactions and that proper medical supervision and medication management is maintained in the majority of cases.
Abstract: To determine the extent to which veterans used a VA Emergency Room (ER) for the treatment of acute drug reactions, the ER log of a VA Hospital was examined to ascertain the number of drug-related visits during the past 24 months. The low base rate suggests that veterans do not rely on a VA ER for the treatment of acute drug reactions and that proper medical supervision and medication management is maintained in the majority of cases. Those who did utilize a VA ER appear to be young (age range 25 to 34), used legally prescribed drugs in combination with alcohol or tranquilizers, and were often suicidal. More attention to the crisis state precipitated by the acute drug reaction is recommended.
TL;DR: The overall successfulness of the program was 39%; the validity of the Treatment Difficulty Scale was demonstrated for both ethnic groups and both first and second year outcome results; and the average stability of first year findings of SAI components as compared to second year results was shown to be 79%.
Abstract: This is an evaluation of an Alcohol Treatment Unit with a focus on a comparison of Mexican-American and Anglo-American outcomes. Social adjustment on a target cohort of 75 was measured on a standard rating instrument (SAI) 2 years after discharge from the hospital. The overall successfulness of the program was 39%; the validity of the Treatment Difficulty Scale (a composite index of anticipated treatment difficulty) was demonstrated for both ethnic groups and both first and second year outcome results; and the average stability of first year findings of SAI components as compared to second year results was shown to be 79%. Use of a standardized index of pretreatment patient characteristics was recommended to facilitate comparative program evaluation research.
TL;DR: The Ontario data suggests alcohol involvement in victims was not associated with smoking as a cause of the fire, and alcohol impairment was more common among those under 50 years of age.
Abstract: Data on recorded alcohol impairment of 264 victims of fatal fires in Ontario in 1976 are analyzed. Male victims were twice as likely to be impaired as females, and impairment was more common among those under SO years of age. Alcohol impairment was most often noted in victims of fires at night and on weekends. Overall, 31% of adult victims were reported as alcohol impaired. The Ontario data suggests alcohol involvement in victims was not associated with smoking as a cause of the fire.