Showing papers in "American Journal of Drug and Alcohol Abuse in 1985"

Adolescent Marijuana and Alcohol Use: The Role of Parents and Peers Revisited

Abstract: The present study focuses on the role of deviant peers, parent child-rearing practices, and parent alcohol use in the initiation of marijuana and alcohol use during adolescence. Composite measures ...

Methylphenidate treatment of cocaine abusers without attention deficit disorder: a negative report.

Abstract: Five cocaine abusers without diagnoses of Attention Deficit Disorder (ADD) were treated with methylphenidate in an open trial. In contrast to previously described patients with ADD, none of these patients showed clinical improvement or decreased cocaine use.

Alcoholism and methadone treatment: consequences for the patient and program.

Abstract: The data on alcoholism presented in this paper were extracted from a major follow-up study of active and discharged methadone patients conducted from 1974 through 1977 in New York City. Alcoholism is a factor in 26% of the terminations from methadone treatment. It is also the leading cause of death in treatment and the second leading cause of death, following complications with opiates, in the post-treatment period. Also, patients with episodes of excessive drinking have markedly lower survival rates over a 10-year period when compared to patients who are social or moderate drinkers.

Trends in Drug Use of Indian Adolescents Living on Reservations: 1975-1983

Abstract: Anonymous surveys on drug use were administered to 7th-12th grade students in Indian reservation schools. A large number of tribes were surveyed from 1975 through 1983. There is reason to believe the results are reasonably representative of Indian youth living on reservations. Lifetime prevalence for most drugs is higher than that for non-Indian youth throughout this period, and rates for alcohol, marijuana, and inhalants, the most frequently tried drugs, were particularly high. Since 1981 there has been a slight drop in lifetime prevalence for most drugs. Current use figures show the same trends, with increasing current use through 1981 and a drop since that time. Analysis of patterns of drug use, classifying youth according to number, type, and depth of involvement with drugs, shows a similar trend, with radical increases until 1981 and then a drop in all but one of the more serious drug use types. Despite this drop, 53% of Indian youth would still be classified as “at risk” in their drug involvement, c...

Interpersonal psychotherapy adapted for ambulatory cocaine abusers.

Abstract: The authors describe the strategies and goals of Klerman et al.'s Interpersonal Psychotherapy (IPT) as revised for application to cocaine abusers. IPT is a brief, individual psychological treatment suitable for use by experienced psychotherapists. The goals are reduction or cessation of cocaine use and development of more productive strategies for dealing with social and interpersonal problems associated with the onset and perpetuation of cocaine use. The treatment has four definitive characteristics: (a) adherence to a medical model of psychiatric disorders; (b) focus on patient's difficulties in current interpersonal functioning; (c) brevity and emphasis on consistency of focus; and (d) use of an exploratory stance by the psychotherapist which is similar to that of supportive and exploratory psychotherapies. It is currently being used in combination with medications in a clinical trial evaluating the efficacy of desipramine, lithium carbonate, methylphenidate, and placebo as treatment for ambulatory cocaine abusers.

Comparison of Clinician Ratings to Self Reports of Withdrawal during Clonidine Detoxification of Opiate Addicts

Abstract: Opiate withdrawal symptom ratings by trained clinicians were compared to self-reports of withdrawal discomfort during an outpatient, blinded, randomized clinical trial of clonidine detoxification for methadone maintained subjects. The randomized comparison group of subjects were detoxified using a slow tapering of methadone over 1 month. For all 39 subjects in this study the observer and self-ratings were substantially correlated (r = .75), but moderate levels of disagreement also occurred and the observer ratings were often lower. The difference in actual withdrawal scores and amount of shared variance between the observer and self-ratings were used as indices of disagreement for each individual subject. We found that detoxification failures had significantly less interrater agreement than the successes and that subjects who reported more distress than the observers noted were more likely to fail at detoxification. Subjects being detoxified using clonidine were more likely to fail at detoxification. Subjects being detoxified using clonidine were more likely to demonstrate this association between failure and disagreement on self versus observed withdrawal than were the methadone group. We concluded that self-reports are as important as observer ratings in assessing treatment efficacy and in the clinical use of clonidine for outpatient detoxification.

Effects of Community-Based Group-Home Treatment Programs on Male Juvenile Offenders′ Use and Abuse of Drugs and Alcohol

Abstract: The research literature suggests that adolescents placed in residential programs due to their delinquent behavior are at high risk for drug and alcohol use and abuse. Research is rare, however, on ...

Effects of Outpatient Treatment for Problem Drinkers

Abstract: This study was designed to investigate the effects of treatment length restriction and follow-up interview style on the outcomes of male alcohol abusers in outpatient treatment. Subjects (N = 48) were randomly assigned to one of four independent groups based on the factorial combination of the two independent variables. Extensive pretreatment data were collected about subjects′ drinking and related behaviors, and subjects were then scheduled for monthly interviews. Subjects were interviewed for 18 months postadmission concerning these same factors. Subjects′ self-reports were compared with collateral reports, official records, and breath tests. Outcome results showed no effects of follow-up interview style or treatment length restriction on drinking behavior and employment outcomes. However, subjects′ drinking behavior postadmission was considerably improved compared to their pretreatment ethanol consumption. Temporal analyses of the drinking behavior data showed that it was possible to predict drinking b...

Variables associated with alcoholic blackouts in men.

Abstract: Alcoholic blackouts are among the most frequently reported symptoms in the progression of alcoholism. The exact etiology of blackouts remains unknown, but relationships to memory disturbance, seizure disorders, underlying psychiatric conditions, head trauma, and drug use have all been suggested. We studied 72 alcoholics admitted to an alcohol inpatient treatment program. Seventy-five percent of the patients had experienced blackouts. Patients who had had blackouts experienced other alcohol-related symptoms such as a need to drink upon awakening, alcohol cravings, tremors, and hallucinations more frequently and they were more likely to have had a past history of depression and to have been arrested for driving while intoxicated than alcoholics who had never experienced blackouts. No significant differences were observed between patients who had experienced blackouts and those who did not in mild to moderate memory disturbance, seizure disorder, a variety of psychiatric conditions, head trauma, or drug use. No significant differences were found between the two groups in most drinking history variables. The present study does not lend support to most hypotheses made about the etiology of alcoholic blackouts. Blackouts in alcoholics were significantly associated with other symptoms resulting from excessive alcohol use.

Drinking patterns and problems among female children and adolescents: a comparison of abstainers, past users, and current users.

Abstract: The sociopsychological factors that underlie drinking behavior among 197 young girls, ages 9 through 17, are explored. Three groups-youthful abstainers, former users, and current users-were interviewed, as were their parents. These comparison groups are contrasted on 110 variables. The relative merits of four competing explanations of youthful drinking behavior-deprivation, personal deficiency, hedonistic peer culture, and family pathology-are assessed.

Cognitive Deficits as a Function of Years of Alcohol Abuse

Abstract: The present study relates duration of alcohol abuse and degree of cognitive impairment among a population of alcohol dependent subjects (DSM-III). Data on 175 consecutively admitted patients were first examined to empirically establish operational definitions of short-term and long-term alcohol abuse for this population. Five or more consecutive years of alcohol abuse was thus defined by a median split as long-term alcoholism. The next 125 consecutive admissions were subsequently identified as either Short-Term or Long-Term alcoholics according to this criterion. Data gathered from these 125 subjects represented a wide range of neuropsychological measures. Analyses showed that Long-Term alcoholics demonstrated significantly greater cognitive deficits on tasks of psychomotor speed, recent memory, and overall alertness relative to less chronic alcoholics. This pattern occurred independent of age and education. These findings are interpreted in terms of a cognitive typology of alcoholism, and implications fo...

The Outcome of Group Psychotherapy Alcoholics: An Empirical Review

Abstract: The empirical literature concerning the outcome of group therapy with alcoholics is reviewed and summarized. Tentative conclusions are drawn.

Marital Interactions and the Duration of Alcoholic Husbands′ Sobriety

Abstract: Recent studies of the family interactions of alcoholics have suggested that the alcoholic's general drinking adjustment may influence marital interactions. The present investigation examined the marital interactions of 30 male alcoholics who had maintained continuous sobriety for various lengths of time ranging from a few days to over 7 years. It was predicted that longer periods of sobriety would be associated with less conflict and fewer struggles for control between husbands and wives. The findings supported the hypothesis, in that the duration of the husbands′ sobriety was significantly negatively correlated with the number of statements of disagreement emitted by husbands and wives. Also, there were trends for duration of sobriety to be negatively associated with the frequencies of question-asking and aggressive behaviors by husbands, and positively associated with the amount of talk time by husbands. Contrasts of 11 high sobriety couples (duration of sobriety: 2 years or longer) and 11 low sobriety ...

Vietnam Military Service and Marijuana Use

Abstract: The effect of military service in Vietnam on drug use among veterans is examined on the basis of data obtained from a nationwide random sample of 2,510 young men. It is generally believed that illicit drug use was more extensive in Vietnam in the 1970s than in earlier years of the conflict. Therefore variables were constructed to reflect location of service (United States; overseas, but not Vietnam; and Vietnam) and the time of service (before 1970; 1970 or later). The results of the analysis indicate that: military service in Vietnam had no significant effect on marijuana use while on active duty, service in 1970 or later had a significant positive effect on during service use while in the service, and location of military service and time of service had a significant interactive effect on rates of marijuana use after discharge from military service. The interaction of service in Vietnam and military service after 1970 has the strongest effect on the veteran's marijuana use in civilian life.

Alcohol-related impairments in male alcoholics and the psychiatric symptoms of their spouses: an attempt to replicate.

Abstract: This paper reports two attempts to replicate a recent finding by Steinglass linking social-behavioral consequences of drinking with the nonalcoholic spouse's psychiatric symto-matology. Only weak support was obtained for the original findings. Discussion focused on several variables which appeared to be importantly related to the strength and generalizability of relationships under investigation.

Prevalence and consequences of nonmedical use of drugs among Canadian Forces personnel: 1982.

Abstract: A single-stage systematic probability sample survey on nonmedical use of drugs was conducted among Canadian Forces (CF) personnel (n = 6,118) in 1982. Overall, 14% of CF personnel reported cannabis use and 4% reported multiple drug use within the 12 months preceding the survey. Prevalence rates are presented for nine classifications of drugs. Higher use rates are linearly and inversely related to age. of CF member. Somewhat lower positive correlations are found between annual use of cannabis and never having married, having completed secondary or vocational school, French mother tongue, and being reared in central Canada. For military service correlates, higher use is reported with each lower rank among members serving overseas or in Quebec. For multiple drug use, two principal correlates are younger age and never having married or currently not married. All drug use is positively correlated with consumption of alcohol. Drug use correlates highly with the occurrence of physical symptoms, social disruption...

Prevalence of Polydrug Use among Alcoholic Soldiers

Abstract: A survey was conducted to determine the extent of polydrug abuse among a population of alcoholics hospitalized in a military treatment program. It was discovered that approximately 21% of patients had no drug exposure other than alcohol, and 48% revealed a history of drug use more extensive then experimentation. Results further indicate that polydrug use was greatest among this population during the Vietnam era (1963 to 1972) and again during the year preceding their referral for treatment. Finally, a significant difference in age was found when comparing non-users to users, and when comparing experimental/nonusers to all other users. This age difference places the low and nonuse groups as achieving their eighteenth birthday significantly before the mid-sixties and users afterwards, supporting the notion of a “drug accepting” versus “drug rejecting” generational difference.

Performance on the Rod and Frame Test for men at elevated risk for alcoholism and controls: a pilot study.

Abstract: Performance scores on the portable Rod and Frame Test were not different for eight pairs of young men with and without an alcoholic close relative. Retesting both groups following placebo, 0.75, or 1.1 mL/kg of ethanol also revealed no significant group differences on this measure.

A Cognitive Typology of Alcoholism: Implications for Treatment Outcome

Abstract: The present study related patterns of alcohol-related cognitive deficits to the adjustment of the alcoholic at 2-year posttreatment follow-up. Patterns of cognitive control, based on the extent to which the individual utilized information concerning contemplated action (i.e., internal scanning), were studied within a sample of 42 male alcoholics shortly after the beginning of treatment. Adjustment scores at 2-year follow-up were determined by the subject's level of functioning in a variety of life-functioning domains (based on phone interviews with subjects and collateral sources). More effective internal scanning proved to be predictive of better adjustment 2 years following the assessment. In addition, alcoholics less aware of internal cues, defined as narrow internal scanners, more often reported drinking to reduce tension than did broad scanning alcoholics. The narrow internal scanning alcoholics also were slower learners at an electromyographic biofeedback training task than were the broad internal s...

Alcoholics Anonymous and the family: a systemic perspective.

Abstract: This paper is an attempt to utilize a cybernetic paradigm for understanding addictive drinking by those individuals defined as alcoholics. Their behavior is anomalous because it is so self-destructive and concurrently often produces a dysphoria that exacerbates the experiential state that is said to be its cause. A cybernetic perspective is illustrated by a description of two social systems: alcoholics and their families, and as members of Alcoholics Anonymous. For some alcoholics, alcoholism can be perceived as the "solution" to the paradoxical psychosocial context within which they find themselves, to which their addictive drinking is an adaptive response, and Alcoholics Anonymous a better "solution."

The 20 percent question and some possible solutions.

Abstract: There is presently in wide use throughout the United States an assumption that alcohol treatment programs should be geared toward handling 20% of the alcohol problem prevalence population. This 20% figure has become so widely accepted that it is now almost axiomatic. The most frequently offered reason for its use is that “many other states use it.” The present discussion raises questions about the foundations upon which the 20% assumption is based. It then describes recent efforts to seek solutions to these and related questions.