Showing papers in "Journal of Psychoactive Drugs in 2009"
TL;DR: In this paper, a qualitative interview with patients prematurely discharged from six methadone treatment programs in Baltimore highlighted factors patients describe as contributing to their reasons for being discharged within the first 12 months of the treatment.
Abstract: Longer retention in drug abuse treatment is associated with better patient outcomes, and research indicates the first 12 months of methadone treatment are critical to patient success. Nevertheless, large-scale multisite longitudinal studies over the past three decades indicate that the majority of patients drop out during the first year of methadone treatment. Through an examination of 42 qualitative interviews with patients prematurely discharged from six methadone treatment programs in Baltimore, this study highlights factors patients describe as contributing to their reasons for being discharged within the first 12 months of the treatment. The two most consistent themes are program-related factors and incarceration. The former factors are richly described through patients' words and underscore the ways in which patients' perceptions of control exerted by the program and by the medication and misunderstandings of program structure can lead to premature discharge. Patients' reasons for discharge were compared to counselors' reasons as indicated in discharge summary forms. An analysis of the patterns of agreement and disagreement are presented. Patient-centered program and policy implications are discussed.
90 citations
TL;DR: Independence was positively correlation with the frequency of ayahuasca use and negatively correlated with the wash-out period, and Independence was positively correlated with a change in attitude towards more independence.
Abstract: The authors assessed 23 subjects immediately before and six months (27.5 weeks) after their first ayahuasca experience in an urban Brazilian religious setting, either Santo Daime (N = 15) or Uniao do Vegetal (N = 8). Measures included scores on instruments assessing psychiatric symptoms, personality variables and quality of life. Independent variables were the frequency of ayahuasca use throughout the period and the length of ayahuasca wash-out after six months. Santo Daime subjects had a significant reduction of minor psychiatric symptoms, improvement of mental health, and a change in attitude towards more confidence and optimism. The Uniao do Vegetal group had a significant decrease in physical pain, and attitude change towards more independence. Independence was positively correlated with the frequency of ayahuasca use and negatively correlated with the wash-out period. We discuss possible mechanisms by which these changes may occur and suggest areas for future research.
84 citations
TL;DR: Current knowledge on pharmacological, epidemiological and clinical aspects of khat use, including its addictive potential, as well as possible psychological, psychiatric and medical consequences related to stimulant use are reviewed.
Abstract: The khat plant contains psychoactive alkaloids with psychostimulant properties, and has been used for centuries as a recreational and religious drug, mainly in some African and Middle Eastern countries. With changing migration patterns, epidemiological and clinical outcomes may have changed. The aim of this article is to review current knowledge on pharmacological, epidemiological and clinical aspects of khat use. Khat use is still highly prevalent in the countries mentioned, and in African and Yemeni emigrant groups. Preclinical and clinical data confirm its addictive potential as well as possible psychological, psychiatric and medical consequences related to stimulant use; however, existing epidemiological studies do not focus on the prevalence of problematic use or dependence. There are no indications of high prevalence of khat use in other cultural and ethnic groups. Data are lacking on possible increased psychotogenic risks when khat is used outside of the original cultural context. As with alcohol use in many countries, khat use can be considered as a lifestyle in some specific countries, covering the spectrum from nonproblematic use to problematic use and dependence. Khat dependence is associated with high morbidity and societal and economical costs.
73 citations
TL;DR: Insight into the experiences of western users of ayahuasca was gained to ascertain the experienced meaning that participants felt by their participation, and participants reported many positive psychological and physical improvements that indicate thatAyahuasca could be of potential interest in the development of new medicines and therapies.
Abstract: Ayahuasca is a psychoactive brew used by the indigenous populations of the Amazon. The aim of this qualitative study was to gain insight into the experiences of western users of ayahuasca, as well as to ascertain the experienced meaning that participants felt by their participation. Twenty-five people from Northern Europe with experiences of group sessions with ayahuasca wrote anonymous descriptions of their experiences. The Empirical Phenomenological Psychological method was used for this analysis. The analysis resulted in 33 categories which were assembled into six general themes: (a) motivation and aim, (b) contractile frightening state (c) sudden transformation of the experience, (d) limitless expansive states with transcendental experiences, (f) reflections, and (g) changed worldview and new orientation to life. These themes provided a new structure, called the transcendental circle. Participants reported many positive psychological and physical improvements that indicate that ayahuasca could be of potential interest in the development of new medicines and therapies.
71 citations
TL;DR: Subjective craving and attention to cues were significantly higher in the VR cannabis environments compared to the VR neutral environments, indicating that VR cannabis cue reactivity may offer a new technology-based method to advance addiction research and treatment.
Abstract: Virtual reality (VR) cue environments have been developed and successfully tested in nicotine, cocaine, and alcohol abusers. Aims in the current article include the development and testing of a novel VR cannabis cue reactivity assessment system. It was hypothesized that subjective craving levels and attention to cannabis cues would be higher in VR environments with cannabis cues compared to VR neutral environments. Twenty nontreatment-seeking current cannabis smokers participated in the VR cue trial. During the VR cue trial, participants were exposed to four virtual environments that contained audio, visual, olfactory, and vibrotactile sensory stimuli. Two VR environments contained cannabis cues that consisted of a party room in which people were smoking cannabis and a room containing cannabis paraphernalia without people. Two VR neutral rooms without cannabis cues consisted of a digital art gallery with nature videos. Subjective craving and attention to cues were significantly higher in the VR cannabis environments compared to the VR neutral environments. These findings indicate that VR cannabis cue reactivity may offer a new technology-based method to advance addiction research and treatment.
62 citations
TL;DR: Experiential differences were displayed within the ayahuasca ceremony group, warranting continued investigation into, and identification of, various confounding variables that prompt reported changes in spirituality within some participants while not in others.
Abstract: Ayahuasca, a hallucinogenic plant brew from the Amazon basin used as part of healing ceremonies by the local indigenous people of the region for centuries, is now being consumed by growing numbers of people throughout the world. Anecdotal evidence and previous research suggest that there are spiritual effects experienced among participants who take part in ayahuasca ceremonies. The current study examined whether novice participants' spirituality was affected through participation in an ayahuasca ceremony, and if so, how. A mixed-design method was used, comparing those participating in an ayahuasca ceremony to those who did not participate. This investigation used the Peak Experience Profile, the Spiritual Well-being Scale, and the Mysticism Scale as quantitative measures. Participant interviews and written accounts of ceremony experiences were analyzed. Results showed that neither the SWB score nor the M-Scale score increased significantly after participating in an ayahuasca ceremony. However, it was found that the higher the PEP score, the greater the positive change in SWB and M-Scale scores. Qualitative data revealed common spiritual themes in many of the participants' interviews and written accounts. Experiential differences were displayed within the ayahuasca ceremony group, warranting continued investigation into, and identification of, various confounding variables that prompt reported changes in spirituality within some participants while not in others.
62 citations
TL;DR: History of childhood emotional abuse might be a risk factor for alexithymia among inpatient substance dependents and the number of childhood trauma types was positively correlated with TAS-20 andDIF and the “difficulty in describing feelings-DDF' items of Tas-20.
Abstract: The prevalence of childhood abuse and neglect (CAN) histories and their associations with alexithymia among male substance-dependent inpatients were studied. Participants were 159 consecutively admitted male substance dependents (115 alcohol and 44 other drugs). Substance dependence was diagnosed by means of the Structured Clinical Interview for DSM-IV (SCID-I), Turkish version. Patients were investigated with the Toronto Alexithymia Scale (TAS-20) and Childhood Abuse and Neglect Questionnaire. Among substance-dependent patients, 57.0% had at least one type of CAN and 45.3% were considered as alexithymic since they had a score greater than 60 on the TAS-20. Rate of unemployment, low educational status, emotional abuse and history of suicide attempts were higher in alexithymic substance dependent patients. Those who had histories of two or more types of childhood abuse or neglect had also higher mean score on TAS-20, particularly on the item "difficulty in identifying feelings-DIF." Also, the number of childhood trauma types was positively correlated with TAS-20 and DIF and the "difficulty in describing feelings-DDF" items of TAS-20. History of childhood emotional abuse was the only determinant for alexithymia. Childhood emotional abuse might be a risk factor for alexithymia among inpatient substance dependents.
61 citations
TL;DR: Findings support the importance of providing appropriate opioid detoxification and/or maintenance therapy to opioid-dependent inmates and support the need for more research into the withdrawal experiences of addicted inmates.
Abstract: Both heroin-addicted individuals and methadone maintenance patients are likely to face untreated opioid withdrawal while incarcerated. Limited research exists concerning the withdrawal experiences of addicted inmates and their impact on individuals' attitudes and plans concerning drug abuse treatment. In the present study, 53 opioid dependent adults (32 in methadone treatment and 21 out of treatment) were interviewed in an ethnographic investigation of withdrawal experiences during incarceration. When treatment for opioid withdrawal was unavailable, detoxification experiences were usually described as negative and were often associated with a variety of unhealthy behaviors designed to relieve withdrawal symptoms. Negative methadone withdrawal experiences also negatively influenced participants' receptivity to seeking methadone treatment upon release. A minority of participants took a positive view of their withdrawal experience and saw it as an opportunity to detox from heroin or discontinue methadone. Findings support the importance of providing appropriate opioid detoxification and/or maintenance therapy to opioid-dependent inmates.
52 citations
TL;DR: Two specific types of collegiate polydrug use, simultaneous interaction and sequential management, are examined within a cultural framework that relates these practices to the expression of two complementary values—control and release.
Abstract: Social science research on polydrug use among young adult college students is scant, adopts definitions of this practice that are often devoid of sociocultural context, and emphasizes a very narrow range of use patterns. This article, based on ethnographic interviews from a study of collegiate prescription drug misuse, expands this focus by offering a cultural analysis of polydrug use. Two specific types of collegiate polydrug use, simultaneous interaction and sequential management, are examined within a cultural framework that relates these practices to the expression of two complementary values—control and release. The college experience provides young people with a culturally sanctioned “time-out” period that affords freedom from many of the roles, responsibilities, and other constraints that come to structure later adult life. At the same time, college students are expected to meet academic and social demands that require organization, initiative, and direction. Specific types of polydrug use provide young adults with a means to navigate these competing prescriptions that are characteristic of contemporary college life.
49 citations
TL;DR: Screening and interventions for NO and VS inhalant use should be implemented in juvenile justice facilities and psychiatric disorders, polydrug use, and temperamental fearlessness were correlates of NO use.
Abstract: Few studies have examined the prevalence of nitrous oxide (NO) inhalation or co-occurrence of NO and volatile solvent (VS) use in adolescents. Study aims were to (1) describe the independent and conjoint prevalence of NO and VS use in incarcerated youth, (2) compare adolescent users of both NO and VS inhalants (NO+VS) to users of NO-only, VS-only, and nonusers of NO and VS (NO/VS nonusers) with regard to demographic, psychological, and behavioral characteristics, and (3) conduct logistic regression analyses identifying correlates of NO use. Residents (N = 723) of Missouri Division of Youth Services were assessed with standardized psychosocial measures. Participants averaged 15.5 (SD = 1.2) years of age, were ethnically diverse and predominantly male. Lifetime prevalence of NO use was 15.8%. NO+VS users evidenced greater impairments compared to NO+VS nonusers. VS-only users evidenced impairments that were similar in kind but at lower prevalences compared to those displayed by NO+VS users, whereas NO-only youth had profiles that were similar to those of NO/VS nonusers. Psychiatric disorders, polydrug use, and temperamental fearlessness were correlates of NO use. NO+VS users were at high risk for behavioral and emotional problems. Screening and interventions for NO and VS inhalant use should be implemented in juvenile justice facilities.
43 citations
TL;DR: Results from a structural equation model indicate that offering services for specific populations and professionalization of staff has limited impact on the six TC elements, and selected modifications are possible without significantly impacting the TC model's core technology.
Abstract: Traditional therapeutic communities (TCs) are characterized by confrontational group therapy, treatment phases, a tenure-based resident hierarchy, and long-term residential care. Many TCs have modified the structure and intensity of the traditional model, tailored services for specific client populations, and hired more professionally trained staff. This study examines the extent to which modified TCs are able to retain the underlying core technology of the TC. Using data from a nationally representative sample of 380 self-identified TCs, six traditional TC elements are identified. Results from a structural equation model indicate that offering services for specific populations and professionalization of staff has limited impact on the six TC elements. Modifications to structure and intensity of TC programming evidenced the strongest effect. Specifically, outpatient-only TCs showed significantly lower adherence to five of the six elements. Short-term residential programs showed a similar negative...
TL;DR: Findings revealed that most methamphetamine users in New Zealand were experienced users of other substances when trying the drug for the first time, but lacked specific knowledge of methamphetamine.
Abstract: Methamphetamine use has risen in many countries around the world in recent years, and New Zealand is no exception, with the substance having become well-established in the illicit drug market. While there is much published on the individual and social harms of this drug, limited data are available on methamphetamine use initiation. Understanding early patterns of behavior is important, given the potential risks involved at this stage of use. This article presents findings from a qualitative study which was undertaken with methamphetamine users, most of whom were in treatment at the time of the research. While the research primarily sought to investigate patterns of methamphetamine use and associated harms, a key issue explored was the way in which respondents came to use the drug. Findings revealed that most were experienced users of other substances when trying the drug for the first time, but lacked specific knowledge of methamphetamine. The majority were introduced to methamphetamine in a social situation by a friend or partner, who also played a key role in preparing the drug for administration. Several reported risk-taking behaviors on the first occasion of use. The findings have important implications for potential interventions and harm reduction strategies at first use.
TL;DR: Outpatient programs should consider establishing SLHs for clients who lack a living environment supportive of sobriety, and the structure and processes of the houses used in Options Recovery Services are described.
Abstract: Finding a living environment that supports recovery is a major challenge for many clients attending outpatient treatment. Yet it is important because family, friends, and roommates who encourage substance use or discourage recovery can undermine the progress made in treatment. Destructive living environments are most problematic for clients who have limited incomes and reside in urban areas where housing markets are tight. Individuals who are homeless face constant threats to their sobriety and often lack the stability necessary to attend treatment consistently. Options Recovery Services is an outpatient program in Berkeley, California that uses sober living houses (SLHs) to provide an alcohol and drug free living environment to clients while they attend the outpatient program. This paper describes the structure and processes of the houses along with six month outcome data on 46 residents. Improvements included the number of months using substances, maximum number of days of substance use per month, arrests, and employment. Seventy six percent of the residents remained in the house at least 5 months and 39% reported being employed at some point during the past 30 days. Outpatient programs should consider establishing SLHs for clients who lack a living environment supportive of sobriety.
TL;DR: Examining Ecstasy sellers' ideas about the role of brand names in Ecstasy markets and their relationship to their beliefs about different types of Ecstasy's purity and quality demonstrates that considering Ecstasy branding increases the understanding of buyer and seller relationships.
Abstract: This article presents selected findings from a qualitative study of Ecstasy sellers and their sales practices, knowledge of distribution networks, buyer-seller relationships, and self-reported drug use. In-depth interviews were conducted with 80 men and women who had sold five or more hits of Ecstasy five or more times in the six months prior to the interview. Study participants described their perceptions of the various types of Ecstasy they had distributed or used themselves. The participants had experience with a variety of Ecstasy labels, from the popular “Blue Dolphin” tablets to the powdered form called “Molly.” We tracked pill brand mentions on Ecstasy-related websites to compare with interviewees’ descriptions of Ecstasy brands. This study examines Ecstasy sellers’ ideas about the role of brand names in Ecstasy markets and their relationship to their beliefs about different types of Ecstasy’s purity and quality. We demonstrate that considering Ecstasy branding increases our understanding of buyer and seller relationships.
TL;DR: Among parolees with moderate to extensive criminal justice histories younger individuals and those with recent heroin use respond less favorably to comprehensive substance abuse treatment services and intensive parole supervision.
Abstract: This study examined the predictors of treatment completion among 380 state parole violators consecutively admitted to a comprehensive 12-month drug treatment program in lieu of reincarceration. Offenders were placed on intensive parole supervision throughout the 12-month treatment protocol and received three months of residential substance abuse treatment followed by nine months of outpatient counseling. Overall 123 (32.4%) of the offenders completed the 12-month treatment protocol. The primary reason for noncompletion was a positive drug screen. Bivariate analyses were performed to determine independent predictors of program completion. Four variables (age, past 30-day heroin use, total months incarcerated, and significant problems with mother) from the baseline Addiction Severity Index were found to be correlated with treatment completion (p < .10). These factors and other demographics (race, marital status, education) and variables found predictive of program completion in previous studies were entered into a multiple logistic regression model. Overall the final model found that only two factors―older age (p < .03) and no heroin use in the past 30 days (p < .02) significantly predicted treatment completion. These findings suggest that among parolees with moderate to extensive criminal justice histories younger individuals and those with recent heroin use respond less favorably to comprehensive substance abuse treatment services and intensive parole supervision.
TL;DR: Examination of the historical spread of methamphetamine misuse in the United States and the resulting individual, social, and environmental consequences offers a public health perspective on family, community, and social aspects.
Abstract: Since 1997, the use of methamphetamine as a drug of abuse has been widespread in the United States. While several forms of amphetamine are useful in some areas of medicine, methamphetamine as an abused substance is associated with severe and multifaceted consequences. Problems associated with the abuse of amphetamine and its derivatives such as methamphetamine have been well documented. As the manufacture and use of methamphetamine across the United States has increased, the impact of methamphetamine abuse has been felt beyond individual users; families as well as communities can be seriously affected. An increase in child neglect and violence as well as a lack of resources for health care, social services, and law enforcement because of methamphetamine abuse have been reported by many communities. This study examines the historical spread of methamphetamine misuse in the United States and the resulting individual, social, and environmental consequences. A public health perspective on family, community, and social aspects is offered, and ideas for future research and policy changes are explored.
TL;DR: A descriptive profile of the practices of preloading and post-loading as well as the motivations underlying these behaviors among New York City area youth are provided.
Abstract: Ecstasy use remains a key concern for professionals working in fields related to youth and drug use. At the forefront of these concerns are issues related to neurological dysfunction and depression--both acute and long-term--associated with MDMA use. Ecstasy users have been shown to assess Ecstasy related harms and to engage in a variety of practices to manage these risks. To contend with risk related to neurological dysfunction and depression, some youth have turned to "preloading" and "post-loading": the practice of consuming other substances to mitigate the negative effects of Ecstasy. Drawing upon data from an ethnographic study of club drug use among youth, the author provides a descriptive profile of the practices of preloading and post-loading as well as the motivations underlying these behaviors among New York City area youth. Youth utilize a range of preloading and post-loading practices, yet do not universally share similar practices, attitudes, and knowledge. It is critical to link clinical and behavioral sciences research to further study both the efficacy and safety of these practices.
TL;DR: The data reviewed in the use of CRA in combination with methadone maintenance shows improvement in a number of areas, including the reduction of opioid use, as well as other drugs of abuse, improved legal status, less psychiatric symptoms, and improved vocational and social functioning.
Abstract: This article reviews the Community Reinforcement Approach (CRA) in the treatment of opioid dependence. It covers the use of CRA with both methadone maintenance patients and patients withdrawing from opioids. The data reviewed in the use of CRA in combination with methadone maintenance shows improvement in a number of areas. These include the reduction of opioid use, as well as other drugs of abuse, improved legal status, less psychiatric symptoms, and improved vocational and social functioning. CRA coupled with vouchers can assist in retaining patients in treatment long enough to improve opioid detoxification rates from buprenorphine and coupled with naltrexone may sustain abstinence. Further, the use of a standardized computerized format may extend the utility of CRA.
TL;DR: Although Salvia users rated their hallucinogenic experiences as similar to those seen in previously published reports, the majority likened their experiences as most sintilar to marijuana instead of more traditional psychedelics, calling into question the reigning theory of LSD-like subjective effects elicited by Salvia.
Abstract: Salvia divinorum is a naturally occurring psychedelic considered to be one of the most potent hallucinogens found to date. The few behavioral studies conducted conclude that Salvia's effects may be similar to traditional psychedelics, which is noteworthy because Salvia acts via a unique molecular mechanism as a kappa opioid receptor agonist. One hundred and ninety-three participants, including 34 Salvia users, were asked to fill out a series of questionnaires related to general drug use, personality characteristics, demographics and their experiences with Salvia. Salvia users were found to differ from nonusers on personality characteristics and reported consuming significantly more alcohol than nonusers. In addition, although Salvia users rated their hallucinogenic experiences as similar to those seen in previously published reports, the majority likened their experiences as most similar to marijuana instead of more traditional psychedelics. Low scores on the ARCI LSD subscale confirmed this finding and call into question the reigning theory of LSD-like subjective effects elicited by Salvia.
TL;DR: Cannabis users and Ecstasy users did not differ from controls on the behavioral measures of creativity, although there was a borderline trend for self-assessment of greater creativity.
Abstract: This study investigated the associations between chronic cannabis and Ecstasy/MDMA use and one objective and two subjective measure of creativity. Fifteen abstinent Ecstasy users, 15 abstinent cannabis users, and 15 nondrug-user controls, completed three measures of creativity: the Consequences behavioral test of creativity, self-assessed performance on the Consequences test, and Gough's Trait Self-Report Creative Adjective Checklist. The Consequences test involved five scenarios where possible consequences had to be devised; scoring was conducted by the standard blind rating (by two independent judges) for "remoteness" and "rarity," and by a frequency and rarity of responses method. Cannabis users had significantly more "rare-creative" responses than controls (Tukey, p < 0.05); this effect remained significant with gender as a covariate. There were no significant differences between the groups on the number of standard scoring "remote-creative" ideas or for fluency of responses. On self-rated creativity, there was a significant ANOVA group difference (p < 0.05), with Ecstasy users tending to rate their answers as more creative than controls (Tukey comparison; p = 0.058, two-tailed). Ecstasy users did not differ from controls on the behavioral measures of creativity, although there was a borderline trend for self-assessment of greater creativity. Cannabis users produced significantly more "rare-creative" responses, but did not rate themselves as more creative.
TL;DR: Stability of sense of coherence (SOC) over time and in relation to the outcomes of former heroin addicts in MMT is a stable parameter that can serve as a predictor for success inMMT, both as retention in treatment and drug abstinence.
Abstract: We studied stability of sense of coherence (SOC) over time and in relation to the outcomes of former heroin addicts in MMT. Between September of 2003 and April of 2006, all 90 newly admitted patients to a MMT clinic in Tel Aviv were studied and followed up for one year. A SOC (inner resources) questionnaire was done at baseline and after one year. Use of opiates, cocaine, benzodiazepines, cannabis and amphetamines in the 13 months after admission was recorded, and defined as positive if at least one urine test for any drug was positive. After one year, 77 (85.6%) stayed in treatment. SOC scores were similar at baseline and after one year, but were lower among 42 patients who still abused any drugs (118.8+27.4), compared with the 35 patients who did not (128.5+26.5, Repeated measures, Groups p = 0.003, Time effect p = 0.5, Time*Group p = 0.003). Cumulative retention revealed that 30 patients with SOC scores greater than 130 had longer retention (3.5 years, 95% CI 3.2–3.9) as compared with 60 patie...
TL;DR: Newspaper coverage of meth was disproportionate to the scale of the meth problem as indicated by site-specific treatment admissions data and two of the three newspapers' portrayals of meth were conducive to promoting a moral panic over the drug.
Abstract: This study examined the coverage of methamphetamine from 1997 to 2005 by three newspapers serving small Midwestern cities and contrasted their portrayals of methamphetamine problems with available data on the severity of the meth problem in each locality. Results of quantitative and qualitative content analyses show that--to varying degrees, across sites and over time--newspaper coverage of meth was disproportionate to the scale of the meth problem as indicated by site-specific treatment admissions data. To some extent, each of the three newspapers used drug-scare rhetoric (e.g., medical metaphors such as "plague") to describe the prevalence and effects of meth. Results indicate that two of the three newspapers' portrayals of meth were conducive to promoting a moral panic over the drug. Potential explanations for variations in coverage are discussed, and findings are considered in light of research on prior drug scares.
TL;DR: Both groups showed a significant improvement in employment outcomes and reduction in HIV risk behaviors at the six-month follow-up, suggesting the problem solving framework may be an improvement over standard methadone counseling.
Abstract: After drug use stabilization, employment has long been considered an important goal for clients enrolled in Methadone Maintenance Treatment Programs (MMTPs). The integrated counseling and employment intervention described here is a manualized treatment based on interpersonal cognitive problem solving (ICPS) theory. The six-month intervention utilized a problem-solving framework to help methadone clients obtain a job and manage employment within the context of drug treatment. In this pilot study, 23 subjects were randomly assigned to either integrated ICPS drug and employment counseling (n = 12) or to an ICPS drug counseling control condition (n = 11). While there were no differences between the integrated and control conditions, both groups showed a significant improvement in employment outcomes and reduction in HIV risk behaviors at the six-month follow-up. Although there may be concerns regarding the generalizability of the findings, overall, the problem solving framework may be an improvement ...
TL;DR: Findings show that drug-addicted female inmates injected drugs to a greater extent than males and that male inmates remained abstinent for longer periods than female inmates, which may indicate the need to require separate gender-oriented therapeutic interventions.
Abstract: The current study examined gender differences in personal and psychological characteristics among drug-abstinent Israeli inmates. The study fo cuses primarily on three personal variables: sense of coherence (SOC), anxiety, and hostility. Additional factors that were examined are demographic variables, which include background, crime, and drug addiction. The sample included 119 inmates (65 males and 54 females) who abstained from drugs use for two different time intervals-up to one year, and more than one year—and did not receive treatment. Overall, males and females shared similar backgrounds except for a higher rate of sexual abuse among female inmates. No gender differences were found in recidivism. These findings show that drug-addicted female inmates injected drugs to a greater extent than males. They also indicated that male inmates remained abstinent for longer periods than female inmates. Additionally, length of abstinence was related to higher SOC, lower trait anxiety, and less hostility ...
TL;DR: Youth who had a mood disorder diagnosis, were male, older, White and had previously run away from home were significantly more likely to be in Class 1 relative to other classes, and these differences have implications for prevention and treatment.
Abstract: This study examines patterns of substance use among youth served in systems of care, and how these patterns relate to diagnosis and other youth characteristics using latent class analysis. Results indicated a four-class solution with the four groups differing in their probabilities of reporting the use of 10 different substances. Class 1 was defined by high probabilities of all drug use. Class 2 had high probabilities of alcohol, tobacco, marijuana use, and low for other drugs. Class 3 had moderate probabilities of alcohol, tobacco, marijuana use, and low probabilities for other drugs. Class 4 had a high probability of tobacco use and no other drug use. Youth who had a mood disorder diagnosis, were male, older, White and had previously run away from home were significantly more likely to be in Class 1 relative to other classes. These differences have implications for prevention and treatment.
TL;DR: Twelve considerations are offered for working with men that include understanding the context of masculinity, how men are socialized, the gender of the therapist, their relationships with their fathers and their children, their male friendships, and sexual issues.
Abstract: Women and men have different histories, presentations, and behaviors in substance abuse groups. Twelve considerations are offered for the beginning group leader when encountering women with substance abuse issues. These include understanding sexism, what brings women to treatment, and how women behave in group treatment. Implications for clinical practice with women in single-gender and mixed-gender groups are included.
TL;DR: Comparisons between the DSM IV and the Big Book of AA are made, identity vs labels are discussed and the influence of the medical community on this controversial topic is discussed.
Abstract: There has always been widespread debate on how people with past substance abuse problems choose to identify themselves with regards to their recovery and the terms used to associate with that identity. Most of the disagreement over these terms is rooted on whether recovery is seen as an ongoing process ("recovering" or "in recovery") or a life event that can be mastered ("recovered"). This article discusses these three controversial terms and attempts to make them available as terms that one can use or identify with by presenting different perspectives on the topic of recovery. Some of these perspectives may be unconventional when compared to traditional views of the recovery process, but they are the realities of many individuals who have had a past experience with substance abuse and may be confronted with prejudice when voicing their recovery in a past tense. The article makes comparisons between the DSM IV and the Big Book of AA and discusses identity vs labels and the influence of the medical community on this controversial topic.
TL;DR: Multivariate analysis revealed several factors associated with greater involvement in effects-boosting behaviors, including race (not being African American), spending time with other drug users, using Ecstasy for its touchenhancing qualities, enjoyment of the music-and-Ecstasy-use experience, and childhood maltreatment experiences.
Abstract: This study examines drug effect-enhancing behaviors practiced by young adult users of the drug, Ecstasy. Between August 2002 and August 2004, 283 face-to-face interviews were conducted with active Ecstasy users. Study participants were recruited in the Atlanta, Georgia metropolitan area using a targeted sampling approach. The large majority of study participants (87%) engaged in at least one behavior specifically designed to bolster the effects of their Ecstasy use, with 61% of the study participants reporting having engaged in at least three such behaviors during the past 30 days. Taking steps to boost one's Ecstasy-related high was associated with binging on Ecstasy and a variety of adverse outcomes, such as experiencing a greater number of negative consequences resulting from Ecstasy use and experiencing more Ecstasy-related drug dependency symptoms. Multivariate analysis revealed several factors associated with greater involvement in effects-boosting behaviors, including race (not being African American), spending time with other drug users, using Ecstasy for its touch-enhancing qualities, enjoyment of the music-and-Ecstasy-use experience, and childhood maltreatment experiences. The implications of these findings for treatment, prevention, and intervention for drug problems among Ecstasy users are discussed.
TL;DR: Comparing African Americans, Caribbean Blacks and non-Hispanic Whites regarding their probability of making treatment contacts over time, comorbid anxiety disorders were found to be a consistent factor associated with a faster time to treatment.
Abstract: Prior research has shown that minority groups experience greater levels of disability associated with psychiatric and substance use conditions due to barriers to treatment. Treatment delays are an important part of the overall problem of service utilization and access to treatment, yet little work has been done to understand the factors associated with treatment delays among ethnic minorities. This study compares African Americans, Caribbean Blacks and non-Hispanic Whites regarding their probability of making treatment contacts over time, using a combined sample of African Americans and Caribbean Blacks from the National Survey of American Life (NSAL) and non-Hispanic Whites from the National Comorbidity Survey-Replication (NCS-R). Alcohol and other drug use disorders (abuse and dependence) were assessed using the World Mental Health Composite International Diagnostic Interview. Cumulative lifetime probability curves were used to examine race differences in treatment contact. Cox regression analysis was used to test the association between race and treatment groups while controlling for other potential confounding variables. Significant delays in making treatment contact were observed across all disorders. However, no evidence of delays was found for racial differences. In the multivariate analysis, race was not significantly associated with delays. However, comorbid anxiety disorders were found to be a consistent factor associated with a faster time to treatment.
TL;DR: Antisocial adolescent nitrite users are at substantially elevated risk for serious functional impairments given their high rates of lifetime head injury, comparatively more varied and intensive levels of involvement with psychoactive drugs, and symptom reports suggestive of psychiatric and cognitive dysfunction.
Abstract: The purpose of this study was to examine the prevalence, patterns, and predictors of nitrite inhalant use in antisocial adolescents. Face-to-face interviews were conducted with 723 Missouri youth (M age = 15.5, SD = 1.2) in residential care for antisocial behavior. The lifetime prevalence of nitrite inhalant use was 1.7% (1.3% for boys; 4.3% for girls, p = .06), a figure somewhat higher than comparable estimates from the MTF and NSDUH national surveys. Most lifetime users reported nitrite use in the prior year (92%) and experienced intoxication (83%) during periods of nitrite inhalation. Nitrite users had significantly higher scores on measures of somatization, obsessive-compulsive traits, interpersonal sensitivity, impulsivity, fearlessness, suicidality, and polydrug use and were significantly more likely to have suffered a serious head injury and to be White than their non-nitrite-using counterparts. Nitrite users also reported significantly higher levels of current psychiatric distress related to periods of faintness or dizziness, hot or cold spells, difficulty making decisions, and their "mind going blank" than did non-nitrite users. Antisocial adolescent nitrite users are at substantially elevated risk for serious functional impairments given their high rates of lifetime head injury, comparatively more varied and intensive levels of involvement with psychoactive drugs, and symptom reports suggestive of psychiatric and cognitive dysfunction.