Showing papers on "Substance abuse published in 1979"

Sensation seeking and psychopathology.

Abstract: A sample of 2,115 persons responded to an article in a popular magazine by taking the Sensation Seeking Scale (SSS) and supplying personal information by mail, including data about past treatment, hospitalization, and diagnosis of psychiatric disorders. Subjects falling into certain diagnostic categories were closely matched with controls from the same sample who reported no history, treatment, or diagnosis of disorder. SSS scores were not related to general psychopathology, unipolar depression, schizophrenia, or neurosis, but were found to be elevated in persons reporting a history of manic-depressive or sociopathic spectrum (including alcoholism and drug abuse) disorder.

The relation of time spent in drug abuse treatment to posttreatment outcome.

Abstract: The author examined follow-up outcomes in the first year after treatment in relation to time spent in treatment in the Drug Abuse Reporting Program. Follow-up interviews were completed with more than 3,000 people admitted to drug abuse treatment during 1969--1972, including clients treated with methadone maintenance, therapeutic communities, outpatient drug-free programs, and outpatient detoxification, as well as a group who completed intake procedures but did not return for treatment. Longer time in treatment was related to better posttreatment outcome, but clients who spent less than 3 months in treatment were not significantly different from the detoxification-only group or the intake-only group.

Impact of alcohol, drug abuse and mental health treatment on medical care utilization. A review of the research literature.

Abstract: This monograph reviews and assesses twenty-five studies that examined the question of whether treatment for mental illness, alcohol abuse or drug abuse reduces subsequent medical care utilization. In general, the studies found that such a reduction did take place. Twelve of thirteen studies found reductions of 5 to 85 per cent in medical care utilization subsequent to a mental health intervention. The median reduction was 20 per cent. The thirteenth study found that mental health services provided in a new neighborhood health center in a medically underserved neighborhood were followed by a 72 per cent increase in medical care encounters. The remaining twelve studies found reductions of 26 to 69 per cent in either medical care utilization or surrogate measures of such utilization subsequent to treatment for alcohol abuse. The median reduction was 40 per cent. The drug abuse literature in this area is sparse and primarily indirect. Although many of the studies suggested that alcohol, drug abuse or mental health (ADM) treatment was a cause of the subsequent reduction in medical care utilization, such causality was not definitively established, due to frequent methodological limitations, such as inadequate comparison groups, short time spans, small samples and lack of trend analysis. In addition, the studies focused primarily on outpatient psychotherapy in organized health care settings, particularly health maintenance organizations (HMOs), and on alcoholism treatment provided through employee-based programs and HMOs. Only very limited policy implications on such topics as health insurance and the linkage of health and ADM services can be drawn from the current body of literature. There is a need for additional research that is broader and more rigorous. To encourage such research, methodological recommendations for future studies are presented.

Development of psychiatric illness in drug abusers. Possible role of drug preference.

Abstract: The origin of the psychiatric illnesses observed in drug abusers is often unclear. This study examines the causal relation between drug abuse and specific psychiatric disorders. Fifty-one male veterans first seen in 1972, who were admitted at least once per year for six consecutive years for inpatient drug-abuse treatment, underwent psychiatric assessments at each admission. Eleven men mainly used stimulants, 14 depressants, and 26 opiates. Initial psychiatric examinations showed low symptom levels in all groups but no statistically significant differences among them. By the end of six years, five of the stimulant users had psychoses, and eight of the depressant users had serious depression. The narcotics users showed no change in psychopathology. Differences between the groups were significant at the 0.01 level. These changes were not due to acute toxic reactions, but our data suggest that abuse of particular drugs has a major role in the development of specific psychiatric illnesses. The possibility that different preexisting personality disorders lead to different kinds of drug abuse cannot be excluded.

Drug abuse and dependency in patients with chronic pain.

Abstract: Of 144 patients with chronic pain of nonmalignant cause, 35 (24%) were drug-dependent, 59 (41%) drug abusers, and 50 (35%) nonabusers Codeine and oxycodone (Percodan) were most frequently abused In regard to characteristics tested, differences between the groups were not great; but there was a significant difference in outcome between nonabuse and dependent groups Early detection and treatment of drug abuse should minimize some of the difficulties involved in management of treatment-resistive patients with chronic pain

Follow-up evaluation of treatment of drug abuse during 1969 to 1972.

Abstract: • A sample of 3,131 persons from approximately 25,000 admitted to drug abuse treatment programs in the Drug Abuse Reporting Program during 1969-1972 were followed up in 1975-1976. Treatment groups included methadone hydrochloride maintenance, therapeutic community, outpatient drug free, outpatient detoxification, and a comparison group that completed intake but did not enter treatment. Outcome criterion measures (drug use, employment, criminality, and treatment readmissions) based on the first year after treatment were more favorable in the methadone maintenance, therapeutic community, and outpatient drug-free groups than in the outpatient detoxification and intake-only groups. Evaluation of differential outcomes and their relationships with pretreatment and duringtreatment measures within each group indicated that pretreatment criminal history, during-treatment performance, and length of time in treatment were significantly related to posttreatment outcomes.

Adolescent Suicide Attempts

Abstract: The conditions of 40 adolescents in treatment following a suicide attempt were diagnosed according to the multiaxial classification of the American Psychiatric Association's proposed third edition of the diagnostic and statistical manual. All were psychiatrically ill before the suicide attempt. The most common diagnoses were those of depressive disorders and substance abuse disorders on the clinical psychiatric syndrome axis and borderline personality disorder on the personality and developmental disorder axis. The typical patient was a polydrug-abusing girl with a borderline personality disorder and a superimposed major depressive disorder. The most prominent personality characteristics associated with suicide attempts by these adolescents were a tendency to react severely to a loss, poorly controlled rage, and impulsivity. Suicide attempts by adolescents should be taken seriously by the physician and necessitate a thorough search for a possible underlying pathological condition. ( JAMA 241:2404-2407, 1979)

Family Therapy of Drug and Alcohol Abuse

Abstract: 1. Constructing a Therapeutic Reality. 2. Family Processes Associated with Alcohol and Drug Use and Abuse. 3. From Psychodynamic to Structural to Integrated Family Treatment of Chemical Dependency. 4. Structural Family Therapy with Drug Addicts. 5. Family Therapy with Adolescent Substance Abusers. 6. Multiple Family Therapy with Drug Abusers. 7. From Multiple Family Therapy to Couples Therapy. 8. Integrating Cybernetics and Constructivism into Structural/Strategic Family Therapy for Drug Abusers. 9. Drug-Abusing Families: Intrafamilial Dynamics and Brief Triphasic Treatment. 10. Adolescent Substance Abuse: Multidimensional Family Therapy in Action. 11. Stepfamilies and Substance Abuse: Unique Treatment Considerations. 12. Behavioral Treatment of the Alcoholic Marriage. 13. Willpower: A Major Issue in the Psychotherapy of Adult Children of Alcoholics. 14. The Therapist's Relationship with Couples with an Alcoholic Member. 15. An Abstinence Model of Family Therapy. 16. Integrative, Individual and Family Therapy as Told by Debby G. 17. The Application of the Basic Principles of Family Therapy to the Treatment of Drug and Alcohol Abusers. Index.

Diazepam and drug-associated deaths. A survey in the United States and Canada.

Abstract: This study describes a population of deceased persons in which death was generally caused by ingestion of numerous drugs, of which diazepam was only one agent. This drug occurred with high frequency relative to the total case load at each site, but its toxicological importance was often of a low order, and its role in the fatal cases was judged as minimal.

Inhalant, Marijuana, and Alcohol Abuse among Barrio Children and Adolescents

Abstract: Prevalence of inhalant, marijuana, and alcohol abuse was studied in a sample of 457 male and female Mexican-American children and adolescents between the ages of 9 and 17 years. Subjects interviewed resided in four housing projects located in East Los Angeles. All interviews were conducted by adolescents who resided in the same housing projects. Results indicated that compared to a national sample, Mexican-American adolescents were at least 14 times more likely to be currently abusing inhalants. The prevalence rate of marijuana was double the national rate, but the prevalence of alcohol was equal to that found nationally. Reasons for elevated substance abuse rates are explored.

Family treatment approaches to drug abuse problems: a review.

Abstract: This review covers the literature that has emerged specifically on the family treatment of drug abuse problems. Following a brief discussion of patterns and structures prevalent in drug-abusing families, 68 different studies or programs (discussed in 74 papers) are compared as to their techniques and results. These are categorized within the following modalities: marital treatment, group treatment for parents, concurrent parent and identified patient treatment, treatment with individual families (both inpatient and outpatient), sibling-oriented treatment, multiple family therapy, and social network therapy. A table presents the various studies, along with the types of results they provide. Outcomes are contrasted for the 14 studies that quantified their results. The final section presents implications for the following areas: treatment activities (clarification of technique, family recruitment, direction and effectiveness of treatment, confidentiality, and treatment delivery systems), training, prevention, and future research (outcome, technique and responsibility). It is concluded that family treatment for drug abuse is gaining widespread acceptance and shows considerable promise for dealing effectively with problems of this type.

Secondary depression: familial, clinical, and research perspectives.

Abstract: The authors evaluate the clinical and research significance of the diagnosis of secondary depression by comparing 48 cases of primary and 26 cases of secondary depression The patients with secondary depression have a higher familial prevalence of alcoholism, affective disorder, and drug abuse The groups differ somewhat on a few sociodemographic, behavioral, and attitudinal variables but are similar in symptomatology, sex ratio, onset and duration of symptoms, treatment received, and response to treatment These results suggest that the distinction between primary and secondary depression should be retained in research that examines neurochemistry or genetics Primary and secondary depression appear to be identical from the persepctive of clinical care Management of these patients should emphasize the diagnosis of depression rather than antecedent diagnoses

Drug abuse among alcoholic women.

Abstract: Of 293 women in an alcoholic treatment center, two-thirds have received prescriptions for drugs of potential abuse, usually hypnotic and antianxiety drugs. One-third of the women admitted abusing substances; 80% of these subjects got prescriptions for potential drugs of abuse while actively abusing. These figures are alarming in light of the lack of evidence that antianxiety drugs, hypnotics, and stimulants are effective in treating alcoholics and drug abusers. Drug-misusing women in this sample reported more suicide attempts and early antisocial problems and had received more psychiatric care than nonabusers. The authors urge that hypnotics, antianxiety drugs, and stimulants almost never be prescribed to outpatient alcoholics and that analgesics be prescribed only with great care.

Abuse of Prescribed Stimulant Medication by a 13-Year-Old Hyperactive Boy

Abstract: It is generally held that the prescription of stimulants for hyperkinesis does not predispose children to later stimulant abuse. The case of a 13-year-old hyperactive boy who abused methylphenidate after two years of therapeutic treatment is reported in this paper. During a research hospitalization, he was administered methylphenidate in a double-blind placebo-controlled fashion to assess the mood changes induced by the drug and to verify expected therapeutic effects. The child met the research criteria of hyperkinesis and did demonstrate a therapeutic effect of methylphenidate. He did not, however, demonstrate the pattern of mood changes characteristic of adult stimulant users. Possible risk factors for later substance abuse in prepubertal patients on prescribed stimulant medications are discussed.

Assessment of assertiveness in drug abusers.

Abstract: Administered measures of assertion, social assertion, aggression, and social anxiety to a heroin-addicted population, psychotic outpatients, court-referred drug users and a college student group (N = 114). The addicts and court-referred drug patients were less assertive, less socially assertive, and more socially anxious than non-addict populations. Furthermore, the heroin and psychiatric outpatient groups had a very high correlation between their assertion and aggression scores, which was not found in the college student or court-referred, drug-using group.

Amphetamine addiction and pregnancy. Psycho-social and medical aspects.

Abstract: The psycho-social backgrounds of 69 amphetamine-addicted mothers were investigated in order to find indicators which might be applicable in predicting the addicted women's chances of adaptation to motherhood. Of these 69 women, 17 stopped taking drugs in the first months of gestation when they realized that they were pregnant (Group 1). The remaining 52 women continued taking drugs throughout pregnancy (Group 2). There was no difference between the groups as to number of years of addiction, or other drugs used except that more women in Group 2 abused alcohol at the same time. A large proportion of the women in both Groups 1 and 2 were, as children, known to the local social welfare agencies because of their unsatisfactory home conditions. In Group 2, psychiatric illness and drug abuse were more common among parents and siblings than in Group 1. In spite of this, the women in Group 2 had, on the average, been placed in a foster home at a significantly older age. Significantly more women in Group 2 also had a poorer educational background and a criminal record including more serious crimes. At the time of their current pregnancy the women in Group 1 had a more stable social situation with regard to permanent dwelling, work and relationship with non-addicted friends.

Psychiatric illness in physicians.

Abstract: Psychiatric illness and behavioural problems among physicians are reviewed in this paper. Some studies suggest that the medical profession has a high rate of alcoholism, drug abuse and marital discord. As well, physicians appear to commit suicide and to seek admission to psychiatric institutions more frequently than comparable populations. Considered as etiologic factors in psychiatric illness among physicians are the role strain inherent in the profession and the personality development of individual practitioners prior to their entering medical school. The review concludes with suggestions for an improved approach to treatment and prevention.

Psychiatric problems in women admitted to an alcoholic detoxification center.

Abstract: The authors studied 293 consecutive female admissions to a public detoxification facility. One-half had a primary diagnosis of alcoholism; the rest had primary diagnosis of affective disorder (14%), antisocial personality (14%), drug abuse (6%) or did not meet the criteria for alcoholism (13%). Each subgroup had unique social backgrounds and characteristic histories of involvement with alcohol, drugs, and antisocial problems. The primary alcoholic woman in the detoxification center resembles the primary alcoholic man in the same setting. The authors underscore the importance of socioeconomic strata and primary versus secondary diagnosis in understanding the prognosis for alcoholics.

The Relationship between Self-Reported Religiosity and Drug Use by College Students

Abstract: As part of an extensive questionnaire on student drug use patterns at a small private college, this study was completed to determine the relationship between self-reported religiosity of college students and 1) the nature and incidence of current drug usage, 2) reasons for abstaining from drug use, 3) acceptable sources for referral in case of drug problems, and 4) persons with whom students would discuss their attitudes toward drugs. Statistically significant differences between religious and non-religious students at the 0.01 level were found in the current use of alcohol and marijuana, in reasons for abstaining from marijuana, amphetamines, barbiturates, and hallucinogens; in referral of drug problems to drug wise friends; and in discussing drug attitudes with parents and with college counselors.