bluuebunny/crossref_metadata_2025 huggingface dataset:
Cocaine Precipitation of Patient‐Identified Opiate Withdrawal
Authors: Stine Susan M. , Satel Sally , Kosten Thomas
Published: February 2010

Self‐reported opiate withdrawal symptoms were precipitated by cocaine use in 27 of 35 opiate‐dependent men. While 13 had used cocaine to relieve withdrawal symptoms, relief occurred only while they were high from cocaine, followed by more severe withdrawal than usual. Similar symptoms were also reported by 24 of 31 non‐opiate‐dependent cocaine abusers. Severity of symptoms was greater for the opiate‐dependent subjects. These results are consistent with noradrenergic sensitivity in opiate‐dependent subjects.
A Comparison of Psychopathology in Cocaine and Alcohol Dependence
Authors: Thevos Angelica K. , Brady Kathleen T. , Grice Dorothy , Dustan Lorraine , Malcolm Robert
Published: February 2010

The authors studied 89 alcohol‐ or cocaine‐dependent inpatients for comorbid Axis I or Axis II psychiatric disorders. Subjects were administered the Structured Clinical Interview for DSM‐III‐R (SCID) to determine Axis I diagnoses. Axis II diagnoses were determined using the SCID II self‐rating questionnaire and interview. High rates of Axis I disorders were found in both groups, but the types of disorders differed between groups. Axis II disorders were also commonly found in both groups but were significantly more common in the cocaine group. The types of personality disorders differed between the alcohol and cocaine groups, with the cocaine group showing significantly more Axis II Cluster A and B diagnoses.
Electroencephalographic Evidence for Residual CNS Hyperexcitability During Cocaine Abstinence
Authors: Bauer Lance O.
Published: February 2010

The author evaluated visual steady‐state evoked responses (SSER) and auditory amplitude‐modulated following responses (AMFR) in 13 cocaine‐dependent patients, 5 alcohol‐dependent patients, and 12 non–drug‐dependent control subjects. The 18 patients were studied after 1, 3, and 12 weeks of verified abstinence; the controls were studied after comparable intervals. Analyses revealed that visual SSER power increased as a function of modulation depth in the cocaine‐dependent group, but not in the other groups. The difference among the groups was greatest at the highest modulation depth (80%) and did not diminish over time. Auditory AMFR power was also greater in the cocaine‐dependent group relative to the other groups. However, unlike the visual SSER, the auditory AMFR normalized with continued cocaine abstinence. Collectively, the SSER and AMFR findings are interpreted as reflecting a residual cocaine effect which heightens CNS reactivity to sine wave (but not square wave)‐modulated visual and auditory input.
Cocaine Dependence: Behavioral Dimensions and Patterns of Progression
Authors: Khalsa M. Elena , Paredes Alfonso , Anglin M. Douglas
Published: February 2010

The authors report a longitudinal study describing the progression and circumstances of cocaine dependence within a large group of men with different usage histories, from initiation of use to entrance into a treatment program at a Veterans Affairs medical center several years later. Data illustrating the course of the disorder were retrospectively collected, using a “natural history” methodology successfully used in prior research. Four patterns of escalation of cocaine use are described. Generally, as the cocaine career progressed, there was a decrease in the consumption of alcohol and other drugs.
Nine Years of the Freebase Cocaine Epidemic in the Bahamas
Authors: Jekel James F. , Allen David F. , Clarke Nelson , Podlewski Henry , Gray Hannah , Roberts Carolyn
Published: February 2010

Nine years after the beginning of the epidemic of freebase (crack) cocaine abuse in the Bahamas, this historical study was done to characterize the natural course of the epidemic and to estimate the effectiveness of control measures. The authors' data include the incidence of new cases at the only psychiatric hospital in the Bahamas and at the primary community psychiatric clinic in the nation. The Bahamian response included 1) demand reduction, 2) supply reduction, and 3) reduction of money laundering. The annual number of new cases of crack abuse presenting for treatment declined from 1987 to mid‐1991 in both facilities, but in 1992 it began rising again in the inpatient setting only. The changes in recent years have been accompanied by an increase in violent crimes against persons, especially robberies. (American Journal on Addictions 1994; 3:14–24)
A Comparative Study of Psychopathology and Cognitive Functions Between Cocaine‐and Opiate‐Dependent Patients
Authors: Montoya Ivan D. , Hess Judith M. , Covi Lino , Fudala Paul J. , Johnson Rolley E.
Published: February 2010

The authors examined cognitive and psychological differences between cocaine‐ and opiate‐dependent individuals, using the Symptom Check List‐90‐Revised (SCL‐90‐R) and the Shipley Institute of Living Scale (SILS). They studied a sample of 135 cocaine‐dependent and 162 opiate‐dependent patients entering drug abuse treatment studies at the National Institute on Drug Abuse‐Addiction Research Center (NIDA‐ARC) outpatient clinic. Cocaine‐dependent patients had significantly higher estimated Wechsler Adult Intelligence Scale (WAIS‐R) IQ, vocabulary, abstraction, and total T scores, as measured by the SILS. On the SCL‐90‐R, cocaine‐dependent patients had significantly higher scores for interpersonal sensitivity, anxiety, phobic anxiety, paranoid ideation, and psychoticism; opiate‐dependent patients had higher scores for somatization. The results suggest that cocaine‐dependent patients have better cognitive function and more psychopathology than opiate‐dependent patients entering drug abuse outpatient treatment studies.
Temperament Mediates the Effects of Family History of Substance Abuse on Externalizing and Internalizing Child Behavior
Authors: Blackson Timothy C. , Tarter Ralph E. , Martin Christopher S. , Moss Howard B.
Published: February 2010

Temperament has been hypothesized to mediate the effects of family history of substance abuse (SA) on behavioral maladjustment in children. To date no study has provided empirical evidence to support this mediation hypothesis. In this study the temperament mediation hypothesis was tested employing hierarchical regression and other linear regression procedures. “Difficult affective temperament” in fathers and sons was found to mediate the relationship between SA+ family history and behavior maladjustment in 10‐ to 12‐year‐old sons of SA+ (n = 41) and SA‐ (n = 39) families. The authors discuss implications of the phenotype of difficult affective temperament in describing the developmental pathway to substance abuse.
Marijuana Use Associated With First Episode of Psychiatric Illness in an Adolescent Population
Authors: Clark Robert R.
Published: February 2010

Marijuana is the most commonly used illicit drug in the United States. Although there have been reports of severe adverse effects, many view its use as relatively innocuous. As millions of adolescents and young adults currently use or have used marijuana, it is important that awareness of both medical and psychiatric risk factors is periodically reinforced. Four case reports are presented in which there appears to be a direct connection between the onset of psychiatric symptoms and the use of marijuana. (American Journal on Addictions 1994; 3:67–71)
Alcohol, Opium, and Tobacco, 1817–1844: A View from America's First Private Mental Hospital
Authors: Leonard Edward C.
Published: February 2010

Clinical examples from the 1817–1844 medical records of Philadelphia's Friends Hospital, the nation's first private psychiatric hospital, demonstrate how its early physicians struggled to describe, understand, and treat substance‐related disorders. They recognized the harmful effects of alcohol, opium, and tobacco, but they also used them as treatments. This was a period of wide use of these substances and of active temperance efforts. Selections from this period's scientific literature reflect developing professional views and explain contemporary treatments.
Psychiatric Comorbidity and Self‐Efficacy to Resist Heavy Drinking in Alcoholic and Nonalcoholic Adolescents
Authors: Moss Howard B. , Kirisci Levent , Mezzich Ada C.
Published: February 2010

The authors examined both the nonspecific effects of psychopathology and the interactions of alcohol use disorders with other specific comorbid psychiatric conditions in an adolescent population on perceived self‐efficacy to resist heavy drinking. The results suggest that nonspecific psychopathology, manifested in the form of any common psychiatric disorder, is associated with decreased situational confidence to resist heavy drinking across various situations. Main effects of alcohol use disorders, and several other specific psychiatric disorders, and specific comorbid interactions were also associated with decreased situational confidence. These results have implications for the etiology, prevention, and treatment of adolescents who abuse alcohol.
Predicting Acceptance of Treatment in Male Dual‐Diagnosis Outpatients
Authors: Berman Jonathan D. , Atkinson Roland M.
Published: February 2010

The authors studied a cohort of 128 male veterans undergoing preadmission screening for a specialized outpatient program for chronically mentally ill substance abusers. Demographic, substance abuse, and comorbid psychiatric variables were evaluated for their correlation with acceptance (44 patients) or rejection (84 patients) of the treatment offered. A later age at onset of both substance abuse and comorbid psychiatric illness significantly increased the likelihood of acceptance, as did the presence of a primary alcohol use disorder and the absence of current medical problems. A strong correlation was observed between the age at onset of substance abuse and comorbid psychiatric disorder, suggesting that in many dual‐diagnosis patients the two disorders could be manifestations of a single process.
A Comparison of High‐Risk Situations for Alcohol and Other Drugs
Authors: Ross Anita A. , Filstead William J. , Parrella David P. , Rossi Jean J.
Published: February 2010

The authors examined situational and affective risk factors associated with the use of alcohol and other drugs. Five primary substance groups (alcohol, cocaine, marijuana, sedatives‐tranquilizers, and heroin‐opiates) were compared on situational risk scales from the Inventory of Drinking and Drug Use Situations. Significant differences were found between groups on both level and pattern of situational and affective risk. Positive social experiences and negative affective states were important risk factors for the alcohol and cocaine groups. Positive affective and situational factors were important for the marijuana group. Negative physical states and interpersonal conflict were important risk factors for the heroin‐opiate and sedative‐tranquilizer groups. Age and gender were also found to be significantly related to level and pattern of situational risk for alcohol and other drug use.
Inhalant Use: Characteristics and Predictors
Authors: Compton Wilson M. , Cottler Linda B. , Dinwiddie Stephen H. , Spitznagel Edward L. , Mager Doug E. , Asmus Gregory
Published: February 2010

Volatile inhalant use has previously been shown to be associated with psychiatric illness and use of other substances. The authors examined the association of history of inhalant use with other drug use, psychiatric disorders, and sociodemographic characteristics in a diverse sample of illicit substance abusers. They found a strong association of inhalant use with antisocial personality disorder, social phobia, alcohol dependence, tobacco dependence, injection drug use, and use of amphetamines, sedatives, opiates, phencyclidine, and hallucinogens. Inhalant use was more common among white than black subjects but not more common among men than women. The implications for prevention and treatment are discussed.
The Alcohol Withdrawal Syndrome.Neurobiology of Treatment and Toxicity
Authors: Adinoff Bryon
Published: February 2010

Our increasing understanding of the neurobiology of the alcohol withdrawal syndrome has been accompanied by its safe and efficacious treatment. In this review, the biologic alterations that are associated with the signs and symptoms of withdrawal, and their relationship to current pharmacologic treatments, will be discussed. Potential long‐term neurotoxic effects of alcohol withdrawal will also be reviewed. The role of the GABAA‐benzodiazepine receptor complex, the N‐methyl‐D‐aspartate (NMDA) receptor, the sympathetic nervous system, the hypothalamic‐pituitary‐adrenal axis, and limbic neuronal sensitization in the acute changes and persistent consequences of alcohol withdrawal will be the focus of this discussion. Potential treatment strategies based on these neurobiologic changes will be proposed. (American Journal on Addictions 1994; 3:277–288)
Using the General Behavior Inventory to Screen for Mood Disorders Among Patients With Psychoactive Substance Dependence
Authors: Saxon Andrew J. , Calsyn Donald A. , Stanton Viki , Hawker C. Stephen
Published: February 2010

The General Behavior Inventory (GBI), a self‐report instrument that measures mood disorders, was completed by 224 drug‐dependent subjects, who also completed other psychometric tests, underwent clinical psychiatric evaluation blind to GBI results, and provided urine toxicology specimens during outpatient treatment. The GBI found unipolar and bipolar disorders in 10.7% and 15.6% of subjects, respectively. Less than optimal concordance occurred between clinical diagnoses and GBI findings. GBI unipolar patients and bipolar patients appeared globally significantly more disturbed than subjects without GBI mood disorders on the Minnesota Multiphasic Personality Inventory‐168 and the Millon Clinical Multiaxial Inventory. GBI bipolar patients tended to have greater frequency of cocaine use prior to and during treatment than the other two groups. The GBI delineates subgroups of addicts with distinctive psychopathology, who in some cases escape clinical detection. Cocaine use shows an association with GBI bipolar disorders.
Language Abilities of Preschool‐Age Children Living With Cocaine‐Using Mothers
Authors: Malakoff Marguerite E. , Mayes Linda C. , Schottenfeld Richard S.
Published: February 2010

Language abilities were assessed in 21 preschool‐age children (ages 29 to 70 months) from a day‐care center affiliated with a drug treatment program for pregnant and postpartum cocaine‐dependent women. All children were living with a cocaine‐dependent mother and 60% had also been exposed to cocaine prenatally. Three findings are notable: 1) Sixty percent of the children in the sample showed serious language delays, and the severity of delay was greater for older children. Only 3 of the 21 children showed minimal to no language delay. 2) In contrast to the expected pattern of language comprehension preceding language production, children in this sample showed more impairment in receptive than expressive skills. 3) The severity of language impairment was not associated with prenatal cocaine exposure. Findings are discussed in terms of the importance of considering special intervention needs of children from substance‐abusing homes and implications for future research.
Smoking Habit and Psychological Distress in Adolescent Female Students
Authors: Schifano Fabrizio , Forza Giovanni , Gallimberti Luigi
Published: February 2010

The authors administered a package containing some smoking‐related questions and a psychiatric inventory, the Symptom Checklist (SCL‐90), to 564 young women students (14–17 years old) to obtain information on the strength of the association between smoking and psychological distress in women smokers. Somatization, anxiety, hostility, and paranoid ideation scores were higher in teenage women smokers than in nonsmokers. Smokers generally have higher levels of minor psychiatric disturbance, but the data show that these symptoms are already present among young women at the start of their smoking careers.
Drug Use and Psychiatric Hospitalization Among Homeless Patients
Authors: Szczucki Denise , Galanter Marc , Lifshutz Harold , Hoven Christina , Moore Robert
Published: February 2010

This is the first study comparing community‐based and hospitalized homeless dually diagnosed men to assess correlates of psychiatric hospitalization. A retrospective review was carried out comparing housing, substance abuse, and psychiatric histories of three cohorts: 53 previously homeless men interviewed while hospitalized for dual psychiatric and addictive disorders, 87 homeless men previously hospitalized, and 500 homeless men never hospitalized. Individuals reporting current or past psychiatric hospitalization more often reported a history of illicit drug use. The findings suggest that history of illicit drug use by homeless men is associated with a higher risk of psychiatric hospitalization.
Patient Predictors of Irregular Discharge From Inpatient Substance Abuse Treatment
Authors: Manu Peter , Burleson Joseph A. , Kranzler Henry R.
Published: February 2010

The authors conducted a controlled cohort study to determine the characteristics of patients irregularly discharged from inpatient substance‐abuse treatment and to derive and validate an instrument to predict such early discharge. The sample was 220 subjects (110 consecutive patients who were discharged early and 110 matched control patients) admitted to a voluntary substance abuse treatment unit of a general hospital. Structured chart audits were used to collect demographic and clinical data. Hierarchical logistic regression identified only three predictors of irregular discharge: predominant heroin use, failure to complete high school, and age younger than 30 years. These three items were used to derive and validate an instrument for predicting completion of treatment. Readily available information on age, education, and psychoactive substance history is useful in identifying the risk of early discharge from inpatient substance abuse treatment.
Demographic and Social Characteristics of Solvent Abuse Patients in Japan
Authors: Wada Kiyoshi , Fukui Susumu
Published: February 2010

The authors conducted a nationwide psychiatric hospital survey in Japan to investigate the characteristics of solvent abusers among patients who visited or were admitted to psychiatric hospitals for solvent dependence or mental disorders resulting from solvent abuse. The findings from this survey confirm that the relationship between the parents and the cohesiveness of the family have a strong influence on juvenile solvent abuse. The survey data show several characteristic features in the attitudes of patients' parents toward their children. The data also show an association between the age when patients were separated from their parents and the patients' first solvent abuse.
A Prospective Study of Integrated Outpatient Treatment for Substance‐Abusing Schizophrenic Patients
Authors: Hellerstein David J. , Rosenthal Richard N. , Miner Christian R.
Published: February 2010

Forty‐seven psychiatric inpatients with concurrent RDC‐diagnosed schizophrenia and psychoactive substance use disorders were randomly assigned to one of two outpatient treatment programs: 1) integrated psychiatric and substance abuse treatment; or 2) non‐integrated treatment. Patients abused cocaine, alcohol, and marijuana, with over two‐thirds using all three drugs. At 4 months, 16 of 23 patients (69.6%) in integrated treatment remained in treatment vs. 9 of 24 (3 7.5%) in the nonintegrated treatment. Rehospitalization did not differ between groups, but treatment nonstarters had significantly more days in the hospital than those who began treatment. At 8 months, addiction and psychiatric severity decreased significantly for patients remaining in treatment. Engagement in integrated outpatient treatment may decrease rehospitalization, and lessen psychiatric and substance abuse severity.
Initiation and Progression of Alcohol, Marijuana, and Cocaine Use Among Adolescent Abusers
Authors: Dupre Deirdre , Miller Norman , Gold Mark , Rospenda Kathy
Published: February 2010

Adolescent alcohol and drug use are associated with many negative consequences. Understanding factors in initiation and patterns of use could aid in treatment and prevention. Sixty‐four adolescents calling a cocaine hotline received structured telephone interviews. Mean age was 16.7 years. Two‐thirds of the adolescents were young men. Sixty‐six percent used alcohol; 60.9%, marijuana; 60.9%, cocaine; mean onset was at 13.57, 13.28, and 14.64 years, respectively. Daily use of alcohol was reported by 25.8%; marijuana, 36.9%; and cocaine, 41.3%. Eighty‐four percent tried drugs because of peer pressure. Multiple alcohol/drug use commonly started in early adolescence. Peer use and pressure were major reasons for initiation. Early interventions can incorporate and make use of these factors.
Improving Treatment Outcome in Pregnant, Methadone‐Maintained Women: Results From a Randomized Clinical Trial
Authors: Carroll Kathleen M. , Chang Grace , Behr Heidi , Clinton Barbara , Kosten Thomas R.
Published: February 2010

The authors used a randomized clinical trial to compare enhanced vs. standard methadone maintenance for pregnant opiate‐addicted women. Although there were no differences by treatment group in maternal drug use, women in the enhanced program had three times as many prenatal care visits, had longer gestations, and had infants of higher birth weight.
Attention Deficit Hyperactivity Disorder and Cocaine Abuse
Authors: McCance‐Katz Elinore F. , Leal Jorge , Schottenfeld Richard S.
Published: February 2010

Recent research has shown that comorbid cocaine abuse and attention deficit hyperactivity disorder (ADHD) occur frequently in clinical populations. These patients are challenging, both diagnostically and clinically, but may respond to combined standard treatment for ADHD and cocaine abuse.
Gender Differences in Sex‐Risk Behaviors, Economic Livelihood, and Self‐Concept Among Drug Injectors and Crack Smokers
Authors: Booth Robert E. , Koester Stephen K. , Pinto Francesca
Published: February 2010

The authors compared male and female substance abusers and found that female substance abusers were at increased risk for HIV, relative to males, through sex‐risk behaviors. Specifically, women were more likely to have had sexual relations with a drug injector and greater involvement in prostitution, including exchanging sex for drugs or money, than men. Women had fewer legitimate employment opportunities and were less likely to have received support through illegal sources, excluding prostitution, than men. Women bad significantly lower perceived self‐concept, greater depression, and more anxiety than men. Gender, economic means of support, and self‐concept were highly interrelated. These findings underscore the need for interventions that address the economically marginalized position of addicted women and their low self‐concept.
Generalizing From Controlled Treatment Outcome Studies
Authors: Gottheil Edward , Sterling Robert C. , Weinstein Stephen P.
Published: February 2010

The gap between published research findings and clinical practice may be due in part to clinician concerns about generalizing from research to real treatment settings. The present study, conducted at a publicly funded, inner‐city cocaine treatment program, compared 102 patients who volunteered for random assignment to treatment with 308 individuals who refused to volunteer. Volunteers and refusers received the same treatment provided by the same staff in the same setting. No differences were found in demographics, addiction severity, psychiatric functioning, or treatment retention. The data suggest that the results of research findings may therefore be more applicable to clinical settings than was previously thought.
Reliability of Methadone Plasma Levels in Methadone Maintenance
Authors: Chitasombat Panupong , Willenbring Mark L. , Maddux Thomas , Severeide Nina
Published: February 2010

The authors investigated the intra‐individual variability of methadone plasma levels in stable methadone‐maintenance patients. Methadone trough levels were obtained from 11 male subjects on Monday, Wednesday, and Friday of the same week. Urine toxicology screens, hematocrit, serum proteins, and liver function tests were obtained at the same time. There was no significant intra‐individual variation in methadone levels. The mean coefficient of variation was 7.9%, and the coefficient of variation was inversely related to dose. Thus, the average range of plasma levels was ± 20 ng/ml across dosages. There was no relationship between the other blood studies and methadone level or variability. Therefore, a single methadone trough level may be used to determine adequacy of dosage in most cases.
Validity of the Distinction Between “Substance‐Induced” and “Independent” Depression and Anxiety Disorders
Authors: Kadden Ronald M. , Kranzler Henry R. , Rounsaville Bruce J.
Published: February 2010

Diagnosis of comorbid psychiatric disorders in substance abuse patients is complicated by the fact that many abused substances induce transient symptoms that mimic independent disorders. The authors applied criteria designed to distinguish “independent” comorbid disorders from those that may have been “substance‐induced,” to determine the impact on rates of diagnosis and on concurrent and predictive validity. Of those with symptoms sufficient to meet criteria for comorbid depression (12%) or anxiety diagnoses (26%), fewer than one‐fourth were considered to have independent disorders, and these patients did not constitute a category of greater severity. Current guidelines for defining independent diagnoses were not supported. Further work is required to identify criteria that will provide a clinically meaningful distinction.
Comparison of Quality of Life Between Alcoholic and Nonalcoholic Patients After Liver Transplantation
Authors: Carrington Pamela A. , Tarter Ralph E. , Switala JoAnn. , Van Thiel David
Published: February 2010

Alcoholic (n = 18) and nonalcoholic (n = 85) recipients of a liver transplant were compared 1–3 years post‐surgery on the Quality of Life Inventory. No differences between groups were observed on any of the 26 domains of health, behavior, and psychosocial functioning. These results indicate that quality of life is similar for alcoholic and nonalcoholic patients after liver transplantation surgery.
What Alcohol/Drug Abuse Clinicians Need to Know About Caffeine
Authors: Hughes John R.
Published: February 2010

Caffeine appears to have few adverse medical effects but can have adverse behavioral effects. Although the effects of caffeine in the population as a whole appear minor, topics deserving further study are whether caffeine use in alcohol/drug abusers can be especially problematic or can interfere with recovery and whether caffeine use can produce a clinically significant dependence syndrome in a subset of users.
A Preliminary Study of Therapeutic Alliance and Dually Diagnosed Inpatients
Authors: Westreich Laurence M. , Rosenthal Richard N. , Muran J. Christopher
Published: February 2010

The therapeutic alliance between the therapist and the inpatient dually diagnosed with major mental illness and substance abuse disorder has rarely been studied. These dually diagnosed patients constitute a “nontraditional” population for psychotherapy research. The authors used a modified version of the California Psychotherapy Alliance Scale (CALPAS) in this preliminary study to measure the therapeutic alliance between a cohort of 10 inpatient schizophrenic substance abusers and their therapists and examined its relationship with outpatient follow‐up. Six patients followed up with outpatient treatment and four did not. Paradoxically, the patients who did not follow up reported a stronger alliance with their inpatient therapists than the patients who did follow up.
Alcoholism Among New World Peoples
Authors: Westermeyer Joseph.
Published: February 2010

This review of the literature focuses on alcoholism among American Indian peoples. It is a critical review, aimed at elucidating methodological problems, establishing areas of relatively firm knowledge, and identifying gaps in our knowledge. The first two sections cover nonclinical areas: that is, 1) historical and anthropological studies of American Indian (AI) alcohol use, and 2) the nature and extent of alcoholism among various AI peoples. The remaining sections emphasize clinically related areas: that is, 1) clinical epidemiology, 2) intervention methods, and 3) outcomes.
What Is the Clinical Importance of Cigarette Smoking in Schizophrenia?
Authors: Lavin Michael R. , Siris Samuel G. , Mason Susan E.
Published: February 2010

may have critical importance in the understanding of this illness. (American Journal on Addictions 1996; 5:189–208)
Buprenorphine as a Pharmacotherapy for Opiate Addiction: What Dose Provides a Therapeutic Response?
Authors: Compton Peggy A. , Wesson Donald R. , Charuvastra V. Charles , Ling Walter
Published: February 2010

The authors used pharmacological response criteria to determine the therapeutic dose range of buprenorphine for the treatment of opiate dependence. One hundred consecutively admitted patients with opiate addiction were followed for 16 weeks while receiving a daily (double‐blinded) buprenorphine dose between 4 mg and 32 mg. Pharmacological response was operationalized as a composite score reflecting urine toxicology, clinic attendance, and withdrawal or toxicity symptomatology. A total of 34 subjects met pharmacological response criteria at an average daily dose of 14.6 ± 6.5 mg; thus the therapeutic dose was somewhat higher than that used in recent efficacy studies. (American Journal on Addictions 1996; 5:220–230)
A Modification of the Structured Clinical Interview for DSM‐III‐R to Evaluate Methadone Patients: Test—Retest Reliability
Authors: Nunes Edward V. , Goehl Leslie , Seracini Angela , Deliyannides Deborah , Donovan Steven , Koenig Theresa , Quitkin Frederic M. , Williams Janet B.W.
Published: February 2010

The Structured Clinical Interview for DSM‐III‐R—Substance Abuse Comorbidity version (SCID‐SAC) was developed to detect treatable mood and anxiety syndromes among substance abusers based on the temporal relationship of these disorders over the lifetime. The authors describe the instrument and report a study of test—retest reliability in 31 methadone maintenance patients prescreened for depression. Kappas for the combined category, Primary or Persistent During Abstinence, were 0.74 within major depression, 0.67 within any depressive syndrome, and 0.43 within panic disorder, with intraclass correlations for ages at onset and ratings of mood disorder chronicity at good levels. This finding suggests that such retrospective data can be reliably measured by use of the SCID‐SAC. (American Journal on Addictions 1996; 5:241–248)
Gender Differences in Patterns of Cocaine Use
Authors: White Kimberly A. , Brady Kathleen T. , Sonne Susan
Published: February 2010

Gender differences in characteristics of substance use disorders may have important implications. To explore this question, the authors compared 27 women and 60 men presenting for treatment of cocaine dependence with regard to demographic and cocaine use patterns. Women had earned less in the previous year (P < 0.01) and were more likely to have been unemployed (P < 0.05). Although women began using cocaine at a later age than men, they attained regular cocaine use at the same age as men and bad fewer years of total cocaine use at the time of presentation for treatment (P < 0.001). Women were more likely to initiate cocaine use with crack cocaine (P < 0.01) and reported shorter duration of abstinent periods since initiating cocaine use (P < 0.05). (American Journal on Addictions 1996; 5:259–261)
Use of a Sense of Coherence Test and Hopkins Symptom Checklist to Predict Completion of Stay in a Postdetoxification Counseling Unit
Authors: Berg John E.
Published: February 2010

The author observed 61 multi‐substance abusers with a mean length of abuse of 16 years who were tested with two psychometric tests to predict completion of a 3‐week post‐detoxification, residential counseling period. Age at entry, length of abusing career, and number of previous detoxifications at the facility did not discriminate between completers and noncompleters of the counseling period. In women, 54% and in men, 79% completed the residential period. Hopkins Symptom Checklist (HSCL‐24) scores indicated psychological stress in both groups but not significantly more in noncompleters. However, Antonovsky's Sense of Coherence Scale differentiated significantly between groups. Noncompleters had a mean score of 2.72 vs. completers' 31. This difference indicates less manageability, comprehensibility, and meaning in the lives of noncompleters. Although the HSCL did not differ between groups, the level of distress was high in both groups. Thus, using both tests may give clinicians a tool to predict early drop‐out. (American Journal on Addictions 1996; 5:327–333)
Substance Abuse in Pregnancy
Authors: Dilts Stephen L. , Casper Edmund
Published: February 2010

Staff collected urine samples anonymously on 100 consecutive pregnant women in a women's clinic and simultaneously on 100 admissions to the “labor deck.” Urines were tested for cocaine, opiates, methadone, benzodiazepines, and THC. Nine percent of the urines were positive in the clinic setting, and 15% were positive on the labor deck; the incidence of cocaine‐ and opiate‐positive urines was significantly higher on the labor deck. The authors discuss the significance of these results. (American Journal on Addictions 1996; 5:351–353)
Clinical Applications of New Alcoholism Studies
Authors: Kleber Herbert D. , Anton Raymond F. , Chick Jonathan , Croop Robert , O'Brien Charles P.
Published: February 2010

Recent clinical trials have examined multiple modalities for enhancing outcome in alcohol dependence. New research presented at the May 1996 American Academy of Addiction Psychiatry symposium described a unique instrument for assessing control over alcohol consumption and the instrument's use in studies assessing its efficacy in the treatment of alcoholism. In addition, long‐term safety data for naltrexone, an opioid‐antagonist that has been shown to be effective in reducing relapse among alcohol‐dependent patients, was reviewed, showing the lack of significant hepatoxicity of naltrexone at the doses normally used for alcoholism treatment. Results of a multicenter study for integrating naltrexone into outpatient treatment programs with less‐intensive psychosocial therapy than previous studies were also presented.
The Treatment of Philadelphia Inebriates
Authors: Leonard Edward C.
Published: February 2010

Preventive education in the United States about the dangers of alcohol had failed to create a temperate society by 1840. But in that year, interest in medical treatment of the “habitual drunkard” rekindled in Philadelphia. It was the year an organization of reformed drunkards revitalized American temperance societies by emphasizing practical concern for the inebriate. The author describes Philadelphia's treatment of alcoholics from 1840 through the beginning of the 20th century, when entrepreneurs were marketing secret cures.
Timing of Paternal Substance Use Disorder Cessation and Effects on Problem Behaviors in Sons
Authors: Moss Howard B. , Clark Duncan B. , Kirisci Levent
Published: February 2010

The developmental timing of paternal substance use disorder (SUD) offset on internalizing and externalizing problem behaviors was examined in prepubertal sons. Analyses revealed a significant main effect of the developmental timing of SUD offset on both internalizing and externalizing problems. No differences were found between sons of control‐subject fathers and SUD+ fathers whose offsets occurred before the son's sixth birthday. However, when paternal SUD extended beyond the boys' sixth year, significant increases in internalizing and externalizing problem behaviors were found. The results suggest the importance of early parental SUD intervention in prevention of the intergenerational transmission of behavioral problems.
Addiction Severity and MMPI‐Derived Typologies in Cocaine Abusers
Authors: Ball Samuel A. , Carroll Kathleen M. , Robinson Jane E. , O'Malley Stephanie S.
Published: February 2010

This study replicated the two Minnesota Multiphasic Personality Inventory subtypes (psychopathic and severe psychiatric) found in inpatient male cocaine abusers in an outpatient sample of 132 men and women. The Addiction Severity Index validated these subtype differences on the basis of psychiatric severity.
Women and Alcohol Abuse in Primary Care
Authors: Chang Grace , Behr Heidi , Goetz Margaret Ann , Hiley Ashlyn , Bigby JudyAnn
Published: February 2010

Female problem drinkers are less likely than men to be identified in the primary care setting. The authors studied 24 adult women attending a general, internal medicine clinic to assess the efficiency of self reports of alcohol consumption when compared with physician identification and other measures and the impact of a brief intervention on alcohol consumption. Despite the high rate of lifetime (79%) and current (67%) alcohol diagnoses, no patient was in alcohol treatment. Physician identification of alcohol problems was least sensitive but most specific, when compared with other measures. Brief intervention, as offered in this study, did not appear to modify alcohol consumption.
Further Evidence of an Association Between Attention‐Deficit/Hyperactivity Disorder and Cigarette Smoking
Authors: Milberger Sharon , Biederman Joseph , Faraone Stephen V. , Chen Lisa , Jones Janice
Published: February 2010

The authors investigated the relationship between attention‐deficit/hyperactivity disorder (ADHD) and cigarette smoking in siblings of ADHD and non‐ADHD probands. They conducted a 4‐year follow‐up of siblings from ADHD and control‐group families. In the siblings of ADHD probands, ADHD was associated with higher rates and earlier onset of cigarette smoking. There was also a significant positive association between cigarette smoking and conduct disorder, major depression, and drug abuse in the siblings, even after adjusting for confounding variables. Moreover, smoking was found to be familial among ADHD families but not control‐group families. Our findings indicate that ADHD is a risk factor for early initiation of cigarette smoking in the high‐risk siblings of ADHD probands.
A Substance Abuse Consultation Service
Authors: McDuff David R. , Solounias Bernadette L. , Beuger Mark , Cohen Art , Klecz Mary , Weintraub Eric
Published: February 2010

The authors review the literature on the high prevalence but underrecognition of substance abuse among hospitalized patients and the general unavailability of hospital‐based substance abuse consultation services. They describe the development, clinical operations, staffing, and teaching activities of a large substance abuse consultation service in one urban academic medical center and detail the service's growth and changing utilization patterns over an 8‐year period, reporting the clinical characteristics of 1,819 patients seen over a 1‐year period. Differences in patient demographics, patterns of substance use, and diagnoses were highly significant from one referring service to another. The authors discuss the implications of such a service for patient care and teaching.
The Link Between Substance Abuse and Posttraumatic Stress Disorder in Women
Authors: Najavits Lisa M. , Weiss Roger D. , Shaw Sarah R.
Published: February 2010

Research has documented a high incidence of comorbid posttraumatic stress disorder (PTSD) and substance abuse. Women substance abusers, in particular, show high rates of this dual diagnosis (30% to 59%), most commonly deriving from a history of repetitive childhood physical and/or sexual assault. Rates for men are two to three times lower and typically stem from combat or crime trauma. Patients with both disorders are characterized by high severity on a multitude of psychological and treatment variables and use of the most severe drugs (cocaine and opioids). Treatment research on women is limited but suggests the possibility of retaining patients and achieving positive outcomes.
Retention in Substance Abuse Treatment
Authors: Ross Helen E. , Cutler Melissa , Sklar Sherrilyn M.
Published: February 2010

The authors investigated the association between psychiatric symptom severity and subsequent treatment retention among substance abusers. The Symptom Check List‐90‐R was administered, after admission to an addiction treatment facility, to 308 male and 106 female clients with moderate‐to‐severe substance abuse problems. Mean scores on nine symptom and three summary scales were computed. Controlling for other sociodemographic and treatment variables, somatization was significantly associated with dropout from specialized outpatient and inpatient treatment programs. This study, however, suggests that psychopathologic symptom severity at admission has only limited utility in predicting subsequent treatment retention among substance abusers with overall moderate levels of psychological distress.
Differences Between Men and Women in Dual‐Diagnosis Treatment
Authors: Westreich Laurence , Guedj Philippe , Galanter Marc , Baird Dawn
Published: February 2010

The authors reviewed the charts of all women and a randomly selected sample of men over a 6‐month period on two addiction treatment units at Bellevue Hospital Center in New York. The men were more likely to be admitted with schizophrenia and to have used substances of abuse other than alcohol, and the women were more likely to be admitted with affective disorders. Also, the women on the dual‐diagnosis ward were more likely to be domiciled (i.e., not homeless), and the women on both units were significantly more likely to report having been crime victims. These findings suggest that dually diagnosed women need a substantially different treatment paradigm from men.
Managing Disability Benefits as Part of Treatment for Persons With Severe Mental Illness and Comorbid Drug/Alcohol Disorders
Authors: Ries Richard K. , Anne Comtois Katherine
Published: February 2010

The objective of this pilot study is to describe the use of a Social Security representative payee program as a clinical intervention integrated into long‐term, dual‐disorder treatment of severely mentally ill outpatients with comorbid drug/alcohol disorders. Compared with non‐payees, patients selected to be payee participants were more likely to be male, have a diagnosis of schizophrenia, have a history of high inpatient utilization, and have higher current ratings of psychiatric symptoms, substance use, and functional disability. Despite these higher severity ratings, which usually predict poor outpatient compliance and higher rate of adverse outcomes, the payee participants attended about twice the number of outpatient service sessions as non‐payees and were no more likely to be currently homeless, hospitalized, or incarcerated. The payee intervention is described, and ethical and research issues are discussed.
Methadone vs. L‐alpha‐acetylmethadol (LAAM) in the Treatment of Opiate Addiction
Authors: Glanz Morton , Klawansky Sidney , McAullife William , Chalmers Thomas
Published: February 2010

The authors conducted a meta‐analysis of the reported randomized, controlled trials comparing methadone to L‐alphaacetylmethadol (LAAM) to assess the efficacy of LAAM relative to methadone in the treatment of opiate addiction. All studies were conducted in standard outpatient opiate addiction treatment clinics. Most patients were men from lower socioeconomic strata. A statistically significant risk difference favoring methadone was detected for retention‐in‐treatment and discontinuation of treatment because of side effects. The risk difference for illicit drug use favored LAAM, but was not significant. A small treatment difference in favor of methadone was noted. LAAM does appear to be a relatively effective alternative in the treatment of opiate addiction, more so in certain select situations.
Results of Two Levels of Adjunctive Treatment Used With the Nicotine Patch
Authors: Lifrak Patricia , Gariti Peter , Alterman Arthur I. , McKay Jim , Volpicelli Joseph , Sparkman Thorne , O'Brien Charles
Published: February 2010

The authors compared 9‐, 16‐, 26‐, and 52‐week outcomes for two randomly assigned groups of nicotine‐dependent subjects: 1) nicotine patch plus four smoking cessation sessions with a nurse‐practitioner giving advice and instruction (n = 36; moderate‐intensity condition, MI); or 2) the foregoing treatments plus 16 weekly individual cognitive/behavioral relapse‐prevention therapy sessions (n = 33; high‐intensity condition, HI). Patch completion rates were 69‐ 7% in the HI group and 556% in the MI group (NS). Self‐reported abstinence rates at the four follow‐up points were comparable for the two treatment groups; HI: 39%, 36%, 36%, and 36%; MI: 44%, 28%, 25%, and 28%, respectively. There was some indication that MI patients with high nicotine dependence had lower abstinence rates than highly dependent HI patients.
Psychosocial Risk Factors for HIV Transmission in Female Drug Abusers
Authors: Brook David W. , Brook Judith S. , Whiteman Martin , Win Pe T. , Gordon‐Maloul Cynthia , Roberto Josephine , Amundsen Frances , Masci Joseph R. , De Catalogne Jacques
Published: February 2010

The authors studied the influences of domains of psychosocial risk factors on needle‐sharing with familiar people and with strangers in a cohort of female injecting drug users (IDUs). Subjects were 119 female IDUs, 46% of whom were HIV+. Subjects were given individually administered questionnaire interviews. Using Pearson correlation coefficients and multiple hierarchical regression analyses, the authors found that personality, family, and peer attributes related to needle‐sharing in women were similar to those found in men, with certain exceptions. The role of the family, particularly the Significant Other, was more important and proximal in its effect on needle‐sharing behavior in women than in men. There was a main effect as well as a mediating effect of family in women, buffering risk factors leading to needle‐sharing.
Maternal Attentiveness of Cocaine Abusers During Child—Based Assessments
Authors: Ball Samuel A. , Mayes Linda C. , DeTeso Jeffrey A. , Schottenfeld Richard S.
Published: February 2010

Cocaine‐abusing mothers were compared with non‐cocaine‐using mothers on videotaped ratings of attentiveness to their children during developmental assessments done at age 3 months (n = 64), 6 months (n = 80), 12 months (n = 90), and 18 months (n = 53). At the 3‐month assessment only, cocaine‐abusing women spent a lower percentage of time being attentive and made more shifts in attentiveness than did control‐group mothers. These differences were not found at 6‐, 12‐, or 18‐month assessments. Maternal attentiveness appears to be more strongly related to current depression symptoms than addiction severity in the cocaine‐abusing group.
Multivariate Typology of Adolescents With Alcohol Use Disorder
Authors: Tarter Ralph E. , Kirisci Levent , Mezzich Ada
Published: February 2010

Adolescent patients qualifying for a DSM‐III‐R diagnosis of alcohol use disorder were studied to determine whether a multidimensional schema could classify subjects into subgroups. The Drug Use Screening Inventory was administered to 151 subjects. To test the concurrent validity of the subtypes, subjects also received a structured diagnostic psychiatric evaluation along with measures of personality, academic achievement, and drinking behavior. Two clusters were identified for each gender. Differences between clusters were reflected primarily on indicators of severity of disorder. Young women were more inclined toward affective disturbances, whereas conduct disorder was the most frequent disorder in young men. This study underscores the heterogeneity of the adolescent population qualifying for a diagnosis of alcohol use disorder. The differential pattern of alcohol involvement and comorbid psychopathology within clusters and between genders demonstrates the need for interventions tailored to specific clinical presentation.