The International journal of the addictions最新文献

The concept of codependency has been advanced to explain certain psychological traits purported to be characteristic of spouses and adult children of alcoholics. To test the validity of this hypothesized syndrome, 97 female subjects living with either an alcoholic (SA), a psychiatric patient (SP), or dentistry patient (SD) were studied; approximately 50% of subjects had a positive family history (FH+) for alcoholism. All subjects were administered an extensive battery of psychological tests. The results revealed significantly greater levels of psychological symptomatology among the SA and FH+ subjects, in part consistent with the hypothesized symptomatology of codependency.

This paper sets forth a multifaceted program which consists of drug user women-centered counseling plus ancillary services based on the five basic steps of Freire's empowerment theory. The program is designed to increase self-awareness, skills, and knowledge acquisition, to reduce feelings of isolation by broadening interpersonal networks, includes activities to enhance assertiveness and communication skills, and parenting education to counteract inappropriate mother-child interaction as well as to positively influence role modeling. Both transportation and child care are recommended ancillary services.

Survey data were used to study the association of methadone maintenance and needle-sharing. An ordinal scale of HIV risk was derived from the number of persons from whom subjects reported accepting a used needle and syringe in the 6 months prior to interview. The odds of respondents in methadone maintenance being in the higher risk group were half those of daily heroin users not in treatment for all three transitions in a four-level ordinal scale of risk (OR 0.55, 95% CL 0.33 to 0.90, ordinal logistic regression). This association disappeared when methadone patients who had not injected in the month prior to interview were excluded from the analysis. Subjects' knowledge concerning HIV and AIDS had no measurable association with the outcome. It is concluded that methadone maintenance reduces heroin addicts' risk of infection with HIV by reducing the likelihood of their injecting drugs rather than by changing their injecting behavior.

Functionality of alcohol use for coping with partner relationship problems was explored in a group of 45 alcohol-dependent women with semistructured interviews. Six functions were categorized, three of them referring to adjustment and three to opposition to the partner. Respondents who had started excessive drinking mainly in response to problems with the partner reported more partner-related functions than respondents for whom a problematic partner relationship was not an important factor in the development of excessive drinking. Respondents of the first group also reported other characteristics of their relationship, notably they said more often that their partner was dominant. It was concluded that for a subgroup of women with alcohol problems, alcohol use may be a way of coping with a situation of powerlessness toward the partner.

This study analyzed the responses of 391 Mexican-Americans (44.9% males) and 531 Central Americans (40.2% males) who were between 21 and 65 years of age and resided in San Francisco, California. In general, Mexican-Americans were found to have a lower proportion of abstainers (56.8%) than Central Americans (64.4%). Mexican-Americans reported drinking more often and in greater quantities than Central Americans, and the proportion of "high" drinkers was higher among Mexican-American men and women than among the Central American respondents. Despite this diversity in the topography of alcoholic beverage consumption between Mexican-Americans and Central Americans, the role of gender and acculturation on shaping those variables was fairly consistent across groups. The acculturation level of the respondents was found to significantly affect the proportion of abstainers in both groups. Furthermore, gender was an important determinant of frequency, total number of drinks, and volume of drinking for Mexican-Americans and for Central Americans.

Substance use treatment for adolescents probably fails more often than it succeeds, yet reasons for these failures are seldom reported in the literature. Much can be learned from failure so that mistakes need not be repeated. A case study of one treatment center is presented with a discussion about the failures that can occur in five primary areas: facility/environment, administrative, staffing, treatment, and cultural application. Incidents that are not addressed immediately can create a cascade of critical incidents that lead quickly to treatment failure. Too often, clients are assigned the responsibility of treatment failure when, in fact, the treatment system is the true problem. Suggestions are made for timely interventions that may divert treatment failure.

Positive patient characteristics have been assumed important in determining treatment outcome for the abstinence-based method of addiction treatment. Thus far, controlled and uncontrolled studies of the abstinence-based method have examined predominantly employed, White, and married populations of alcoholics. We present a treatment outcome study of the abstinence-based method of treatment in unemployed, Black, and unmarried population of alcoholics. The negative patient characteristics of our study did not predict an unfavorable outcome in comparison to those in other studies that included positive patient characteristics.

The validity of drug and sexual behavior data collected by drug user treatment staff using a short clinical risk assessment among 387 injection drug users is evaluated using in-depth, confidential interview process. Moderate to high agreement levels were found for most, but not all, variables. Participants consistently reported less risky behaviors on the clinical risk assessment than on the in-depth interview. More easily recalled information can be accurately gathered through a short clinical risk assessment. However, in-depth, confidential interviewing is important when gathering self-reports of the frequency of drug and sexual behaviors.