Advances in alcohol & substance abuse最新文献

During their recovery, special populations of alcoholics and addicts have need for both (1) involvement with their own special social identity groups and (2) involvement with others broadly representative of the communities in which they will live and function. Self-help groups and treatment institutions in the societal mainstream have often neglected special populations and their special needs. Family education, support and therapy is especially important to many patients from these special populations. Obstacles to treatment for these special groups are described, along with strategies for overcoming these obstacles.

This study presents outcome rates for inpatient treatment for alcohol, cocaine and other drug dependence. The abstinence rates at six and twelve months post discharge and other demographic information are compiled on 1,627 patients admitted to an inpatient treatment unit for the rehabilitation of cocaine, alcohol and other drug dependence. The percent of the 1,627 patients with the diagnosis of alcohol dependence only was 42%, cocaine, alcohol and other drug dependence 25%, and alcohol and other drugs, 28%. The abstinence rate at six months for patients with alcohol dependence only was 75%, alcohol and other drug dependence 82%, cocaine dependence 76%; at twelve months, the abstinence rates were 71%, 66%, and 62% respectively.

The ALKO AA and ANA rats have been selectively bred for high versus low ethanol preference, respectively. AA rats have been shown to self-administer ethanol, whereas ANA rats do not. These animals also show a range of differences on tasks which measure sensitivity to ethanol, but the relationship between ethanol intake and sensitivity to this drug in these rats is not clear. This study examined sensitivity to ethanol in AA and ANA rats as determined by ethanol's rate depressant effects on schedule controlled (Fixed-Ratio (FR) 32) responding reinforced by water deliveries. Non-drug rates of responding were similar for both lines across baseline, sham injection and vehicle conditions. Ethanol produced dose-dependent decreases in responding in both the AA and ANA rats. Dose-response curves indicated that AA rats were slightly more sensitive to the acute effects of ethanol than were ANA rats, with ED50 values of 0.52 and 0.69 g/kg for AA and ANA rats, respectively. Overall, however, the effects of ethanol on rats of responding were similar across the two lines of rats. While it is possible that constraints on behavior imposed by FR schedules could be masking underlying differences in tissue sensitivity between these animals, the results indicate that ethanol intake under preference or reinforcement conditions does not appear to be highly controlled by initial sensitivity to ethanol as measured by effects on operant performance.

An investigation into the use of psychometric assessment instruments to produce psychographic profiles which proved superior to the use of individual measures on drug accepting versus drug rejecting age generational gaps is appropriate when considering drug and alcohol education programs. Clinical studies show that polydrug abusers have many psychoneurotic and psychopathic traits which can be measured through valid personality tests. Cuevas (1989), employed the Western Personality Inventory (Manson 1963) to identify individuals whose behavior and personality structure indicated they were polydrug users or had serious polydrug problems. The instrument revealed that a combinative process utilizing comparison groups from known polydrug abusers as a discriminant analysis technique with controls provided a high degree of accuracy. A high degree of precision in prediction was maintained in validation trials on independent samples. The personality characteristics and traits were extracted from a combination of commonly ordered personality tests. Results of the investigation indicate that clinical usage of the screening procedure is readily available without sophisticated computer support or the need for trained psychometricians. Additional results identified the process as interventive, therefore providing a simple way to produce early didactic preventive instruction.

This study replicates and extends the results of our earlier findings which showed that 35% of children at age 9 had experimented with cigarettes for various reasons. Seven hundred eighty-seven children from the earlier sample and 361 children from the current sample participated in this study. Forty-one percent of the current sample had puffed a cigarette, 18% had tried it in the last year, 6% in the last 4 weeks and 3.5% in the last week. The study also showed that children who had puffed a cigarette had a significantly positive attitude towards smoking when compared with children who had not experimented with cigarettes. The puffers believed smoking is good, wise and fun.

The opioids vary greatly in addictive potential, from the highly addictive such as heroin to the opioid antagonists such as naltrexone, which can be used to treat opioid dependence and overdose. The various opioid compounds have different euphorigenic properties and also produce withdrawal syndromes of distinct patterns of duration and intensity. Dependence liability is affected by both the pleasure-seeking motives for initiating drug use and the painful consequences of abstinence or withdrawal. Detoxification, which takes 7-10 days for the short-acting opioids, is usually the first stage in treatment. Methadone is often used as a preliminary stage in detoxification, but some patients are maintained on methadone for years, since it allows them to lead relatively normal lives. Non-opioid drugs used to control withdrawal symptoms include clonidine. After detoxification, naltrexone, a long-acting opioid antagonist, can be administered orally to prevent relapse.

Central stimulants have been abused since their inception and we are currently in the midst of a cocaine epidemic that challenges our resources and capabilities. Through their actions on powerful endogenous reward centers, central stimulants produce intense euphoria that reinforces subsequent usage and eventual dependence. Considerable evidence indicates that the activation of dopamine circuits mediates stimulant reward. With regard to cocaine, it has been hypothesized that depletion of central dopamine leads to craving. Euphoria and craving, the key dynamics of stimulant addiction, may therefore result largely from neurochemical alterations of dopamine systems in the brain's reward center. Progressive deterioration of the stimulant addict involving medical, psychiatric, and psychosocial impairment occurs rapidly, underscoring the addiction potential of these agents. Tolerance, sensitization and withdrawal phenomena are discussed from clinical and neurochemical perspectives.