Advances in alcohol & substance abuse最新文献

Based on anthropological evidence, MacAndrews and Edgerton state that drunken comportment consists of "time-out" behaviors, subject to the norms of drinking groups, the rewards of such socially licensed behaviors comprising the drinking motive. This perspective was applied to working-class bars in Middletown, Indiana. Although there was a wide range of behavior by bar, drinker category, and the number of drinks consumed, observed patterns suggest the presence of norms. Dramaturgical styles were also noted and typologized; these styles appear to comprise the acting out of sub-culturally desirable roles. The possibility that alcohol facilitates such activities is suggested by earlier laboratory work on drinking fantasies. Drinking rewards may, therefore, stem from altered states of consciousness rather than social license alone.

The emotional and behavioral responses of methadone patients to HIV antibody testing were examined by comparing 8 seropositives with 8 matched seronegatives. Seropositives displayed a wide range of immediate emotional reactions to learning their results, but no severe or damaging reactions; seronegatives were uniformly relieved. Almost all patients informed other persons of their serostatus with unremarkable consequences. Seropositives had higher anxiety than seronegatives at the 3-month follow-up, but behavioral outcomes were similar, tending towards reduced AIDS risk. The sample's program retention rate one year later was 94%.

In this paper the nature, scope, and drug relatedness of violent events reported by a sample of methadone maintenance treatment clients is examined and compared with events reported by a sample of drug abusers not in treatment. The drug relatedness of events is ascertained according to a tripartite model of the drugs-violence relationship. Data derive from a study of the drugs-violence nexus among male drug users and distributors who lived in or frequented the lower east side of Manhattan. Among the major findings were that while events reported by the treatment group were less likely than those reported by the not-in-treatment group to be related to heroin, total alcohol and cocaine related dimensions of violence were similar for the two groups. There was no difference between these groups in terms of the proportion of events that were drug related or the proportion of drug related events that could be attributed to each of the three posited models of drug relatedness. The implications of our findings are discussed.

An attempt is made to contribute toward a unifying theory of alcoholism with the concept of "pain phobia" as its central factor. A brief theoretical exposition of pain phobia is offered and results of an empirical study are presented which lend considerable support to the position that pain phobia may be a central factor underlying alcoholism. The research utilizes the Pain Phobia Scale (PPS) as the measure of pain phobia and finds that pain phobia is present to a significantly greater degree in problem drinkers than a norm group and that pain phobia also discriminates non-problem drinkers in the degree of their consumption of alcohol. Suggestions are made for how the concept of pain phobia and the PPS can be useful in the treatment and prevention of alcoholism. The possible relationship between pain phobia and all addictions is also considered.

The inhalation of a wide variety of substances for recreational purposes is a health problem of worldwide proportions. The inhalation of non-narcotic agents, such as volatile inhalants (e.g., solvents and glues), anesthetics and nitrites, adds significantly to the growing number of substance abusers. This is of particular concern because it affects the younger members of the population, and the substances abused are, for the most part, legally obtainable. The toxicity of these inhaled substances are reviewed and compared, as are their potentials for addiction and dependence.

Even though the percent of adults who smoke has been reduced dramatically in the last 20 years, more than 50 million people continue to use tobacco on a daily basis. A majority of these people claim that they would like to stop smoking, but cannot. This review discusses the data suggesting that tobacco smokers are seeking nicotine. The behavioral effects elicited by nicotine and its relative reinforcing properties, as well as the development of tolerance to nicotine and the role of nicotine in the tobacco withdrawal syndrome are discussed. The data indicate that nicotine has addiction liability, but this liability is probably not equal to that of other agents such as cocaine and the opiates.

In two separate studies using DSM-III-R criteria for substance dependence in two hundred sixty-three (263) inpatients we confirm the clinical experience that cocaine addicts use other drugs including alcohol. As many as 89% of cocaine addicts diagnosed by DSM-III-R criteria for cocaine dependence qualify for other substance dependence diagnoses. Previous reports regarding alcohol and other drug use among cocaine addicts are few and inconclusive. The diagnoses of other substance use and dependence in cocaine dependence has important impact on etiology, prognosis and treatment. Our study finds a high prevalence of alcohol dependence and cannabis dependence in patients with cocaine dependence.

This paper reviews the addiction potential of all benzodiazepines currently available in the U.S.A. as well as several non-benzodiazepine anxiolytic drugs. Addiction potential was assessed by separately considering the potential for these drugs to produce three different phenomena of addiction; namely, physical dependence, psychological dependence and deleterious consequences. This review focuses on human studies conducted with research volunteers outside the therapeutic context and also on clinical studies conducted with patients receiving treatment in the therapeutic context. It is concluded that benzodiazepines have a reduced addiction potential in comparison to the predecessor barbiturates. Conclusions regarding the relative addiction potential of several non-benzodiazepine anxiolytics are difficult due to a paucity of data; however limited evidence suggests a reduced addiction potential for several of these compounds. Within the benzodiazepine class, qualitative differences in addiction potential between individual drugs are not well established.

This paper examines data on the question of possible differences between benzodiazepines in abuse liability and potential for causing physical dependence. The data on potential for causing physical dependence indicates that all benzodiazepines cause physical dependence and there is little evidence for substantial differences between them in this respect. The evidence for substantive differences between benzodiazepines with respect to abuse liability is reviewed: problems with methodology and with definitions make problematic the assertion of some authors that there are clinically meaningful differences in abuse liability. There is general agreement that all benzodiazepines have at least some abuse liability.

The chronic abuse of many drugs produces both marked tolerance and physical dependence. Marked tolerance to cannabis has been observed in experimental animals and humans. However, reports of physical dependence, as characterized by significant withdrawal symptomatology upon cessation of chronic cannabis exposure, has not been well established or clearly defined in any species. The abuse potential of cannabis is more readily observed in humans than in experimental animal investigations. This may be due to the physiochemical characteristics of cannabis or delta 9-THC, which complicates this type of animal experimentation. It is more likely that the greatest dangers of cannabis abuse involve the pharmacological effects of the drug upon the central nervous system and other organs, rather than the development of dependence.