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Sample records for abuse treatment completion

  1. Barriers to Successful Treatment Completion in Child Sexual Abuse Survivors

    Science.gov (United States)

    McPherson, Paul; Scribano, Philip; Stevens, Jack

    2012-01-01

    Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental…

  2. Predicting Substance Abuse Treatment Completion using a New Scale Based on the Theory of Planned Behavior

    OpenAIRE

    Zemore, Sarah E.; Ajzen, Icek

    2013-01-01

    We examined whether a 9-item scale based on the theory of planned behavior (TPB) predicted substance abuse treatment completion. Data were collected at a public, outpatient program among clients initiating treatment (N=200). Baseline surveys included measures of treatment-related attitudes, norms, perceived control, and intention; discharge status was collected from program records. As expected, TPB attitude and control components independently predicted intention (model R-squared=.56), and i...

  3. Predicting Substance Abuse Treatment Completion using a New Scale Based on the Theory of Planned Behavior

    Science.gov (United States)

    Zemore, Sarah E.; Ajzen, Icek

    2013-01-01

    We examined whether a 9-item scale based on the theory of planned behavior (TPB) predicted substance abuse treatment completion. Data were collected at a public, outpatient program among clients initiating treatment (N=200). Baseline surveys included measures of treatment-related attitudes, norms, perceived control, and intention; discharge status was collected from program records. As expected, TPB attitude and control components independently predicted intention (model R-squared=.56), and intention was positively associated with treatment completion even including clinical and demographic covariates (model R-squared=.24). TPB components were generally associated with the alternative readiness scales as expected, and the TPB remained predictive at higher levels of coercion. Meanwhile, none of the standard measures of readiness (e.g., the URICA and TREAT) or treatment coercion were positively associated with treatment participation. Results suggest promise for application of the TPB to treatment completion and support use of the intention component as a screener, though some refinements are suggested. PMID:23953167

  4. Characteristics of drug-abusing women with children in residential treatment: a preliminary evaluation of program retention and treatment completion.

    Science.gov (United States)

    Simons, Lori

    2008-01-01

    An ex post facto study was conducted to investigate treatment outcomes for 80 women and 168 children admitted into a residential substance-abuse treatment program. The results indicated childhood emotional neglect is a barrier for remaining in and completing treatment for African-American women with comorbid psychological disorders but not for those with crack cocaine dependent disorders. African-American women with comorbid psychological disorders were also three times more likely to dropout of treatment. In addition, there were relatively few differences for between drug-exposed and nonexposed children. However, the results indicated that children of substance-abusing women who completed treatment were more likely to have behavioral problems, to receive early intervention services, and to have mothers as legal guardians by the end of treatment. Implications for gender-specific interventions for African-American women and their children in residential treatment are discussed.

  5. Predictors of Substance Abuse Assessment and Treatment Completion for Parents Involved with Child Welfare: One State's Experience in Matching across Systems.

    Science.gov (United States)

    Traube, Dorian E; He, Amy S; Zhu, Limei; Scalise, Christine; Richardson, Tyrone

    2015-01-01

    To date, few studies have examined the effect of interagency collaboration on substance abuse assessment ity of Southern California and treatment completion for parents who are involved in child welfare. The purpose of this paper is to: (1) describe a statewide, interagency collaborative program aimed at providing targeted substance abuse assessment and treatment to parents engaged in the child welfare system; (2) document the specialized assessment and treatment outcomes for parents engaged through this collaborative program; and (3) determine factors related to successful treatment completion for parents involved in the child welfare system. This is a retrospective study of an open cohort of 13,829 individuals admitted to the New Jersey Child Protection Substance Abuse Initiative (CPSAI) program from October 1, 2009, through September 30, 2010. Data were drawn from two unique administrative data sources. Multivariate Cox regression models were used to explore factors related to successfil treatment completion for parents involved in the child welfare system. Trend analysis for the total sample in the CPSAI program revealed that, of the 10,909 individuals who received a CPSAI assessment, 59% were referred to treatment. Of those referred to treatment, 40% enrolled in a treatment program. Once enrolled in a treatment program, 55% completed or were in the process of completing substance abuse treatment. These findings suggest that when adequate screening and treatment is available through a streamlined process, many of the ethnic and gender disparities present among other populations of individuals seeking treatment are minimized. Utilizing inherent child welfare case factors appears to be an important motivating element that aids parents during the assessment and treatment process.

  6. Treatment for Child Abusers

    Science.gov (United States)

    Tracy, James J.; Clark, Elizabeth H.

    1974-01-01

    Staff of a child abuse program in a Philadelphia hospital worked with parents in their own homes to help them develop greater competence as adults and as parents. This article describes the use of social learning theory, with some techniques of behavior therapy, as the basis for treatment. (Author)

  7. Substance Abuse Treatment Facilities Locator

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Substance Abuse and Mental Health Services Administration (SAMHSA) provides on-line resource for locating drug and alcohol abuse treatment programs. The...

  8. Medical marijuana users in substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Swartz Ronald

    2010-03-01

    Full Text Available Abstract Background The rise of authorized marijuana use in the U.S. means that many individuals are using cannabis as they concurrently engage in other forms of treatment, such as substance abuse counseling and psychotherapy. Clinical and legal decisions may be influenced by findings that suggest marijuana use during treatment serves as an obstacle to treatment success, compromises treatment integrity, or increases the prevalence or severity of relapse. In this paper, the author reviews the relationship between authorized marijuana use and substance abuse treatment utilizing data from a preliminary pilot study that, for the first time, uses a systematic methodology to collect data examining possible effects on treatment. Methods Data from the California Outcomes Measurement System (CalOMS were compared for medical (authorized marijuana users and non-marijuana users who were admitted to a public substance abuse treatment program in California. Behavioral and social treatment outcomes recorded by clinical staff at discharge and reported to the California Department of Alcohol and Drug Programs were assessed for both groups, which included a sample of 18 reported medical marijuana users. Results While the findings described here are preliminary and very limited due to the small sample size, the study demonstrates that questions about the relationship between medical marijuana use and involvement in drug treatment can be systematically evaluated. In this small sample, cannabis use did not seem to compromise substance abuse treatment amongst the medical marijuana using group, who (based on these preliminary data fared equal to or better than non-medical marijuana users in several important outcome categories (e.g., treatment completion, criminal justice involvement, medical concerns. Conclusions This exploratory study suggests that medical marijuana is consistent with participation in other forms of drug treatment and may not adversely affect

  9. Metaphyseal fractures mimicking abuse during treatment for clubfoot

    Energy Technology Data Exchange (ETDEWEB)

    Grayev, A.M.; Boal, D.K.B. [Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, PA (United States); Wallach, D.M.; Segal, L.S. [Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, PA (United States)

    2001-08-01

    Background. Metaphyseal injuries resembling the classic metaphyseal lesion (CML) of abuse may occur as the result of serial casting during treatment of clubfoot deformity. Mentioned in the orthopedic literature in 1972, this iatrogenic fracture has not been described in the radiologic literature nor has the similarity to injuries occurring with abuse been previously recognized. Objective. To describe the mechanism and radiographic appearance of metaphyseal injury observed during serial casting of clubfoot. Note similarities to the CML of abuse. Materials and methods. Eight children ranging in age from 1 to 4 months underwent casting for clubfoot. Five orthopedic surgeons from three different institutions performed the casting. Two patients had spina bifida and one, arthrogryposis. A complete skeletal survey was performed on one child who was abused; there was no suspicion of abuse in the remaining seven. Results. All children manifest injury with periosteal new bone. One child had clear evidence of abuse with 24 rib fractures. X-rays of lower extremities in short leg casts revealed bilateral tibial metaphyseal fractures. Four other children had metaphyseal fractures resembling the CML of abuse, and three developed an area of sclerosis within the metaphysis. Conclusion. In the setting of serial casting for equinovarus deformity, metaphyseal injury even the CML of abuse may be noted. Since inflicted injuries are almost always unobserved and explanations rarely offered, the fact that the CML occurs as a result of orthopedic manipulation may offer some further insight concerning the pathogenesis of this well-described abuse injury. (orig.)

  10. The Substance Abuse Treatment Workforce of South Africa

    Science.gov (United States)

    Sodano, Ruthlyn; Watson, Donnie W.; Rataemane, Solomon; Rataemane, Lusanda; Ntlhe, Nomvuyo; Rawson, Richard

    2010-01-01

    The purpose of this paper is to describe characteristics of substance abuse treatment counselors in the Republic of South Africa, including demographics, education, training, and job duties. Counselors recruited from 24 treatment centers completed a survey after signing informed consent. Counselors were primarily female (75%), racially diverse…

  11. Adolescent Drug Abuse: Etiological and Treatment Considerations

    Science.gov (United States)

    Amini, Fariboz; And Others

    1976-01-01

    Issues involved in treating adolescent drug abusers and literature describing abuser personality traits are examined. The Youth Service at Langley Porter Institute and the problems encountered and solutions attempted there are discussed. The importance of residential as opposed to outpatient treatment and honesty in staff-patient relationships is…

  12. Residential Treatment Centers for Child Abuse

    Directory of Open Access Journals (Sweden)

    Serhat Nasiroglu

    2014-02-01

    Full Text Available Every year millions of reports are being held and cases regarding those reports in courts are carrying on about abusement and omission against children . Abusement against children has been seen throughout of the history. Significant and permanent impacts can occur upon child abusement and neglect on victim children. It is important to know the psychological dynamics which have been lived by the children by the mental health professionalsto protect the children after the abusement report has been written. Cognitive Behaviour Therapy and medications are being used commonly in the treatment of abusement cases. However in some cases it is necessary to send away the victims from environment, enable them to continue their education life, make sure that they are treated by the professional individuals in safe area. For this end there are many Residential Treatment Centers around the world. and ldquo;Oguz Kagan Koksal Social Care and Rehabilitation Center and rdquo; was established in Adana as the first Residential Treatment Center in Turkey. In this report the historical dimensions of the child abusement, the definition of it, its psychological dynamics, the psychological disorders caused by it, treatment approaches and residential treatment centers have been reviewed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(1.000: 67-78

  13. Exercise treatment for drug abuse -a Danish pilot study

    DEFF Research Database (Denmark)

    Roessler, Kirsten Kaya

    2010-01-01

    is considered as a success in treatments with drug abusers, usually characterized by a low compliance and commitment. The results of the participants who completed the programme (n = 20) showed an increased oxygen uptake of an average of 10%, improved self-reported quality of life and a higher energy level...... for the majority of the participants. The addicts obtained a better body image, became more sensitive to physical pain and disorders and reduced their drug intake during the training period. The long-term effect showed that five of the 20 abusers interviewed reported that they still had not taken drugs, 10 had...... downgraded their intake, four experienced no change at all and one died through an overdose. CONCLUSIONS: The results show that physical exercise can provide important support in the treatment of drug abuse and that the main problem is maintaining change in behaviour and peer group influence to ensure long...

  14. Addressing substance abuse treatment needs of parents involved with the child welfare system.

    Science.gov (United States)

    Oliveros, Arazais; Kaufman, Joan

    2011-01-01

    The goal of this paper is to synthesize available data to help guide policy and programmatic initiatives for families with substance abuse problems who are involved with the child welfare system, and identify gaps in the research base preventing further refinement of practices in this area. To date, Family Treatment Drug Court and newly developed home-based substance abuse treatment interventions appear the most effective at improving substance abuse treatment initiation and completion in child welfare populations. Research is needed to compare the efficacy of these two approaches, and examine cost and child well-being indicators in addition to substance abuse treatment and child welfare outcomes.

  15. Failure to get into substance abuse treatment.

    Science.gov (United States)

    Fisher, Dennis G; Reynolds, Grace L; D'Anna, Laura H; Hosmer, David W; Hardan-Khalil, Kholoud

    2017-02-01

    Among substance abusers in the US, the discrepancy in the number who access substance abuse treatment and the number who need treatment is sizable. This results in a major public health problem of access to treatment. The purpose of this study was to examine characteristics of Persons Who Use Drugs (PWUDs) that either hinder or facilitate access to treatment. 2646 participants were administered the Risk Behavior Assessment (RBA) and the Barratt Impulsiveness Scale. The RBA included the dependent variable which was responses to the question "During the last year, have you ever tried, but been unable, to get into a drug treatment or detox program?" In multivariate analysis, factors associated with being unable to access treatment included: Previously been in drug treatment (OR=4.51), number of days taken amphetamines in the last 30days (OR=1.18), traded sex for drugs (OR=1.53), homeless (OR=1.73), Nonplanning subscale of the Barratt Impulsiveness Scale (OR=1.19), age at interview (OR=0.91), and sexual orientation, with bisexual men and women significantly more likely than heterosexuals to have tried but been unable to get into treatment. The answers to the question on "why were you unable to get into treatment" included: No room, waiting list; not enough money, did not qualify, got appointment but no follow through, still using drugs, and went to jail before program start. As expected, findings suggest that limiting organizational and financial obstacles to treatment may go a long way in increasing drug abuse treatment accessibility to individuals in need. Additionally, our study points to the importance of developing approaches for increasing personal planning skills/reducing Nonplanning impulsivity among PWUDs when they are in treatment as a key strategy to ensure access to additional substance abuse treatment in the future.

  16. Therapeutic Progression in Abused Women Following a Drug-Addiction Treatment Program.

    Science.gov (United States)

    Fernández-Montalvo, Javier; López-Goñi, José J; Arteaga, Alfonso; Cacho, Raúl; Azanza, Paula

    2015-06-30

    This study explored the prevalence of victims of abuse and the therapeutic progression among women who sought treatment for drug addiction. A sample of 180 addicted Spanish women was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual), socio-demographic factors, consumption variables, and psychological symptoms. Of the total sample, 74.4% (n = 134) of the addicted women had been victims of abuse. Psychological abuse affected 66.1% (n = 119) of the patients, followed by physical abuse (51.7%; n = 93) and sexual abuse (31.7%; n = 57). Compared with patients who had not been abused, the addicted women with histories of victimization scored significantly higher on several European version of the Addiction Severity Index (EuropASI) and psychological variables. Specifically, physical abuse and sexual abuse were related to higher levels of severity of addiction. Regarding therapeutic progression, the highest rate of dropout was observed among victims of sexual abuse (63.5%; n = 33), followed by victims of physical abuse (48.9%; n = 23). Multivariate analysis showed that medical and family areas of the EuropASI, as well as violence problems and suicide ideation, were the main variables related to physical and/or sexual abuse. Moreover, women without abuse and with fewer family problems presented the higher probability of treatment completion. The implications of these results for further research and clinical practice are discussed.

  17. Addressing Trauma in Substance Abuse Treatment

    Science.gov (United States)

    Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie

    2016-01-01

    Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…

  18. Molecular approaches to treatments for cocaine abuse

    Science.gov (United States)

    Flippen-Anderson, Judith L.; George, Clifford; Deschamps, Jeffrey R.

    2003-02-01

    Cocaine is a potent stimulant of the central nervous system with severe addiction potential. Its abuse is a major problem worldwide. The exact mechanism of action of cocaine is still uncertain but it is known that its reinforcing and stimulant effects are related to its ability to inhibit the membrane bound dopamine transporter (DAT). This paper discusses efforts that are underway to identify ligands for possible use in the treatment of cocaine abuse. Much of this effort has been focussed on understanding cocaine interactions at DAT receptor sites.

  19. Heart rate variability biofeedback in adolescent substance abuse treatment.

    Science.gov (United States)

    Thurstone, Chris; Lajoie, Travis

    2013-01-01

    Strategies are needed to improve adolescent substance abuse treatment outcomes. For example, during outpatient substance abuse treatment, up to 80% of adolescents continue to use.(1),(2) Following residential substance abuse treatment, 88% of adolescents relapse within 6 months.(3.)

  20. Incest and substance abuse: implications for treatment professionals.

    Science.gov (United States)

    Janikowski, T P; Glover, N M

    1994-01-01

    Seventy-seven volunteer participants enrolled in eight substance abuse treatment facilities were surveyed using the Substance Abuse and Incest Survey. Of the sample, 36 (48%) reported histories of incest. For participants reporting incest, data on substance abuse history, perceptions of the relationship between incest and substance abuse, and opinions regarding incest-related counseling in the context of substance abuse treatment are presented. Recommendations for substance abuse professionals and facilities are made, including intake screening, barriers to treatment, counselor education, and future research.

  1. Impact of substance abuse treatment on arrests among opiate users in Washington State.

    Science.gov (United States)

    Campbell, Kevin M; Deck, Dennis; Krupski, Antoinette

    2007-01-01

    Administrative data from Washington State's Division of Alcohol and Substance Abuse drive this three-year prospective study of the impact of substance abuse treatment on arrests among 12,962 opiate users receiving publicly funded substance abuse services. Using survival analysis, the risk of arrest among opiate users who receive substance abuse treatment is compared to those who do not receive treatment. Propensity scores control for client characteristics associated with admission to substance abuse treatment. Overall, a reduction in the risk of arrest was found among subjects in treatment (Hazard Ratio = 0.59-0.78, p < .05) and subjects successfully completing treatment (Hazard Ratio = 0.75, p < .05). Risk of arrest was elevated among those with a negative outcome to treatment (Hazard Ratio = 1.23, p < .05).

  2. A Study of Clinical Supervision Techniques and Training in Substance Abuse Treatment

    Science.gov (United States)

    West, Paul L.; Hamm, Terri

    2012-01-01

    Data from 57 clinical supervisors in licensed substance abuse treatment programs indicate that 28% had completed formal graduate course work in clinical supervision and 33% were professionally licensed or certified. Findings raise concerns about the scope and quality of clinical supervision available to substance abuse counselors. (Contains 3…

  3. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community... RDAP, they must participate in TDAT in the community. If inmates refuse or fail to complete TDAT,...

  4. Integrating translational neuroscience to improve drug abuse treatment for adolescents.

    Science.gov (United States)

    Boyce, Cheryl Anne; Lynne-Landsman, Sarah D

    2013-06-01

    Adolescence is an exciting and challenging period of maturation, rapid brain development, and developmental changes in neurobiological, neurocognitive, and neurobehavioral processes. Although behavioral therapies available for adolescent substance abuse have increased, effectiveness research in this area lags considerably behind that of clinical research on treatment for drug-abusing adults. Behavioral treatment approaches show significant promise for treating drug-abusing adolescents, but many have not incorporated innovations in neuroscience on brain development, cognitive processes, and neuroimaging. Linking developmental neuroscience with behavioral treatments can create novel drug abuse interventions and increase the effectiveness of existing interventions for substance-abusing adolescents. Contemporary research on brain development, cognition, and neuroscience is ripe for translation to inform developmentally sensitive drug abuse treatments for adolescents. Neuroscientists and interventionists are challenged to build mutual collaborations for integration of neuroscience and drug abuse treatment for adolescents.

  5. Comorbidity of Schizophrenia and Substance Abuse: Implications for Treatment.

    Science.gov (United States)

    Mueser, Kim T.; And Others

    1992-01-01

    Reviews substance abuse disorders in schizophrenia patients, including prevalence of comorbid disorders, assessment, hypothesized mechanisms underlying abuse, and clinical effects of abuse on course of illness and cognitive functioning. Outlines principles of treatment for dual-diagnosis schizophrenia patients, noting limitations of existing…

  6. Pregabalin Abuse amongst Opioid Substitution Treatment Patients.

    Science.gov (United States)

    McNamara, S; Stokes, S; Kilduff, R; Shine, A

    2015-01-01

    Pregabalin (Lyrica®) is used in treating epilepsy, nerve pain and anxiety. Pregabalin was initially thought to have a low misuse potential however there are emerging reports of Pregabalin being abused. A study was commenced at the National Drug Treatment Centre's (NDTC) Drug Analysis Laboratory to determine the level of usage of Pregabalin within the addiction services population in Ireland. A total of 498 urine samples representing samples from 440 individual opioid substitution patients, initially screened by immunoassay for drugs of abuse, were subjected to further analysis for Pregabalin by Liquid Chromatography/Mass Spectrometry (LC/MS). Of 440 patients tested, 39 tested positive for Pregabalin (9.2%). Only 10 patients from this group were prescribed this drug to our knowledge thus giving an estimated rate of misuse of 7.0%. Other drugs detected in the Pregabalin positive patients were Opiates (31.8%), Cocaine (11.4%), Benzodiazepines (79.5%) and Cannabis (77.8%). Our study confirms that Pregabalin abuse is taking place amongst the addiction services population. We believe that misuse of this prescription drug is a serious emerging issue which should be monitored carefully.

  7. Reinforcement-based outpatient treatment for opiate and cocaine abusers.

    Science.gov (United States)

    Katz, E C; Gruber, K; Chutuape, M A; Stitzer, M L

    2001-01-01

    A reinforcement-based intensive outpatient treatment was delivered to 37 recently detoxified, inner city, heroin and/or cocaine abusers who did not want methadone treatment. Attendance was scheduled and urine collected daily for the first 2 weeks, four times weekly for the next 2 weeks, and then thrice weekly for the final 8 weeks. As attendance incentives, patients received transportation assistance (bus tokens), and $28-$30 per week in vouchers to be spent on activities/items chosen and agreed upon with their counselor. As abstinence incentives, patients received weekend supported recreational activities, lunches, $42-$45 per week in vouchers, and rent or utilities payment ($150 over 4 weeks). Total potential earnings was $1,435 per patient; actual mean earnings was $583. Forty-three percent (n=16) completed 10 or more weeks of treatment. These 16 long-stay patients submitted 92% (SD=19) opiate- and cocaine-negative urines during their enrollment compared with 56% (SD=42) drug-negative urines submitted by 21 drop-outs, F(1,35)=9.99, p=0.003. Overall, 32% of clients became employed during their treatment episode; 94% of long-stay patients were employed at the end of their treatment episode. Patients who were drug-positive at intake were highly likely to drop out. Treatment outcomes compare favorably with those reported in the literature for outpatient nonmethadone treatment of opiate and cocaine abusers. Continued evaluation of this new treatment appears warranted.

  8. An holistic approach to substance abuse treatment.

    Science.gov (United States)

    Breslin, Kathy T; Reed, Maria R; Malone, Sandra B

    2003-01-01

    The purpose of this article is to describe a model outpatient substance abuse treatment program. This program is designed to provide patients with not only traditional modalities of treatment such as individual, group, and family therapy, but also to provide an opportunity for patients to express thoughts and feelings through holistic modalities. These modalities include dance/movement therapy, Tai Chi, art therapy, leisure and recreational skills, spiritual growth and development, cultural awareness and appreciation, vocational services, psychiatric care and physical health. The authors describe features of this program that they believe to be unique and that focus on ways to help patients develop a stronger sense of self-identity, self-esteem and self-confidence.

  9. Attempted and Completed Incidents of Stranger-Perpetrated Child Sexual Abuse and Abduction

    Science.gov (United States)

    Gallagher, Bernard; Bradford, Michael; Pease, Ken

    2008-01-01

    Objective: To establish the prevalence, typology and nature of attempted or completed incidents of stranger-perpetrated sexual abuse or abduction of children "away from home". Methods: A questionnaire was completed by 2,420 children (83% response rate) aged 9-16 years in 26 elementary and high schools in North-West England. Results: Of these…

  10. Attempted and Completed Incidents of Stranger-Perpetrated Child Sexual Abuse and Abduction

    Science.gov (United States)

    Gallagher, Bernard; Bradford, Michael; Pease, Ken

    2008-01-01

    Objective: To establish the prevalence, typology and nature of attempted or completed incidents of stranger-perpetrated sexual abuse or abduction of children "away from home". Methods: A questionnaire was completed by 2,420 children (83% response rate) aged 9-16 years in 26 elementary and high schools in North-West England. Results: Of…

  11. Treatment programs in the National Drug Abuse Treatment Clinical Trials Network.

    Science.gov (United States)

    McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W; Nunes, Edward V; Miller, Michael; Forman, Robert; Magruder, Kathryn M; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

    2008-01-01

    Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed Organizational Surveys (n=106 of 112; 95% response rate) and Treatment Unit Surveys (n=348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to National Survey of Substance Abuse Treatment Services (N-SSATS), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services provided. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice.

  12. Treatment Programs in the National Drug Abuse Treatment Clinical Trials Network

    Science.gov (United States)

    McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W.; Nunes, Edward V.; Miller, Michael; Forman, Robert; Magruder, Kathryn M.; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

    2008-01-01

    Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed organizational (n = 106 of 112; 95% response rate) and treatment unit surveys (n = 348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to N-SSATS (National Survey of Substance Abuse Treatment Services), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services proved. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice. PMID:17875368

  13. Implementation of Cognitive-Behavioral Substance Abuse Treatment in Sub-Saharan Africa: Treatment Engagement and Abstinence at Treatment Exit.

    Directory of Open Access Journals (Sweden)

    Hetta Gouse

    Full Text Available This study documented the treatment cascade for engagement in care and abstinence at treatment exit as well as examined correlates of these outcomes for the first certified Matrix Model® substance abuse treatment site in Sub-Saharan Africa.This retrospective chart review conducted at a resource-limited community clinic in Cape Town, South Africa, assessed treatment readiness and substance use severity at treatment entry as correlates of the number of sessions attended and biologically confirmed abstinence at treatment exit among 986 clients who initiated treatment from 2009-2014. Sociodemographic and clinical correlates of treatment outcomes were examined using logistic regression, modeling treatment completion and abstinence at treatment exit separately.Of the 2,233 clients who completed screening, approximately 44% (n = 986 initiated treatment. Among those who initiated treatment, 45% completed at least four group sessions, 30% completed early recovery skills training (i.e., at least eight group sessions, and 13% completed the full 16-week program. Approximately half (54% of clients who provided a urine sample had negative urine toxicology results for any substance at treatment exit. Higher motivation at treatment entry was independently associated with greater odds of treatment completion and negative urine toxicology results at treatment exit.Findings provide initial support for the successful implementation the Matrix Model in a resource-limited setting. Motivational enhancement interventions could support treatment initiation, promote sustained engagement in treatment, and achieve better treatment outcomes.

  14. Assessment of AIDS Risk among Treatment Seeking Drug Abusers.

    Science.gov (United States)

    Black, John L.; And Others

    Intravenous (IV) drug abusers are at risk for contracting transmittable diseases such as acquired immunodeficiency syndrome (AIDS) and hepatitis B. This study was conducted to investigate the prevalence of risk behaviors for acquiring and transmitting AIDS and hepatitis B among treatment-seeking drug abusers (N=168). Subjects participated in a…

  15. Treatment of drug abusers in Malaysia: a comparison.

    Science.gov (United States)

    Johnson, S H

    1983-10-01

    The purpose of this paper is to compare two forms of treatment for heroin abusers in Malaysia--traditional medicine and institutional--and to evaluate which form of treatment the drug abusers consider more effective. The study involved interviewing 100 male drug abusers in Malaysia who had had treatment from an institution and from a traditional healer. The data revealed that traditional medicine was better for some abusers, but institutional treatment was better for others, depending upon an individual's own needs and personality. Advantages and disadvantages of both forms of treatment were given by those interviewed. The data can be used as guidelines for the development of a more flexible, individualized program within an institutional setting in Malaysia.

  16. Substance Abuse Treatment for Children and Adolescents: Questions to Ask

    Science.gov (United States)

    ... Families Guide Substance Abuse Treatment For Children And Adolescents: Questions To Ask No. 41; Reviewed July 2013 Many children and adolescents use alcohol and other drugs. Some develop serious ...

  17. A National Survey of Substance Abuse Treatment for Juvenile Offenders

    OpenAIRE

    Young, Douglas W.; Dembo, Richard; Henderson, Craig E.

    2007-01-01

    Despite consensus about the value of substance abuse treatment for delinquent youth, information about its prevalence and availability is inadequate and inconsistent. This paper presents findings about treatment and other correctional service provision from a national survey of directors of 141 juvenile institutional and community corrections facilities. Educational/GED programming and drug and alcohol education were the most prevalent types of correctional and substance abuse services. Other...

  18. 28 CFR 550.52 - Non-residential drug abuse treatment services.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services,...

  19. Transportation and retention in outpatient drug abuse treatment programs.

    Science.gov (United States)

    Friedmann, P D; Lemon, S C; Stein, M D

    2001-09-01

    To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that provision of car, van, or contracted transportation services improved treatment retention beyond these thresholds for both OMM and ODF, but individual vouchers or payment for public transportation did not. Future research should validate whether car, van, or contracted transportation services improve retention and other treatment outcomes in outpatient drug abuse treatment.

  20. Substance Abuse Treatment: Critical Issues and Challenges in the Treatment of Latina Women.

    Science.gov (United States)

    Amaro, Hortensia; Nieves, Rita; Johannes, Sergut Wolde; Cabeza, Nirzka M. Labault

    1999-01-01

    Among 66 Latina mothers in a residential substance abuse treatment program, 80% reported childhood experiences of abuse. Compared to other female participants, women abused as children were more likely to be predominantly Spanish speakers, to have health problems, to have had children removed from their custody, and to drop out quickly from…

  1. Randomized Trial of Drug Abuse Treatment-Linkage Strategies

    Science.gov (United States)

    Sorenson, James L.; Masson, Carmen L.; Delucchi, Kevin; Sporer, Karl; Barnett, Paul G.; Mitsuishi, Fumi; Lin, Christine; Song, Yong; Chen, TeChieh; Hall, Sharon M.

    2005-01-01

    A clinical trial contrasted 2 interventions designed to link opioid-dependent hospital patients to drug abuse treatment. The 126 out-of-treatment participants were randomly assigned to (a) case management, (b) voucher for free methadone maintenance treatment (MMT), (c) case management plus voucher, or (d) usual care. Services were provided for 6…

  2. A national survey of substance abuse treatment for juvenile offenders.

    Science.gov (United States)

    Young, Douglas W; Dembo, Richard; Henderson, Craig E

    2007-04-01

    Despite consensus about the value of substance abuse treatment for delinquent youth, information about its prevalence and availability is inadequate and inconsistent. This article presents findings about treatment and other correctional service provision from a national survey of directors of 141 juvenile institutional and community corrections (CC) facilities. Educational/General Educational Development programming and drug and alcohol education were the most prevalent types of correctional and substance abuse services. Other common services included physical health services and mental health assessment, provided to about 60% of youth across facilities, and mental health counseling, life and communication skills, and anger management, provided to about half of the youth. Substance abuse treatment, as with most other services, were more prevalent in large, state-funded residential facilities (where 66% provided treatment) than in local detention centers (20%) and CC facilities (56%). More detailed data showed that the number of youth attending treatment in all types of facilities on any given day was very low.

  3. Study protocol: a randomized controlled trial of a computer-based depression and substance abuse intervention for people attending residential substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Kelly Peter J

    2012-02-01

    Full Text Available Abstract Background A large proportion of people attending residential alcohol and other substance abuse treatment have a co-occurring mental illness. Empirical evidence suggests that it is important to treat both the substance abuse problem and co-occurring mental illness concurrently and in an integrated fashion. However, the majority of residential alcohol and other substance abuse services do not address mental illness in a systematic way. It is likely that computer delivered interventions could improve the ability of substance abuse services to address co-occurring mental illness. This protocol describes a study in which we will assess the effectiveness of adding a computer delivered depression and substance abuse intervention for people who are attending residential alcohol and other substance abuse treatment. Methods/Design Participants will be recruited from residential rehabilitation programs operated by the Australian Salvation Army. All participants who satisfy the diagnostic criteria for an alcohol or other substance dependence disorder will be asked to participate in the study. After completion of a baseline assessment, participants will be randomly assigned to either a computer delivered substance abuse and depression intervention (treatment condition or to a computer-delivered typing tutorial (active control condition. All participants will continue to complete The Salvation Army residential program, a predominantly 12-step based treatment facility. Randomisation will be stratified by gender (Male, Female, length of time the participant has been in the program at the commencement of the study (4 weeks or less, 4 weeks or more, and use of anti-depressant medication (currently prescribed medication, not prescribed medication. Participants in both conditions will complete computer sessions twice per week, over a five-week period. Research staff blind to treatment allocation will complete the assessments at baseline, and then 3, 6, 9

  4. Culturally competent substance abuse treatment with transgender persons.

    Science.gov (United States)

    Nuttbrock, Larry A

    2012-01-01

    Transgender individuals are misunderstood and inadequately treated in many conventional substance abuse treatment programs. This article reviews current concepts regarding the definition and diversity of transgenderism and summarizes the existing literature on the prevalence and correlates of substance use in transgendered populations. Examples of culturally competent and gender-sensitive treatment in specialized settings are cited, with a call to extend these initiatives throughout the gamut of service venues that engage transgender individuals. Cultural competence combined with gender sensitivity should improve the effectiveness of substance abuse treatment for transgender individuals and will contribute to the goal of providing effective services in an increasingly diverse society.

  5. Treatment of Drug Abuse: An Overview. National Clearinghouse for Drug Abuse Information Report Series 34, Number 1.

    Science.gov (United States)

    National Inst. on Drug Abuse (DHEW/PHS), Rockville, MD. National Clearinghouse for Drug Abuse Information.

    This report presents a brief review of the development of methods and programs for treatment of drug abusers in the United States. In order to limit the scope of the report, discussion of the treatment of alcohol abuse and alcoholism is excluded. The report focuses primarily on the treatment of opiate dependence, since most of the experience on…

  6. 29 CFR 825.119 - Leave for treatment of substance abuse.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Leave for treatment of substance abuse. 825.119 Section 825... Leave for treatment of substance abuse. (a) Substance abuse may be a serious health condition if the... substance abuse by a health care provider or by a provider of health care services on referral by a...

  7. Child Physical and Sexual Abuse: Guidelines for Treatment. Final Report.

    Science.gov (United States)

    Saunders, B. E.; Berliner, L.; Hanson, R. F.

    Helping child abuse victims receive the mental health treatment they need is an important component of victim advocacy with children, and benefits both the children and the criminal justice system. As part of this work, the National Crime Victims Research and Treatment Center at the Medical University of South Carolina and the Center for Sexual…

  8. Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care

    Science.gov (United States)

    Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart

    2011-01-01

    Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

  9. Endodontic treatment completion following emergency pulpectomy.

    LENUS (Irish Health Repository)

    Lynch, C D

    2010-06-01

    Emergency pulpectomy is frequently performed to relieve pain experienced by patients following acute episodes of endodontic pain, or to limit the risks of infection or possible root resorption following traumatic pulpal exposures. The aim of this study was to examine subsequent patient attendance for completion of root canal treatment following pulpectomy procedures in a dental emergency unit.

  10. Treatment of alcoholism and concomitant drugs of abuse.

    Science.gov (United States)

    Zeiner, A R; Stanitis, T; Spurgeon, M; Nichols, N

    1985-01-01

    It has been proposed that concomitant substances of abuse may have additive or synergistic properties such that alcoholics using other substances of abuse concurrently may have a harder time giving up alcohol than alcoholics abusing only alcohol. The present study surveyed 291 alcoholics in an alcohol treatment program and 86 social drinker controls matched on age, education, SES and gender. Alcohol consumption, smoking, coffee intake, other substances of abuse. Beck depression and Spielberger Anxiety (State) were measured. Alcoholics drank significantly more alcohol than did social drinkers per day (350.19 cc versus 28.08 cc, p less than 0.001), consumed more caffeine/day (486.3 mg versus 339.9 mg, p less than 0.002), smoked more cigarettes/day (27.8 versus 12.8, p less than 0.001), were more depressed (16.8 versus 4.4 (Beck), p less than 0.0001), had lower internal locus of control scores (37.6 versus 39.7, p less than 0.005), had higher scores on control by chance (22.7 versus 20.2, p less than 0.03) and were significantly more anxious (52.5 versus 33.9 on Spielberger's State Inventory p less than 0.0001). Some patients used stimulants, tranquilizers, depressants, narcotics or toluene. Only 3/258 abused alcohol without using other drugs. Results support earlier studies showing strong associations between alcohol and smoking and between alcohol and caffeine consumption. The alcoholic abusing only alcohol is very rare. Treatment programs need to pay attention to concomitant drugs of abuse.

  11. Child Sexual Abuse: Intervention and Treatment Issues. The User Manual Series.

    Science.gov (United States)

    Faller, Kathleen Coulborn

    This manual describes professional practices in intervention and treatment of sexual abuse and discusses how to address the problems of sexually abused children and their families. It makes an assumption that the reader has basic information about sexual abuse. The discussion focuses primarily on the child's guardian as the abuser. The manual…

  12. Sex and Aggression: The Relationship between Gender and Abuse Experience in Youngsters Referred to Residential Treatment

    Science.gov (United States)

    Doerfler, Leonard A.; Toscano, Peter F., Jr.; Connor, Daniel F.

    2009-01-01

    We examined the relationship of gender and different forms of abuse experience on internalizing symptoms, externalizing symptoms, and IQ in a sample of 397 youngsters who were admitted to a residential treatment program. Three types of abuse experience were examined in this study: sexual abuse only, physical abuse only, and "both" sexual and…

  13. Medical Student Views of Substance Abuse Treatment, Policy and Training

    Science.gov (United States)

    Agrawal, Shantanu; Everett, Worth W.; Sharma, Sonali

    2010-01-01

    Purpose: This study examined the impact of medical education on students' views of substance abuse treatment, public policy options and training. Method: A longitudinal survey was conducted on a single-class cohort of 101 students in a major American, urban medical school. The survey was administered in the Spring semesters of the first to third…

  14. A Model Adolescent Substance-Abuse Treatment Program.

    Science.gov (United States)

    Copans, Stuart

    1993-01-01

    Describes two adolescent substance abuse treatment programs in New England psychiatric center: Osgood Three, which is no longer in existence, and Tyler Three, which replaced it and is struggling to grow. Considers transition from Osgood Three to Tyler Three, process of change, and learning what can be preserved from past and what must be…

  15. Medical Marijuana Use among Adolescents in Substance Abuse Treatment

    Science.gov (United States)

    Salomonsen-Sautel, Stacy; Sakai, Joseph T.; Thurstone, Christian; Corley, Robin; Hopfer, Christian

    2012-01-01

    Objective: To assess the prevalence and frequency of medical marijuana diversion and use among adolescents in substance abuse treatment and to identify factors related to their medical marijuana use. Method: This study calculated the prevalence and frequency of diverted medical marijuana use among adolescents (n = 164), ages 14-18 years (mean age…

  16. Therapeutic Factors in Spouse-Abuse Group Treatment.

    Science.gov (United States)

    Schwartz, Jonathan P.; Waldo, Michael

    1999-01-01

    Examines men's experiences in educational groups for batterers. Two factors, imparting of information and development of socializing techniques, were found to be predominant. Other factors thought to be important for abuse treatment (i.e. hope, family reenactment, and modeling) were found to be minimally present. Analysis demonstrates relationship…

  17. 78 FR 53789 - Technology Innovations for Substance Abuse and Mental Health Treatment Conference & Related...

    Science.gov (United States)

    2013-08-30

    ... CONTROL POLICY Technology Innovations for Substance Abuse and Mental Health Treatment Conference & Related... Technology Innovations for Substance Abuse and Mental Health Treatment Conference highlighting promising innovations for treating these disorders. This conference will bring together innovators in technology...

  18. Functional assessment and treatment of aggressive and destructive behaviors in a child victim of physical abuse.

    Science.gov (United States)

    Luiselli, J K

    1996-03-01

    This case study describes the functional assessment and treatment of aggressive and destructive behaviors in a 14-year-old male child with a history of physical abuse. Evaluation was performed in a classroom within a residential school setting. Functional assessment in forms of indirect and descriptive methods was used to generate hypotheses regarding sources of behavioral control. A treatment plan that combined multi-level differential reinforcement of other behavior (DRO) and positive reinforcement for task completion was implemented based on the outcome of functional assessment. Treatment was associated with a gradual and steady reduction in challenging behaviors with near-zero rates achieved at follow-up. This case provides an example of clinical intervention for behavior disorders commonly observed in children who have been abused physically and a hypothesis-driven model of treatment formulation.

  19. Selection and utilization of assessment instruments in substance abuse treatment trials: the National Drug Abuse Treatment Clinical Trials Network experience

    Directory of Open Access Journals (Sweden)

    Rosa C

    2012-07-01

    Full Text Available Carmen Rosa, Udi Ghitza, Betty TaiCenter for the Clinical Trials Network, National Institute on Drug Abuse, Bethesda, MD, USAAbstract: Based on recommendations from a US Institute of Medicine report, the National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN in 1999, to accelerate the translation of science-based addiction treatment research into community-based practice, and to improve the quality of addiction treatment, using science as the vehicle. One of the CTN's primary tasks is to serve as a platform to forge bi-directional communications and collaborations between providers and scientists, to enhance the relevance of research, which generates empirical results that impact practice. Among many obstacles in moving research into real-world settings, this commentary mainly describes challenges and iterative experiences in regard to how the CTN develops its research protocols, with focus on how the CTN study teams select and utilize assessment instruments, which can reasonably balance the interests of both research scientists and practicing providers when applied in CTN trials. This commentary also discusses the process by which the CTN further selects a core set of common assessment instruments that may be applied across all trials, to allow easier cross-study analyses of comparable data.Keywords: addiction, assessment, drug abuse treatment, drug dependence, NIDA Clinical Trials Network, substance use disorder

  20. Substance Abuse Treatment Admissions Aged 12 to 14. The TEDS Report

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration, 2011

    2011-01-01

    This report uses data from the Treatment Episode Data Set (TEDS) for 2008 to provide information on the characteristics of youths aged 12 to 14 admitted to substance abuse treatment. In 2008, approximately 23,770 substance abuse treatment admissions were adolescents aged 12 to 14. The two most frequently reported primary substances of abuse among…

  1. Abuse

    Science.gov (United States)

    ... basic needs like food, shelter, and love. Family violence can affect anyone. It can happen in any kind of family. Sometimes parents abuse each other, which can be hard for a child to witness. Some parents abuse their kids by using physical or verbal cruelty as a way of discipline. ...

  2. Substance-Abusing Parents in the Criminal Justice System: Does Substance Abuse Treatment Improve Their Children's Outcomes?

    Science.gov (United States)

    Phillips, Susan D.; Gleeson, James P.; Waites-Garrett, Melissa

    2009-01-01

    The expansion of the criminal justice system over the last several decades helped to focus attention on children of incarcerated parents, many of whom have parents with substance abuse problems. Since the 1990's, a national grassroots campaign has been underway to make substance abuse treatment an alternative to incarceration for parents who…

  3. Acculturation and polysubstance abuse in Arab-American treatment clients.

    Science.gov (United States)

    Arfken, Cynthia L; Kubiak, Sheryl P; Farrag, Mohamed

    2009-12-01

    Acculturation to U.S. culture by Latinos and Asian Americans has been associated with increased prevalence of substance abuse. However, little is known about the association between acculturation and substance use among Arab Americans, or more specifically, among Arab-American treatment clients. In 156 Arab-American male treatment clients, we found that higher levels of U.S. acculturation were positively associated with increased prevalence of polysubstance abuse. This first report on a large series of Arab-American clients also found considerable within-group variability. These results can be used to develop treatment plans and work-force training on the importance of U.S. acculturation and variability within Arab Americans.

  4. Emotion regulation promotes persistence in a residential substance abuse treatment.

    Science.gov (United States)

    Hopwood, Christopher J; Schade, Nick; Matusiewicz, Alexis; Daughters, Stacey B; Lejuez, Carl W

    2015-01-01

    Emotion regulation at treatment entry was evaluated among 115 patients in an inner-city substance use residential facility who either persisted (N = 94) or discontinued treatment (N = 21). Emotion regulation capacity including emotional clarity and the ability to engage in goal-directed behavior despite emotional distress, as well as lower scores on a measure of trait-negative emotionality, were associated with treatment persistence, whereas motivational variables were not. Findings indicate the importance of regulating negative emotions for treatment engagement among substance abusers.

  5. Abuse

    Science.gov (United States)

    ... indicate neglect. Belittling, threats or other uses of power by spouses, family members or others may indicate verbal or emotional abuse. Strained or tense relationships and frequent arguments between ...

  6. 45 CFR 96.46 - Substance abuse prevention and treatment services.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Substance abuse prevention and treatment services... BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.46 Substance abuse prevention... organizations under the substance abuse prevention and treatment Block Grant. (b) For the purpose of...

  7. HIV Rapid Testing in Substance Abuse Treatment: Implementation Following a Clinical Trial

    Science.gov (United States)

    Haynes, L. F.; Korte, J. E.; Holmes, B. E.; Gooden, L.; Matheson, T.; Feaster, D. J.; Leff, J. A.; Wilson, L.; Metsch, L. R.; Schackman, B. R.

    2011-01-01

    The Substance Abuse Mental Health Services Administration has promoted HIV testing and counseling as an evidence-based practice. Nevertheless, adoption of HIV testing in substance abuse treatment programs has been slow. This article describes the experience of a substance abuse treatment agency where, following participation in a clinical trial,…

  8. Elimination of drugs of abuse and their toxicity from natural waters by photo-Fenton treatment.

    Science.gov (United States)

    Catalá, M; Domínguez-Morueco, N; Migens, A; Molina, R; Martínez, F; Valcárcel, Y; Mastroianni, N; López de Alda, M; Barceló, D; Segura, Y

    2015-07-01

    This paper investigates the elimination of drugs of abuse from six different chemical classes and their metabolites in natural fluvial waters (nearby the output of a sewage system). Mineralization of these substances and toxicological characterization before and after treatment by a heterogeneous photo-Fenton system has been evaluated. This advanced oxidation technology was able to significantly reduce the concentration of the drugs of abuse in all the tested conditions (different hydrogen peroxide and catalyst loadings). However, toxicological analyses measured as inhibition of fern spore mitochondrial activity, showed only a complete elimination of acute and chronic toxicity when a higher solid catalyst loading was used (0.6 g/L). A lower catalyst loading of 0.2 g/L was not enough for toxicity elimination. These results evidence the need for combining toxicological tests and chemical analyses in order to establish the effectiveness of the water treatment technologies based on advanced oxidation processes.

  9. Multidimensional Family Therapy (MDFT) for Young People in Treatment for Non-opioid Drug Abuse:

    DEFF Research Database (Denmark)

    Filges, Trine; Rasmussen, Pernille; Andersen, Ditte

    2015-01-01

    The main objectives of this review are to evaluate the current evidence on the effects of MDFT on drug abuse reduction for young people (aged 11-21 years) in treatment for non-opioid drug abuse, and if possible to examine moderators of drug abuse reduction effects, specifically analysing whether...

  10. 78 FR 15961 - Center for Substance Abuse Treatment National Advisory Council; Meeting

    Science.gov (United States)

    2013-03-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment National Advisory Council; Meeting Pursuant to Public Law 92-463, notice is hereby given of the meeting of the Substance Abuse and...

  11. 78 FR 45544 - Center for Substance Abuse Treatment (CSAT) National Advisory Council; Notice of Meeting

    Science.gov (United States)

    2013-07-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (CSAT) National Advisory Council; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and...

  12. Influence of pretreatment coping strategies on the outcome of outpatient treatment of Danish alcohol abusers

    DEFF Research Database (Denmark)

    Bussey Rask, Marie; Jørgensen, Tina; Pinnerup Jensen, Jeanette

    2006-01-01

    An important issue regarding treatment for alcohol abuse is the high rate of relapse following treatment. In the research on treatment of alcohol abuse, the concept of coping has been proposed as a relevant factor in the relationship between relapse crises and treatment outcome. The present study...

  13. Substance abuse treatment providers' explicit and implicit attitudes regarding sexual minorities.

    Science.gov (United States)

    Cochran, Bryan N; Peavy, K Michelle; Cauce, Ana Mari

    2007-01-01

    Lesbian, gay, bisexual, and transgender (LGBT) individuals have been found to have elevated rates of substance use disorders when compared with heterosexuals. However, little is known about the challenges a sexual minority might face in presenting for substance use treatment. In this study, treatment providers' attitudes toward LGBT individuals were assessed among a sample of 46 substance abuse treatment counselors who provide publicly funded treatment. Participants completed both explicit measures of heterosexist bias and an implicit measure designed to assess for biases that exist at an automatic, uncontrolled level. Results indicate that treatment counselors' negative biases regarding LGBT individuals were stronger for heterosexual counselors and for those with few LGBT friends. However, biases among this sample were significantly less than in comparison samples. Findings were also related to a newly developed measure of cultural competence in working with LGBT substance users. Implications for provision of appropriate services and recommendations to treatment agencies are discussed.

  14. A qualitative study of exodus graduates: family-focused residential substance abuse treatment as an option for mothers to retain or regain custody and sobriety in Los Angeles, California.

    Science.gov (United States)

    Einbinder, Susan D

    2010-01-01

    In this article, 21 long-term, poly-substance abusing mothers describe how they successfully completed an 18-month family-focused residential substance abuse treatment program in southern California that helped them retain or regain custody of their children. Their stories and experiences with specific program characteristics and approaches of this rare treatment option are described, in their own voices. Policy implications for child welfare and parental substance abuse treatment are examined in light of these success stories.

  15. 45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

    Science.gov (United States)

    2010-10-01

    ... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2010-10-01 2010-10-01 false Capacity of treatment for intravenous...

  16. [Emotional responsiveness of substance abusers under outpatient treatment].

    Science.gov (United States)

    Chicharro, Juan; Pérez-García, Ana M; Sanjuán, Pilar

    2012-01-01

    The emotions predispose to action providing information from both internal and external environment. There is evidence indicating that the emotional response in drugdependent patients is different from that of the not consuming population. The present work analyzed the emotions of drugdependent under ambulatory treatment (N=57), following the Lang's theory of emotion, considering the dimensions of valence, arousal and dominance or control, across the International Affective Picture System (IAPS), individually applied. The results were contrasted with a control group of not consuming persons (N=44) of similar age, since this variable concerns emotional experience. The influence of sex was also analyzed, considering the possible differences between men and women in emotional experience. The results can be summarized in the following points: (1) There were significant differences between substance abusers and not consumers in the dimension of valence, valuing the consumers the emotional stimuli of the most extreme form (the agreeable ones as better, and the disagreeable ones as worse); (2) there were no differences between both groups in the arousal and dominance dimensions; and (3) women reported more arousal before aversive images, and less before the sexual ones, than males, independently of they were or not substance abusers. Finally, it is suggested the need to deep into the analysis of sex differences and into the images selected, as well as into the usefulness of the emotion centred therapies for the treatment of drugdependency.

  17. Interaction effects of treatment setting and client characteristics on retention and completion.

    Science.gov (United States)

    Klein, Chris; di Menza, Salvatore; Arfken, Cynthia; Schuster, Charles R

    2002-01-01

    Client-treatment matching assumes treatment outcome will be improved if characteristics of clients are matched to specific elements of treatment. Few empirical studies, however, have examined matching across different types of treatment settings. The present research examined differences in demographics and substance-related problems in populations admitted to three substance abuse treatment settings--outpatient (n = 1132), intensive outpatient (n = 1190), and residential (n = 149)--and tested whether interactions between client characteristics and type of setting predicted rates of 30-day retention and treatment completion. In addition, three specific hypotheses based on prior theoretical and empirical investigations were tested. Client characteristics included demographic information (e.g., sex, age, race) and Addiction Severity Index (ASI) composite scores. Client-setting interactions were found for both retention and completion. All three hypotheses received at least partial support. Implications for client assignment and future research are discussed.

  18. Psychoanalytic treatment of psychological addiction to alcohol (alcohol abuse).

    Science.gov (United States)

    Johnson, Brian

    2011-01-01

    The DSM-V Committee plans to abolish the distinction between Alcohol Abuse and Alcohol Dependence (dsm5.org). The author presents a case report as a proof of concept that this distinction should be retained. The author has asserted that Alcohol Abuse is a purely psychological addiction, while Alcohol Dependence involves capture of the ventral tegmental dopaminergic SEEKING system (Johnson, 2003). In psychological addiction the brain can be assumed to function normally, and ordinary psychoanalytic technique can be followed. For the patient described, transference interpretation was the fundamental key to recovery. Alcoholic drinking functioned to prevent this man from remembering overwhelming childhood events; events that were also lived out in his current relationships. Murders that occurred when he was a child were hidden in a screen memory. The patient had an obsessional style of relating where almost all feeling was left out of his associations. After he stopped drinking compulsively, he continued to work compulsively. The maternal transference had to be enacted and then interpreted in order for overwhelming memories to be allowed into conscious thought. After psychoanalysis, the patient resumed drinking and worked a normal schedule that allowed more fulfilling relationships. He had no further symptoms of distress from drinking over a 9-year followup. This case illustrates that Alcohol Abuse is a purely psychological illness, that it does not have the brain changes typical of Alcohol Dependence. Combining epidemiological, neurobiological, longitudinal, and psychoanalytic observations would allow multiple sources of information to be used in creating diagnostic categories. Losing details of human behavior by relying only on epidemiological studies is likely to cause errors in categorization of disorders. In turn, having faulty categories as the basis of further research is likely to impair identification of specific effective treatments.

  19. Motivating Treatment Seeking and Behavior Change by Untreated Military Personnel Abusing Alcohol or Drugs

    Science.gov (United States)

    2015-10-01

    Award Number:W81XWH-09-2-0135 TITLE: Motivating Treatment Seeking and Behavior Change by Untreated Military Personnel Abusing Alcohol or Drugs ...Untreated Military Personnel Abusing Alcohol or Drugs 5b. GRANT NUMBER DR081215 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Denise Walker...consequences, (b) self-initiated change or enrollment in a treatment or self-help program, and (c) cessation of abuse of alcohol or other drugs

  20. Survival Analysis of Drug Abuse Relapse in Addiction Treatment Centers

    Directory of Open Access Journals (Sweden)

    Kassani

    2015-09-01

    Full Text Available Background Drug abuse is a chronic and enduring phenomenon, which is among the important challenging public health problems. One of the main aspects in drug abuse is the relapse. Objectives The aims of this study were to estimate the time to relapse (survival rate and to evaluate some of its associated variables by survival analysis. Patients and Methods This research was conducted in four addiction treatment centers on 140 self-referred addicts in Ilam city, Iran, in 2012. Cluster sampling method was used for selecting the samples and data were collected by interview and referring to the subjects’ records. The gathered data were analyzed through the life table, Kaplan-Meier analysis, log rank test, and Cox regression. Results The relapse rate was 30.42%, mean and median of the time to relapse (survival time were 27.40 ± 1.63 months (CI 95%: 24.19 - 30.60 and 25 ± 2.25 months (CI 95%: 22.5 - 27.5, respectively. In the first six months, the cumulative survival rate was 83%, while in the 24th month it was 46% and the following time was consistent. Job status (OR = 2.64, marital status (OR = 1.55, family size (OR = 1.20 and age (OR = 0.23 were statistically significant in Cox regression model. Conclusions In the initial treatment, it seems necessary to supervise and monitor the treatment process through staff in addiction treatment centers together with the company of the addicts’ families to reduce relapse rate.

  1. Smoking cessation treatment in community-based substance abuse rehabilitation programs.

    Science.gov (United States)

    Reid, Malcolm S; Fallon, Bryan; Sonne, Susan; Flammino, Frank; Nunes, Edward V; Jiang, Huiping; Kourniotis, Eva; Lima, Jennifer; Brady, Ron; Burgess, Cynthia; Arfken, Cynthia; Pihlgren, Eric; Giordano, Louis; Starosta, Aron; Robinson, James; Rotrosen, John

    2008-07-01

    Nicotine dependence is highly prevalent among drug- and alcohol-dependent patients. A multisite clinical trial of smoking cessation (SC) treatment was performed at outpatient community-based substance abuse rehabilitation programs affiliated with the National Drug Abuse Treatment, Clinical Trials Network. Cigarette smokers (N=225) from five methadone maintenance programs and two drug and alcohol dependence treatment programs were randomly assigned in a 2:1 ratio to receive either (1) SC treatment as an adjunct to substance abuse treatment-as-usual (TAU) or (2) substance abuse TAU. Smoking cessation treatment consisted of 1 week of group counseling before the target quit date and 8 weeks of group counseling plus transdermal nicotine patch treatment (21 mg/day for Weeks 1-6 and 14 mg/day for Weeks 7 and 8) after the target quit date. Smoking abstinence rates in SC, 10%-11% during treatment and 5%-6% at the 13- and 26-week follow-up visits, were significantly better than those in TAU during treatment (p< .01). In addition, SC was associated with significantly greater reductions as compared with TAU in cigarettes smoked per day (75% reduction, p< .001), exhaled carbon monoxide levels (p< .001), cigarette craving (p< .05), and nicotine withdrawal (p< .05). Smoking cessation did not differ from TAU on rates of retention in substance abuse treatment, abstinence from primary substance of abuse, and craving for primary substance of abuse. Compliance with SC treatment, moderate at best, was positively associated with smoking abstinence rates. Smoking cessation treatment resulted in significant reductions in daily smoking and modest smoking abstinence rates without having an adverse impact on substance abuse rehabilitation when given concurrently with outpatient substance abuse treatment. Substance abuse treatment programs should not hesitate to implement SC for established patients.

  2. Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Risk for Child Abuse.

    Science.gov (United States)

    Kelley, Michelle L; Bravo, Adrian J; Braitman, Abby L; Lawless, Adrienne K; Lawrence, Hannah R

    2016-03-01

    Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6-month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For both mothers and fathers, attending more BCT sessions lead to a direct increase in relationship satisfaction, which in turn led to stronger reductions in risk for child abuse. This effect was maintained from the post-intervention through the 6-month post-intervention follow-up. For fathers, number of days abstinent significantly influenced reduction in child abuse potential at post-intervention via relationship satisfaction. This indirect effect was not present for mothers. The overall benefits of BCT on mothers' and fathers' risk for child abuse suggest that BCT may have promise in reducing risk for child abuse among couples in which one or both parents have SUD.

  3. Methadone versus buprenorphine for the treatment of opioid abuse in pregnancy: science and stigma.

    Science.gov (United States)

    Holbrook, Amber M

    2015-01-01

    The past decade has seen an increase in rates of opioid abuse during pregnancy. This clinical challenge has been met with debate regarding whether or not illicit and prescription opioid-dependent individuals require different treatment approaches; whether detoxification is preferable to maintenance; and the efficacy of methadone versus buprenorphine as treatment options during pregnancy. The clinical recommendations resulting from these discussions are frequently influenced by the comparative stigma attached to heroin abuse and methadone maintenance versus prescription opioid abuse and maintenance treatment with buprenorphine. While some studies have suggested that a subset of individuals who abuse prescription opioids may have different characteristics than heroin users, there is currently no evidence to suggest that buprenorphine is better suited to treatment of prescription opioid abuse than methadone. Similarly, despite its perennial popularity, there is no evidence to recommend detoxification as an efficacious approach to treatment of opioid dependence during pregnancy. While increased access to treatment is important, particularly in rural areas, there are multiple medical and psychosocial reasons to recommend comprehensive substance abuse treatment for pregnant women suffering from substance use disorders rather than office-based provision of maintenance medication. Both methadone and buprenorphine are important treatment options for opioid abuse during pregnancy. Methadone may still remain the preferred treatment choice for some women who require higher doses for stabilization, have a higher risk of treatment discontinuation, or who have had unsuccessful treatment attempts with buprenorphine. As treatment providers, we should advocate to expand available treatment options for pregnant women in all States.

  4. Long-term residential substance abuse treatment for women: lessons learned from Israel

    Directory of Open Access Journals (Sweden)

    Schori M

    2012-02-01

    Full Text Available Maayan Schori1, Yaffa Sapir2, Eli Lawental31School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA; 2Central School for the Training of Social Welfare Workers, Ministry of Social Affairs and Social Services, Tel Aviv, Israel; 3Department of Social Work, Tel-Hai College, Upper Galilee, IsraelBackground: Policymakers and treatment providers must consider the role of gender when designing effective treatment programs for female substance abusers. This study had two aims. First, to examine female substance abusers' perceptions regarding factors that contribute to their retention (and therefore positive treatment outcomes in a women-only therapeutic community in Northern Israel. Second, to explore pretreatment internal and external factors including demographic, personal and environmental factors, factors associated with substance use and with the treatment process, and networks of support that contribute to retention and abstinence.Methods: The study was a conducted using a mixed methods approach. Semi-structured qualitative interviews examining perceptions towards treatment were conducted in five focus groups (n = 5 per group; total n = 25. Intake assessments and a battery of questionnaires examining pretreatment internal and external factors related to treatment retention and abstinence were collected from 42 women who were treated in the program during the 2 year study period. Twenty-three women who completed the 12 month program were compared to the 19 women who did not, using chi-square for categorical variables and t-tests for continuous variables. Nineteen of the 23 women who completed the questionnaires also completed a post-treatment follow-up questionnaire.Results: A content analysis of the interviews revealed five central themes: factors associated with treatment entry; impact of treatment in a women-only setting; significant aspects of treatment; difficulties with the setting; prospects for the future

  5. Hispanic Subgroups, Acculturation, and Substance Abuse Treatment Outcomes.

    Science.gov (United States)

    Chartier, Karen G; Carmody, Tom; Akhtar, Maleeha; Stebbins, Mary B; Walters, Scott T; Warden, Diane

    2015-12-01

    This study explored Hispanic subgroup differences in substance use treatment outcomes, and the relationship of acculturation characteristics to these outcomes. Data were from a multisite randomized clinical trial of motivational enhancement therapy versus treatment as usual in a sample of Spanish-speaking substance abusers. Participants were Cuban American (n=34), Mexican American (n=209), Puerto Rican (n=78), and other Hispanic American (n=54). Results suggested that Cuban Americans and individuals with more connection to Hispanic culture had lower treatment retention. Hispanics born in the U.S and those who spoke English at home had a lower percentage of days abstinent during weeks 5-16, although Puerto Ricans born in the U.S. and Cuban Americans living more years in the U.S. had a higher percentage of days abstinent in weeks 1-4 and 5-16, respectively. Results may inform future hypothesis-driven studies in larger Hispanic treatment seeking samples of the relationship between acculturation and treatment outcome.

  6. Attributions and Coping in Sexually Abused Adolescents Referred for Group Treatment

    Science.gov (United States)

    Daigneault, Isabelle; Hebert, Martine; Tourigny, Marc

    2006-01-01

    This study aims to assess the predictive value of two sets of variables, self-attributions, and coping behaviors, on sexually abused (SA) teenagers' functioning, while controlling for abuse-related and family variables. A total of 103 female adolescents completed self-report measures to assess their psychological functioning in terms of anxiety,…

  7. Patterns of pre-treatment drug abuse, drug treatment history and characteristics of addicts in methadone maintenance treatment in Iran

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    Shekarchizadeh Hajar

    2012-06-01

    Full Text Available Abstract Background Opiates are the main drugs of abuse, and Methadone Maintenance Treatment (MMT is the most widely administered drug addiction treatment program in Iran. Our study aimed to investigate patterns of pre-treatment drug abuse, addiction treatment history and characteristics of patients in MMT in Tehran. Methods We applied a stratified cluster random sampling technique and conducted a cross-sectional survey utilizing a standard patient characteristic and addiction history form with patients (n = 810 in MMT. The Chi-square test and t-test served for statistical analyses. Results A clear majority of the participants were men (96%, more than 60% of whom were between 25 and 44 years of age, educated (89% had more than elementary education, and employed (>70%. The most commonly reported main drugs of abuse prior to MMT entry were opium (69% and crystalline heroin (24%. The patients’ lifetime drug experience included opium (92%, crystalline heroin (28%, cannabis (16%, amphetamines (15%, and other drugs (33%. Crystalline heroin abusers were younger than opium users, had begun abusing drugs earlier, and reported a shorter history of opiate addiction. Conclusion Opium and crystalline heroin were the main drugs of abuse. A high rate of addiction using more dangerous opiate drugs such as crystalline heroin calls for more preventive efforts, especially among young men.

  8. American Youths' Access to Substance Abuse Treatment: Does Type of Treatment Facility Matter?

    Science.gov (United States)

    Lo, Celia C.; Cheng, Tyrone C.

    2013-01-01

    Using data from the 2007 National Survey on Drug Use and Health, this study examines whether several social exclusion and psychological factors affect adolescents' receipt of substance abuse treatment. Multinomial logistic regression techniques were used to analyze data. The study asked how the specified factors provide pathways to receipt of…

  9. Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

    Science.gov (United States)

    Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

    2014-01-01

    The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed.

  10. Impact of Physical and Sexual Abuse on Treatment Response in the Treatment of Resistant Depression in Adolescent Study (TORDIA)

    Science.gov (United States)

    Shamseddeen, Wael; Asarnow, Joan Rosenbaum; Clarke, Gregory; Vitiello, Benedetto; Wagner, Karen Dineen; Birmaher, Boris; Keller, Martin B.; Emslie, Graham; Iyengar, Satish; Ryan, Neal D.; McCracken, James T.; Porta, Giovanna; Mayes, Taryn; Brent, David A.

    2011-01-01

    Objective: We previously reported that a history of abuse was associated with a poorer response to combination treatment in the Treatment of Resistant Depression in Adolescents study (TORDIA). We now report on the nature and correlates of abuse that might explain these findings. Method: Youth who did not benefit from an adequate selective…

  11. Alcohol abuse and related disorders treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Yu. P. Sivolap

    2014-01-01

    Full Text Available Alcohol abuse and alcoholism are the leading causes of worse health and increased mortality rates. Excessive alcohol consumption is the third leading cause of the global burden of diseases and a leading factor for lower lifespan and higher mortality. Alcohol abuse decreases working capacity and efficiency and requires the increased cost of the treatment of alcohol-induced disorders, which entails serious economic losses. The unfavorable medical and social consequences of excessive alcohol use determine the importance of effective treatment for alcoholism. The goals of rational pharmacotherapy of alcohol dependence are to enhance GABA neurotransmission, to suppress glutamate neurotransmission, to act on serotonin neurotransmission, to correct water-electrolyte balance, and to compensate for thiamine deficiency. Alcoholism treatment consists of two steps: 1 the prevention and treatment of alcohol withdrawal syndrome and its complications (withdrawal convulsions and delirium alcoholicum; 2 antirecurrent (maintenance therapy. Benzodiazepines are the drugs of choice in alleviating alcohol withdrawal and preventing its convulsive attacks and delirium alcoholicum. Diazepam and chlordiazepoxide are most commonly used for this purpose; the safer drugs oxazepam and lorazepam are given to the elderly and patients with severe liver lesions. Anticonvulsants having normothymic properties, such as carbamazepine, valproic acid, topiramate, and lamotrigine, are a definite alternative to benzodiazepines. The traditional Russian clinical practice (clearance detoxification has not a scientific base or significant impact on alcohol withdrawal-related states in addicts. Relapse prevention and maintenance therapy for alcohol dependence are performed using disulfiram, acamprosate, and naltrexone; since 2013 the European Union member countries have been using, besides these agents, nalmefene that is being registered in Russia. Memantine and a number of other

  12. Variables associated with environmental scanning among clinicians at substance abuse treatment clinics

    OpenAIRE

    Koch, Alison L; Arfken, Cynthia L; Marcus W. Dickson; Elizabeth Agius; Mitchelson, Jacqueline K.

    2005-01-01

    Introduction. Environmental scanning, as a component of absorptive capacity, has been shown to be associated with increased use of innovative treatment techniques at substance abuse treatment programmes. As the transfer of innovative, evidence-based treatment techniques from research to practice is gaining attention, we aimed to identify variables associated with higher levels of environmental scanning among substance abuse treatment clinicians. Method. A cross-sectional survey was administ...

  13. Predictors of death among patients who completed tuberculosis treatment: a population-based cohort study.

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    Juan-Pablo Millet

    Full Text Available BACKGROUND: Mortality among patients who complete tuberculosis (TB treatment is still high among vulnerable populations. The objective of the study was to identify the probability of death and its predictive factors in a cohort of successfully treated TB patients. METHODS: A population-based retrospective longitudinal study was performed in Barcelona, Spain. All patients who successfully completed TB treatment with culture-confirmation and available drug susceptibility testing between 1995-1997 were retrospectively followed-up until December 31, 2005 by the Barcelona TB Control Program. Socio-demographic, clinical, microbiological and treatment variables were examined. Mortality, TB Program and AIDS registries were reviewed. Kaplan-Meier and a Cox regression methods with time-dependent covariates were used for the survival analysis, calculating the hazard ratio (HR with 95% confidence intervals (CI. RESULTS: Among the 762 included patients, the median age was 36 years, 520 (68.2% were male, 178 (23.4% HIV-infected, and 208 (27.3% were alcohol abusers. Of the 134 (17.6% injecting drug users (IDU, 123 (91.8% were HIV-infected. A total of 30 (3.9% recurrences and 173 deaths (22.7% occurred (mortality rate: 3.4/100 person-years of follow-up. The predictors of death were: age between 41-60 years old (HR: 3.5; CI:2.1-5.7, age greater than 60 years (HR: 14.6; CI:8.9-24, alcohol abuse (HR: 1.7; CI:1.2-2.4 and HIV-infected IDU (HR: 7.9; CI:4.7-13.3. CONCLUSIONS: The mortality rate among TB patients who completed treatment is associated with vulnerable populations such as the elderly, alcohol abusers, and HIV-infected IDU. We therefore need to fight against poverty, and promote and develop interventions and social policies directed towards these populations to improve their survival.

  14. Predictors of Death among Patients Who Completed Tuberculosis Treatment: A Population-Based Cohort Study

    Science.gov (United States)

    Millet, Juan-Pablo; Orcau, Angels; Rius, Cristina; Casals, Marti; de Olalla, Patricia Garcia; Moreno, Antonio; Nelson, Jeanne L.; Caylà, Joan A.

    2011-01-01

    Background Mortality among patients who complete tuberculosis (TB) treatment is still high among vulnerable populations. The objective of the study was to identify the probability of death and its predictive factors in a cohort of successfully treated TB patients. Methods A population-based retrospective longitudinal study was performed in Barcelona, Spain. All patients who successfully completed TB treatment with culture-confirmation and available drug susceptibility testing between 1995–1997 were retrospectively followed-up until December 31, 2005 by the Barcelona TB Control Program. Socio-demographic, clinical, microbiological and treatment variables were examined. Mortality, TB Program and AIDS registries were reviewed. Kaplan-Meier and a Cox regression methods with time-dependent covariates were used for the survival analysis, calculating the hazard ratio (HR) with 95% confidence intervals (CI). Results Among the 762 included patients, the median age was 36 years, 520 (68.2%) were male, 178 (23.4%) HIV-infected, and 208 (27.3%) were alcohol abusers. Of the 134 (17.6%) injecting drug users (IDU), 123 (91.8%) were HIV-infected. A total of 30 (3.9%) recurrences and 173 deaths (22.7%) occurred (mortality rate: 3.4/100 person-years of follow-up). The predictors of death were: age between 41–60 years old (HR: 3.5; CI:2.1–5.7), age greater than 60 years (HR: 14.6; CI:8.9–24), alcohol abuse (HR: 1.7; CI:1.2–2.4) and HIV-infected IDU (HR: 7.9; CI:4.7–13.3). Conclusions The mortality rate among TB patients who completed treatment is associated with vulnerable populations such as the elderly, alcohol abusers, and HIV-infected IDU. We therefore need to fight against poverty, and promote and develop interventions and social policies directed towards these populations to improve their survival. PMID:21980423

  15. Psychological, physical, and sexual abuse in addicted patients who undergo treatment.

    Science.gov (United States)

    Fernández-Montalvo, Javier; López-Goñi, José J; Arteaga, Alfonso

    2015-05-01

    This study explored the prevalence of a history as victims of abuse among patients who sought outpatient treatment for drug addiction. A sample of 252 addicted patients was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual abuse), sociodemographic factors, consumption factors, psychopathological factors, and personality variables. Drug-addicted patients who present a lifelong history of abuse were compared with patients who were not abused. Of the total sample, 46% of the patients (n = 115) who were addicted to drugs had been victims of abuse. There was a statistically significant difference between the victimization rates of men (37.8%) and women (79.6%). Moreover, for some variables, significant differences were observed between patients who had been abused and those who had not. Compared with patients who had not been abused, the addicted patients with a history of victimization scored significantly higher on several European Addiction Severity Index, Millon Clinical Multiaxial Inventory-II, and maladjustment variables but not on the Symptom Checklist-90-Revised. The current results indicate that patients who present a lifelong history of abuse exhibit both a more severe addiction than patients who were not abused and several comorbidities. The implications of these results for further research and clinical practice are discussed.

  16. Developing cohesion in court-mandated group treatment of male spouse abusers.

    Science.gov (United States)

    Robbins, Reuben N

    2003-07-01

    Cohesion in group treatment of spouse abusers plays an important and often overlooked role. Involuntary abuser groups can benefit from cohesion, but due to their unique structure, cohesion may develop differently than in voluntary psychotherapy groups. Initially, abuser groups may develop premature levels of cohesion that can make group members unwilling to express conflict, develop intimacy, and take responsibility for their actions. Understanding the abuser personality and the unique characteristics of involuntary abuser groups can shed light on why cohesion develops the way it does and the importance it plays in abuser groups. Developing effective interventions that target premature cohesion can help the group members express conflict, develop intimacy, and take responsibility for their actions, thus bringing about therapeutic levels of cohesion.

  17. Alcohol and Drug Abusers Entering Treatment: How Different Are They?

    Science.gov (United States)

    Seraganian, Peter; And Others

    A major shift in drug abuse epidemiology has been witnessed in North America over the past decade. Although alcohol continues to be widely abused, usage of other substances has proliferated. While addicted individuals share some attributes, certain demographic, psychological, and cognitive characteristics may distinguish alcoholics from those who…

  18. Relapse Among Adolescent Drug Abusers Following Treatment: The Role of Probable ADHD Status

    Science.gov (United States)

    Latimer, William W.; Ernst, Jenna; Hennessey, Jodi; Stinchfield, Randy D.; Winters, Ken C.

    2004-01-01

    This is a report on a sample of adolescent drug abusers in treatment (N = 220) to estimate the degree to which probable ADHD status increases the odds of posttreatment alcohol, marijuana, and other drug relapse during the initial 6 months following discharge. Drug abusing youth with probable ADHD status exhibited 2.5 times the risk of…

  19. Psychic Symptomatology as Predictor to Outcome of Treatment for Adolescent Drug Abusers.

    Science.gov (United States)

    Friedman, Alfred S.; Terras, Arlene

    1996-01-01

    Study of 176 adolescent drug abusers found that greater psychopathology at pretreatment was not found to be related to less improvement in drug treatment. For the male subsample, greater paranoid trends predicted to less reduction in substance use/abuse. Borderline psychotic symptomatology predicted to more improvement. (RJM)

  20. Training Needs for Substance Abuse Treatment and Assessment among Rehabilitation Counselors: California State Project

    Science.gov (United States)

    Ong, Lee Za; Lee, Dal-Yob; Cha, Grace; Arokiasamy, Charles

    2008-01-01

    One hundred rehabilitation counselors in California reported that about 90% of consumers with whom they worked with had substance abuse and cooccurring issues, yet about half rated their graduate training in substance abuse treatment and assessment as poor and their practices as marginally proficient. The correlation analysis revealed that…

  1. The Development of a Substance Abuse Treatment Program for Forensic Patients with Cognitive Impairment

    Science.gov (United States)

    Glassmire, David M.; Welsh, Robert K.; Clevenger, Jeanne K.

    2007-01-01

    The Substance Abuse and Mental Illness (SAMI) program combines cognitive rehabilitation and dual-diagnosis substance abuse treatment within a stages of change context. This article describes the development, implementation, and preliminary outcome analysis of the SAMI program in a forensic hospital.

  2. Implementation of a Smoking Cessation Treatment Study at Substance Abuse Rehabilitation Programs: Smoking Behavior and Treatment Feasibility Across Varied Community-based Outpatient Programs.

    Science.gov (United States)

    Reid, Malcolm S; Fallon, Bryan; Sonne, Susan; Nunes, Edward V; Lima, Jennifer; Jiang, Huiping; Tyson, Clare; Hiott, Robert; Arfken, Cynthia; Bohs, Rhonda; Orr, Deborah; Muir, Joan; Pihlgren, Eric; Loree, Amy; Fuller, Brett E; Giordano, Louis; Robinson, James; Rotrosen, John

    2007-09-01

    Cigarette smoking is widely prevalent among individuals in treatment for drug or alcohol dependence; however, the treatment of nicotine addiction in this population has numerous obstacles at both programmatic and patient levels. Despite these difficulties, recent studies have demonstrated moderate success in implementing smoking cessation treatment in drug rehabilitation programs. The National Drug Abuse Treatment Clinical Trials Network sponsored a smoking cessation study in 13 community-based outpatient substance abuse rehabilitation programs across the country. The study evaluated the effectiveness of smoking cessation treatment provided as an adjunct to substance abuse treatment-as-usual. This report summarizes the practical and clinical experiences encountered at each of the study sites with regard to implementing the smoking cessation treatment intervention. Smoking behavior of the treatment clientele was assessed by anonymous survey at each site. In addition, sites were systematically characterized by using program review and assessment tools completed by the respective staff and program directors at the site. Survey and recruitment data indicated that cigarette smoking is more prevalent and that smoking cessation treatment is more feasible, in methadone maintenance treatment programs. Other factors associated with smoking behavior and with the recruitment of drug- and alcohol-dependent individuals into the smoking cessation treatment study are described.

  3. Co-occurring disorders in the adolescent mental health and substance abuse treatment systems.

    Science.gov (United States)

    Turner, Win C; Muck, Randolph D; Muck, Rebekah J; Stephens, Robert L; Sukumar, Bhuvana

    2004-12-01

    This article explores the rates of co-occurring disorders in two large federally-funded programs that target youth. In the mental health treatment system, the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS) supports the Comprehensive Community Mental Health Services for Children and Their Families Program. SAMHSA's Center for Substance Abuse Treatment (CSAT) supports a number of grant programs providing substance abuse treatment for adolescents. The data from these programs underscores the need for the use of systematic, validated, biopsychosocial assessment instruments for all youth entering either the substance abuse or mental health treatment systems. The current evidence base for models of co-occurring treatment for youth is discussed and recommendations made for future activity related to adolescent co-occurring treatment.

  4. Women's steps of change and entry into drug abuse treatment. A multidimensional stages of change model.

    Science.gov (United States)

    Brown, V B; Melchior, L A; Panter, A T; Slaughter, R; Huba, G J

    2000-04-01

    The Transtheoretical, or Stages of Change Model, has been applied to the investigation of help-seeking related to a number of addictive behaviors. Overall, the model has shown to be very important in understanding the process of help-seeking. However, substance abuse rarely exists in isolation from other health, mental health, and social problems. The present work extends the original Stages of Change Model by proposing "Steps of Change" as they relate to entry into substance abuse treatment programs for women. Readiness to make life changes in four domains-domestic violence, HIV sexual risk behavior, substance abuse, and mental health-is examined in relation to entry into four substance abuse treatment modalities (12-step, detoxification, outpatient, and residential). The Steps of Change Model hypothesizes that help-seeking behavior of substance-abusing women may reflect a hierarchy of readiness based on the immediacy, or time urgency, of their treatment issues. For example, women in battering relationships may be ready to make changes to reduce their exposure to violence before admitting readiness to seek substance abuse treatment. The Steps of Change Model was examined in a sample of 451 women contacted through a substance abuse treatment-readiness program in Los Angeles, California. A series of logistic regression analyses predict entry into four separate treatment modalities that vary. Results suggest a multidimensional Stages of Change Model that may extend to other populations and to other types of help-seeking behaviors.

  5. Evaluation of the Effectiveness of Client Participation in Drug Abuse Treatment

    Directory of Open Access Journals (Sweden)

    Akbar Aliverdinia

    2014-01-01

    The results suggest an inverse relationship between participation in the treatment process and differential association. Previous studies have also shown that as long as the patient is present in the treatment system there is a lower risk of committing social crimes. In general, we can conclude that participation in the treatment process leads to reduction of drug abuse by increasing associations and beliefs that are against drug abuse and by negating positive attitudes towards drugs.

  6. Contingency management treatment in substance abusers with and without legal problems.

    Science.gov (United States)

    Petry, Nancy M; Rash, Carla J; Easton, Caroline J

    2011-01-01

    Drug and alcohol abusers frequently have legal difficulties, and the legal system often provides negative reinforcement for substance abuse treatment. In contrast, contingency management (CM) treatments utilize positive reinforcement procedures to improve patient outcomes. This study evaluated whether substance-abusing patients with legal problems at treatment entry had differential outcomes, in general and in response to CM, compared with those without legal problems. Data from three randomized CM trials (n = 393) were used in an evaluation of main and interactive effects of legal status and treatment condition, with respect to retention and abstinence. Compared with patients without legal difficulties, those with legal problems remained in treatment for shorter durations and achieved shorter periods of abstinence. CM was positively and significantly associated with longer durations of abstinence, regardless of legal status. Results suggest that substance abusers with legal problems have generally poor outcomes, but that CM is effective regardless of the patient's legal status.

  7. Characteristics of lesbian, gay, bisexual, and transgender individuals entering substance abuse treatment.

    Science.gov (United States)

    Cochran, Bryan N; Cauce, Ana Mari

    2006-03-01

    Previous research has suggested that lesbian, gay, bisexual, and transgender (LGBT) individuals enter treatment for substance abuse with more severe problems than heterosexual individuals. However, methodological difficulties, particularly the difficulty of obtaining a representative sample, have limited the ability to draw conclusions about LGBT individuals who receive services for substance abuse. This study took advantage of a unique opportunity to examine a representative sample of openly LGBT clients receiving publicly funded substance abuse treatment by using data gathered by treatment providers in Washington State. Baseline differences between openly LGBT and heterosexual clients were compared in a variety of domains. Results demonstrated that openly LGBT clients enter treatment with more severe substance abuse problems, greater psychopathology, and greater medical service utilization when compared with heterosexual clients. When the analyses were stratified based on sex, different patterns of substance use and associated psychosocial characteristics emerged for the LGBT clients. Implications for provision of appropriate services and recommendations to treatment agencies are discussed in this article.

  8. The Effect of Substance Abuse Treatment on High Risk Behaviors in the National Treatment Improvement Evaluation Study (NTIES).

    Science.gov (United States)

    Greenfield, Lawrence; Finkbiner, Richard; Bishop, Sharon

    Substance abusers are at particular risk for becoming infected with, and for spreading, a number of serious communicable diseases. The value of substance abuse treatment in helping to reduce the associated risk behaviors for these diseases is the focus of this technical report. This analysis examines the risk behaviors of injection drug use and…

  9. Feminist-cognitive-behavioral and process-psychodynamic treatments for men who batter: interaction of abuser traits and treatment models.

    Science.gov (United States)

    Saunders, D G

    1996-01-01

    At a community-based domestic violence program, 218 men with a history of partner abuse were randomly assigned to either feminist-cognitive-behavioral or process-psychodynamic group treatments. The treatments were not hypothesized to differ in outcome. However, men with particular characteristics were expected to have lower recidivism rates depending on the type of treatment received. Treatment integrity was verified through audio-taped codings of each session. The partners of 79% of the 136 treatment completers gave reports of the men's behavior an average of 2 years post-treatment. These reports were supplemented with arrest records and self-reports. Rates of violence did not differ significantly between the two types of treatment nor did reports from the women of their fear level, general changes perceived in the men, and conflict resolution methods. However, interaction effects were found between some offender traits and the two treatments. As predicted, men with dependent personalities had better outcomes in the process-psychodynamic groups and those with antisocial traits had better outcomes in the cognitive-behavioral groups. The results suggest that more effective treatment may occur if it is tailored to specific characteristics of offenders.

  10. The relationship between vulnerable attachment style, psychopathology, drug abuse, and retention in treatment among methadone maintenance treatment patients.

    Science.gov (United States)

    Potik, David; Peles, Einat; Abramsohn, Yahli; Adelson, Miriam; Schreiber, Shaul

    2014-01-01

    The relationship between vulnerable attachment style, psychopathology, drug abuse, and retention in treatment among patients in methadone maintenance treatment (MMT) was examined by the Vulnerable Attachment Style Questionnaire (VASQ), the Symptom Checklist-90 (SCL-90), and drug abuse urine tests. After six years, retention in treatment and repeated urine test results were studied. Patients with vulnerable attachment style (a high VASQ score) had higher rates of drug abuse and higher psychopathology levels compared to patients with secure attachment style, especially on the interpersonal sensitivity, anxiety, hostility, phobic anxiety, and paranoid ideation scales. Drug abstinence at baseline was related to retention in treatment and to higher rates of drug abstinence after six years in MMT, whereas a vulnerable attachment style could not predict drug abstinence and retention in treatment. Clinical Implications concerning treatment of drug abusing populations and methodological issues concerning the VASQ's subscales are also discussed.

  11. National Survey of Substance Abuse Treatment Services (N-SSATS-1997-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  12. National Survey of Substance Abuse Treatment Services (N-SSATS-2014)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  13. National Survey of Substance Abuse Treatment Services (N-SSATS-2007)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  14. National Survey of Substance Abuse Treatment Services (N-SSATS-2013)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  15. 1997 through 2010 National Survey of Substance Abuse Treatment Services (N-SSATS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) (formerly titled Uniform Facility Data Set (UFDS)) is designed to collect information from all...

  16. A plan analysis of pedophile sexual abusers' motivations for treatment: a qualitative pilot study.

    Science.gov (United States)

    Drapeau, Martin; Körner, Annett; Granger, Luc; Brunet, Louis; Caspar, Franz

    2005-06-01

    Many authors have suggested adapting treatment programs to the specific needs of sexual abusers. However, little research has been conducted to understand what these patients seek in therapy or what elements play a key role in keeping them in treatment. In this pilot study, fifteen (N=15) pedophile sexual abusers from La Macaza clinic for sexual abusers were interviewed. Plan analysis was used to investigate the most prevalent components involved in staying in or leaving therapy. Results suggest that many components involved in the plans leading to doing and to avoiding treatment were similar. Differences were found in regards to the outcome of confrontations with the therapists, a tendency to isolate and overcomply, guilt related to the abuse, a need for a stable environment, and a need to be accepted. These results are discussed along with possible ways to improve the patients' involvement in treatment.

  17. National Survey of Substance Abuse Treatment Services (N-SSATS-2004)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  18. National Survey of Substance Abuse Treatment Services (N-SSATS-2003)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  19. National Survey of Substance Abuse Treatment Services (N-SSATS-2009)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  20. National Survey of Substance Abuse Treatment Services (N-SSATS-2002)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  1. National Survey of Substance Abuse Treatment Services (N-SSATS-2008)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  2. National Survey of Substance Abuse Treatment Services (N-SSATS-2012)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  3. National Survey of Substance Abuse Treatment Services (N-SSATS-2006)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  4. National Survey of Substance Abuse Treatment Services (N-SSATS-2010)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  5. National Survey of Substance Abuse Treatment Services (N-SSATS-2005)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  6. National Survey of Substance Abuse Treatment Services (N-SSATS-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  7. National Survey of Substance Abuse Treatment Services (N-SSATS-2000)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  8. Tuberculosis Treatment Completion Rates in Southern New Mexico Colonias.

    Science.gov (United States)

    Holden, Maria Arroyo; Huttlinger, Kathleen; Schultz, Pamela; Mullins, Iris; Forster-Cox, Sue

    2016-04-01

    TB medication completion treatment rates for active TB patients living in impoverished US-Mexico border communities called colonias in southern New Mexico counties are unknown. It might be suspected that residents of colonias have lower completion rates than those living in incorporated and medically more accessible areas. A retrospective record review of closed TB case records from 1993 to 2010 of southern New Mexico border counties, was conducted using a modified version of the New Mexico Department of Health Tuberculosis Targeted Health Assessment/History form (Appendix 1). Study findings reveal that despite their unincorporated status, poorer living conditions and questionable legal status, colonia TB patients had a higher medication completion rate than their non-colonia counterparts. A robust New Mexico TB treatment program contributed to high completion rates with death being the number-one reason for treatment non-completion in both colonia and non-colonias.

  9. Client-Provider relationship in comprehensive substance abuse treatment: differences in residential and nonresidential settings.

    Science.gov (United States)

    Shin, Hee-Choon; Marsh, Jeanne C; Cao, Dingcai; Andrews, Christina M

    2011-12-01

    As the substance abuse service system shifts from primarily residential to primarily nonresidential settings, it becomes important to understand how substance abuse treatment processes and outcomes may vary across service setting. Research increasingly indicates that, along with specific treatment and service strategies, client-provider relationship is an important ingredient in effective substance abuse treatment. This study uses a moderator-mediator analysis of a comprehensive service model to examine how the relation between client-provider relationship and substance abuse treatment outcomes may differ in residential and nonresidential settings. The study used data collected for the National Treatment Improvement Evaluation Study, a prospective, cohort-based study of U.S. substance abuse treatment programs and their clients, with an analytic sample of 59 publicly funded service delivery units and 3,027 clients. Structural equation modeling is used to assess the structural relations and causal connections between treatment process and treatment outcome variables. Results indicate that for nonresidential settings, a better client-provider relationship is directly related to improved outcomes of treatment duration and reduced posttreatment substance use and is indirectly related to both outcomes through provision of services matched to client needs. In residential settings, the quality of the client-provider relationship is unrelated to process or outcome variables. The findings point to the importance of the client-provider relationship in all settings but particularly in outpatient settings where there are limited physical constraints on the treatment process.

  10. Emotional concerns and treatment of male partners of female sexual abuse survivors.

    Science.gov (United States)

    Chauncey, S

    1994-11-01

    Many men are discovering that they are involved with women who were sexually abused as children. However, male partners of female sexual abuse survivors have thus far received little attention in the literature. As these men increasingly seek treatment with concerns of their own, social workers must become familiar with their emotional experiences and treatment needs. This article outlines the major concerns expressed by 20 male partners of sexual abuse survivors. These concerns included conflicts about expressing needs, frustration with various aspects of their relationships, guilt and shame at having feelings, questions about how to deal with relatives, and sexual issues. The author recommends a treatment approach that combines attention to both the individual's and the couple's concerns and uses insight and the safety of the therapeutic relationship to promote growth. The importance of further outreach to partners of women who were sexually abused as children and the need for increased attention to other partner populations are highlighted.

  11. Differences in methylphenidate abuse rates among methadone maintenance treatment patients in two clinics.

    Science.gov (United States)

    Peles, Einat; Schreiber, Shaul; Linzy, Shirley; Domani, Yoav; Adelson, Miriam

    2015-07-01

    Methylphenidate, an amphetamine-like prescription medication for attention deficit hyperactivity disorder (ADHD) was suspected as being abused among methadone maintenance treatment (MMT) patients. We tested its presence in the routine urine monitoring of all patients in both Tel Aviv and Las Vegas MMT clinics. Data on demographic and addiction history, ADHD (Wender Utah Rating Scale), cognitive impairment (Mini Mental State Exam), and lifetime DSM-IV-TR psychiatric diagnosis from admission were retrieved, and retention following 6 months. None of the 190 patients in Las Vegas tested positive for methylphenidate, while 14.7% (45/306) did in Tel Aviv. Abusers were less educated (p = 0.01), had higher ADHD scores (p = 0.02), lower cognitive scores (p = 0.05), and a higher benzodiazepine (BDZ) abuse rate (p abuse and infectious disease. Of the methylphenidate abuse 42.2% have take-home methadone dose privileges. Not like opiate use, being methylphenidate positive did not relate to 6-months retention. Compared to Tel Aviv, Las Vegas patients were more educated, with lower BDZ, and cocaine abuse. The greater abuse of methylphenidate among ADHD subjects might indicate their using it as self-medication, raising a possible indication for its prescription for that subgroup of MMT patients. The high rate of methylphenidate abuse in Israel needs future study.

  12. Electronic health records: essential tools in integrating substance abuse treatment with primary care

    Directory of Open Access Journals (Sweden)

    Clark HW

    2012-02-01

    Full Text Available Betty Tai1, Li-Tzy Wu2, H Westley Clark31Center for Clinical Trials Network, National Institute on Drug Abuse, Bethesda, MD, 2Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, 3Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Rockville, MD, USAAbstract: While substance use problems are considered to be common in medical settings, they are not systematically assessed and diagnosed for treatment management. Research data suggest that the majority of individuals with a substance use disorder either do not use treatment or delay treatment-seeking for over a decade. The separation of substance abuse services from mainstream medical care and a lack of preventive services for substance abuse in primary care can contribute to under-detection of substance use problems. When fully enacted in 2014, the Patient Protection and Affordable Care Act 2010 will address these barriers by supporting preventive services for substance abuse (screening, counseling and integration of substance abuse care with primary care. One key factor that can help to achieve this goal is to incorporate the standardized screeners or common data elements for substance use and related disorders into the electronic health records (EHR system in the health care setting. Incentives for care providers to adopt an EHR system for meaningful use are part of the Health Information Technology for Economic and Clinical Health Act 2009. This commentary focuses on recent evidence about routine screening and intervention for alcohol/drug use and related disorders in primary care. Federal efforts in developing common data elements for use as screeners for substance use and related disorders are described. A pressing need for empirical data on screening, brief intervention, and referral to treatment (SBIRT for drug-related disorders to inform SBIRT and related EHR efforts is highlighted

  13. Drug Abuse: The Crack Cocaine Epidemic Health Consequences and Treatment.

    Science.gov (United States)

    1991-01-01

    glands. 2Kalku, David A. M.D., and Daniel H. Lowenstein, M.D., "Emergence of Recreational Drug Abuse as a Major Risk Factor for Stroke in Young Adults...Desipramine." Psychiatric Annals, Vol. 18, No. 9 (Sept. 1988), pp. 535-37. Fischman , Marian W., Ph.D., "Behavioral Pharmacology of Cocaine." Journal of...Consequences and Treal•met for Crack Abse " Bibliography Kaku, David A., M.D. and Daniel H. Lowenstein, M.D., "Emergence of Recreational Drug Abuse as a Major

  14. An investigation of scale effects in family substance abuse treatment programs

    Directory of Open Access Journals (Sweden)

    Lee A James

    2010-07-01

    Full Text Available Abstract This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families was too small to be economical. Although the sample size (just nine programs was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.

  15. A rationale and model for addressing tobacco dependence in substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Richter Kimber P

    2006-08-01

    Full Text Available Abstract Most persons in drug treatment smoke cigarettes. Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses. This paper reviews the literature on the health benefits of quitting smoking for drug treatment patients, whether smoking causes relapse to other drug or alcohol abuse, the treatment of tobacco dependence, and good and bad times for quitting smoking among drug treatment patients. It also presents a conceptual model and recommendations for treating tobacco in substance abuse treatment, and provides references to internet and paper-copy tools and information for treating tobacco dependence. At present, research on tobacco treatment in drug treatment is in its infancy. Although few drug treatment programs currently offer formal services, many more will likely begin to treat nicotine dependence as external forces and patient demand for these services increases. In the absence of clear guidelines and attention to quality of care, drug treatment programs may adopt smoking cessation services based on cost, convenience, or selection criteria other than efficacy. Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with emerging interventions that have proven to be effective for patients in drug treatment.

  16. Late Onset of Prescription Drug Abuse or Dependence Among Older Adults: Implications for Treatment

    Directory of Open Access Journals (Sweden)

    Kathy Lay

    2007-12-01

    Full Text Available Prescription drug abuse and dependence is an increasing concern for older adults. This article describes issues specific to older adults with late onset abuse or dependence on prescription sedatives and/or opiates.The older adult with late onset should not be viewed as having the same issues as individuals who have a life pat- tern of drug and alcohol abuse/dependence.A chart review of older adults in a treatment program contrasts late onset prescription dependence clients (n=12 and early onset addiction clients (n=104 and outlines differences and similarities between the two samples. Social workers need to understand the specific and changing needs of older adults as they relate to assessment and treatment of drug abuse and dependence.

  17. Manualized treatment for substance abusers with personality disorders: dual focus schema therapy.

    Science.gov (United States)

    Ball, S A

    1998-01-01

    The presence of an untreated personality disorder may be associated with worse compliance and outcome in substance abuse treatment. Therapeutic attention to the symptoms of personality disorder may reduce the severity of substance abuse and other Axis I symptoms which potentially contribute to relapse. A 24-week manual-guided individual cognitive-behavioral therapy approach has been developed that integrates relapse prevention with targeted intervention for early maladaptive schemas (enduring negative beliefs about oneself, others, and events) and coping styles. This Dual Focus Schema Therapy is being compared to 12-Step Drug Counseling for opioid-dependent individuals with personality disorders in an ongoing study funded by the National Institute on Drug Abuse. This article reviews Young's (1994) schema-focused theory and approach and summarizes the treatment manual, which integrates relapse prevention for substance abuse.

  18. Integrating Substance Abuse Treatment and Child Welfare Services: Findings from the Illinois Alcohol and Other Drug Abuse Waiver Demonstration

    Science.gov (United States)

    Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard

    2006-01-01

    Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…

  19. National Analysis of Differences among Substance Abuse Treatment Outcomes: College Student and Nonstudent Emerging Adults

    Science.gov (United States)

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2015-01-01

    Objective: To discover differences between student and nonstudent substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in nonintensive and ambulatory intensive outpatient treatment…

  20. Variables Associated with Environmental Scanning among Clinicians at Substance Abuse Treatment Clinics

    Science.gov (United States)

    Koch, Alison L.; Arfken, Cynthia L.; Agius, Elizabeth; Dickson, Marcus W.; Mitchelson, Jacqueline K.

    2005-01-01

    Introduction: Environmental scanning, as a component of absorptive capacity, has been shown to be associated with increased use of innovative treatment techniques at substance abuse treatment programmes. As the transfer of innovative, evidence-based treatment techniques from research to practice is gaining attention, we aimed to identify variables…

  1. Perceptions of Organizational Functioning in Substance Abuse Treatment Facilities in South Africa

    Science.gov (United States)

    Bowles, Steven; Louw, Johann; Myers, Bronwyn

    2011-01-01

    Directors' and treatment staff's perceptions of organizational functioning within substance abuse treatment facilities in four provinces in South Africa were examined via the Texas Christian University's Organizational Readiness for Change instrument. Forty-four treatment facilities (out of 89) participated in the study. Results indicated that…

  2. Medical treatment of the adolescent drug abuser. An opportunity for rehabilitative intervention.

    Science.gov (United States)

    Schonberg, S K

    1976-03-01

    Illnesses related to both the pharmacologic properties of abused substances and their methods of administration often bring the teenager to medical attention and may provide sufficient motivation for the adolescent to seek help beyond the acute problem. Successful treatment of an overdose reaction, an abstinence syndrome, or any other medical complication of drug abuse may give the physician a unique opportunity to begine further evalution for future care.

  3. Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse

    OpenAIRE

    Ehring, T.; Welboren, R; Morina, N; Wicherts, J.M.; J. Freitag; Emmelkamp, P.M.G.

    2014-01-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in adult survivors of childhood sexual and/or physical abuse. However, intervention studies focusing on this group of patients are underrepresented in earlier meta-analyses on the efficacy of PTSD treatments. The current meta-analysis exclusively focused on studies evaluating the efficacy of psychological interventions for PTSD in adult survivors of childhood abuse. Sixteen randomized controlled trials meeting inclusion criteria could b...

  4. Functional Impressions in Complete Denture and Overdenture Treatment

    OpenAIRE

    2015-01-01

    Tooth loss can cause loss of occlusal, masticatory, esthetic, physiognomic, phonetic and psychosocial function of patients. The most frequently used treatment method of completely edentulous patients and patients with a small number of remaining teeth are complete dentures or overdentures. One of the most important clinical and laboratory procedures in their fabrication is functional impression taking. The aim of this paper was to present procedures of taking functional impressions in fabrica...

  5. A family-oriented treatment program for youths with ketamine abuse and their caregivers: a pilot study in Taiwan

    Directory of Open Access Journals (Sweden)

    Wang LJ

    2015-07-01

    Full Text Available Liang-Jen Wang,1 Shing-Fang Lu,1 Wen-Jiun Chou,1 Mian-Yoon Chong,2 Yao-Hsing Wang,1 Yu-Lian Hsieh,1 Yi-Hsuan Lee,1 Ching Chen2 1Department of Child and Adolescent Psychiatry, 2Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Objective: The abuse of ketamine by youths has grown into a serious public health issue. However, a reliable and efficient treatment has still not been found for youths who abuse ketamine. This pilot study investigated the effects of a family-oriented treatment program for ketamine-using youths and their caregivers.Methods: To carry out this study, 42 youths with ketamine use (mean age 16.6±1.1 years who were referred to take part in a 10-week treatment program based on motivational enhancement principles were selected, as were their principal caregivers (mean age 46.4±7.1 years, who were similarly referred to take part in a 10-week training program for parenting skills. The study had the youths complete the Chinese Craving Beliefs Questionnaire, the Adolescents’ Behavior problem Scale, and the Family APGAR both immediately before and after the program. Likewise, the youths’ caregivers completed the Family APGAR, the 12-item version of the Chinese Health Questionnaire, and the Parenting Stress Index.Results: Of the 42 youth–caregiver pairs that took part in this study, 37 (88% completed the 10-week program and both sets of assessments. After the treatment, the participating youths’ substance cravings declined (t=3.88, P<0.001, while family function, as perceived by the participating caregivers, significantly increased (t=2.22, P=0.033. The improvement in caregivers’ perceptions of family function were positively related to the improvement of the caregivers’ health status (r=-0.36, P=0.022.Conclusion: According to its results, this pilot study submits that family-oriented treatment programs may be considered a potentially effective

  6. [Sexual abuse of boys. Examples of a group-oriented treatment].

    Science.gov (United States)

    Horneland, M; Hanstad, A M

    1996-11-30

    Although the sexual abuse of boys is much less written and talked about than the sexual abuse of girls, it is thought that one of three victims of abuse is a boy. This article sums up the symptoms and reactions seen in male victims. Whereas women usually react with depression and guilt, men react more with anger. Psychosomatic symptoms are often seen, as well as sexual problems such as homophobia or exaggerated masculinisation. As many as 30-50% of male rapist and child molesters have been molested as children. This makes it important to establish a therapeutic dialogue with these men about what they have been through, so as to avoid the development of such behaviour if possible. Experience from the treatment of male adults who were sexually abused in childhood is described, and placed in relation to the existing literature on the subject.

  7. Typologies of prescription opioid use in a large sample of adults assessed for substance abuse treatment.

    Directory of Open Access Journals (Sweden)

    Traci C Green

    Full Text Available BACKGROUND: As a population, non-medical prescription opioid users are not well-defined. We aimed to derive and describe typologies of prescription opioid use and nonmedical use using latent class analysis in an adult population being assessed for substance abuse treatment. METHODS: Latent class analysis was applied to data from 26,314 unique respondents, aged 18-70, self-reporting past month use of a prescription opioid out of a total of 138,928 cases (18.9% collected by the Addiction Severity Index-Multimedia Version (ASI-MV®, a national database for near real-time prescription opioid abuse surveillance. Data were obtained from November 2005 through December 2009. Substance abuse treatment, criminal justice, and public assistance programs in the United States submitted data to the ASI-MV database (n = 538. Six indicators of the latent classes derived from responses to the ASI-MV, a version of the ASI modified to collect prescription opioid abuse and chronic pain experience. The latent class analysis included respondent home ZIP code random effects to account for nesting of respondents within ZIP code. RESULTS: A four-class adjusted latent class model fit best and defined clinically interpretable and relevant subgroups: Use as prescribed, Prescribed misusers, Medically healthy abusers, and Illicit users. Classes varied on key variables, including race/ethnicity, gender, concurrent substance abuse, duration of prescription opioid abuse, mental health problems, and ASI composite scores. Three of the four classes (81% of respondents exhibited high potential risk for fatal opioid overdose; 18.4% exhibited risk factors for blood-borne infections. CONCLUSIONS: Multiple and distinct profiles of prescription opioid use were detected, suggesting a range of use typologies at differing risk for adverse events. Results may help clinicians and policy makers better focus overdose and blood-borne infection prevention efforts and intervention strategies

  8. Importance of occlusion aspects in the completion of orthodontic treatment

    OpenAIRE

    2007-01-01

    The purpose of this study was to address the therapeutic goals regarding the static and functional occlusion in the completion of orthodontic treatment. For such purpose, a study population comprising 20 female treated Class II malocclusion subjects with an initial mean age of 11 years underwent a two-phase treatment (orthopedics and orthodontics). The patients were diagnosed in centric relation and were treated according to the six keys for normal occlusion and functional occlusal parameters...

  9. Training Needs of Rehabilitation Counselors concerning Alcohol and Other Drugs Abuse Assessment and Treatment

    Science.gov (United States)

    Ong, Lee Za; Cardoso, Elizabeth; Chan, Fong; Chronister, Julie; Chou, Chih Chin

    2007-01-01

    Forty-two rehabilitation counselors participated in a study regarding perceived training needs concerning alcohol and other drug abuse (AODA) treatment and assessment. Participants reported that 85% of consumers with whom they worked had AODA issues, yet over half rated their graduate training in AODA treatment and assessment as poor, and their…

  10. The Economic Cost of Substance Abuse Treatment in the State of Florida

    Science.gov (United States)

    Alexandre, Pierre K.; Beulaygue, Isabelle C.; French, Michael T.; McCollister, Kathryn E.; Popovici, Ioana; Sayed, Bisma A.

    2012-01-01

    Objective: Public and private stakeholders of substance abuse treatment services require economic cost data to guide program evaluations and funding decisions. Background: Rigorous cost assessments have been conducted for several treatment programs across the United States, but a systematic and comprehensive evaluation of programs in a particular…

  11. How Outpatient Substance Abuse Treatment Unit Director Activities May Affect Provision of Community Outreach Services

    Science.gov (United States)

    Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey; Green, Sherri

    2013-01-01

    Aims: Community outreach services play an important role in infectious disease prevention and engaging drug users not currently in treatment. However, fewer than half of US substance abuse treatment units provide these services and many have little financial incentive to do so. Unit directors generally have latitude about scope of services,…

  12. A Meta-Analysis of Parent-Involved Treatment for Child Sexual Abuse

    Science.gov (United States)

    Corcoran, Jacqueline; Pillai, Vijayan

    2008-01-01

    Sexual abuse in children not only occurs with alarming frequency, it also potentially leads to deleterious consequences for victims. Previous narrative reviews have touted the benefits of including the nonoffending caregiver in child sexual treatment. Objective: A meta-analysis is conducted to determine the effects of parent-involved treatment in…

  13. Social Network Characteristics of Urban Adolescents in Brief Substance Abuse Treatment

    Science.gov (United States)

    Mason, Michael

    2009-01-01

    In this study, the social network characteristics of 102 urban adolescents in brief substance abuse treatment are described and analyzed longitudinally to examine risk and protective mechanisms. The treatment intervention had one session devoted to social support and networks. Social networks were conceptualized and measured along two dimensions…

  14. Longitudinal HIV Risk Behavior among the Drug Abuse Treatment Outcome Studies (DATOS) Adult Sample

    Science.gov (United States)

    Murphy, Debra A.; Brecht, Mary-Lynn; Herbeck, Diane; Evans, Elizabeth; Huang, David; Hser, Yih-Ing

    2008-01-01

    Longitudinal trajectories for HIV risk were examined over 5 years following treatment among 1,393 patients who participated in the nationwide Drug Abuse Treatment Outcome Studies. Both injection drug use and sexual risk behavior declined over time, with most of the decline occurring between intake and the first-year follow-up. However, results of…

  15. Treatment Needs and Services for Mothers with a Dual Diagnosis: Substance Abuse and Mental Illness.

    Science.gov (United States)

    Morris, Sylvia K.; Schinke, Steven P.

    1990-01-01

    Reviews treatment needs of dual diagnosed, substance abusing and mentally ill mothers. Suggests treatment strategies and programmatic options for serving and meeting needs of these mothers and their children. Devotes particular attention to residential and continuing care services and skills-based interventions for target clients. Concludes with…

  16. Attachment as an organizer of behavior: implications for substance abuse problems and willingness to seek treatment

    Directory of Open Access Journals (Sweden)

    Troutman Beth

    2006-11-01

    Full Text Available Abstract Background Attachment theory allows specific predictions about the role of attachment representations in organizing behavior. Insecure attachment is hypothesized to predict maladaptive emotional regulation whereas secure attachment is hypothesized to predict adaptive emotional regulation. In this paper, we test specific hypotheses about the role of attachment representations in substance abuse/dependence and treatment participation. Based on theory, we expect divergence between levels of maladaptive functioning and adaptive methods of regulating negative emotions. Methods Participants for this study consist of a sample of adoptees participating in an ongoing longitudinal adoption study (n = 208. The Semi-Structured Assessment of the Genetics of Alcohol-II 41 was used to determine lifetime substance abuse/dependence and treatment participation. Attachment representations were derived by the Adult Attachment Interview [AAI; 16]. We constructed a prior contrasts reflecting theoretical predictions for the association between attachment representations, substance abuse/dependence and treatment participation. Results Logistic regression was used to test our hypotheses. As predicted, individuals classified as dismissing, preoccupied or earned-secure reported the highest rates of substance abuse/dependence. Individuals classified as dismissing reported significantly lower rates of treatment participation despite their high rates of substance abuse/dependence. As expected, the continuous-secure group reported lowest rates of both substance abuse/dependence and treatment participation. Conclusion The findings from this study identify attachment representations as an influential factor in understanding the divergence between problematic substance use and treatment utilization. The findings further imply that treatment may need to take attachment representations into account to promote successful recovery.

  17. Parental stress and child behavioral outcomes following substance abuse residential treatment. Follow-up at 6 and 12 months.

    Science.gov (United States)

    Killeen, T; Brady, K T

    2000-07-01

    Residential treatment programs specifically designed for alcohol/drug-addicted women and their children have become a popular treatment modality across the United States. Outcome evaluation of these programs are beginning to show promising results. In this article, outcome data from a study of a residential substance abuse treatment program for women and young children in rural South Carolina will be presented. Data from 35 women and 23 children in the area of addiction severity, parenting and child emotional and behavioral development at 6 and 12 months following discharge from a substance abuse residential treatment program is examined. Results showed that women who completed treatment had better scores on addiction severity and parental stress, and their children had improved behavioral and emotional functioning at 6 and 12 months after discharge from the program. These results suggest that residential treatment has benefits for mothers and their children. This data adds to the growing body of evidence supporting intensive and inclusive care for certain groups of individuals with substance use disorders during critical periods.

  18. Meeting the substance abuse treatment needs of lesbian, bisexual and transgender women: implications from research to practice

    Directory of Open Access Journals (Sweden)

    Stevens S

    2012-02-01

    Full Text Available Sally StevensSouthwest Institute for Research on Women (SIROW and Department of Gender and Women’s Studies (GWS, University of Arizona, Tucson, AZ, USAAbstract: Research on the incidence, etiology and substance abuse treatment needs of lesbian, bisexual and transgender (LBT women is limited. Most research indicates higher levels of alcohol and drug abuse among these populations compared to their heterosexual counterparts, with recent research indicating that substance abuse is a particular concern for transgender individuals and an increasing problem among younger LBT individuals. Risk factors and reasons for substance abuse among sexual minority women are similar to those of heterosexual women, yet are substantially complicated by issues of family rejection and lack of social support, stigma and minority stress, as well as abuse and harassment. Historically, substance abuse prevention, early intervention, and clinical treatment programs were designed to meet the needs of the sexual majority population with relatively few programs designed to incorporate the specific needs of sexual minorities. This article reviews findings from previous studies and utilizes new data collected from community-based and residential substance abuse treatment programs to (1 examine issues relevant to LBT women and substance use, and (2 make recommendations for tailoring substance abuse treatment programs to meet the needs of these populations.Keywords: lesbian, bisexual, transgender, substance abuse, family rejection, social support, stigma, minority stress, abuse, harassment

  19. The Costs and Benefits of Substance Abuse Treatment: Findings from the National Treatment Improvement Evaluation Study (NTIES).

    Science.gov (United States)

    Koenig, Lane; Denmead, Gabrielle; Nguyen, Robert; Harrison, Margaret; Harwood, Henrick

    This study seeks to quantify the costs and benefits of alcohol and drug abuse treatment and the resulting economic benefits to society. Using data from the National Treatment Improvement Evaluation Study (NTIES), and client questionnaires, estimates were made of the average costs per client in terms of crime-related costs, health care costs, and…

  20. Psychoanalytic treatment of psychological addiction toalcohol (alcohol abuse

    Directory of Open Access Journals (Sweden)

    Brian eJohnson

    2011-12-01

    Full Text Available AbstractThe DSM-V Committee plans to abolish the distinction between Alcohol Abuse and Alcohol Dependence (DSM5.org. The author presents a case report as a proof of concept that this distinction should be retained. The author has asserted that Alcohol Abuse is a purely psychological addiction, while Alcohol Dependence involves capture of the ventral tegmental dopaminergic SEEKING system (Johnson 2003. In psychological addiction the brain can be assumed to function normally, and ordinary psychoanalytic technique can be followed. For the patient described, transference interpretation was the fundamental key to recovery.Alcoholic drinking functioned to prevent this man from remembering overwhelming childhood events; events that were also lived out in his current relationships. Murders that occurred when he was a child were hidden in a screen memory. The patient had an obsessional style of relating where almost all feeling was left out of his associations. After he stopped drinking compulsively, he continued to work compulsively. The maternal transference had to be enacted and then interpreted in order for overwhelming memories to be allowed into conscious thought. After psychoanalysis, the patient resumed drinking and worked a normal schedule that allowed more fulfilling relationships. He had no further symptoms of distress from drinking over a 9 year followup.

  1. Implementing Effective Substance Abuse Treatments in General Medical Settings: Mapping the Research Terrain.

    Science.gov (United States)

    Ducharme, Lori J; Chandler, Redonna K; Harris, Alex H S

    2016-01-01

    The National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), and Veterans Health Administration (VHA) share an interest in promoting high quality, rigorous health services research to improve the availability and utilization of evidence-based treatment for substance use disorders (SUD). Recent and continuing changes in the healthcare policy and funding environments prioritize the integration of evidence-based substance abuse treatments into primary care and general medical settings. This area is a prime candidate for implementation research. Recent and ongoing implementation projects funded by these agencies are reviewed. Research in five areas is highlighted: screening and brief intervention for risky drinking; screening and brief intervention for tobacco use; uptake of FDA-approved addiction pharmacotherapies; safe opioid prescribing; and disease management. Gaps in the portfolios, and priorities for future research, are described.

  2. Brief screening for co-occurring disorders among women entering substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Chernoff Miriam

    2006-09-01

    Full Text Available Abstract Background Despite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential and out-patient at five treatment sites were screened at intake (N = 374. Results Eighty nine percent reported a history of interpersonal violence, and 70% reported a history of sexual assault. Eighty-eight percent reported mental health symptoms in the last 30 days. The screening questions administered to 88 female clients were validated against in-depth psychiatric diagnostic assessments by trained mental health clinicians. We estimated measures of predictive validity, including sensitivity, specificity and predictive values positive and negative. Screening items were examined multiple ways to assess utility. The screen is a useful and valid proxy for PTSD but not for other mental illness. Conclusion Substance abuse treatment programs should incorporate violence exposure questions into clinical use as a matter of policy. More work is needed to develop brief screening tools measures for front-line treatment staff to accurately assess other mental health needs of women entering substance abuse treatment

  3. Substance abuse treatment in the Commonwealth of Massachusetts: gaps, consequences and solutions.

    Science.gov (United States)

    Brolin, Mary F; Horgan, Constance; Amaro, Hortensia; Doonan, Michael

    2005-11-17

    This issue brief outlines five strategies for improving the quality of treatment in Massachusetts: (1) Engaging detoxification clients in a broader continuum of treatment, (2) Improving retention in treatment, (3) Providing client/family-centered services, (4) Increasing the use of evidence-based treatment approaches, and (5) Supporting recovery to address the chronic nature of substance use disorders. These strategies are essential to maximizing the impact of our substance abuse dollars. We need to do it right and then expand access to treatment more broadly and fill the treatment gap. Although not the focus of this report we need to think harder about upfront prevention and efforts to encourage more people to seek care. Part of the public strategy also requires better coordination between BSAS, MassHealth, provider organizations, and other state agencies, including criminal justice and mental health agencies. Through these efforts we can reduce the costs and consequences of substance abuse and build a healthier, more productive community.

  4. The influence of personality disorder features on social functioning in substance abusing women five year after compulsive residential treatment

    DEFF Research Database (Denmark)

    Jansson, Irene; Hesse, Morten; Fridell, Mats

    2009-01-01

    Background Personality disorders (PD) are related to negative outcome in substance abuse treatment, and in the general population, personality disorders are related to negative outcome in overall functioning. Little is known about the impact of PD on adjustment following substance abuse treatment...

  5. A Behavioral Perspective of Childhood Trauma and Attachment Issues: Toward Alternative Treatment Approaches for Children with a History of Abuse

    Science.gov (United States)

    Prather, Walter; Golden, Jeannie A.

    2009-01-01

    Attachment theory provides a useful conceptual framework for understanding trauma and the treatment of children who have been abused. This article examines childhood trauma and attachment issues from the perspective of behavior analysis, and provides a theoretical basis for two alternative treatment models for previously abused children and their…

  6. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  7. Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse.

    Science.gov (United States)

    Ehring, Thomas; Welboren, Renate; Morina, Nexhmedin; Wicherts, Jelte M; Freitag, Janina; Emmelkamp, Paul M G

    2014-12-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in adult survivors of childhood sexual and/or physical abuse. However, intervention studies focusing on this group of patients are underrepresented in earlier meta-analyses on the efficacy of PTSD treatments. The current meta-analysis exclusively focused on studies evaluating the efficacy of psychological interventions for PTSD in adult survivors of childhood abuse. Sixteen randomized controlled trials meeting inclusion criteria could be identified that were subdivided into trauma-focused cognitive behavior therapy (CBT), non-trauma-focused CBT, eye movement desensitization and reprocessing, and other treatments (interpersonal, emotion-focused). Results showed that psychological interventions are efficacious for PTSD in adult survivors of childhood abuse, with an aggregated uncontrolled effect size of g=1.24 (pre- vs. post-treatment), and aggregated controlled effect sizes of g=0.72 (post-treatment, comparison to waitlist control conditions) and g=0.50 (post-treatment, comparison with TAU/placebo control conditions), respectively. Effect sizes remained stable at follow-up. As the heterogeneity between studies was large, we examined the influence of two a priori specified moderator variables on treatment efficacy. Results showed that trauma-focused treatments were more efficacious than non-trauma-focused interventions, and that treatments including individual sessions yielded larger effect sizes than pure group treatments. As a whole, the findings are in line with earlier meta-analyses showing that the best effects can be achieved with individual trauma-focused treatments.

  8. Swift and Complete Healing of Digital Ulcers after Macitentan Treatment

    Directory of Open Access Journals (Sweden)

    Emilio Giner Serret

    2016-01-01

    Full Text Available Digital ulcers are a burdensome and painful condition with sparse options of treatment. We report the case of a 78-year-old female patient with limited cutaneous systemic sclerosis that sequentially developed digital ulcers. After the appearance of digital ulcers in the soles of her feet she was successfully treated with bosentan. The report of two new digital ulcers in her hands 9 months later alongside with elevated transaminase levels led to a switch to macitentan treatment. A swift and complete healing of both digital ulcers was observed after 3 months, with the restoration of normal biochemical values.

  9. Swift and Complete Healing of Digital Ulcers after Macitentan Treatment

    Science.gov (United States)

    2016-01-01

    Digital ulcers are a burdensome and painful condition with sparse options of treatment. We report the case of a 78-year-old female patient with limited cutaneous systemic sclerosis that sequentially developed digital ulcers. After the appearance of digital ulcers in the soles of her feet she was successfully treated with bosentan. The report of two new digital ulcers in her hands 9 months later alongside with elevated transaminase levels led to a switch to macitentan treatment. A swift and complete healing of both digital ulcers was observed after 3 months, with the restoration of normal biochemical values. PMID:27994906

  10. MAPIT: development of a web-based intervention targeting substance abuse treatment in the criminal justice system.

    Science.gov (United States)

    Walters, Scott T; Ondersma, Steven J; Ingersoll, Karen S; Rodriguez, Mayra; Lerch, Jennifer; Rossheim, Matthew E; Taxman, Faye S

    2014-01-01

    Although drug and alcohol treatment are common requirements in the U.S. criminal justice system, only a minority of clients actually initiate treatment. This paper describes a two-session, web-based intervention to increase motivation for substance abuse treatment among clients using illicit substances. MAPIT (Motivational Assessment Program to Initiate Treatment) integrates the extended parallel process model, motivational interviewing, and social cognitive theory. The first session (completed near the start of probation) targets motivation to complete probation, to make changes in substance use (including treatment initiation), and to obtain HIV testing and care. The second session (completed approximately 30days after session 1) focuses on goal setting, coping strategies, and social support. Both sessions can generate emails or mobile texts to remind clients of their goals. MAPIT uses theory-based algorithms and a text-to-speech engine to deliver custom feedback and suggestions. In an initial test, participants indicated that the program was respectful, easy to use, and would be helpful in making changes in substance use. MAPIT is being tested in a randomized trial in two large U.S. probation agencies. MAPIT addresses the difficulties of many probation agencies to maximize client involvement in treatment, in a way that is cost effective and compatible with the existing service delivery system.

  11. An Experimental Test of a Craving Management Technique for Adolescents in Substance-Abuse Treatment

    Science.gov (United States)

    Florsheim, Paul; Heavin, Sarah; Tiffany, Stephen; Colvin, Peter; Hiraoka, Regina

    2008-01-01

    This paper describes an experiment designed to test an imagery-based craving management technique with a sample of adolescents diagnosed with substance-use disorders. Seventy adolescents between the ages of 14 and 18 (41 males) were recruited through two substance-abuse treatment programs. The experimental procedure involved stimulating craving…

  12. The influence of distance on utilization of outpatient mental health aftercare following inpatient substance abuse treatment.

    Science.gov (United States)

    Schmitt, Susan K; Phibbs, Ciaran S; Piette, John D

    2003-08-01

    This study examined whether substance abuse patients who live farther from their source of outpatient mental health care were less likely to obtain aftercare following an inpatient treatment episode. For those patients who did receive aftercare, distance was evaluated as a predictor of the volume of care received. A national sample of 33,952 veterans discharged from Department of Veterans Affairs (VA) inpatient substance abuse treatment programs was analyzed using a two-part choice model utilizing logistic and linear regression. Patients living farther from their source of outpatient mental health care were less likely to obtain aftercare following inpatient substance abuse treatment. Patients who traveled 10 miles or less were 2.6 times more likely to obtain aftercare than those who traveled more than 50 miles. Only 40% of patients who lived more than 25 miles from the nearest aftercare facility obtained any aftercare services. Patients who received aftercare services had fewer visits if they lived farther from their source of aftercare. Lack of geographic access (distance) is a barrier to outpatient mental health care following inpatient substance abuse treatment, and influences the volume of care received once the decision to obtain aftercare is made. Aftercare services must be geographically accessible to ensure satisfactory utilization.

  13. Imagery rescripting as a stand-alone treatment for posttraumatic stress disorder related to childhood abuse

    NARCIS (Netherlands)

    Raabe, S.; Ehring, T.; Marquenie, L.; Olff, M.; Kindt, M.

    2015-01-01

    Objective This case series tested the feasibility and explored the efficacy of Imagery Rescripting (ImRs) as a stand-alone treatment for PTSD related to childhood physical and/or sexual abuse (CA). Method Participants (6 women and 2 men) were patients with PTSD related to CA who entered an 8 week tr

  14. Evaluating Animal-Assisted Therapy in Group Treatment for Child Sexual Abuse

    Science.gov (United States)

    Dietz, Tracy J.; Davis, Diana; Pennings, Jacquelyn

    2012-01-01

    This study evaluates and compares the effectiveness of three group interventions on trauma symptoms for children who have been sexually abused. All of the groups followed the same treatment protocol, with two of them incorporating variations of animal-assisted therapy. A total of 153 children ages 7 to 17 who were in group therapy at a Child…

  15. The Nature of Victimization among Youths with Hearing Loss in Substance Abuse Treatment

    Science.gov (United States)

    Titus, Janet C.

    2010-01-01

    The author profiles the prevalence, severity, and characteristics of victimization among a group of youths with hearing loss presenting to substance abuse treatment. Intake data on 111 deaf and hard of hearing youths (42% female) were analyzed and compared with data from a weighted, gender-matched sample of hearing youths. After gender is…

  16. Child Abuse and Multiple Personality Disorders: Review of the Literature and Suggestions for Treatment.

    Science.gov (United States)

    Coons, Philip M.

    1986-01-01

    Multiple personality disorder is associated with a high incidence of physical and sexual abuse during childhood. While difficult to diagnose, multiple personality is easier to treat if diagnosed early in childhood or adolescence. Treatment for multiple personality focuses on establishing trust and communicating with and integrating the…

  17. The Incidence of Incest Histories among Clients Receiving Substance Abuse Treatment.

    Science.gov (United States)

    Glover, Noreen M.; And Others

    1995-01-01

    Volunteer participants (n=77) enrolled in 8 substance abuse treatment facilities were surveyed in order to examine the prevalence and nature of incest contacts among the group. Results indicated that approximately 49 percent of the participants had reported histories of incest. Data are presented under various parameters. Also gives comparisons by…

  18. Cost-Effectiveness of Connecticut's In-Prison Substance Abuse Treatment

    Science.gov (United States)

    Daley, Marilyn; Love, Craig T.; Shepard, Donald S.; Petersen, Cheryl B.; White, Karen L.; Hall, Frank B.

    2004-01-01

    Over the past two decades, the criminal justice population in the US has grown by over 200%, most of this due to an increase in drug-involved offenders. Although there is good evidence that prison-based substance abuse treatment programs can be effective in reducing rearrest, few cost-effectiveness studies have been conducted. Using data from the…

  19. Developing, Implementing, and Evaluating a Treatment Protocol for Rural Substance Abusers.

    Science.gov (United States)

    Clark, James J.; Leukefeld, Carl; Godlaski, Theodore; Brown, Cyndy; Garrity, John; Hays, Lon

    2002-01-01

    Evaluation of an innovative substance abuse treatment program designed for rural areas involved 45 clients, 10 clinicians, and 2 program directors from three sites. Most clients felt the program was beneficial, but stressful. Clinicians found the program demanding to learn and adopt. Program directors liked the rural-specific design and the…

  20. The Challenge Project: A Treatment Program Evaluation for Perpetrators of Child Sexual Abuse.

    Science.gov (United States)

    Craissati, Jackie; McClurg, Grace

    1997-01-01

    A British follow-up study of 25 convicted perpetrators of child abuse compared group and individual treatment outcomes. Results found some evidence for positive change in the group condition in terms of greater honesty in reporting normal and deviant sexual outlets, in addition to the improvement in attitudes toward women. (CR)

  1. Markers of Marijuana Use Outcomes within Adolescent Substance Abuse Group Treatment

    Science.gov (United States)

    Engle, Brett; Macgowan, Mark J.; Wagner, Eric F.; Amrhein, Paul C.

    2010-01-01

    Objectives: Despite their popularity, little is known about what distinguishes effective from ineffective or even iatrogenic adolescent group interventions. Methods: Audio recordings and transcripts from 19, 8-10 session, school-based treatment groups comprised of 108, substance abusing 10- to 19-year olds were analyzed. "Group leader empathy" was…

  2. Addressing Substance Abuse Treatment Needs of Parents Involved with the Child Welfare System

    Science.gov (United States)

    Oliveros, Arazais; Kaufman, Joan

    2011-01-01

    The goal of this paper is to synthesize available data to help guide policy and programmatic initiatives for families with substance abuse problems who are involved with the child welfare system, and identify gaps in the research base preventing further refinement of practices in this area. To date, Family Treatment Drug Court and newly developed…

  3. Vitamin D as an Effective Treatment Approach for Drug abuse and Addiction

    Directory of Open Access Journals (Sweden)

    Jaqueline Kalleian Eserian

    2013-07-01

    Full Text Available Effective pharmacological treatments for drug abuse and addiction have not yet been identified. Evidences show that vitamin D may be involved in neurodevelopment and may have a neuroprotective effect on dopaminergic pathways in the adult brain. The fact that vitamin Dincreases the levels of tyrosine hydroxylase expression implies that vitamin D could modulate dopa- minergic processes. Drugs of abuse act through different mechanisms of action and on differentlocations in the brain reward system; however, all of them share a final action in which they increase dopamine levels in the reward pathway. Vitamin D-treated animals showed significant attenuatedmethamphetamine-induced reductions in dopamine and metabolites when compared to control, indicating that vitamin D provides protection for the dopaminergic system against the depleting effects of methamphetamine. In this article, it is speculated that vitamin D would be an effective treatment approach for drug abuse and addiction, if we consider that vitamin D would provide pro-tection for the dopaminergic system against dopamine-depleting effects of drugs, as it did for meth- amphetamine. This hypothesis can provide a new direction towards a new treatment approach fordrug abuse and addiction, as we have no pharmacological treatments at our disposal at the present moment, although several issues need further investigation

  4. Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse

    NARCIS (Netherlands)

    Ehring, T.; Welboren, R; Morina, N.; Wicherts, J.M.; Freitag, J.; Emmelkamp, P.M.G.

    2014-01-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in adult survivors of childhood sexual and/or physical abuse. However, intervention studies focusing on this group of patients are underrepresented in earlier meta-analyses on the efficacy of PTSD treatments. The current meta-analysis exclusiv

  5. "Who can you tell?" Features of Arab culture that influence conceptualization and treatment of childhood sexual abuse.

    Science.gov (United States)

    Haboush, Karen L; Alyan, Hala

    2013-01-01

    The literature on child sexual abuse reflects growing recognition of the manner in which culture impacts the conceptualization, experience, and treatment of such cases. Despite heightened visibility of Arab Americans within the United States, population due to recent media attention, little empirical research exists on the occurrence of child sexual abuse within this population. Arab culture is often characterized by an emphasis on collectivism and familial obligations, and such features may prove to either facilitate or impede assessment and treatment of child sexual abuse, depending on how they are manifested. In terms of reporting child sexual abuse, cultural values pertaining to shame and honor as well as the stigma attached to mental health problems may influence the response to abuse. As such, enhancing the cultural competence of the therapist is key to facilitating effective cultural practice. Empirical research is required to investigate and substantiate these concepts as they relate to child sexual abuse in Arab-American populations.

  6. Variables associated with environmental scanning among clinicians at substance abuse treatment clinics

    Directory of Open Access Journals (Sweden)

    Alison L. Koch

    2005-01-01

    Full Text Available Introduction. Environmental scanning, as a component of absorptive capacity, has been shown to be associated with increased use of innovative treatment techniques at substance abuse treatment programmes. As the transfer of innovative, evidence-based treatment techniques from research to practice is gaining attention, we aimed to identify variables associated with higher levels of environmental scanning among substance abuse treatment clinicians. Method. A cross-sectional survey was administered to 162 clinicians at 15 substance abuse treatment clinics in Michigan. Measures: Environmental scanning was measured by frequency of use of the Internet, journals, seminars or conferences, and people at other treatment clinics for new substance abuse treatment information. Clinicians were asked for their perceptions of their clinic’s openness to new treatment techniques and support for acquiring new information, access to and satisfaction with information sources at work, as well as if they feel it is their job to keep up to date with current treatment research. Additional measures included whether they intended to quit their jobs and whether they were emotionally drained from work. Findings: We found positive associations between environmental scanning and perceived clinic support for acquiring new information, perceived clinic openness to new treatment techniques, access to e-mail and Internet at work, and satisfaction with resources. Turnover intention and being emotionally drained were negatively associated with environmental scanning. Conclusion. : Individual and organizational level variables were found to be associated with higher levels of environmental scanning activity. Although the causal directions of these associations are not known, the findings suggest ways to increase environmental scanning among clinicians.

  7. Meth abuse and oral health

    Directory of Open Access Journals (Sweden)

    Deviprasad Makonahally

    2015-01-01

    Full Text Available Methamphetamine abuse is spreading its roots in India due to its widespread appeal, ease of manufacture and low cost compared with other stimulant drugs. Methamphetamine-induced caries is a characteristic finding among methamphetamine abusers. Thus, it is important to understand the typical clinical manifestations inclusive of cervical and proximal caries, elicit proper case history and develop a comprehensive treatment plan to help patients in a complete rehabilitation. We present a series of cases of "meth" abuser for dental professionals to help ensure successful treatment and prevention of disease progression.

  8. Substance Abuse Treatment in Persons with HIV/AIDS: Challenges in Managing Triple Diagnosis

    OpenAIRE

    Durvasula, Ramani; Miller, Theodore R.

    2014-01-01

    This paper provides a review of the current literature addressing substance abuse treatment in persons living with HIV/AIDS. Clinical management of HIV must account for the “triple diagnosis” of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the...

  9. A Complete Treatment of CMB Anisotropies in a FRW Universe

    CERN Document Server

    Hu, W; White, M; Zaldarriaga, M; Hu, Wayne; Seljak, Uros; White, Martin; Zaldarriaga, Matias

    1998-01-01

    We generalize the total angular momentum method for computing Cosmic Microwave Background anisotropies to Friedman-Robertson-Walker (FRW) spaces with arbitrary geometries. This unifies the treatment of temperature and polarization anisotropies generated by scalar, vector and tensor perturbations of the fluid, seed, or a scalar field, in a universe with constant comoving curvature. The resulting formalism generalizes and simplifies the calculation of anisotropies and, in its integral form, allows for a fast calculation of model predictions in linear theory for any FRW metric. With this work, the perturbation theory of CMB temperature and polarization anisotropy formation through gravitational instability in an FRW universe may be considered complete.

  10. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Science.gov (United States)

    2010-07-01

    ... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Alcohol and...

  11. Early Childhood Interventionists' Perceptions of the Child Abuse Prevention and Treatment Act: Provider Characteristics and Organizational Climate

    Science.gov (United States)

    Herman-Smith, Robert L.

    2013-01-01

    Research Findings: A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to develop plans to ensure that children younger than the age of 3 years who are victims of substantiated abuse or neglect have access to developmental screenings. Programs authorized under Part C of the Individuals with Disabilities…

  12. Effect of Educational Program to Encourage Safe Sexual Behaviors Among Addicted Men Refered to Substance Abuse Treatment Centers in Hamadan, Western Iran: Applying the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Babak Moeini

    2014-06-01

    Full Text Available Introduction: Unsafe sexual behaviors as important risky behaviors can expose individuals and society to dangerous infectious disease such as AIDS and viral hepatitis. Considering the high prevalence of unsafe sexual behaviors, this study aimed to determine the effect of educational programs to encourage safe sexual behaviors among substance abusers referred to substance abuse treatment centers in Hamadan, Western Iran by applying the theory of planned behavior. Materials & Methods: This quasi-experimental study was performed on 104 men substance abusers (52 participants in each of the control and intervention groups referred to substance abuse treatment centers in Hamadan. Data collection tool was a questionnaire containing demographic information and the theory of planned behavior constructs. Before the educational program, questionnaires were completed by both groups. After the pretest in both groups, participants in the intervention group participated in four educational sessions designed based on the theory of planned behavior. Two months after the end of program, posttest was performed. Data was analyzed using independent T-test, chi-square, fisher exact test, McNemar’s test and multiple linear regressions using SPSS-16. Results: After educational intervention, the mean scores of the theory constructs (attitude toward behavior, subjective norms, behavioral control, behavioral intention and behaviors, in the intervention group increased significantly (P<0.05, despite the fact, changes were not significant in the control group. Conclusion: Implementation of educational courses to encourage safe sexual behaviors based on the theory of planned behavior can be beneficial for substance abusers referred to substance abuse treatment centers.

  13. Assessment of coercive and noncoercive pressures to enter drug abuse treatment.

    Science.gov (United States)

    Marlowe, D B; Kirby, K C; Bonieskie, L M; Glass, D J; Dodds, L D; Husband, S D; Platt, J J; Festinger, D S

    1996-10-01

    This paper reports preliminary data derived from a standardized interview scoring procedure for detecting and characterizing coercive and noncoercive pressures to enter substance abuse treatment. Coercive and noncoercive pressures stemming from multiple psychosocial domains are operationalized through recourse to established behavioral principles. Inter-rater reliability for the scoring procedure was exceptional over numerous rater trials. Substantive analyses indicate that, among clients in outpatient cocaine treatment, 'coercion' is operative in multiple psychosocial domains, and that subjects perceive legal pressures as exerting substantially less influence over their decisions to enter treatment than informal psychosocial pressures. Implications for drug treatment planning, legal and ethical issues, and directions for future research are proposed.

  14. Benefits and costs of substance abuse treatment programs for state prison inmates: results from a lifetime simulation model.

    Science.gov (United States)

    Zarkin, Gary A; Cowell, Alexander J; Hicks, Katherine A; Mills, Michael J; Belenko, Steven; Dunlap, Laura J; Houser, Kimberly A; Keyes, Vince

    2012-06-01

    Reflecting drug use patterns and criminal justice policies throughout the 1990s and 2000s, prisons hold a disproportionate number of society's drug abusers. Approximately 50% of state prisoners meet the criteria for a diagnosis of drug abuse or dependence, but only 10% receive medically based drug treatment. Because of the link between substance abuse and crime, treating substance abusing and dependent state prisoners while incarcerated has the potential to yield substantial economic benefits. In this paper, we simulate the lifetime costs and benefits of improving prison-based substance abuse treatment and post-release aftercare for a cohort of state prisoners. Our model captures the dynamics of substance abuse as a chronic disease; estimates the benefits of substance abuse treatment over individuals' lifetimes; and tracks the costs of crime and criminal justice costs related to policing, adjudication, and incarceration. We estimate net societal benefits and cost savings to the criminal justice system of the current treatment system and five policy scenarios. We find that four of the five policy scenarios provide positive net societal benefits and cost savings to the criminal justice system relative to the current treatment system. Our study demonstrates the societal gains to improving the drug treatment system for state prisoners.

  15. Meth abuse and oral health

    OpenAIRE

    Deviprasad Makonahally; Vaibhav Gupta; Pushpanjali Krishnappa

    2015-01-01

    Methamphetamine abuse is spreading its roots in India due to its widespread appeal, ease of manufacture and low cost compared with other stimulant drugs. Methamphetamine-induced caries is a characteristic finding among methamphetamine abusers. Thus, it is important to understand the typical clinical manifestations inclusive of cervical and proximal caries, elicit proper case history and develop a comprehensive treatment plan to help patients in a complete rehabilitation. We present a series o...

  16. Prefrontal cortex and drug abuse vulnerability: translation to prevention and treatment interventions.

    Science.gov (United States)

    Perry, Jennifer L; Joseph, Jane E; Jiang, Yang; Zimmerman, Rick S; Kelly, Thomas H; Darna, Mahesh; Huettl, Peter; Dwoskin, Linda P; Bardo, Michael T

    2011-01-01

    Vulnerability to drug abuse is related to both reward seeking and impulsivity, two constructs thought to have a biological basis in the prefrontal cortex (PFC). This review addresses similarities and differences in neuroanatomy, neurochemistry and behavior associated with PFC function in rodents and humans. Emphasis is placed on monoamine and amino acid neurotransmitter systems located in anatomically distinct subregions: medial prefrontal cortex (mPFC); lateral prefrontal cortex (lPFC); anterior cingulate cortex (ACC); and orbitofrontal cortex (OFC). While there are complex interconnections and overlapping functions among these regions, each is thought to be involved in various functions related to health-related risk behaviors and drug abuse vulnerability. Among the various functions implicated, evidence suggests that mPFC is involved in reward processing, attention and drug reinstatement; lPFC is involved in decision-making, behavioral inhibition and attentional gating; ACC is involved in attention, emotional processing and self-monitoring; and OFC is involved in behavioral inhibition, signaling of expected outcomes and reward/punishment sensitivity. Individual differences (e.g., age and sex) influence functioning of these regions, which, in turn, impacts drug abuse vulnerability. Implications for the development of drug abuse prevention and treatment strategies aimed at engaging PFC inhibitory processes that may reduce risk-related behaviors are discussed, including the design of effective public service announcements, cognitive exercises, physical activity, direct current stimulation, feedback control training and pharmacotherapies. A major challenge in drug abuse prevention and treatment rests with improving intervention strategies aimed at strengthening PFC inhibitory systems among at-risk individuals.

  17. Treatment of cocaine abuse during pregnancy: translating research to clinical practice.

    Science.gov (United States)

    Hull, Lynn; May, James; Farrell-Moore, Dawn; Svikis, Dace S

    2010-10-01

    In the late-1980s and early-1990s, much attention in America was focused on cocaine abuse. In particular, the effects of prenatal cocaine use on mothers and infants were in the news spotlight. Risks of adverse effects prompted funding for novel treatment programs. More recently, media attention has shifted elsewhere, and specialized treatment resources have grown scarce. This redirection of funding is unfortunate, as social stigma and fear of legal consequences continue to encourage cocaine-abusing pregnant women to hide drug use and avoid prenatal care. The purpose of this article is to summarize the most prominent adverse maternal and fetal/infant effects associated with prenatal cocaine use; review treatment options, focusing on comprehensive care programs of the 1990s as well as recent research on evidence-based practices and their applicability to pregnant women; and highlight the population of prenatal cocaine-abusing women uninterested in treatment, with a focus on promising strategies to promote drug abstinence and other positive health behaviors.

  18. Psychotherapy and Counseling in the Treatment of Drug Abuse [Technical Review] (Rockville, Maryland, May 18-19, 1989). National Institute on Drug Abuse Research Monograph Series 104.

    Science.gov (United States)

    Onken, Lisa Simon; Blaine, Jack D.

    This monograph is based on the papers from a technical review. These papers are included: (1) Psychotherapy and Counseling Research in Drug Abuse Treatment: Questions, Problems, and Solutions (Lisa Onken, Jack Blaine); (2) Psychotherapy and Counseling for Methadone-Maintained Opiate Addicts: Results of Research Studies (George Woody, A. T.…

  19. Predictors of Physical Altercation among Adolescents in Residential Substance Abuse Treatment

    OpenAIRE

    Crawley, Rachel D.; Becan, Jennifer Edwards; Knight, Danica Kalling; Joe, George W.; Flynn, Patrick M.

    2015-01-01

    This study tested the hypothesis that basic social information-processing components represented by family conflict, peer aggression, and pro-aggression cognitive scripts are related to aggression and social problems among adolescents in substance abuse treatment. The sample consisted of 547 adolescents in two community-based residential facilities. Correlation results indicated that more peer aggression is related to more pro-aggression scripts; scripts, peer aggression, and family conflict ...

  20. Sexual Orientation and Substance Abuse Treatment Utilization in the United States: Results from a National Survey

    OpenAIRE

    McCabe, Sean Esteban; West, Brady T.; Hughes, Tonda L.; Boyd, Carol J.

    2012-01-01

    This study examined substance abuse treatment utilization across three dimensions of sexual orientation (identity, attraction, behavior) in a large national sample of adults in the United States. Prevalence estimates were based on data collected from the 2004–2005 National Epidemiologic Survey on Alcohol and Related Conditions. The sample consisted of 34,653 adults aged 20 years and older: 52% women, 71% White, 12% Hispanic, 11% African American, 4% Asian, and 2% other race/ethnicities. Appro...

  1. Examining human rights and mental health among women in drug abuse treatment centers in Afghanistan

    Directory of Open Access Journals (Sweden)

    Abadi MH

    2012-04-01

    Full Text Available Melissa Harris Abadi1, Stephen R Shamblen1, Knowlton Johnson1, Kirsten Thompson1, Linda Young1, Matthew Courser1, Jude Vanderhoff1, Thom Browne21Pacific Institute for Research and Evaluation – Louisville Center, Louisville, KY, USA; 2United States Department of State, Bureau of International Narcotics and Law Enforcement, Washington, DC, USAAbstract: Denial of human rights, gender disparities, and living in a war zone can be associated with severe depression and poor social functioning, especially for female drug abusers. This study of Afghan women in drug abuse treatment (DAT centers assesses (a the extent to which these women have experienced human rights violations and mental health problems prior to entering the DAT centers, and (b whether there are specific risk factors for human rights violations among this population. A total of 176 in-person interviews were conducted with female patients admitted to three drug abuse treatment centers in Afghanistan in 2010. Nearly all women (91% reported limitations with social functioning. Further, 41% of the women indicated they had suicide ideation and 27% of the women had attempted suicide at least once 30 days prior to entering the DAT centers due to feelings of sadness or hopelessness. Half of the women (50% experienced at least one human rights violation in the past year prior to entering the DAT centers. Risk factors for human rights violations among this population include marital status, ethnicity, literacy, employment status, entering treatment based on one’s own desire, limited social functioning, and suicide attempts. Conclusions stemming from the results are discussed.Keywords: Afghanistan, women, human rights, mental health, drug abuse treatment

  2. Accessing substance abuse treatment: issues for parents involved with child welfare services.

    Science.gov (United States)

    Rockhill, Anna; Green, Beth L; Newton-Curtis, Linda

    2008-01-01

    The complex issues associated with barriers to treatment entry for parents who are involved with child welfare has not been well explored. Accessing timely treatment is now critical for these parents since the introduction of the Adoption and Safe Families Act of 1997, limiting the time until a permanency decision is made. Using a longitudinal, qualitative approach, substance-abusing parents from 15 families, their relevant family members, and service providers were interviewed approximately every 3 months over an 18-month period. The experiences of these parents add to our knowledge of the unique barriers this population faces, and expands our understanding of the mechanisms by which certain barriers may delay treatment.

  3. HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa.

    Science.gov (United States)

    Meade, Christina S; Lion, Ryan R; Cordero, Daniella M; Watt, Melissa H; Joska, John A; Gouse, Hetta; Burnhams, Warren

    2016-10-01

    South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34 % multiple partners, 26 % unprotected intercourse with a casual partner, and 24 % sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25 % had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.

  4. Examining human rights and mental health among women in drug abuse treatment centers in Afghanistan.

    Science.gov (United States)

    Abadi, Melissa Harris; Shamblen, Stephen R; Johnson, Knowlton; Thompson, Kirsten; Young, Linda; Courser, Matthew; Vanderhoff, Jude; Browne, Thom

    2012-01-01

    Denial of human rights, gender disparities, and living in a war zone can be associated with severe depression and poor social functioning, especially for female drug abusers. This study of Afghan women in drug abuse treatment (DAT) centers assesses (a) the extent to which these women have experienced human rights violations and mental health problems prior to entering the DAT centers, and (b) whether there are specific risk factors for human rights violations among this population. A total of 176 in-person interviews were conducted with female patients admitted to three drug abuse treatment centers in Afghanistan in 2010. Nearly all women (91%) reported limitations with social functioning. Further, 41% of the women indicated they had suicide ideation and 27% of the women had attempted suicide at least once 30 days prior to entering the DAT centers due to feelings of sadness or hopelessness. Half of the women (50%) experienced at least one human rights violation in the past year prior to entering the DAT centers. Risk factors for human rights violations among this population include marital status, ethnicity, literacy, employment status, entering treatment based on one's own desire, limited social functioning, and suicide attempts. Conclusions stemming from the results are discussed.

  5. Insights from a national survey into why substance abuse treatment units add prevention and outreach services

    Directory of Open Access Journals (Sweden)

    Lemak Christy

    2006-08-01

    Full Text Available Abstract Background Previous studies have found that even limited prevention-related interventions can affect health behaviors such as substance use and risky sex. Substance abuse treatment providers are ideal candidates to provide these services, but typically have little or no financial incentive to do so. The purpose of this study was therefore to explore why some substance abuse treatment units have added new prevention and outreach services. Based on an ecological framework of organizational strategy, three categories of predictors were tested: (1 environmental, (2 unit-level, and (3 unit leadership. Results A lagged cross-sectional logistic model of 450 outpatient substance abuse treatment units revealed that local per capita income, mental health center affiliation, and clinical supervisors' graduate degrees were positively associated with likelihood of adding prevention-related education and outreach services. Managed care contracts and methadone treatment were negatively associated with addition of these services. No hospital-affiliated agencies added prevention and outreach services during the study period. Conclusion Findings supported the study's ecological perspective on organizational strategy, with factors at environmental, unit, and unit leadership levels associated with additions of prevention and outreach services. Among the significant predictors, ties to managed care payers and unit leadership graduate education emerge as potential leverage points for public policy. In the current sample, units with managed care contracts were less likely to add prevention and outreach services. This is not surprising, given managed care's emphasis on cost control. However, the association with this payment source suggests that public managed care programs might affects prevention and outreach differently through revised incentives. Specifically, government payers could explicitly compensate substance abuse treatment units in managed care

  6. Clinicians' information sources for new substance abuse treatment.

    Science.gov (United States)

    Arfken, Cynthia L; Agius, Elizabeth; Dickson, Marcus W

    2005-09-01

    Little is known about clinicians' information sources for new treatments or ways to improve dissemination of that information. We analyzed 163 clinicians' responses to a checklist of where and how frequently they obtain information on new treatment approaches. They reported at least yearly use of a median of four cosmopolite categories (e.g., journals or books, Internet) and a median of three local categories (e.g., co-workers, personal experience) with interpersonal contact with co-workers (89%) and seminars/conferences (86%) being the most frequently endorsed responses for at least yearly use. In response to the hypothetical scenario of receiving monthly e-mail summaries of journal articles, 59% of the clinicians rated the strategy as "very helpful". If continuing education credits were offered, more clinicians (from 50-80%) would read the relevant articles. Information dissemination may improve with expanded Internet access at programs and short e-mailed summaries carrying links to full articles coupled with the incentive of earning continuing education credits.

  7. Impact of approach used to determine removal levels of drugs of abuse during wastewater treatment.

    Science.gov (United States)

    Rodayan, Angela; Majewsky, Marius; Yargeau, Viviane

    2014-07-15

    In this study the levels of 19 drugs of abuse were estimated throughout a wastewater treatment plant using polar organic chemical integrative samplers (POCIS), 24h composite samples and grab samples. Overall removal efficiencies and removals in between each treatment unit were calculated using load data for each sampling technique as well as removals that take into account the hydraulic residence time distribution of the treatment plant (time-shifted mass balancing approach). Amphetamine-type stimulants, cocaine and its major metabolite, benzoylecgonine and opioid levels determined with 24h composite samples were generally comparable to those obtained with POCIS and grab samples. Negative mass balances resulting from the estimation of overall removal efficiencies by POCIS, day-to-day mass balancing of 24h composite and grab sample data did not occur when the hydraulic retention time (HRT) distributions of the plant were taken into account for calculation. Among the compounds investigated, cocaine exhibited the highest overall removal (90%) while codeine had the lowest with 13%, respectively. Sampling between the treatment units revealed that highest removal occurs during biological treatment as compared to primary or secondary clarification. Methylenedioxyamphetamine (MDA), fentanyl, dihydrocodeine and heroin were not detected in wastewater at any of the sampling locations at the treatment plant regardless of the sampling technique. The study demonstrates the benefits of applying the time-shifted mass balancing approach to the calculation of removals of drugs of abuse during wastewater treatment.

  8. Identifying the substance abuse treatment needs of caregivers involved with child welfare.

    Science.gov (United States)

    Chuang, Emmeline; Wells, Rebecca; Bellettiere, John; Cross, Theodore P

    2013-07-01

    Parental substance use significantly increases risk of child maltreatment, but is often under-identified by child protective services. This study examined how agency use of standardized substance use assessments and child welfare investigative caseworker education, experience, and caseload affected caseworkers' identification of parental substance abuse treatment needs. Data are from a national probability sample of permanent, primary caregivers involved with child protective services whose children initially remained at home and whose confidential responses on two validated instruments indicated harmful substance use or dependence. Investigative caseworkers reported use of a formal assessment in over two thirds of cases in which substance use was accurately identified. However, weighted logistic regression indicated that agency provision of standardized assessment instruments was not associated with caseworker identification of caregiver needs. Caseworkers were also less likely to identify substance abuse when their caseloads were high and when caregivers were fathers. Implications for agency practice are discussed.

  9. The costs of crime and the benefits of substance abuse treatment for pregnant women.

    Science.gov (United States)

    Daley, M; Argeriou, M; McCarty, D; Callahan, J J; Shepard, D S; Williams, C N

    2000-12-01

    Although many pregnant, drug-dependent women report extensive criminal justice involvement, few studies have examined reductions in crime as an outcome of substance abuse treatment programs for pregnant women. This is unfortunate, because maternal criminal involvement can have serious health and cost implications for the unborn child, the mother and society. Using the Addiction Severity Index, differences in pre- and posttreatment criminal involvement were measured for a sample of 439 pregnant women who entered publicly funded treatment programs in Massachusetts between 1992 and 1997. Accepted cost of illness methods were supplemented with information from the Bureau of Justice Statistics to estimate the costs and benefits of five treatment modalities: detoxification only (used as a minimal treatment comparison group), methadone only, residential only, outpatient only, and residential/outpatient combined. Projected to a year, the net benefits (avoided costs of crime net of treatment costs) ranged from US$32,772 for residential only to US$3,072 for detoxification. Although all five modalities paid for themselves by reducing criminal activities, multivariate regressions controlling for baseline differences between the groups showed that reductions in crime and related costs were significantly greater for women in the two residential programs. The study provides economic justification for the continuation and possible expansion of residential substance abuse treatment programs for criminally involved pregnant women.

  10. Substance abuse treatment services for pregnant women: psychosocial and behavioral approaches.

    Science.gov (United States)

    Haug, Nancy A; Duffy, Megan; McCaul, Mary E

    2014-06-01

    Women who use tobacco, alcohol and drugs during pregnancy are at increased risk of maternal and fetal morbidity. Universal screening using empirically validated approaches can improve identification of substance-using pregnant women and facilitate comprehensive assessment of treatment needs. There is strong evidence for effectiveness of psychosocial and behavioral substance abuse treatments across a range of intensities and levels of care. In addition to addressing substance use, services for co-occurring psychiatric disorders, trauma exposure, and prenatal care are important components of coordinated systems of care. More research on and greater access to evidence-based interventions is needed for this underserved population.

  11. Barriers to Implementing Individualized Substance Abuse Treatment: Qualitative Findings from the CASPAR Replication Studies.

    Science.gov (United States)

    Mericle, Amy A; Casaletto, Kathryn; Knoblach, Dan; Brooks, Adam C; Carise, Deni

    2010-10-01

    Problem-to-services matching is critical to patient-centered care. Further, the extent to which substance abuse treatment is individualized to meet specific client needs is a key predictor of success and represents "best practice" in substance abuse treatment. The CASPAR Resource Guide, an electronic database of local free and low-cost services, is an evidence-based tool designed to help counselors easily and quickly provide offsite referrals to services not available in most community treatment programs to increase problem-to-service matching. This paper examines system-level barriers to using the CASPAR Resource Guide among 30 counselors and 21 site directors across 16 sites in two different studies. Results from qualitative implementation analyses found that key program components needed to support the implementation of this evidence-based practice (e.g., individualized treatment planning, individual treatment sessions, and individual counselor supervision) were lacking, which jeopardized successful adoption of the CASPAR research interventions and prompted a redesign of the studies in order to enhance each program's ability to support individualized care.

  12. Substance abuse treatment in persons with HIV/AIDS: challenges in managing triple diagnosis.

    Science.gov (United States)

    Durvasula, Ramani; Miller, Theodore R

    2014-01-01

    Clinical management of HIV must account for the "triple diagnosis" of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990s, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention.

  13. American Indian culture as substance abuse treatment: pursuing evidence for a local intervention.

    Science.gov (United States)

    Gone, Joseph P; Looking, Patrick E Calf

    2011-01-01

    Contemporary tribal commitments to traditional cultural reclamation and revitalization find continued expression by recent generational cohorts of American Indians who, when it comes to matters of recovery, healing, and wellness in the context of substance abuse, routinely assert that "our culture is our treatment." And yet, empirical investigations of this culture-as-treatment hypothesis--namely, that a (post)colonial return to indigenous cultural orientations and practices is sufficient for effecting abstinence and recovery from substance use disorders for many American Indians--have yet to appear in the scientific literature. Preliminary activities of a research partnership dedicated to the empirical exploration of this hypothesis for reducing Native American substance use disorders are summarized. Specifically, collaboration between a university-based research psychologist and a reservation-based substance abuse treatment program staff has thus far resulted in a detailed blueprint for a radically alternative, culturally-grounded intervention developed for reservation residents. This proposed alternative intervention--a seasonal cultural immersion camp designed to approximate the day-to-day experiences of prereservation ancestors--was designed for eventual implementation and evaluation with adult clients referred for residential treatment on the Blackfeet Indian reservation. It is anticipated that the proposed intervention will eventually afford empirical evaluation of the culture-as-treatment hypothesis.

  14. Treatment refusal/attrition among adults randomly assigned to programs at a drug treatment campus: The New Jersey Substance Abuse Treatment Campus, Seacaucus, NJ.

    Science.gov (United States)

    Condelli, W S; Koch, M A; Fletcher, B

    2000-06-01

    The New Jersey Substance Abuse Treatment Campus was funded to assess the feasibility of establishing a new model for delivering substance abuse treatment services and to serve as a research laboratory for conducting comparative evaluations of those services. The 350-bed campus was designed to improve treatment effectiveness by providing special services needed by underserved populations, and reduce treatment costs by serving large numbers of clients, centralizing services, and sharing facilities. First-time clients who met preliminary eligibility requirements during phone screening were randomly assigned to therapeutic community and chemical dependency programs. We used data collected on 1,573 adults who were ultimately accepted for admission to analyze treatment refusals and attrition during the 25 days after admission. Only 6.4% of the clients refused admission when informed of their treatment assignment. Planned duration of the residential phase of treatment, gender, and language spoken (English/Spanish) interacted with one another and differentially predicted treatment refusal/attrition. These findings may be useful for understanding treatment refusal and attrition in substance abuse treatment programs.

  15. Adverse Effect of Child Abuse Victimization among Substance-Using Women in Treatment.

    Science.gov (United States)

    Kang, Sung-Yeon; Magura, Stephen; Laudet, Alexandre; Whitney, Shirley

    1999-01-01

    Study examined adverse effects of childhood sexual/physical abuse among substance-abusing women with children. Several significant differences between abused and nonabused women were found in service outcomes. Abused women had more problems relating to drug use and psychiatric/psychological adjustment at follow-up. Findings support a need for…

  16. Level of analysis issues in assessing treatment beliefs in substance abuse clinics.

    Science.gov (United States)

    Mitchelson, Jacqueline K; Dickson, Marcus W; Arfken, Cynthia L; Agius, Elizabeth

    2007-12-01

    The current study applies the growing literature in the organizational sciences regarding levels of analysis issues to the analysis of substance abuse treatment beliefs. Research on clinicians' beliefs in substance abuse treatment is often based on the assumption that the beliefs are sufficiently shared by clinicians within a clinic and sufficiently vary across clinics that they can be treated as a group-level phenomenon. Further, efforts to introduce new innovations are often focused at the group or clinic level without testing this assumption, which can lead to failure to adopt or to successfully implement the innovation. We tested the assumption of sharedness by examining if there was sufficient agreement about treatment beliefs within clinics, within groups of clinics or within groups of clinicians to justify treating these aggregations as meaningful groups. Using three statistical approaches to examining level of analysis (Within and Between Analysis (WABA I), Intraclass Correlation Coefficients (ICC(1)), and r(wg)), we found that variability in treatment beliefs largely occurred at the individual rather than at the tested aggregate levels of analysis. These findings serve as an example of the importance of testing the assumption of shared perceptions in future research.

  17. Level of analysis issues in assessing treatment beliefs in substance abuse clinics

    Science.gov (United States)

    Mitchelson, Jacqueline K.; Dickson, Marcus W.; Arfken, Cynthia L.; Agius, Elizabeth

    2010-01-01

    The current study applies the growing literature in the organizational sciences regarding levels of analysis issues to the analysis of substance abuse treatment beliefs. Research on clinicians' beliefs in substance abuse treatment is often based on the assumption that the beliefs are sufficiently shared by clinicians within a clinic and sufficiently vary across clinics that they can be treated as a group-level phenomenon. Further, efforts to introduce new innovations are often focused at the group or clinic level without testing this assumption, which can lead to failure to adopt or to successfully implement the innovation. We tested the assumption of sharedness by examining if there was sufficient agreement about treatment beliefs within clinics, within groups of clinics or within groups of clinicians to justify treating these aggregations as meaningful groups. Using three statistical approaches to examining level of analysis (Within and Between Analysis (WABA I), Intraclass Correlation Coefficients (ICC(1)), and rwg), we found that variability in treatment beliefs largely occurred at the individual rather than at the tested aggregate levels of analysis. These findings serve as an example of the importance of testing the assumption of shared perceptions in future research. PMID:17570604

  18. Introduction to the special issue on organizational dynamics within substance abuse treatment: a complex human activity system.

    Science.gov (United States)

    Flynn, Patrick M; Knight, Danica K; Godley, Mark D; Knudsen, Hannah K

    2012-03-01

    Substance abuse treatment programs represent complex human activity systems in which multiple actors, including clients, counselors, and managers, are nested. Furthermore, treatment programs are nested within the broader environmental context of resource allocation and regulatory enforcement. This special issue of the Journal of Substance Abuse Treatment presents 12 empirical papers that address organizational dynamics within specialty treatment programs. In this introduction to the special issue, the guest editors describe a conceptual framework of organizational dynamics, offer an overview of the articles within this issue, and discuss future prospects for research.

  19. Prison-based rehabilitation: Predictors of offender treatment participation and treatment completion

    NARCIS (Netherlands)

    Bosma, A.; Kunst, M.; Dirkzwager, A.J.E.; Nieuwbeerta, Paul

    2016-01-01

    The purpose of the current study was to examine to what extent risk factors and treatment readiness were related to engagement (i.e., participation and completion) in prison-based rehabilitation programs. The sample consisted of the total 6-month inflow of male detainees in the Netherlands who were

  20. [Diagnostics and treatment of Wernicke-Korsakoff syndrome patients with an alcohol abuse].

    Science.gov (United States)

    Nilsson, Maria; Sonne, Charlotte

    2013-04-01

    Wernicke-Korsakoff syndrome is a condition with high morbidity and mortality and occurs as a consequence of thiamine deficiency. Clinical symptoms are often ambiguous and post-mortem examinations show that the syndrome is underdiagnosed and probably undertreated. There is sparse clinical evidence concerning optimal dosage and duration of treatment. This article reviews the current literature and concludes that all patients with a history of alcohol abuse should be treated with high dosage IV thiamine for an extended period of time, albeit further research is needed.

  1. John Henryism Active Coping as a Cultural Correlate of Substance Abuse Treatment Participation Among African American Women.

    Science.gov (United States)

    Stevens-Watkins, Danelle; Knighton, Joi-Sheree'; Allen, Kristin; Fisher, Sycarah; Crowell, Candice; Mahaffey, Carlos; Leukefeld, Carl; Oser, Carrie

    2016-04-01

    The rates of illicit drug use among African American women are increasing, yet African American women are least likely to participate in treatment for substance use disorders when compared to women of other racial groups. The current study examined family history of substance use, perceived family support, and John Henryism Active Coping (JHAC) as correlates to seeking treatment for substance abuse. The underlying theoretical frame of JHAC (James et al., 1983) suggests that despite limited resources and psychosocial stressors, African Americans believe that hard work and self-determination are necessary to cope with adversities. The current study is a secondary data analyses of 206 drug-using African American women (N=104 urban community women with no criminal justice involvement and N=102 women living in the community on supervised probation) from urban cities in a southern state. It was expected that African American women with a family history of substance abuse, higher levels of perceived family support, and more active coping skills would be more likely to have participated in substance abuse treatment. Step-wise logistic regression results reveal that women on probation, had children, and had a family history of substance abuse were significantly more likely to report participating in substance abuse treatment. Perceived family support and active coping were significant negative correlates of participating in treatment. Implication of results suggests coping with psychosocial stressors using a self-determined and persistent coping strategy may be problematic for drug-using women with limited resources.

  2. Childhood sexual abuse characteristics, intimate partner violence exposure, and psychological distress among women in methadone treatment.

    Science.gov (United States)

    Engstrom, Malitta; El-Bassel, Nabila; Gilbert, Louisa

    2012-10-01

    Traumatic experiences and their biopsychosocial sequelae present complex challenges in substance use treatment. For women with substance use problems, childhood sexual abuse (CSA), intimate partner violence exposure (IPV), posttraumatic stress disorder (PTSD), and overall psychological distress are often co-occurring concerns. To address gaps in knowledge and to strengthen practice regarding these critical issues in substance use treatment, we drew upon cross-sectional and longitudinal data from baseline and 12-month interviews with a random sample of 416 women in methadone treatment to examine relationships between CSA characteristics, particularly the presence of force and involvement of family, IPV, and mental health concerns. Although CSA involving force and family was not associated with IPV as hypothesized, it was associated with increased risk of PTSD and overall psychological distress. The multivariate findings underscore the psychological vulnerabilities associated with CSA involving force and family and suggest that drug use and financial circumstances may be important targets to reduce IPV risk.

  3. Direct Care Workers in the National Drug Abuse Treatment Clinical Trials Network: Characteristics, Opinions, and Beliefs

    Science.gov (United States)

    McCarty, Dennis; Fuller, Bret E.; Arfken, Cynthia; Miller, Michael; Nunes, Edward V.; Edmundson, Eldon; Copersino, Marc; Floyd, Anthony; Forman, Robert; Laws, Reesa; Magruder, Kathy M.; Oyama, Mark; Sindelar, Jody; Wendt, William W.

    2010-01-01

    Objective Individuals with direct care responsibilities in 348 drug abuse treatment units were surveyed to obtain a description of the workforce and to assess support for evidence-based therapies. Methods Surveys were distributed to 112 programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN). Descriptive analyses characterized the workforce. Analyses of covariance tested the effects of job category (counselors, medical staff, manager-supervisors, and support staff) on opinions about evidence-based practices and controlled for the effects of education, modality (outpatient or residential), race, and gender. Results Women made up two-thirds of the CTN workforce. One-third of the workforce had a master’s or doctoral degree. Responses from 1,757 counselors, 908 support staff, 522 managers-supervisors, and 511 medical staff (71% of eligible participants) suggested that the variables that most consistently influenced responses were job category (19 of 22 items) and education (20 of 22 items). Managers-supervisors were the most supportive of evidence-based therapies, and support staff were the least supportive. Generally, individuals with graduate degrees had more positive opinions about evidence-based therapies. Support for using medications and contingency management was modest across job categories. Conclusions The relatively traditional beliefs of support staff could inhibit the introduction of evidence-based practices. Programs initiating changes in therapeutic approaches may benefit from including all employees in change efforts. PMID:17287373

  4. Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems.

    Science.gov (United States)

    Orwat, John; Saitz, Richard; Tompkins, Christopher P; Cheng, Debbie M; Dentato, Michael P; Samet, Jeffrey H

    2011-10-01

    This is a prospective cohort study to identify factors associated with receipt of substance abuse treatment (SAT) among adults with alcohol problems and HIV/AIDS. Data from the HIV Longitudinal Interrelationships of Viruses and Ethanol study were analyzed. Generalized estimating equation logistic regression models were fit to identify factors associated with any service utilization. An alcohol dependence diagnosis had a negative association with SAT (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [95% CI] = 0.19-0.67), as did identifying sexual orientation other than heterosexual (AOR = 0.46, CI = 0.29-0.72) and having social supports that use alcohol/drugs (AOR = 0.62, CI = 0.45-0.83). Positive associations with SAT include presence of hepatitis C antibody (AOR = 3.37, CI = 2.24-5.06), physical or sexual abuse (AOR = 2.12, CI = 1.22-3.69), social supports that help with sobriety (AOR = 1.92, CI = 1.28-2.87), homelessness (AOR = 2.40, CI = 1.60-3.62), drug dependence diagnosis (AOR = 2.64, CI = 1.88-3.70), and clinically important depressive symptoms (AOR = 1.52, CI = 1.08-2.15). While reassuring that factors indicating need for SAT among people with HIV and alcohol problems (e.g., drug dependence) are associated with receipt, nonneed factors (e.g., sexual orientation, age) that should not decrease likelihood of receipt of treatment were identified.

  5. Combining Motivational Interviewing with Cognitive-Behavioral Treatments for Substance Abuse: Lessons from the COMBINE Research Project

    Science.gov (United States)

    Moyers, Theresa B.; Houck, Jon

    2011-01-01

    Motivational Interviewing began as a treatment for substance misuse and has strong empirical support as an intervention for these disorders. It is very common for MI to be combined with other types of treatment when it is used for substance abuse, and this article focuses on one example of this: the COMBINE Research Project. We examine the…

  6. Men Who Are Abusive to Their Female Intimate Partners: Incorporating Family of Origin Work into Group Treatment

    Science.gov (United States)

    Musick-Neily, Erin Francess; McBride, Dawn Lorraine

    2012-01-01

    This paper examines and provides a rationale for incorporating past victimization into group treatment for men who have been abusive to their female intimate partners. It begins with providing a general overview of the issue of family violence in Canada and in the U.S including statistics and an overview of group treatment effectiveness overall.…

  7. Demand for Substance Abuse Treatment Related to Use of Crystal Methamphetamine in Ontario: An Observational Study

    Science.gov (United States)

    Brands, Bruna; Corea, Larry; Strike, Carol; Singh, Veeran-Anne S.; Behrooz, Renee C.; Rush, Brian

    2012-01-01

    Concerns about methamphetamine/crystal methamphetamine (MA) have featured prominently in the Canadian media and on addiction treatment agency agendas. We examined MA admissions at addiction treatment agencies to determine if a service gap existed. In 2006, all addiction treatment agencies (n = 124) in Ontario, Canada were invited to complete an…

  8. The Attitudes of Members of the Association for the Treatment of Sexual Abusers towards Treatment, Release, and Recidivism of Violent Sex Offenders: An Exploratory Study

    Science.gov (United States)

    Engle, Michael J.; McFalls, Joseph A., Jr.; Gallagher, Bernard J., III

    2007-01-01

    Attitudes of members of the Association for the Treatment of Sexual Abusers (ATSA) towards treatment, release, and recidivism of sexual predators are assessed through an anonymous questionnaire. Fifty-two percent (540 members) responded. A large majority report little hope for cure (63%) and fear of recidivism after treatment (88%). No differences…

  9. Computerized cephalometric evaluation of changes following treatment with complete dentures

    Directory of Open Access Journals (Sweden)

    Strajnić Ljiljana

    2012-01-01

    Full Text Available The aim of this study was to provide longitudinal evaluation of the changes after complete dentures therapy and the rate of residual ridge resorption through a six-year period of denture wearing. The authors presented the case of a 76-year-old patient, edentulous for twelve years, wearing complete dentures for six years, with the eugnat jaw relationship. Cephalometric radiograph was carried out in the process of new complete denture production, while the evaluation was carried out after six years. Cephalometric analysis was performed by using ”Dr. Ceph” computer software (FYI Technologies, GA, USA. After six years, the reduction of anterior total facial height was 5.5 mm and the anterior lower facial height was 5.5 mm, the vertical residual ridge reduction of the maxilla was 1.4 mm and the reduction of the mandible was 3mm. The study confirms the reliability and advantages of cephalometric analyses and reveals their application possibilities in prosthetic diagnostics and therapy, as well as in evaluation of rehabilitative results in edentulous patients and longitudinal analysis of changes on the orofacial complex tissues and intemaxillary relationships.

  10. The use of art and music therapy in substance abuse treatment programs.

    Science.gov (United States)

    Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M; Bride, Brian E

    2014-01-01

    Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

  11. Improving quality of care in substance abuse treatment using five key process improvement principles.

    Science.gov (United States)

    Hoffman, Kim A; Green, Carla A; Ford, James H; Wisdom, Jennifer P; Gustafson, David H; McCarty, Dennis

    2012-07-01

    Process and quality improvement techniques have been successfully applied in health care arenas, but efforts to institute these strategies in alcohol and drug treatment are underdeveloped. The Network for the Improvement of Addiction Treatment (NIATx) teaches participating substance abuse treatment agencies to use process improvement strategies to increase client access to, and retention in, treatment. NIATx recommends five principles to promote organizational change: (1) understand and involve the customer, (2) fix key problems, (3) pick a powerful change leader, (4) get ideas from outside the organization, and (5) use rapid cycle testing. Using case studies, supplemented with cross-agency analyses of interview data, this paper profiles participating NIATx treatment agencies that illustrate successful applications of each principle. Results suggest that organizations can successfully integrate and apply the five principles as they develop and test change strategies, improving access and retention in treatment, and agencies' financial status. Upcoming changes requiring increased provision of behavioral health care will result in greater demand for services. Treatment organizations, already struggling to meet demand and client needs, will need strategies that improve the quality of care they provide without significantly increasing costs. The five NIATx principles have potential for helping agencies achieve these goals.

  12. Psychodynamic psychotherapy for posttraumatic stress disorder related to childhood abuse--Principles for a treatment manual.

    Science.gov (United States)

    Wöller, Wolfgang; Leichsenring, Falk; Leweke, Frank; Kruse, Johannes

    2012-01-01

    In this article, the authors present a psychodynamically oriented psychotherapy approach for posttraumatic stress disorder (PTSD) related to childhood abuse. This neurobiologically informed, phase-oriented treatment approach, which has been developed in Germany during the past 20 years, takes into account the broad comorbidity and the large degree of ego-function impairment typically found in these patients. Based on a psychodynamic relationship orientation, this treatment integrates a variety of trauma-specific imaginative and resource-oriented techniques. The approach places major emphasis on the prevention of vicarious traumatization. The authors are presently planning to test the approach in a randomized controlled trial aimed at strengthening the evidence base for psychodynamic psychotherapy in PTSD.

  13. Social reinforcement of substance abuse treatment aftercare participation: Impact on outcome.

    Science.gov (United States)

    Lash, Steven J; Burden, Jennifer L; Monteleone, Brian R; Lehmann, Lauren P

    2004-02-01

    Although adherence to aftercare therapy in substance abuse treatment is associated with improved outcome, little research has explored the effects of adherence interventions on outcome. We compared 20 graduates of our 28-day intensive treatment program who received a standard aftercare orientation with 20 graduates who received this intervention plus social reinforcement of aftercare group therapy attendance. The social reinforcement group showed less alcohol use than the standard care group at a 6-month follow-up assessment as measured by the Addiction Severity Index (ASI), but not less drug use. Additionally, compared to standard care, the social reinforcement participants were more likely to be abstinent at the 6-month follow up (76% vs. 40%). The groups did not differ on hospital readmission rates over a 12-month follow-up period. Additionally, the social reinforcement group showed better long-term aftercare attendance compared to the standard care group.

  14. Effects of Methadone Maintenance Treatment on Decision-Making Processes in Heroin-Abusers: A Cognitive Modeling Analysis

    Directory of Open Access Journals (Sweden)

    Arash Khodadadi

    2010-05-01

    Full Text Available A B S T R A C TIntroduction: Although decision-making processes have become a principal target of study among addiction researchers, few researches are published according to effects of different treatment methods on the cognitive processes underlying decision making up to now. Utilizing cognitive modeling method, in this paper we examine the effects of Methadone maintenance treatment (MMT on cognitive processes underlying decision-making disorders in heroin-abusers. Methods: For this purpose, for the first time, we use the balloon analog risk task (BART to assess the decision-making ability of heroin-abusers before and after treatment and compare it to the non heroin-dependent subjects. Results: Results demonstrate that heroin-abusers show more risky behavior than other groups. But, there is no difference between the performance of heroin-abusers after 6 months of MMT and control group. Modeling subjects’ behavior in BART reveals that poor performance in heroin-abusers is due to reward-dependency and insensitivity to evaluation. Discussion: Results show that 6 months of MMT decreases reward-dependency and increases sensitivity to evaluation.

  15. The comparition of Personality Patterns, irrational beliefs and impulsivity in males with with drug abuse disorder under Treatment

    Directory of Open Access Journals (Sweden)

    samere asadi

    2015-03-01

    Full Text Available Objective: the aim of this research was to determine the difference between personality Patterns, irrational beliefs and impulsivity in men with drug abuse disorder under Treatment. Method: in this casual- comparative research, 80 men ( 40 males with drug abuse under Treatment and 40 of normal males that were selected with available sampling .Groups were matched in terms of demoghraphy characteristics ( age, sexuality, education level and marital status and were valued with means of Eysenk Perceived Stress Inventory, Jonze Irrational Beliefs Scale and Baret Impulsivity Inventory. Results: The result of variance analysis showed that addicts compared to normal people, get more scores on extraversion, neuroticism and psychosis. Addicts group had Higher men scores in irrational beliefs compare of other group. There was significant difference between groups in impulsivity and impulsivity in addicts persons is the most. Conclussion: The traits of Personality, irrational beliefs and Unrealistic and high level impulsivity are factors that propel individuals toward more drug abuse and finally addict and aiming this factors in individuals with abuse disorder under Treatment can lead to prevent of Substance Abuse Relapse.

  16. An Examination of Addiction Treatment Completion by Gender and Ethnicity

    Science.gov (United States)

    Matthews, Connie R.; Lorah, Peggy

    2005-01-01

    This article examines the discharge status of all clients admitted to an intensive outpatient facility over the course of 1 year, specifically exploring differences based on client gender and ethnicity. The article also argues the need for more culturally sensitive addiction treatment and addresses some alternative approaches. The purpose of the…

  17. A reinforcement-based therapeutic workplace for the treatment of drug abuse: six-month abstinence outcomes.

    Science.gov (United States)

    Silverman, K; Svikis, D; Robles, E; Stitzer, M L; Bigelow, G E

    2001-02-01

    This study evaluated a novel drug abuse treatment, the Therapeutic Workplace. In this treatment, patients are paid to perform jobs or to participate in job training. Salary is linked to abstinence by requiring patients to provide drug-free urine samples to gain access to the workplace. Pregnant and postpartum drug abuse patients (N = 40) were randomly assigned to a Therapeutic Workplace or usual care control group. Therapeutic Workplace participants were invited to work 3 hr every weekday for 6 months and could earn up to $4,030 in vouchers for abstinence, workplace attendance, and performance. On average, 45% of participants attended the workplace per day. Relative to controls, the Therapeutic Workplace nearly doubled patients' abstinence from opiates and cocaine (33% vs. 59% of thrice-weekly urine samples drug negative, respectively, p Workplace can effectively treat heroin and cocaine abuse in pregnant and postpartum women.

  18. The National Drug Abuse Treatment Clinical Trials Network: forging a partnership between research knowledge and community practice

    Directory of Open Access Journals (Sweden)

    Liu D

    2011-03-01

    Full Text Available Betty Tai, Steven Sparenborg, David Liu, Michele StrausCenter for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, USAAbstract: The National Drug Abuse Treatment Clinical Trials Network (CTN has faced many challenges over its first eleven years. This review explores some of these challenges and the paths the CTN took to meet these challenges, including: designing clinical trials that reflect the CTN’s mission and changing public health needs, finding the synergies in the varied expertise of clinical treatment providers and academic researchers, promoting evidence-based practices and expanding the Network into mainstream medical practices to reach a broader patient population. Included in this exploration are specific examples from CTN clinical trials.Keywords: Clinical Trials Network, drug abuse, addiction 

  19. Postmarketing surveillance of abuse liability of sibutramine.

    Science.gov (United States)

    Arfken, Cynthia L; Schuster, Charles R; Johanson, Chris-Ellyn

    2003-03-01

    The abuse liability of medications is a growing concern as the number of newly approved psychoactive medications increases. Postmarketing surveillance can assist in determining abuse liability, but strategies are not well-defined for medications believed to be at low abuse risk. Using a newly approved medication (sibutramine--an anorectic drug), a novel approach to postmarketing abuse surveillance was introduced. A one-page anonymous questionnaire covering sibutramine, a scheduled anorectic drug (phentermine), and a fabricated name was added to the intake process of 58 treatment programs. From the 8780 completed questionnaires, 8.8% had heard of sibutramine and phentermine. For continued use to get high (a proxy for abuse), the rate for sibutramine was lower than for phentermine (0.6 vs. 2.2%, McNemar's chi(2) = 110.45, P < 0.001) but was higher than for the fabricated name (0.6 vs. 0.3%, McNemar's chi(2) = 11.86, P < 0.001). These results suggest the risk of abuse associated with sibutramine was lower than that associated with a known abused drug, one that itself is considered low risk despite decades of population exposure. The relatively high rate of hearing of sibutramine may be due to the direct-to-consumer advertisement. This approach is only one indicator in a surveillance framework but appears promising and validates findings from laboratory-based abuse liability studies that also indicate low abuse liability for sibutramine.

  20. Low-income cancer patients in depression treatment: dropouts and completers.

    Science.gov (United States)

    Wells, Anjanette A; Palinkas, Lawrence A; Shon, En-Jung; Ell, Kathleen

    2013-10-01

    This study aims to explore reasons for depression treatment dropout among low-income, minority women with depression and cancer. Semi-structured telephone interviews are conducted with 20, predominately Latina, patients who dropped out of depression treatment and 10 who completed. Transcripts analyzed using techniques rooted in grounded theory. Treatment completion barriers cluster according to Meichenbaum and Turk's (Facilitating treatment adherence: A practitioner's guidebook, Plenum Press, New York, 1987) five adherence dimensions: (a) Barriers to Treatment (informational, instrumental, cultural [language, discrimination]); (b) Disease Features (emotional burden of cancer/depression); (c) Cancer/Depression Treatment Regimens; (d) Provider-Patient Relationship (depression treatment dissatisfaction); and (e) Clinical Setting (hospital organizational issues). Although both groups describe multiple overlapping dimensions of barriers, completers seem more motivated and satisfied with treatment, possibly due to completers experiencing the positive treatment effects after the first several sessions. More research should be conducted to determine the most effective clinical treatment methods for this population.

  1. Barriers to accessing substance abuse treatment in Mexico: national comparative analysis by migration status

    Science.gov (United States)

    2014-01-01

    Background We examined Mexican migrants’ perceived barriers to entering substance abuse treatment and potential differences by gender. Methods This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment. Results Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City. Conclusions Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico. PMID:25074067

  2. Substance Abuse Treatment in Adult and Juvenile Correctional Facilities: Findings from the Uniform Facility Data Set 1997 Survey of Correctional Facilities.

    Science.gov (United States)

    Marsden, Mary Ellen, Ed.; Straw, Richard S., Ed.

    This report presents methodology and findings from the Uniform Facility Data Set (UFDS) 1997 Survey of Correctional Facilities, which surveyed about 7,600 adult and juvenile correctional facilities to identify those that provide on-site substance abuse treatment to their inmates or residents. The survey assesses substance abuse treatment provided…

  3. Technology transfer for the implementation of a clinical trials network on drug abuse and mental health treatment in Mexico.

    Science.gov (United States)

    Horigian, Viviana E; Marín-Navarrete, Rodrigo A; Verdeja, Rosa E; Alonso, Elizabeth; Perez, María A; Fernández-Mondragón, José; Berlanga, Carlos; Medina-Mora, María Elena; Szapocznik, José

    2015-09-01

    Low- and middle-income countries (LMIC) lack the research infrastructure and capacity to conduct rigorous substance abuse and mental health effectiveness clinical trials to guide clinical practice. A partnership between the Florida Node Alliance of the United States National Drug Abuse Treatment Clinical Trials Network and the National Institute of Psychiatry in Mexico was established in 2011 to improve substance abuse practice in Mexico. The purpose of this partnership was to develop a Mexican national clinical trials network of substance abuse researchers and providers capable of implementing effectiveness randomized clinical trials in community-based settings. A technology transfer model was implemented and ran from 2011-2013. The Florida Node Alliance shared the "know how" for the development of the research infrastructure to implement randomized clinical trials in community programs through core and specific training modules, role-specific coaching, pairings, modeling, monitoring, and feedback. The technology transfer process was bi-directional in nature in that it was informed by feedback on feasibility and cultural appropriateness for the context in which practices were implemented. The Institute, in turn, led the effort to create the national network of researchers and practitioners in Mexico and the implementation of the first trial. A collaborative model of technology transfer was useful in creating a Mexican researcher-provider network that is capable of changing national practice in substance abuse research and treatment. Key considerations for transnational technology transfer are presented.

  4. Complete treatment of CMB anisotropies in a FRW universe

    Science.gov (United States)

    Hu, Wayne; Seljak, Uroš; White, Martin; Zaldarriaga, Matias

    1998-03-01

    We generalize the total angular momentum method for computing cosmic microwave background anisotropies to Friedmann-Robertson-Walker (FRW) spaces with arbitrary geometries. This unifies the treatment of temperature and polarization anisotropies generated by scalar, vector and tensor perturbations of the fluid, seed, or a scalar field, in a universe with constant comoving curvature. The resulting formalism generalizes and simplifies the calculation of anisotropies and, in its integral form, allows for a fast calculation of model predictions in linear theory for any FRW metric.

  5. Towards a complete treatment of the cosmological recombination problem

    CERN Document Server

    Chluba, J

    2010-01-01

    A new approach to the cosmological recombination problem is presented, which completes our previous analysis on the effects of two-photon processes during the epoch of cosmological hydrogen recombination, accounting for ns-1s and nd-1s Raman events and two-photon transitions from levels with n>=2. The recombination problem for hydrogen is described using an effective 400-shell multi-level approach, to which we subsequently add all important recombination corrections discussed in the literature thus far. We explicitly solve the radiative transfer equation of the Lyman-series photon field to obtain the required modifications to the rate equations of the resolved levels. In agreement with earlier computations we find that 2s-1s Raman scattering leads to a delay in recombination by DN_e/N_e~0.9% at z~920. Two-photon decay and Raman scattering from higher levels (n>3) result in a small additional modifications, and precise results can be obtained when including their effect for the first 3-5 shells. This work is a...

  6. Therapist’s Gender and Gender Roles: Impact on Attitudes toward Clients in Substance Abuse Treatment

    Directory of Open Access Journals (Sweden)

    Tytti Artkoski

    2013-01-01

    Full Text Available The purpose of the present study was to investigate the impact of therapist’s gender and gender roles on attitudes toward clients. Attitudes toward motivational interviewing were also a focus as MI can be hypothesized to be feminine rather than masculine in nature. The subjects ( were Finnish substance abuse therapists. Their attitudes toward clients were measured using a vignette task. Results indicated that female therapists were significantly more positive toward clients than were male therapists. Although females were significantly more feminine than males, they saw themselves as masculine as the males did. The more feminine the therapist was, the more s/he preferred MI. In the future, an examination of this kind should be combined with measurement of treatment processes and outcomes.

  7. A metaphor analysis of recovering substance abusers' sensemaking of medication-assisted treatment.

    Science.gov (United States)

    Malvini Redden, Shawna; Tracy, Sarah J; Shafer, Michael S

    2013-07-01

    In this study, we examined metaphors invoked by people recovering from opioid dependence as they described the challenges and successes of using medication-assisted treatment. Metaphors provide linguistic tools for expressing issues that are confusing, complex, hidden, and difficult to state analytically or literally. Using data from eight focus groups with 68 participants representing four ethnic minority groups, we conducted a grounded analysis to show how recovering substance users communicatively constructed addiction and recovery. The primary medication, methadone, was framed as "liquid handcuffs" that allowed those in recovery to quit "hustling," get "straight," and find "money in their pockets." Nonetheless, methadone also served as a "crutch," leaving them still feeling like "users" with "habits" who "came up dirty" to friends and family. In this analysis, we tease out implications of these metaphors, and how they shed light on sensemaking, agency, and related racial- and class-based structural challenges in substance abuse recovery.

  8. Comparing credentialing requirements of substance abuse treatment staff by funding source.

    Science.gov (United States)

    Kubiak, Sheryl Pimlott; Arfken, Cynthia L

    2008-07-01

    Studies have found that clinicians with higher education and/or attainment of national certification have a more favorable outlook regarding the adoption of evidence-based practices. However, staff hiring decisions may be based on a multitude of factors, including available resources and demands stemming from different funders. Using a mixed-methods case study approach with 34 agencies within one state, we assessed administrators' perspectives of the most important funding source, views on clinical hiring practices, and current staffing. We found that funding source predicted views and actual staff level of credentialing and education. Those agencies citing a criminal justice entity as the most important funder had the lowest requirements for credentialing and education. As the substance abuse treatment delivery system evolves and expands, we must ensure that vulnerable groups have access to more highly--rather than less--skilled workers to assess and facilitate recovery.

  9. Quality of life in studies with patients under treatment for substance abuse and addiction

    Directory of Open Access Journals (Sweden)

    Selva Rios Campêlo

    2015-12-01

    Full Text Available The purpose of this study was to find Quality of Life (QoL instruments and their purpose in studies with patients under treatment for substance abuse and addiction. This is an integrative review, whose articles were available on the Virtual Health Library (VHL and published between 2010 and 2015 with the associated descriptors "Substance-Related Disorders" and "Quality of Life". Twenty-nine texts were analyzed and the instruments were grouped into four possible uses of measurement of Quality of Life. The majority used generic instruments such as WHOQOL-Bref for general Quality of Life and the SF-36 of Health-Related Quality of Life (HRQoL. It is recommended that further studies be carried out on the use of Quality of Life instruments in relation to addiction, especially with specific instruments that are beginning to appear in some studies and which have not been consolidated in the field.

  10. Completion of treatment for latent tuberculosis infection with monthly drug dispensation directly through the tuberculosis clinic.

    Directory of Open Access Journals (Sweden)

    Claudia C Dobler

    Full Text Available SETTING: An Australian metropolitan TB clinic where treatment for latent tuberculosis infection (LTBI comprises six months of isoniazid, self-administered but dispensed monthly by the clinic. OBJECTIVE: To determine the proportion of patients who complete treatment for LTBI and to identify factors associated with non-completion. METHODS: Clinical files of all patients receiving treatment for LTBI between 01/2000 and 12/2010 were reviewed. The study population comprised all patients who were commenced on isoniazid as treatment for LTBI. Odds ratios (OR for completing treatment were estimated by logistic regression. RESULTS: Of 216 patients who commenced isoniazid treatment for LTBI, 163 (75% completed six months treatment [corrected]. Fifty-three percent of the 53 patients who did not complete treatment dropped out after three months treatment. The mean (SD age of the patients was 27 (16 years and 123 (57% were female. The majority of patients (59% were born overseas and 69% received treatment for LTBI because they were contacts of patients with TB. Patients' sex, age, country of birth, time since immigration for overseas born people, health care worker status, TST conversion status, chest x-ray findings, language, employment status and the indication for which treatment of LTBI was prescribed were not significantly related to treatment completion. CONCLUSION: In a setting where isoniazid is dispensed monthly by the TB clinic, a relatively high proportion of patients who commence treatment for LTBI complete the six month scheduled course of treatment. The study did not identify any patient characteristics that predicted treatment completion. Interventions to improve completion rates should extend over the whole duration of treatment.

  11. Women are less likely to be admitted to substance abuse treatment within 30 days of assessment.

    Science.gov (United States)

    Arfken, Cynthia L; Borisova, Natalie; Klein, Chris; di Menza, Salvatore; Schuster, Charles R

    2002-01-01

    The information gathered in a centralized intake unit (CIU) allows payers and administrators to examine if there are access issues for their population. For this study, the authors examined whether there were gender differences in the rate at which people are admitted to treatment within 30 days of assessment. Of the 5,004 individuals seeking publicly-funded substance abuse treatment in Detroit for the years 1996-97, 50.3% of those assessed at the CIU actually entered treatment. Women (31% of the people assessed) had a lower rate of admission (45% for women versus 53% for men) a difference that was maintained even after controlling for known risk factors. Women who were given priority for admission (i.e., those who were pregnant, had children, or injected drugs) had a higher rate of admission than other women (73% versus 39%), but only 17% of the women presenting were included in the priority groups. Men who were injecting drugs (a priority group) also had a higher rate of admission than other men (83% versus 49%). In multivariate analysis controlling for priority groups and known risk factors, women were still less likely to be admitted to treatment within 30 days of admission than men. Establishing priorities improves the rate of admission within 30 days of assessment for those groups, but more needs to be done to improve the admission rate for women. These results demonstrate that a CIU allows administrators to monitor for access issues.

  12. Investigating Impacts of Incorporating an Adjuvant Mind–Body Intervention Method Into Treatment as Usual at a Community-Based Substance Abuse Treatment Facility

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    Yoshio Nakamura

    2015-02-01

    Full Text Available Treatment of substance use/misuse (SUM continues to pose a difficult challenge. This exploratory pilot study evaluated whether a novel mind–body intervention program called “Mind–Body Bridging” (MBB could be an effective short-term adjuvant intervention for managing SUM and coexisting symptoms in women undergoing residential and outpatient substance use treatment in a community setting. Thirty-eight women attending a local substance abuse (SA facility were recruited and randomly assigned to either (a treatment as usual (TAU or (b MBB and TAU. The MBB program consisted of 20 sessions and lasted for 10 weeks. Participants were asked to complete a set of self-report questionnaires designed to assess drug/alcohol cravings, impact of past trauma, depression, sleep disturbance, mindfulness, self-compassion, and well-being. They completed the questionnaires at three time points: preintervention, midintervention (after the fifth week, and postintervention. MBB + TAU significantly reduced drug/alcohol cravings, trauma-related thinking, and disturbed sleep in comparison with TAU. Furthermore, MBB + TAU significantly increased mindfulness, self-compassion, and well-being in comparison with TAU. MBB for SUM appears promising as a complementary adjuvant intervention, warranting future larger scale randomized controlled trials of MBB for SUM populations. SUM is a difficult condition to treat and manage clinically, especially given the multiple comorbid conditions that frequently affect those with SUM. In the search to develop effective adjuvant interventions for SUM, the present pilot study suggested that adding MBB to standard SUM treatment in community-based settings could enhance therapeutic efficacy and quality of care.

  13. The Millon Clinical Multiaxial Inventory II: stability over time? A seven-year follow-up study of substance abusers in treatment.

    Science.gov (United States)

    Ravndal, Edle; Vaglum, Per

    2010-01-01

    Measuring personality disorders among substance abusers may entail special problems related to the reliability and validity of the instruments. The Millon Clinical Multiaxial Inventory II (MCMI-II), a well-known self-reporting instrument, was used in a prospective study of drug abusers from 21 treatment programs in Norway (n = 481) to investigate the influence of substance abuse on the reliability and stability of the MCMI personality traits at intake to treatment and after 7 years (n = 342). As regards the drug-abusing and drug-free subgroups, the MCMI-II dimensional scores were equally reliable and stable in both groups, and were not influenced by the abusing state. Using the MCMI-II in a categorical diagnostic way did not show sufficient predictive validity. The MCMI-II dimensional scores should therefore be used to measure personality disorder traits among help-seeking and former drug abusers.

  14. Should psychosocial intervention be added to pharmacological treatment for opiate abuse/dependence? An overview of systematic reviews of the literature

    Directory of Open Access Journals (Sweden)

    Laura Amato

    2006-06-01

    Full Text Available

    Background: Opioid abuse and dependence are major health and social issues in most societies. Different interventions are available, but the majority of heroin patients relapse and these relapses are a substantial problem to their rehabilitation. Psychosocial interventions for drug addicts have been suggested as possible instruments to overcome the difficulty of maintaining a drug-free state. The aim of this paper is to provide a summary of the available evidence of effectiveness.

    Methods: We summarised the results from two systematic reviews on psychosocial interventions combined with Methadone Maintenance Treatment and Methadone or Buprenorphine Detoxification Treatment.

    Results: For detoxification treatments, the results show that benefits can be gained from adding any psychosocial treatment to any substitution detoxification treatment in terms of completion of treatment: relative risk (RR 1.68 (95% CI 1.11-2.55, and compliance (proportion of clinical absences: RR 0.48 (95% CI 0.38-0.59; for the use of heroin during treatment, the differences were not statistically significant. For maintenance treatments, there is an additional benefit to be gained in adding any psychosocial treatment to methadone maintenance treatment in relation to the use of heroin during treatment: RR 0.69(95% CI 0.53-0.91; no statistically significant additional benefit was shown in terms of treatment retention and results at follow-up.

    Conclusions: Psychosocial treatments offered in addition to pharmacological detoxification treatments are effective in terms of completion of treatment and compliance, while adding any psychosocial support to methadone maintenance significantly improves the non-use of heroin during treatment but does not improve the other outcomes considered.

  15. Course of self-reported symptoms of attention deficit and hyperactivity in substance abusers during early treatment

    DEFF Research Database (Denmark)

    Hesse, Morten

    2010-01-01

    . A sample of 75 substance abusers were assessed after they were admitted to a centralized intake unit, and followed at 3 and 6 months after intake by independent interviewers (follow-up rate 81%). Symptoms of attention deficit and hyperactivity were assessed with the Adult Self-report Scale for ADHD (ASRS...... adjustment after controlling for baseline functioning. Hyperactivity was associated with poorer substance use outcomes at the trend level. In conclusion, both dimensions of ADHD contribute to worse functioning during early treatment for substance abusers, and the ASRS is a reasonably stable measure of ADHD...

  16. Characteristics of U.S. substance abuse treatment facilities adopting buprenorphine in its initial stage of availability.

    Science.gov (United States)

    Koch, Alison L; Arfken, Cynthia L; Schuster, Charles R

    2006-07-27

    This study examined the adoption of buprenorphine for the treatment of opiate dependence among U.S. substance abuse treatment facilities and their characteristics at the time of the initial availability of the medication. Data come from a 2003 national survey of all substance abuse treatment facilities in the U.S. Out of our sample of 13,060 facilities, 5.5% of facilities reported they offered buprenorphine. Not unexpectedly, the prevalence was higher in certified opioid treatment programs (11.3%) compared to other facilities (4.6%). For opioid treatment programs, offering Naltrexone (OR=8.34, 95% CI=5.53, 12.58) and offering medically supervised withdrawal (OR=2.76, 95% CI=1.38, 5.52) were independent and robust predictors of offering buprenorphine. These same variables were independent predictors for the non-opioid treatment programs as well (Naltrexone, OR=14.32, 95% CI=7.85, 26.10; and medically supervised withdrawal services, OR=4.42, 95% CI=3.01, 6.49). Our results suggest that the adoption of buprenorphine soon after the Food and Drug Administration approved its use for treatment of opioid dependence and the shipping of the medication commenced was associated with facilities already offering pharmacotherapies such as Naltrexone and medically assisted withdrawal. These findings provide baseline data to track the adoption of buprenorphine by substance abuse treatment programs in future years.

  17. Personal networks of women in residential and outpatient substance abuse treatment.

    Science.gov (United States)

    Kim, HyunSoo; Tracy, Elizabeth; Brown, Suzanne; Jun, MinKyoung; Park, Hyunyong; Min, Meeyoung; McCarty, Chris

    This study compared compositional, social support, and structural characteristics of personal networks among women in residential (RT) and intensive outpatient (IOP) substance abuse treatment. The study sample included 377 women from inner-city substance use disorder treatment facilities. Respondents were asked about 25 personal network members known within the past 6 months, characteristics of each (relationship, substance use, types of support), and relationships between each network member. Differences between RT women and IOP women in personal network characteristics were identified using Chi-square and t-tests. Compared to IOP women, RT women had more substance users in their networks, more network members with whom they had used substances and fewer network members who provided social support. These findings suggest that women in residential treatment have specific network characteristics, not experienced by women in IOP, which may make them more vulnerable to relapse; they may therefore require interventions that target these specific network characteristics in order to reduce their vulnerability to relapse.

  18. Addiction and Women Gender Differences Concerning Drug Abuse and its Treatment

    Directory of Open Access Journals (Sweden)

    Fatemeh Safari

    2003-05-01

    Full Text Available This article focuses on the quantitative grounds for the emergence and spread of addiction among women, its medical, social and psychological problems, impediments for the treatment of addiction among women as well as gender differences concerning drug abuse and its treatment. This article is a translation of a statistical research on addiction among women and a number of other researches. Based on conclusions drawn from the said researches, women become inclined to addiction mostly by their husbands due to their cordial relationships. Moreover, the negative attitudes of peer groups can overshadow girls and women more than boys and men. From the viewpoint of psychological disorders, the relationship between disorders resulting from psychological pressure after an incident and addiction is stronger among girls and women compared to boys and men. Addiction among women in addition to certain ailments such as malnutrition, hypertension and cancer, can expose them to dangerous diseases such as Hepatitis and AIDS. There is more possibility for addicted women to be infected with AIDS and other sexually transmitted diseases compared to men and they are more exposed to female ailments compared to other women. As far as treatment impediments are concerned, women face a greater social stigma due to their addiction compared to men. Social approach considering addicted women as an indecent person is a major impediment for their treatment. Taking care of the child is also another obstacle for their treatment. There is less possibility for women to receive support from their families for quitting their addiction compared to men. Treatment programs also unwantedly may create obstacles for the treatment of women such as financial constraints, administrative bureaucracy, concentration of treatment programs for men and lack of sensitivity towards women’s addiction. The psychological impediments to treatment include internalizing the notion that addiction is a

  19. Factors Associated With Use of ASAM Criteria and Service Provision in a National Sample of Outpatient Substance Abuse Treatment Units.

    Science.gov (United States)

    Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey A; Friedmann, Peter D; Lee, I-Heng

    2009-09-01

    Standardized patient placement criteria such as those developed by the American Society of Addiction Medicine are increasingly common in substance abuse treatment, but it is unclear what factors are associated with their use or with treatment units' provision of related services. This study examined these issues in the context of a national survey of outpatient substance abuse treatment units. Regressions using 2005 data revealed that both public and private managed care were associated with a greater likelihood of using American Society of Addiction Medicine criteria to develop client treatment plans. However, only public managed care was associated with a greater likelihood of offering more resource-intensive services. Associations between client population severity and resource-intensive service provision were sparse but positive.

  20. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

    OpenAIRE

    Dorrepaal, Ethy; Thomaes, Kathleen; Hoogendoorn, Adriaan W.; Veltman, Dick J.; Draijer, Nel; van Balkom, Anton J. L. M.

    2014-01-01

    Introduction: Effective first-line treatments for posttraumatic stress disorder (PTSD) are well established, but their generalizability to child abuse (CA)-related Complex PTSD is largely unknown.Method: A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates.Results: Only six studies with...

  1. Impulsivity is associated with treatment non-completion in cocaine- and methamphetamine-dependent patients but differs in nature as a function of stimulant-dependence diagnosis.

    Science.gov (United States)

    Winhusen, Theresa; Lewis, Daniel; Adinoff, Bryon; Brigham, Gregory; Kropp, Frankie; Donovan, Dennis M; Seamans, Cindy L; Hodgkins, Candace C; Dicenzo, Jessica C; Botero, Christopher L; Jones, Davina R; Somoza, Eugene

    2013-01-01

    Greater impulsivity, assessed by the Barratt Impulsiveness Scale-11 (BIS-11) and Stroop interference scores, has been associated with treatment completion in cocaine-dependent patients. This study evaluated the relationships among impulsivity, stimulant-dependence diagnosis, and treatment completion. Six sites evaluating 12-step facilitation for stimulant abusers obtained the BIS-11 and Stroop from 182 methamphetamine- and/or cocaine-dependent participants. Methamphetamine-dependent, relative to cocaine-dependent, participants evidenced significantly greater BIS-11 non-planning and total scores. There was a trend for poorer response inhibition, measured by the Stroop, in cocaine-dependent, relative to methamphetamine-dependent, participants. Accounting for other factors related to treatment completion, BIS-11 motor score, assessing the tendency to act without thinking, predicted treatment completion for both cocaine-dependent and methamphetamine-dependent patients. These results suggest that methamphetamine-dependent and cocaine-dependent patients may have different impulsivity profiles but that the BIS-11 may be useful in identifying both methamphetamine-dependent and cocaine-dependent patients who are at risk for treatment non-completion.

  2. Psychedelics as medicines for substance abuse rehabilitation: evaluating treatments with LSD, Peyote, Ibogaine and Ayahuasca.

    Science.gov (United States)

    Winkelman, Michael

    2014-01-01

    Substances known as psychedelics, hallucinogens and entheogens have been employed in ethnomedical traditions for thousands of years, but after promising uses in the 1950's and 1960's they were largely prohibited in medical treatment and human research starting in the 1970's as part of the fallout from the war on drugs. Nonetheless, there are a number of studies which suggest that these substances have potential applications in the treatment of addictions. While these substances are generally classified as Schedule I, alleging no established medical uses and a high drug abuse potential, there is nonetheless evidence indicating they might be safe and effective tools for short term interventions in addictions treatment. Evidence suggests that the psychedelics have a much greater safety profile than the major addictive drugs, having extremely low levels of mortality, and producing little if any physical dependence. This paper reviews studies evaluating the use of LSD, peyote, ibogaine and ayahuasca in the treatment of dependencies and the possible mechanisms underlying the indications of effectiveness. Evidence suggests that these substances help assist recovery from drug dependency through a variety of therapeutic mechanisms, including a notable "after-glow" effect that in part reflects their action on the serotonin neurotransmitter system. Serotonin has been long recognized as central to the psychedelics' well-known phenomenological, physical, emotional and cognitive dynamics. These serotonin-based dynamics are directly relevant to treatment of addiction because of depressed serotonin levels found in addict populations, as well as the role of serotonin as a neuromodulators affecting many other neurotransmitter systems.

  3. Differential responsiveness to a parenting intervention for mothers in substance abuse treatment.

    Science.gov (United States)

    Paris, Ruth; Herriott, Anna; Holt, Melissa; Gould, Karen

    2015-12-01

    This study examines the relationship between levels of psychological distress in substance-dependent mothers and their differential response to a dyadic parent-child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social-emotional development. Additionally, clinicians provided assessments of the parent-child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal-Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women with moderately elevated levels of psychological distress did not. Women who were most distressed at baseline showed increased levels of parental reflective functioning post-treatment while women with moderate and lower levels of baseline psychological distress showed improvements on clinician-rated assessments of parent-child relationships. Chi Square analyses showed that parents who endorsed the highest levels of distress at baseline reported that their children's risk status regarding social-emotional development decreased post-treatment. Despite similarities in substance dependence, mothers in this sample had different needs and outcomes in the context of this parenting intervention due to variation in mental health. Given this variation, parenting interventions for substance-dependent mothers need to account for the individual differences in levels of psychological distress.

  4. Adapting an evidence-based HIV prevention intervention for pregnant African-American women in substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Winona Poulton

    2011-02-01

    Full Text Available Wendee M Wechsberg1, Felicia A Browne1, Winona Poulton1, Rachel Middlesteadt Ellerson1, Ashley Simons-Rudolph1, Deborah Haller2,  1RTI International,* Research Triangle Park, NC, USA; 2Columbia University College of Physicians and Surgeons, New York, NY, USA,  *RTI International is a trade name of Research Triangle InstituteAbstract: An adaptation of an evidence-based, woman-focused intervention designed to reduce HIV risk behaviors was conducted for pregnant, African-American women in substance abuse treatment in North Carolina. The intervention adaptation process included focus groups, expert panels, and the filming of women who spoke about their experiences with pregnancy, drug use, sex risk behaviors, HIV testing and treatment, need for substance abuse treatment, violence, and victimization. The assessment instrument was adapted for pregnant women and the intervention was organized into a 4-session PowerPoint presentation, with an additional session if a woman tested positive for HIV. All sessions and assessment instrument were installed on laptop computers for portability in treatment programs. We pilot tested our adaptation with 59 pregnant African-American women who had used an illicit drug within the past year and were enrolled in substance abuse treatment. At baseline, 41% were currently homeless, 76% were unemployed, 90% had not planned their current pregnancy, and approximately 70% reported drug use since finding out about the pregnancy. This sample of participants rated the intervention sessions and were highly satisfied with their experience, resulting in a mean satisfaction score of 6.5 out of 7. Pregnant African-American women who use drugs need substance abuse treatment that they do not currently access. Woman-focused HIV interventions help to address intersecting risk behaviors and need for treatment prevalent among this vulnerable group.Keywords: African-American woman, HIV prevention pregnancy, drug use, violence, sexual

  5. Substance abuse, treatment needs and access among female sex workers and non-sex workers in Pretoria, South Africa

    Directory of Open Access Journals (Sweden)

    Browne Felicia A

    2009-05-01

    Full Text Available Abstract Background This study examined cross-sectional data collected from substance-using female sex workers (FSW and non-sex workers (non-SW in Pretoria, South Africa, who entered a randomized controlled trial. Methods Women who reported alcohol use and recently engaging in sex work or unprotected sex were recruited for a randomized study. The study sample (N = 506 comprised 335 FSW and 171 female non-SW from Pretoria and surrounding areas. Self-reported data about alcohol and other drug use as well as treatment needs and access were collected from participants before they entered a brief intervention. Results As compared with female non-SW, FSW were found to have a greater likelihood of having a past year diagnosis of alcohol or other drug abuse or dependence, having a family member with a history of alcohol or other drug abuse, having been physically abused, having used alcohol before age 18, and having a history of marijuana use. In addition, the FSW were more likely to perceive that they had alcohol or other drug problems, and that they had a need for treatment and a desire to go for treatment. Less than 20% of participants in either group had any awareness of alcohol and drug treatment programs, with only 3% of the FSW and 2% of the non-SW reporting that they tried but were unable to enter treatment in the past year. Conclusion FSW need and want substance abuse treatment services but they often have difficulty accessing services. The study findings suggest that barriers within the South African treatment system need to be addressed to facilitate access for substance-using FSW. Ongoing research is needed to inform policy change that fosters widespread educational efforts and sustainable, accessible, woman-sensitive services to ultimately break the cycle for current and future generations of at-risk South African women.

  6. Childhood Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Evrim Aktepe

    2009-08-01

    behavioral and psychological results by itself, early trauma may also lead to biological effects. Especially traumas during neuron plasticity phase may lead hypersensitivity of neuroendocrine stress response. Early life stresses are shown to lead changes in corticotrophin releasing factor system in preclinical and clinical phase studies. In the treatment of sexual abuse, emotional process related with trauma should be focused on. This process may be conducted with play therapy. Development of higher level defense mechanism, increasing ego capacity, orientation to social activity and personal activity according to skills is aimed. For the elimination of guiltiness related with stigmatization, the child should be told that it is not herhis fault to incorporate into sexual interaction and the culprit is abuser. It is fairly important for medical staff, school and family to have sufficient information about sexual abuse for prevention and early recognition.

  7. Behavior of pharmaceuticals and drugs of abuse in a drinking water treatment plant (DWTP) using combined conventional and ultrafiltration and reverse osmosis (UF/RO) treatments

    Energy Technology Data Exchange (ETDEWEB)

    Boleda, Ma Rosa [AGBAR-Aiguees de Barcelona, Gral Batet 5-7, 08028 Barcelona (Spain); Galceran, Ma Teresa [University of Barcelona, Department Analytical Chemistry, Av. Diagonal 647, 08028 Barcelona (Spain); Ventura, Francesc, E-mail: fventura@agbar.es [AGBAR-Aiguees de Barcelona, Gral Batet 5-7, 08028 Barcelona (Spain)

    2011-06-15

    The behavior along the potabilization process of 29 pharmaceuticals and 12 drugs of abuse identified from a total of 81 compounds at the intake of a drinking water treatment plant (DWTP) has been studied. The DWTP has a common treatment consisting of dioxychlorination, coagulation/flocculation and sand filtration and then water is splitted in two parallel treatment lines: conventional (ozonation and carbon filtration) and advanced (ultrafiltration and reverse osmosis) to be further blended, chlorinated and distributed. Full removals were reached for most of the compounds. Iopromide (up to 17.2 ng/L), nicotine (13.7 ng/L), benzoylecgonine (1.9 ng/L), cotinine (3.6 ng/L), acetaminophen (15.6 ng/L), erythromycin (2.0 ng/L) and caffeine (6.0 ng/L) with elimination efficiencies {>=}94%, were the sole compounds found in the treated water. The advanced treatment process showed a slightly better efficiency than the conventional treatment to eliminate pharmaceuticals and drugs of abuse. - Highlights: > The presence of pharmaceuticals and drugs of abuse in surface water was demonstrated. > Elimination in both potabilization processes reached levels >99% for most compounds. > Four pharmaceuticals and three drugs of abuse survived the potabilization process. - The efficiency of potabilization processes to eliminate or transform pharmaceuticals and illicit drugs is evaluated.

  8. Demographic and clinical profile of substance abusing women seeking treatment at a de-addiction center in north India

    Directory of Open Access Journals (Sweden)

    Naresh Nebhinani

    2013-01-01

    Full Text Available Background: In the recent decades increasing number of women have been seeking deaddiction services. Despite that the report data is very limited from India. Objectives: The present research aimed to study the demographic and clinical profile of women seeking deaddiction treatment at a tertiary care center in North India. Materials and Methods: Retrospective structured chart review of 100 women substance abusers seeking treatment at a deaddiction center between September 1978 and December 2011. Results: A typical case was of 36.3 years age, married (65%, urban (61%, nuclear family (59% based housewife (56%, with good to fair social support (69%. The commonest substance of abuse was tobacco (60%, followed by opioids (27%, alcohol (15%, and benzodiazepines (13%. The common reasons for initiation of substance use were to alleviate frustration or stress (49% and curiosity (37%. Family history of drug dependence (43%, comorbidity (25%, and impairments in health (74%, family (57%, and social domains (56% were common. Only a third of the sample paid one or more follow visit, and of those 58% were abstinent at the last follow-up. Significant predictors identified were being non-Hindu and higher educational years for abstinent status at follow-up. Conclusion: The common substances of abuse were tobacco, opioids, and alcohol and benzodiazepines; and family history of drug abuse and comorbidity were common. The follow-up and outcome were generally poor. This profile gives us some clues to address a hidden health problem of the community.

  9. Predictors of retention in a drug-free unit/substance abuse treatment in prison.

    Science.gov (United States)

    Casares-López, María José; González-Menéndez, Ana; Festinger, David S; Fernández-García, Paula; Fernández-Hermida, José Ramón; Secades, Roberto; Matejkowski, Jason

    2013-01-01

    The high rate of dropout from treatment programs is a recurring problem in the field of drug dependence. The purpose of this study was to identify the predictors of retention in a prison-based drug-free unit (DFU). The relationships among subscales of the Addiction Severity Index (ASI) as well as motivation and personality profiles and length of stay in a DFU, of 57 prisoners admitted for the first time to the program were analyzed. The mean dropout rates were 52.9% at six months and 67.8% at one year. The mean length of stay was 195.05 days. Predictors of retention at six months included the ASI Family Composite Score, the motivation subscale Taking Steps, and Narcissistic personality trait score. Predictors of retention at one year included lower ASI Psychological Composite Score, higher scores on the motivation subscale Ambivalence, and higher number of charges pending at the time of admission to the program. Identification of these predictor variables may be useful for developing strategies to increase retention in the context of in-prison substance abuse treatment.

  10. Social costs of robbery and the cost-effectiveness of substance abuse treatment.

    Science.gov (United States)

    Basu, Anirban; Paltiel, A David; Pollack, Harold A

    2008-08-01

    Reduced crime provides a key benefit associated with substance abuse treatment (SAT). Armed robbery is an especially costly and frequent crime committed by some drug-involved offenders. Many studies employ valuation methods that understate the true costs of robbery, and thus the true social benefits of SAT-related robbery reduction. At the same time, regression to the mean and self-report bias may lead pre-post comparisons to overstate crime reductions associated with SAT. Using 1992-1997 data from the National Treatment Improvement Evaluation Study (NTIES), we examined pre-post differences in self-reported robbery among clients in five residential and outpatient SAT modalities. Fixed-effect negative binomial regression was used to examine incidence rate reductions (IRR) in armed robbery. Published data on willingness to pay to avoid robbery were used to determine the social valuation of these effects. Differences in IRR across SAT modalities were explored to bound potential biases.All SAT modalities were associated with large and statistically significant reductions in robbery. The average number of self-reported robberies declined from 0.83/client/year pre-entry to 0.12/client/year following SAT (pcosts of these interventions. Conventional wisdom posits the economic benefits of SAT. We find that SAT is even more beneficial than is commonly assumed.

  11. Influence networks among substance abuse treatment clinics: implications for the dissemination of innovations.

    Science.gov (United States)

    Johnson, Kimberly; Quanbeck, Andrew; Maus, Adam; Gustafson, David H; Dearing, James W

    2015-09-01

    Understanding influence networks among substance abuse treatment clinics may speed the diffusion of innovations. The purpose of this study was to describe influence networks in Massachusetts, Michigan, New York, Oregon, and Washington and test two expectations, using social network analysis: (1) Social network measures can identify influential clinics; and (2) Within a network, some weakly connected clinics access out-of-network sources of innovative evidence-based practices and can spread these innovations through the network. A survey of 201 clinics in a parent study on quality improvement provided the data. Network measures and sociograms were obtained from adjacency matrixes created by UCINet. We used regression analysis to determine whether network status relates to clinics' adopting innovations. Findings suggest that influential clinics can be identified and that loosely linked clinics were likely to join the study sooner than more influential clinics but were not more likely to have improved outcomes than other organizations. Findings identify the structure of influence networks for SUD treatment organizations and have mixed results on how those structures impacted diffusion of the intervention under study. Further study is necessary to test whether use of knowledge of the network structure will have an effect on the pace and breadth of dissemination of innovations.

  12. Advances in Substance Abuse Prevention and Treatment Interventions Among Racial, Ethnic, and Sexual Minority Populations.

    Science.gov (United States)

    Bloom, Arthur W

    2016-01-01

    Substance abuse research among racial, ethnic, and sexual minority populations historically has lagged behind that conducted with majority samples. However, interesting and potentially important advances in prevention, brief interventions, and treatment have been made in the last few years, at least among some minority populations, such as American Indian youth. New prevention efforts have focused on point-of-sale interventions for alcohol, as well as on family-unit interventions designed with subpopulation cultural values in mind. In addition, previously established evidence-based and culturally relevant interventions are being combined with computer technology. Empirical data support using brief interventions with patients of color in medical settings, capitalizing on teachable and reachable moments during a physical trauma or other health crisis. Finally, use of empirically supported treatment may be helpful, with a caveat that these interventions must appropriately match cultural traditions and respect the values of the clients. More research clearly is needed, especially among certain minority populations in the United States. A greater emphasis should be placed on developing novel, culturally grounded interventions in partnership with communities, in addition to adapting existing mainstream interventions for use by other cultures.

  13. Stimulating a barefoot completion with multiple sand fracture treatments using an inflatable Packer Straddle system

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, C. [Pinnacle Wellsite Consultants (Canada); Brooks, R. T.; Davis, T. [Society of Petroleum Engineers (Canada)

    2011-07-01

    There is always a need for efficient multi-stage fracture treatments as well as for ways to reduce completion costs. A novel method for producing multiple fractures in a barefoot completion with sand fracture treatment has been successfully implemented in Canada. This paper presents the stimulation of a barefoot completion with multiple sand fracture treatments using an inflatable packer straddle system. This system allows all possible pay intervals to be effectively stimulated. It also stimulates the open hole without the need for permanent packers and frac sleeves, which reduces completion costs and improves production results. A barefoot completion can add incremental production from naturally fractured intervals that otherwise would be sealed with cement. This also provides flexibility. The considerations taken into account during development and operation of the tool are discussed. The study cited shows a 60% reduction in completion and stimulation costs.

  14. An exploration of child sexual abusers' sexual fantasies before and after treatment.

    Science.gov (United States)

    Swaffer, T; Hollin, C; Beech, A; Beckett, R; Fisher, D

    2000-01-01

    Although there is a substantial literature looking at the relationship between deviant sexual fantasies and child sexual abuse, there is scant previous work that focuses upon the actual content of such fantasies. The present study looks at child sexual abusers' deviant fantasies both pre- and postintervention. Using both qualitative and quantitative methodologies, a description of the frequency and content of, and triggers for, child sexual abusers' deviant fantasies is reported both pre- and postintervention. The implications of this information for subsequent intervention programs is explored.

  15. Relationship power and sexual risk among women in community-based substance abuse treatment.

    Science.gov (United States)

    Campbell, Aimee N C; Tross, Susan; Dworkin, Shari L; Hu, Mei-Chen; Manuel, Jennifer; Pavlicova, Martina; Nunes, Edward V

    2009-11-01

    Relationship power has been highlighted as a major factor influencing women's safer sex practices. Little research, however, has specifically examined relationship power in drug-involved women, a population with increased risk for HIV transmission. Using baseline data from a National Institute on Drug Abuse Clinical Trials Network multisite trial of a women's HIV prevention intervention in community-based drug treatment programs, this paper examined the association between sexual relationship power and unprotected vaginal or anal sex. The Sexual Relationship Power Scale, a measure of relationship control and decision-making dominance, was used to assess the association between power and unprotected sex in relationships with primary male partners. It was hypothesized that increased relationship power would be associated with decreased unprotected sexual occasions, after controlling for relevant empirical and theoretical covariates. Findings show a more complex picture of the association between power and sexual risk in this population, with a main effect in the hypothesized direction for decision-making dominance but not for relationship control. Possible explanations for these findings are discussed, and future research directions for examining power constructs and developing interventions targeting relationship power among drug-involved women are suggested.

  16. Methylphenidate and dextroamphetamine abuse in substance-abusing adolescents.

    Science.gov (United States)

    Williams, Robert J; Goodale, Leslie A; Shay-Fiddler, Michele A; Gloster, Susan P; Chang, Samuel Y

    2004-01-01

    The prevalence of methylphenidate and dextroamphetamine misuse and abuse was examined in 450 adolescents referred for substance abuse treatment. Twenty three percent reported nonmedical use of these substances and six percent were diagnosed as methylphenidate or dextroamphetamine abusers. Abuse was more common in individuals who were out of school and had an eating disorder. Methylphenidate and dextroamphetamine abuse appears to be much less common than abuse of most other substances. It does occur, however, and parents and schools need to exert greater control over the dispensing of these medications. Physicians are advised to prescribe non-stimulant medications (eg, bupropion) when treating attention deficit hyperactivity disorder in substance-abusing individuals.

  17. Muscarinic Acetylcholine Receptor Subtypes as Potential Drug Targets for the Treatment of Schizophrenia, Drug Abuse and Parkinson's Disease

    DEFF Research Database (Denmark)

    Dencker, Ditte; Thomsen, Morgane; Wörtwein, Gitta

    2011-01-01

    's disease and drug abuse. Dopaminergic systems are regulated by cholinergic, especially muscarinic, input. Not surprisingly, increasing evidence implicates muscarinic acetylcholine receptor-mediated pathways as potential targets for the treatment of these disorders classically viewed as "dopamine based...... site. Such agents may lead to the development of novel classes of drugs useful for the treatment of psychosis, drug abuse and Parkinson's disease. The present review highlights recent studies carried out using muscarinic receptor knock-out mice and new subtype-selective allosteric ligands to assess...... the roles of M(1), M(4), and M(5) receptors in various central processes that are under strong dopaminergic control. The outcome of these studies opens new perspectives for the use of novel muscarinic drugs for several severe disorders of the CNS....

  18. Substance abusers' personality disorders and staff members' emotional reactions

    DEFF Research Database (Denmark)

    Thylstrup, Birgitte; Hesse, Morten

    2008-01-01

    workshops completed a self-report inventory of emotional reactions to patients, the Feeling Word Checklist-58, and substance abusers completed a self-report of DSM-IV personality disorder, the DSM-IV and ICD-10 Personality Disorder Questionnaire. Correlational analysis and multiple regression analysis...... impact on emotional reactions. Conclusion The findings confirm clinical experiences that personality disorder features in patients with substance abuse have an impact on staff members reactions to them. These reactions should be considered in supervision of staff, and in treatment models for patients...... with co-morbid personality disorders and substance abuse....

  19. Modifications to the Trauma Recovery and Empowerment Model (TREM) for Substance-Abusing Women with Histories of Violence: Outcomes and Lessons Learned at a Colorado Substance Abuse Treatment Center

    Science.gov (United States)

    Toussaint, Danielle W.; VanDeMark, Nancy R.; Bornemann, Angela; Graeber, Carla J.

    2007-01-01

    A growing body of literature demonstrates the co-occurrence of posttraumatic stress disorder and substance use disorder for females seeking substance abuse treatment. Nonetheless, relatively few trauma-specific treatments have been implemented or evaluated with this population. In this quasi-experimental study (N = 170), the Trauma Recovery and…

  20. Treatment and prevention of elder abuse and neglect: where knowledge and practice meet-a model for intervention to prevent and treat elder abuse in Israel.

    Science.gov (United States)

    Alon, Sara; Berg-Warman, Ayelet

    2014-01-01

    Successful handling of elder abuse and neglect requires various interventions. This article presents findings from an evaluation study of a model for intervention implemented in three municipalities in Israel. Data from 558 older adults, exposed to abuse and treated through the program, and interviews with victims, abusers, and professionals revealed that improvement was achieved in 66% of the cases. In 20% of the cases, the abuse was stopped. The most widespread type of intervention consisted of individual counseling. Legal intervention yielded the highest rate of improvement (82%). Provision of supportive services for victims of neglect was found to be most effective (82% of improvement in the situation).

  1. Patterns of drug abuse among drug users with regular and irregular attendance for treatment as detected by comprehensive UHPLC-HR-TOF-MS.

    Science.gov (United States)

    Sundström, Mira; Pelander, Anna; Simojoki, Kaarlo; Ojanperä, Ilkka

    2016-01-01

    The most severe consequences of drug abuse include infectious diseases, overdoses, and drug-related deaths. As the range of toxicologically relevant compounds is continually changing due to the emergence of new psychoactive substances (NPS), laboratories are encountering analytical challenges. Current immunoassays are insufficient for determining the whole range of the drugs abused, and a broad-spectrum screening method is therefore needed. Here, the patterns of drug abuse in two groups of drug users were studied from urine samples using a comprehensive screening method based on high-resolution time-of-flight mass spectrometry. The two groups comprised drug abusers undergoing opioid maintenance treatment (OMT) or drug withdrawal therapy and routinely visiting a rehabilitation clinic, and drug abusers with irregular attendance at a harm reduction unit (HRU) and suspected of potential NPS abuse. Polydrug abuse was observed in both groups, but was more pronounced among the HRU subjects with a mean number of concurrent drugs per sample of 3.9, whereas among the regularly treated subjects the corresponding number was 2.1. NPS and pregabalin were more frequent among HRU subjects, and their abuse was always related to drug co-use. The most common drug combination for an HRU subject included amphetamine, cannabis, buprenorphine, benzodiazepine, and alpha-pyrrolidinovalerophenone. A typical set of drugs for treated subjects was buprenorphine, benzodiazepine, and occasionally amphetamine. Abuse of several concurrent drugs poses a higher risk of drug intoxication and a threat of premature termination of OMT. Since the subjects attending treatment used fewer concurrent drugs, this treatment could be valuable in reducing polydrug abuse.

  2. Substance Abuse, Relapse, and Treatment Program Evaluation in Malaysia: Perspective of Rehab Patients and Staff Using the Mixed Method Approach

    Science.gov (United States)

    Chie, Qiu Ting; Tam, Cai Lian; Bonn, Gregory; Dang, Hoang Minh; Khairuddin, Rozainee

    2016-01-01

    This study examined reasons for substance abuse and evaluated the effectiveness of substance treatment programs in Malaysia through interviews with rehab patients and staff. Substance rehab patients (aged 18–69 years; n = 30) and staff (ages 30–72 years; n = 10) participated in semi-structured interviews covering a range of topics, including family and peer relationships, substance use and treatment history, factors for substance use and relapse, motivation for entering treatment, work experience, job satisfaction, treatment evaluation, and patient satisfaction. Most patients did not demonstrate the substance progression trend and had normal family relationships. Most patients reported having peers from normal family backgrounds as well. Various environmental and personal factors was cited as contributing to substance abuse and relapse. There was no significant difference between patient and staff program evaluation scores although the mean score for patients was lower. A holistic treatment approach with a combination of cognitive–behavioral, medical, social, and spiritual components was favored by patients. Suggestions for improving existing programs include better tailoring treatment to individual needs, and providing more post-treatment group support. PMID:27303313

  3. Substance Abuse, Relapse, and Treatment Program Evaluation in Malaysia: Perspective of Rehab Patients and Staff Using the Mixed Method Approach.

    Science.gov (United States)

    Chie, Qiu Ting; Tam, Cai Lian; Bonn, Gregory; Dang, Hoang Minh; Khairuddin, Rozainee

    2016-01-01

    This study examined reasons for substance abuse and evaluated the effectiveness of substance treatment programs in Malaysia through interviews with rehab patients and staff. Substance rehab patients (aged 18-69 years; n = 30) and staff (ages 30-72 years; n = 10) participated in semi-structured interviews covering a range of topics, including family and peer relationships, substance use and treatment history, factors for substance use and relapse, motivation for entering treatment, work experience, job satisfaction, treatment evaluation, and patient satisfaction. Most patients did not demonstrate the substance progression trend and had normal family relationships. Most patients reported having peers from normal family backgrounds as well. Various environmental and personal factors was cited as contributing to substance abuse and relapse. There was no significant difference between patient and staff program evaluation scores although the mean score for patients was lower. A holistic treatment approach with a combination of cognitive-behavioral, medical, social, and spiritual components was favored by patients. Suggestions for improving existing programs include better tailoring treatment to individual needs, and providing more post-treatment group support.

  4. Self-Esteem and Attitudes toward Love in Abused and Non-Abused Women.

    Science.gov (United States)

    Chambliss, Catherine; And Others

    This study sought to identify personality differences in abused versus non-abused women. Abused women (N=25) were from several centers for abused women and non-abused women (N=39) were students in evening psychology classes. All subjects completed Rubin's Love Scale, the abbreviated Dominance and Romanticism Scale, Rosenberg's Self-Esteem Scale,…

  5. An overview of child physical abuse: developing an integrated parent-child cognitive-behavioral treatment approach.

    Science.gov (United States)

    Runyon, Melissa K; Deblinger, Esther; Ryan, Erika E; Thakkar-Kolar, Reena

    2004-01-01

    This article reviews and summarizes the extant literature regarding child physical abuse (CPA). Literature is summarized that describes the wide range of short- and long-term effects of CPA on children as well as the documented characteristics of parents/caregivers who engage in physically abusive parenting practices. Although the reviewed research documents that interventions geared only toward the parent have been found to produce significant improvements with respect to parenting abilities, parent-child interactions, and children's behavior problems, there is a paucity of research examining the efficacy of interventions developed specifically to target the child's emotional and behavioral difficulties. Based on the few studies that have shown emotional and behavioral gains for children who have participated in treatment, an integrated parent-child cognitive-behavioral therapy (CBT) approach is proposed here to address the complex issues presented by both parent and child in CPA cases. The direct participation of the child in treatment also may improve our ability to target posttraumatic stress disorder (PTSD), depressive symptoms as well as anger control and dysfunctional abuse attributions in the children themselves. Implications for practice, public policy, and research are also addressed.

  6. Prevalence and predictors of Axis I disorders in a large sample of treatment-seeking victims of sexual abuse and incest

    Directory of Open Access Journals (Sweden)

    Eoin McElroy

    2016-04-01

    Full Text Available Background: Childhood sexual abuse (CSA is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. Objective: This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. Method: The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434. Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III. Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts and 10 adult clinical syndromes. Results: There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. Conclusions: The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses.

  7. Referrals and Treatment Completion for Prescription Opioid Admissions: Five Years of National Data

    Science.gov (United States)

    St Marie, Barbara; Sahker, Ethan; Arndt, Stephan

    2016-01-01

    This study examines sources of referral for prescription opioid admission to substance use disorder treatment facilities and their relative completion success rates using secondary analysis of an existing data set (Treatment Episode Datasets – Discharge). Five years of data from public and private treatment facilities were extracted for client discharges with no prior treatment (N = 2,909,884). Healthcare professionals account for very few referrals to treatment (<10%). Prescription opioid clients referred into treatment had lower treatment success compared to other substance clients and when referred by healthcare providers had lower success rates (OR = 0.72, 95% CI 0.70 – 0.75) than clients from other referral sources. Fewer treatment referrals for prescription opioid misuse by healthcare providers and lower success rates are significant and timely findings due to the prevalence of prescription opioid misuse. Healthcare providers are well positioned to refer early for prescription opioid misuse and continue support of their patients during treatment. PMID:26362002

  8. Drug Abuse in Southeast Asia.

    Science.gov (United States)

    Scorzelli, James F.

    This report examines the incidence of drug abuse and the methods of treatment and prevention of drug abuse used in Southeast Asia. Countries studied include Malaysia, Singapore, Thailand, Indonesia, and the Philippines. Because of Malaysia's intensive effort to eliminate its drug abuse problem, emphasis is placed on this country's treatment and…

  9. The Effect of Matrix Method on Anxiety and Attitude Toward Methamphetamine and Crack Abuse in Males Referring to Addiction Treatment Centers in Tonkabon, Iran

    Directory of Open Access Journals (Sweden)

    Hemmati Sabet

    2015-11-01

    Full Text Available Background Drug abuse is a major problem in the communities and has many harmful effects on human body. Objectives The current study aimed to compare the efficacy of matrix method on anxiety and attitude of male crack abusers referred to addiction treatment centers in Tonkabon, Iran, in 2014. Patients and Methods The current semi -experimental study included 1,000 males referred to addiction treatment centers in Tonkabon with crack abuse history in 2014. Based on Morgan sample volume formula, 278 males with anxiety and higher attitude to drug abuse were randomly selected from 1,000 males referred to addiction treatment centers in Tonkabon. Then, 30 subjects were reselected out of them and equally assigned into two groups of experimental and control, 15 subjects in each group. The experimental group received 24 sessions of 30 - 60 minutes matrix treatment method in group, but the control group received no training. At the end of training period the post-test was carried out. The research findings confirmed the efficacy of matrix method on anxiety and attitude to crack abuse among those referring to the addition treatment center. Results The single covariance analysis of ANCOVA indicated that the value of Eta about 72% of variance of anxiety variable and about 76% of variance of drug abuse variable are taken in to account for variable of group. The intervention was effective in reducing anxiety and attitude to crack in males. Evaluating the adjusted mean showed the effectiveness of matrix method on anxiety and attitude to crack abuse in males. Conclusions The research result showed that matrix method affected the reduction of methamphetamine and attitude to crack abuse in males referred to the addition treatment center.

  10. The Drug-Abuse Questionnaire.

    Science.gov (United States)

    Ferneau, E.; Mueller, S.

    The drug-abuse questionnaire used to survey college student attitudes on the subject is provided. It is identical to the alcoholism questionnaire except for word changes appropriate to the subject matter. The questionnaire consists of 40 statements about drug abuse and drug abusers, with 7 possible responses: (1) completely disagree; (2) mostly…

  11. Male perpetrators, the gender symmetry debate, and the rejection-abuse cycle: implications for treatment.

    Science.gov (United States)

    Brown, Jac

    2012-07-01

    This review article examined the gender symmetry debate in light of recent research relating to the feminist and family research perspectives on intimate partner violence, providing a context for rethinking perpetrator programs. The concept of coercive control is considered as an explanatory factor in an attempt to integrate the feminist and family research perspectives. The limited effectiveness of perpetrator programs is examined. Research highlighting potential factors that could improve the effectiveness of perpetrator programs is introduced, followed by a discussion of the rejection-abuse cycle, one attempt to incorporate current research into a more inclusive program. The rejection-abuse cycle identifies a pattern of perpetrator behavior, which links rejection, threat to self, defense against threat, and abuse. Finally, suggestions for changing perpetrator programs are elaborated, incorporating past research, which would make them appropriate for both male and female perpetrators. These implications are contextualized within a meta-theory to provide greater clarity for the development of future perpetrator programs.

  12. On the Comparison of Cognitive Function in Substance Abusers and Addicts under Methadone Treatment with Normal Individuals

    Directory of Open Access Journals (Sweden)

    reza mohammadzadeghan

    2015-09-01

    Full Text Available Objective: This study was an attempt to compare cognitive functioning in substance abusers and addicts under methadone treatment with normal individuals. Method: The current study was a causal-comparative one. The statistical population of this research consisted of all male substance abusers who had referred to addiction treatment centers of Khoy city in 2013. The total of 40 addicts under methadone treatment, 40 active drug users, and 40 non-addicts were selected as the participants of this study via convenience sampling method. Wisconsin Card Sorting Test and Wechsler Memory Scale were administered to the three groups for data collection purposes. Results: The results showed that the substance abusers’ scores in Wisconsin card sorting test and Wechsler memory scale were significantly different from those of addicts under methadone treatment and normal individuals. In the same way, there was a significant difference between addicts under methadone treatment and normal individuals in terms of cognitive function however, there was no significant difference between these two groups in terms of perseveration error. Conclusion: It can be concluded that chronic use of psychoactive substances causes damage to multiple brain regions such as prefrontal cortex and hippocampus and, thereby, it leads to cognitive malfunctioning in these areas.

  13. Endoscopic treatment of complete bladder neck obstruction by transurethral Seldinger technique.

    Science.gov (United States)

    Aygün, C; Peskircioglu, L; Tekin, M I; Dirim, A; Ozkardes, H

    2001-08-01

    Bladder neck contracture is usually a complication of prostatectomy and the treatment of choice in such a condition should be endoscopic surgery. However, in a few patients the bladder neck may be completely obstructed preventing retrograde access into the bladder. A case is presented of complete bladder neck obstruction occurring after transurethral resection of prostate, which was treated after an access was provided by using transurethral Seldinger technique.

  14. Psychiatric comorbidity and additional abuse of drugs in maintenance treatment with L- and D,L-methadone.

    Science.gov (United States)

    Wedekind, Dirk; Jacobs, Stefan; Karg, Iris; Luedecke, Christel; Schneider, Udo; Cimander, Konrad; Baumann, Pierre; Ruether, Eckart; Poser, Wolfgang; Havemann-Reinecke, Ursula

    2010-03-01

    Sixty D,L- or L-methadone treated patients in maintenance therapy were interviewed for additional drug abuse and psychiatric comorbidity; 51.7% of the entire population had a comorbid Axis-I disorder, with a higher prevalence in females (P=0.05). Comorbid patients tended to have higher abuse of benzodiazepines, alcohol, cannabis, and cocaine, but not of heroin. They had received a significantly lower D,L- (P<0.05) and L-methadone dose than non-comorbid subjects. The duration of maintenance treatment showed an inverse relationship to frequency of additional heroin intake (P<0.01). Patients with additional heroin intake over the past 30 days had been treated with a significantly lower L-methadone dosage (P<0.05) than patients without. Axis-I comorbidity appears to be decreased when relatively higher dosages of D,L- (and L-methadone) are administered; comorbid individuals, however, were on significantly lower dosages. Finally, L-, but not D,L-methadone seems to be more effective in reducing additional heroin abuse.

  15. Client Preferences Affect Treatment Satisfaction, Completion, and Clinical Outcome: A Meta-Analysis

    Science.gov (United States)

    Lindhiem, Oliver; Bennett, Charles B.; Trentacosta, Christopher J.; McLear, Caitlin

    2014-01-01

    We conducted a meta-analysis on the effects of client preferences on treatment satisfaction, completion, and clinical outcome. Our search of the literature resulted in 34 empirical articles describing 32 unique clinical trials that either randomized some clients to an active choice condition (shared decision making condition or choice of treatment) or assessed client preferences. Clients who were involved in shared decision making, chose a treatment condition, or otherwise received their preferred treatment evidenced higher treatment satisfaction (ESd = .34; p < .001), increased completion rates (ESOR = 1.37; ESd = .17; p < .001), and superior clinical outcome (ESd = .15; p < .0001), compared to clients who were not involved in shared decision making, did not choose a treatment condition, or otherwise did not receive their preferred treatment. Although the effect sizes are modest in magnitude, they were generally consistent across several potential moderating variables including study design (preference versus active choice), psychoeducation (informed versus uninformed), setting (inpatient versus outpatient), client diagnosis (mental health versus other), and unit of randomization (client versus provider). Our findings highlight the clinical benefit of assessing client preferences, providing treatment choices when two or more efficacious options are available, and involving clients in treatment-related decisions when treatment options are not available. PMID:25189522

  16. MMPI Patterns in Drug Abusers Before and After Treatment in Therapeutic Communities

    Science.gov (United States)

    Zuckerman, Marvin; And Others

    1975-01-01

    MMPI was given to 145 male and female drug abusers on admission to three therapeutic communities, and retests were done at the finish of the first phase of the program. Comparisons of stayers and quitters showed quitters higher on the F and psychotic scales. (Author)

  17. Pediatrician-Therapist Cooperation in the Treatment of Sexually Abused Children.

    Science.gov (United States)

    Madansky, Deborah; Santora, Donna

    1990-01-01

    An expressive arts therapist and a pediatrician in an inpatient child psychiatric unit collaborated on the design of psychotherapeutic visits for sexually abused children. Three cases illustrate the potential therapeutic role of the pediatrician in resolving traumatic events, by decreasing the child's anxiety about physical concerns. (JDD)

  18. Disparities in Access to Substance Abuse Treatment among People with Intellectual Disabilities and Serious Mental Illness

    Science.gov (United States)

    Slayter, Elspeth M.

    2010-01-01

    People with intellectual disabilities (ID) have experienced increasing levels of community participation since deinstitutionalization. This freedom has facilitated community inclusion, access to alcohol and drugs, and the potential for developing substance abuse (SA) disorders. People with ID, who are known to have high rates of co-occurring…

  19. Nearly Half of College Student Treatment Admissions Were for Primary Alcohol Abuse. Data Spotlight

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration, 2012

    2012-01-01

    Many students, and the public in general, believe that drinking alcohol is a normal part of the college experience. Unfortunately, students' efforts to "be sociable" or "fit in" can escalate into substance use behavior that puts their health and well-being at risk: One in four full-time college students have experienced past year alcohol abuse or…

  20. Progress Report on the Development of Child Abuse Prevention, Identification, and Treatment Systems in Eastern Europe

    Science.gov (United States)

    Lewis, Owen; Sargent, John; Chaffin, Mark; Friedrich, William N.; Cunningham, Nicholas; Cantor, Pamela; Coffey, Pamela Sumner; Villani, Susan; Beard, Philip R.; Clifft, Mary Ann; Greenspun, David

    2004-01-01

    Problem: After the Soviet Union dissolved in 1989, it became apparent that there was little recognition of the problems of child abuse and neglect, professionally, legally, or societally. There were no effective systems or laws in place to deal with these problems. Method: Beginning in 1995 the Children's Mental Health Alliance, in conjunction…

  1. Clinical Assessment Instruments in the Treatment of Child Abuse and Neglect.

    Science.gov (United States)

    Rittner, Barbara; Wodarski, John S.

    1995-01-01

    A variety of objective measures have been developed to assess child abuse and neglect and that can be used by practitioners with minimal disruption in terms of time, energy, cost, and ease of use. Reviews instruments that child welfare workers, specifically, and practitioners involved in children's services, in general, can use in the assessment…

  2. Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Childhood Abuse Based on Psycho-Education and Cognitive Behavioral Therapy: A Pilot Study

    Science.gov (United States)

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; van Balkom, Anton J. L. M.; van Dyck, Richard; Veltman, Dick J.; Draijer, Nel

    2010-01-01

    Objective: This study tests a Stabilizing Group Treatment protocol, designed for the management of the long-term sequelae of child abuse, that is, Complex Posttraumatic Stress Disorder (Complex PTSD). Evidence-based treatment for this subgroup of PTSD patients is largely lacking. This stabilizing treatment aims at improving Complex PTSD using…

  3. The practice and process of healthy exercise: an investigation of the treatment of exercise abuse in women with eating disorders.

    Science.gov (United States)

    Calogero, Rachel M; Pedrotty, Kelly N

    2004-01-01

    This study investigates the effectiveness of an exercise program designed to reduce exercise abuse in women who are in residential treatment for eating disorders. One hundred and twenty-seven women who participated in the exercise program were compared to 127 non-participants on weight gain and self-reported obligatory attitudes and beliefs about exercise. The exercise participants were women who were medically cleared and attended at least two exercise groups during treatment. The control group were women who were medically cleared, but did not attend any exercise groups during treatment. Significant group x diagnosis interactions revealed that women in the exercise group who were diagnosed with anorexia nervosa gained more than one-third as much weight as those in the control group. Also, women in the exercise group demonstrated significantly reduced obligatory attitudes toward exercise compared to the control group. These findings suggest that the use of an exercise program that targets exercise abuse in women with eating disorders is feasible during residential treatment and results in positive change without interfering with weight gain. Limitations that result from the lack of random assignment to the exercise and control group are discussed.

  4. The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment

    Science.gov (United States)

    Hong, Mihee; Kook, Yoon-Ah; Kim, Myeng-Ki; Lee, Jae-Il; Kim, Hong-Gee

    2016-01-01

    Objective Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system―the Improvement and Completion of Outcome (ICO) index―to evaluate the outcome of orthodontic treatment. Methods Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or −1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process. PMID:27478797

  5. Parents with co-occurring mental health and substance abuse conditions involved in Child Protection Services: clinical profile and treatment needs.

    Science.gov (United States)

    Stromwall, Layne K; Larson, Nancy C; Nieri, Tanya; Holley, Lynn C; Topping, Diane; Castillo, Jason; Ashford, José B

    2008-01-01

    This article reports findings of an exploratory study of 71 parents with substance abuse conditions involved in a child dependency court. Over half (59%) of the parents had a co-occurring mental health condition. Parents with co-occurring conditions (PWCC) differed in several important ways from those with only substance abuse conditions. PWCC were also more likely than their case managers were to report a need for mental health treatment. Implications for child welfare practice and research are offered.

  6. 28 CFR 550.51 - Drug abuse education course.

    Science.gov (United States)

    2010-07-01

    ... DRUG PROGRAMS Drug Abuse Treatment Program § 550.51 Drug abuse education course. (a) Purpose of the... inmates of the consequences of drug/alcohol abuse and addiction; and (2) Motivate inmates needing drug abuse treatment to apply for further drug abuse treatment, both while incarcerated and after release....

  7. Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik;

    2012-01-01

    To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

  8. Health-related quality of life after completion of successful treatment for childhood cancer

    NARCIS (Netherlands)

    Engelen, V.; Koopman, H.M.; Detmar, S.B.; Raat, H.; Wetering, M.D. van de; Brons, P.; Anninga, J.K.; Abbink, F.; Grootenhuis, M.A.

    2011-01-01

    Background: Previous studies have assessed health-related quality of life (HRQOL) during several treatment stages in children with cancer, but there is limited knowledge about HRQOL shortly after completing therapy. This study determined HRQOL of children with cancer shortly after the end of success

  9. Demographic characteristics and rates of progress of deaf and hard of hearing persons receiving substance abuse treatment.

    Science.gov (United States)

    Moore, Dennis; McAweeney, Mary

    A lack of demographic information and data related to the achievement of short-term goals during substance abuse treatment among persons who are deaf or hard of hearing dictated the need for the study. New York State maintains a database on all individuals who participate in treatment. Within this database, 1.8% of persons in treatment for substance use disorder (SUD) were also deaf or hard of hearing. As hypothesized, members of the deaf and hard of hearing sample were older, likelier to be white, and likelier to be female, relative to the SUD-only group. For both groups, alcohol, heroin, and cocaine had the highest rates of reported use. Achievement of short-term goals in the areas of alcohol use, drug use, vocational/educational goals, and overall goals indicated no differences between the deaf and hard of hearing group and the SUD-only group. Implications of these findings are discussed.

  10. Psychometric properties of the Chinese craving beliefs questionnaire for heroin abusers in methadone treatment

    Directory of Open Access Journals (Sweden)

    Liu Yi-Lien

    2011-03-01

    Full Text Available Abstract Background This paper reports the psychometric properties of the Chinese version of Craving Beliefs Questionnaire (CCBQ, an easy-to-administer assessment instrument of measurement of craving beliefs for heroin abusers. Methods Participants were 445 heroin abusers from four methadone clinics in Northern Taiwan. Fifty-one of the participants were tested twice within a two-week period at a different hospital to examine test-retest reliability. Results Three-factor solution using principal component analysis was identified in the CCBQ: will power, compulsive behavior, and negative coping, accounting for 54.6% of the variance. Internal consistency analysis indicated that the three factors have strong reliability, with Cronbach alphas ranging from .81 to .92. The test-retest ICC coefficient is .80. The test-retest coefficients for the subscales will power, compulsive behavior, and negative coping are .76, .51, and .64, respectively. Overall, the data show that the CCBQ has acceptable reliability and validity, demonstrating that it can be a research instrument for assessing heroin craving beliefs. Conclusions The psychometric properties of the CCBQ seem promising for both research and clinical purposes, and the scale thus deserves further refinement and validation with heroin abusers.

  11. MASTICATION, PHONETICS AND ESTHETICS AS A FINAL RESULT OF PARTIAL OR COMPLETE DENTURE TREATMENT.

    Directory of Open Access Journals (Sweden)

    Kalina Georgieva

    2015-08-01

    Full Text Available Three target groups- dentists/ dental students, dental technicians and patients were asked to fill in an anonymous questionnaire about their satisfaction of the final results after prosthetic treatment with removable dentures using a scale from 1 to 5 (1- completely dissatisfied, 2-dissatisfied, 3-indifferent, 4-satisfied, 5-completely satisfied. The mean results (including colour, shape and size of artificial teeth, arrangement of front teeth, colour of artificial gums, phonetics, mastication, natural smile, enough space for tongue for all three groups of respondents were compared. Dental technicians (4,34 are more satisfied than dentists/dental students (3,62 and patients (3,53. A successful outcome of prosthetic treatment depends on one hand on the professional approach of the dental team and on the other hand on the patient’s motivation and cooperation. The predictive final results and realistic expectations lead to satisfaction of all participants in the treatment process.

  12. Novel approaches for the treatment of psychostimulant and opioid abuse – focus on opioid receptor-based therapies

    Science.gov (United States)

    Bailey, Chris P.; Husbands, Steve M.

    2015-01-01

    Introduction Psychostimulant and opioid addiction are poorly treated. The majority of abstinent users relapse back to drug-taking within a year of abstinence, making ‘anti-relapse’ therapies the focus of much current research. There are two fundamental challenges to developing novel treatments for drug addiction. Firstly, there are 3 key stimuli that precipitate relapse back to drug-taking: stress, presentation of drug-conditioned cue, taking a small dose of drug. The most successful novel treatment would be effective against all 3 stimuli. Secondly, a large number of drug users are poly-drug users: taking more than one drug of abuse at a time. The ideal anti-addiction treatment would therefore be effective against all classes of drugs of abuse. Areas Covered In this review, the authors discuss the clinical need and animal models used to uncover potential novel treatments. There is a very broad range of potential treatment approaches and targets currently being examined as potential anti-relapse therapies. These broadly fit into 2 categories: ‘memory-based’ and ‘receptor-based’ and the authors discuss the key targets here within. Expert opinion Opioid receptors and ligands have been widely studied, and research into how different opioid subtypes affect behaviours related to addiction (reward, dysphoria, motivation) suggests that they are tractable targets as anti-relapse treatments. Regarding opioid ligands as novel ‘anti-relapse’ medications targets - research suggests that a ‘non-selective’ approach to targeting opioid receptors will be the most effective. PMID:25253272

  13. Client perceptions of incest and substance abuse.

    Science.gov (United States)

    Janikowski, T P; Bordieri, J E; Glover, N M

    1997-01-01

    Clients receiving substance abuse treatment from 35 treatment facilities throughout the United States were surveyed using the Substance Abuse and Incest Survey-Revised (SAIS-R). A total of 732 participants responded to the survey; 518 (71%) were males, 204 (28%) were females, and 10 (1%) did not indicate gender. Participants had a mean age of 33.8 years, were predominately Caucasian (61.6%), never married (45.2%), were currently unemployed (69.4%), and had completed an average of 11.7 years of education. Of the entire sample, 266 (36.3%) reported having been victims of incest; 151 were males and 113 were females (2 did not indicate gender). The group reporting incest histories had a significantly greater percentage of females that did the group not reporting incest histories (chi 2 = 48.1, p incest histories were asked about their perceptions regarding incest, substance abuse, and counseling. Item responses were examined using descriptive statistics and factor analysis. The factor analysis on SAIS-R perception items identified five factors that accounted for 68.9% of the variance; these factors were Stigma and Resistance to Counseling; Substance Abuse and Incest; Ambivalence; Fear and Anticipation; and Receptivity to Counseling. Results are presented and the implications for substance abuse treatment and counseling are discussed.

  14. Hitting rock bottom? Resource loss as a predictor of alcoholism treatment completion.

    Science.gov (United States)

    Gruszczyńska, Ewa; Kaczmarek, Małgorzata; Chodkiewicz, Jan

    2016-07-01

    Background Efforts to better understand the phenomenon of the 'bottom', the beginning of the process of turning away from alcohol, are important for both theoretical and practical goals. The conservation of resources theory by Hobfoll may represent a suitable framework to base these attempts around. Aim The aim of the study was to examine the role of resource loss in completing alcoholism treatment on the basis of Hobfoll's conservation of resources theory. Methods The study included 86 patients undergoing inpatient alcoholism treatment. An assessment of resource loss and gain during the previous year, as well as of the decisional balance regarding the pros and cons of drinking alcohol, took place at the beginning of therapy. Results The results of hierarchical binary logistic regression confirmed that resource loss was the only significant predictor of therapy completion, after adjustment for decisional balance, demographics and basic clinical data. Additionally, gender moderated the relationship between resource gain and therapy completion: while an increase in gain was related to a decreased chance of completing therapy in men, the opposite effect was noted in women. Conclusions Resource loss has more influence than decisional balance in predicting therapy completion, which can be translated into clinically valid recommendations based on gender differences.

  15. ASAM Patient Placement Criteria treatment levels: do they correspond to care actually received by homeless substance abusing adults?

    Science.gov (United States)

    O'Toole, Thomas P; Freyder, Paul J; Gibbon, Jeanette L; Hanusa, Barbara J; Seltzer, Debora; Fine, Michael J

    2004-01-01

    We report findings from a community-based two-city survey of homeless adults comparing the level of substance abuse treatment assigned to them using the ASAM Patient Placement Criteria with care actually received during the previous 12 months. Overall 531 adults were surveyed with 382 meeting DSM-IIIR criteria of being in need of treatment or having a demand for treatment. Of those with a treatment need, 1.5% met criteria for outpatient care, 40.3% intensive outpatient/partial hospitalization care, 29.8% medically monitored care and 28.8% managed care levels. In contrast, of those receiving treatment (50.5%, 162 persons), almost all care received by this cohort was either inpatient or residential based (83.6%). Unsheltered homeless persons and those without insurance were significantly more likely to report not receiving needed treatment. Lack of treatment availability or capacity, expense, and changing one's mind while on a wait list were the most commonly cited reasons for no treatment.

  16. Expanding the National Drug Abuse Treatment Clinical Trials Network to address the management of substance use disorders in general medical settings

    Directory of Open Access Journals (Sweden)

    Tai B

    2014-07-01

    Full Text Available Betty Tai, Steven Sparenborg, Udi E Ghitza, David Liu Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA Abstract: The Patient Protection and Affordable Care Act (2010 and the Mental Health Parity and Addiction Equity Act (2008 expand substance use disorder (SUD care services in the USA into general medical settings. Care offered in these settings will engage substance-using patients in an integrated and patient-centered environment that addresses physical and mental health comorbidities and follows a chronic care model. This expansion of SUD services presents a great need for evidence-based practices useful in general medical settings, and reveals several research gaps to be addressed. The National Drug Abuse Treatment Clinical Trials Network of the National Institute on Drug Abuse can serve an important role in this endeavor. High-priority research gaps are highlighted in this commentary. A discussion follows on how the National Drug Abuse Treatment Clinical Trials Network can transform to address changing patterns in SUD care to efficiently generate evidence to guide SUD treatment practice within the context of recent US health care legislation. Keywords: Patient Protection and Affordable Care Act, National Drug Abuse Treatment Clinical Trials Network, substance use disorders, practice-based research network, electronic health records

  17. Aesthetic treatment option for completely edentulous patients using CAD/CAM technology.

    Science.gov (United States)

    Kleinman, Alejandro; Avendano, Sergio; Leyva, Francisco

    2008-04-01

    In recent years, advancements have been made in CAD/CAM technology that have allowed for the development of different treatments regarding the rehabilitation of patients with natural dentition, as well as patients with dental implants. Contemporary systems can also allow prosthetic rehabilitation for partially and completely edentulous patients. This article describes a restorative alternative to fixed implant-supported reconstruction of completely edentulous patients, utilizing a CAD/CAM-generated framework and CAD/CAM-generated all-ceramic cement-retained crowns. In addition to delivering an optimally aesthetic restoration, this design permits a precise and passive prosthetic fit.

  18. Researching Development of Treatment of Drug Abuse%治疗毒品成瘾的研究进展

    Institute of Scientific and Technical Information of China (English)

    乐凯; 陈琳; 马宝苗; 李超英

    2012-01-01

    自20世纪80年代起我国重新面对毒品的威胁,至2011年我国政府对外正式公布登记在册的吸毒人数为154.5万。海洛因滥用造成了严重的社会和卫生问题,尤其是造成了51.2%的艾滋病传播。目前,在中国针对海洛因依赖的治疗主要有以下几种方法:美沙酮维持疗法、传统中医药疗法、心理干预疗法以及免疫戒毒法,针对以上几种方法,阐述海洛因成瘾治疗方法的研究进展和展望。%The drug abuse problem in China reappeared in the late 1980s. The number of registered addicts in 2011 was 1.54 million. Heroin abuse leads to serious social and health prob- lems, especially to the spread of 51.2% of HIV/AIDS in China. Currently, the main treatments for heroin dependence in China include methadone maintenance treatment (MMT), treatment of tra- ditional Chinese herbal medicine, psychological intervention treatment, and immunotherapy. The paper demonstrates researching development and future of treating heroin addiction concerning the above-mentioned treatments.

  19. Readiness to adopt a performance measurement system for substance abuse treatment: Findings from the Service Quality Measures initiative

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    B Myers

    2017-02-01

    Full Text Available Background. A performance measurement system – the Service Quality Measures (SQM initiative – has been developed to monitor the quality of South Africa (SA’s substance abuse treatment services. Identifying factors associated with readiness to adopt this system may inform strategies to facilitate its robust implementation. Objective. To examine factors associated with readiness to adopt a performance measurement system among SA substance abuse treatment providers. Methods. We surveyed 81 treatment providers from 13 treatment sites in the Western Cape, SA. The survey examined awareness, resources, organisational climate, leadership support and readiness to adopt the SQM system. Regression analysis was used to identify factors associated with readiness to adopt this system. Results. Readiness to adopt the SQM initiative was high (M=5.64, standard deviation 1.63. In bivariate analyses, caseload size (F=3.73 (degrees of freedom (df=3.70, p=0.015, awareness (r=0.78, p<0.0001, leadership support (r=0.70, p<0.0001, resources (r=0.65, p<0.0001, openness to change (r=0.372, p=0.001, and external pressure to change were associated with readiness to adopt the SQM. In multivariate analyses, only awareness of the SQM initiative (B=0.34, standard error (SE 0.08, t=4.4, p<0.0001 and leadership support (B=0.45, SE 0.11, t=4.0, p<0.0001 were significantly associated with readiness to adopt this system. Conclusion. While treatment providers report high levels of readiness to adopt the SQM system, findings show that the likelihood of adoption can be further increased through improved provider awareness and enhanced leadership support for this health innovation.

  20. The Effect of Using Assessment Instruments on Substance-abuse Outpatients' Adherence to Treatment: a Multi-centre Randomised Controlled Trial

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    Broekaert Eric

    2011-05-01

    Full Text Available Abstract Background Drop-out is an important problem in the treatment of substance use disorder. The focus of this study was to investigate the effectiveness of within treatment assessment with feedback directly to patients with multiple substance use disorder on outpatient individual treatment adherence. Feedback consisted of personal resources' and readiness to change status and progress that facilitate or hinder change, thereby using graphical representation. Methods Informed consent was obtained from both the control and experimental groups to be involved in research and follow-up. Following Zelen's single consent design, baseline participants (n = 280 were randomised (sample-size-estimation: 80%power, p=.05, 2-sided and treatment consent was obtained from those allocated to the experiment (n = 142. In both groups, equal numbers of patients did not attend sessions after allocation. So, 227 persons were analyzed according to intention-to-treat analysis (ITT: experiment n = 116;control n = 111. Excluding refusals 211 participants remained for per-protocol analysis (PP: experiment n = 100; control n = 111, The study was conducted in five outpatient treatment-centres of a large network (De Sleutel in Belgium. Participants were people with multiple substance use disorder -abuse and dependence- who had asked for treatment and who had been advised to start individual treatment after a standardised admission assessment with the European Addiction Severity Index. The experimental condition consisted of informing the patient about the intervention and of subsequent assessments plus feedback following a protocol within the first seven sessions. Assessments were made with the Readiness to Change Questionnaire and the Personal Resources Diagnostic System. The control group received the usual treatment without within treatment assessment with feedback. The most important outcome measure in this analysis of the study was the level of adherence to treatment

  1. Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following childhood sexual abuse

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    Antje Krüger

    2014-09-01

    Full Text Available Background: Exposure-based treatment approaches are first-line interventions for patients suffering from posttraumatic stress disorder (PTSD. However, the dissemination of exposure-based treatments for PTSD is challenging, as a large proportion of clinicians report being concerned about symptoms worsening as a result of this type of intervention and are therefore reluctant to offer it to patients with PTSD. However, there is only little empirical evidence to date on the pattern of symptom worsening during exposure-based treatment for PTSD. Objective: The goal of the present study was to explore the frequency of sudden losses and sudden gains in the course of an exposure-based treatment programme for female patients suffering from PTSD related to childhood sexual abuse who also show severe comorbidity. In addition, the relationship between sudden changes and treatment outcome was examined. Methods: Female participants (N=74 were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. The pattern of symptom change was assessed via weekly assessments using the Posttraumatic Diagnostic Scale (PDS. Sudden changes were computed as suggested by the literature on sudden gains. Results: During treatment, only one participant (3% experienced a sudden loss, whereas 25% of participants experienced sudden gains. In the waiting condition, 8% of the participants experienced sudden losses and 5% experienced sudden gains during the same time period. No symptom worsening was observed in response to exposure sessions. However, sudden gains occurred during exposure and non-exposure treatment weeks. Patients with sudden gains showed better treatment outcome in the post-treatment and follow-up assessments. Conclusions: Exposure-based treatment did not lead to PTSD symptom worsening in the study sample. Results show that sudden gains occur frequently during PTSD treatment and have a prognostic value for treatment outcome.

  2. Helping Yourself Heal: A Recovering Woman's Guide to Coping with Childhood Abuse Issues

    Science.gov (United States)

    ... the publication Substance Abuse Treatment for Persons With Child Abuse and Neglect Issues , #36 in the Treatment Improvement ... people who have been abused as children. Addressing child abuse issues takes time; you’ll need to develop ...

  3. Engaging stakeholders in review and recommendations for models of outcome monitoring for substance abuse treatment.

    Science.gov (United States)

    Rush, Brian; Martin, Garth; Corea, Larry; Rotondi, Nooshin Khobzi

    2012-10-01

    We present an example of a collaborative process designed to review models of outcome monitoring for substance abuse services, with a view to assessing the feasibility of different approaches in Ontario, Canada. A conceptual framework that describes the parameters of an outcome monitoring system and four models of outcome monitoring were identified. Consultations were held with stakeholders (managers, directors, researchers, clinicians, and governmental representatives) about the types of information they would like to obtain from an outcome monitoring system. Our process is useful as a model for collaborative research with respect to performance measurement. The study's implications and limitations are noted.

  4. Child Sexual Abuse

    Science.gov (United States)

    ... sense of self-esteem, cope with feelings of guilt about the abuse, and begin the process of overcoming the trauma. Such treatment can help reduce the ... Child and Adolescent Psychiatrists Teen Suicide ...

  5. Who seeks public treatment for substance abuse in Brazil? Results of a multicenter study involving four Brazilian state capitals

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    Sibele Faller

    2014-12-01

    Full Text Available OBJECTIVE: To assess the characteristics of alcohol and drug users who seek treatment at the Brazilian Unified Health System in Brazil.METHOD:A multicenter cross-sectional study involving five clinical and research centers located in four Brazilian state capitals was conducted with 740 in- and outpatients. The only exclusion criterion was the presence of neurological or severe psychiatric symptoms at the moment of the interview. The Addiction Severity Index (ASI-6 and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST were used to assess the severity of substance use and the problems related.RESULTS: There were significantly more men than women in the sample; mean age was 36 years. The drug most frequently used at all sites was alcohol (78%, followed by cocaine/crack (51%. Alcohol was the drug that most commonly motivated treatment seeking, at all centers. ASI-6 Summary Scores for Recent Functioning (SS-Rs were quite similar among centers. SS-Rs were compared between users who had never received treatment for psychoactive substance abuse (n = 265, 36.1% and those who had already been treated at one or more occasions (n = 470, 63.9%. This analysis revealed significant differences between the groups in the drug, psychiatric symptoms, legal, and family/social problems areas (p < 0.05.CONCLUSION: Our findings confirm previous evidence suggesting that the management of patients seeking drug abuse treatment should take several different aspects into consideration, e.g., education, employment, and family relationships, which often appear as areas of concern for these individuals.

  6. Personality Disorders in Substance Abusers: A Comparison of Patients Treated in a Prison Unit and Patients Treated in Inpatient Treatment

    Science.gov (United States)

    Stefansson, Ragnar; Hesse, Morten

    2008-01-01

    A large body of literature has shown a high prevalence of personality disorders in substance abusers. We compared a sample of substance abusers treated in a prison setting with substance abusers treated in a non-prison inpatient setting rated with the Millon Clinical Multiaxial Inventory-III. Base-rate scores indicated a prevalence of 95% of…

  7. The Spectrum of Child Abuse: Assessment, Treatment, and Prevention. Brunner/Mazel Basic Principles into Practice Series, Volume 8.

    Science.gov (United States)

    Oates, R. Kim

    This book is intended to provide an overview of current knowledge about child abuse rather than a focus on one particular professional viewpoint or facet of the problem. Introductory and concluding chapters address the definition of child abuse and neglect, why it occurs, and what happens to abused children. Chapters 3, 4, and 5 explore physical…

  8. An examination of the relationship between childhood emotional abuse and borderline personality disorder features: the role of difficulties with emotion regulation.

    Science.gov (United States)

    Kuo, Janice R; Khoury, Jennifer E; Metcalfe, Rebecca; Fitzpatrick, Skye; Goodwill, Alasdair

    2015-01-01

    Childhood abuse has been consistently linked with borderline personality disorder (BPD) and recent studies suggest that some forms of childhood abuse might be uniquely related to both BPD and BPD features. In addition, difficulties with emotion regulation have been found to be associated with childhood abuse, BPD, as well as BPD features. The present study examined (1) whether frequency of childhood emotional abuse is uniquely associated with BPD feature severity when controlling for other forms of childhood abuse and (2) whether difficulties with emotion regulation accounts for the relationship between childhood emotional abuse and BPD feature severity. A sample of undergraduates (n=243) completed the Childhood Trauma Questionnaire - Short Form, Difficulties in Emotion Regulation Scale, and Borderline Symptom List-23. Multiple regression analyses and Structural Equation Modeling were conducted. Results indicated that frequency of childhood emotional abuse (and not sexual or physical abuse) was uniquely associated with BPD feature severity. In addition, while there was no direct path between childhood emotional abuse, childhood physical abuse, or childhood sexual abuse and BPD features, there was an indirect relationship between childhood emotional abuse and BPD features through difficulties with emotion regulation. These findings suggest that, of the different forms of childhood abuse, emotional abuse specifically, may have a developmental role in BPD pathology. Prevention and treatment of BPD pathology might benefit from the provision of emotion regulation strategies.

  9. Occurrence and environmental implications of the presence of drugs of abuse in wastewater treatment plants of Valencia (Spain)

    Science.gov (United States)

    Picó, Yolanda; Andres-Costa, M. Jesus; Andreu, Vicente

    2014-05-01

    Drugs of abuse are continuously discharged into wastewaters due to human excretion as parent compounds and/or secondary metabolites after consumption or accidental disposal into the toilets. (Boles and Wells,2010). Incomplete removal of these compounds during wastewater treatment results in their release to the environment. Pollution by illicit drug residues at very low concentrations is generalized in populated areas, with potential risks for human health and the environment. The impact of treated wastewater effluent on the quality of receiving waters can be evaluated performing an investigated performing an ecotoxicological risk assessment calculating the risk quotient (RQ) of the drugs of abuse level observed. In addition, back-calculation from the concentration of illicit drug in the influents of wastewater treatment plants (WWTPs) provides an important tool for estimating its local consumption (Daughton 2001). Sampling campaigns were in three years, 2011 (March 9th to 15th), 2012 (April 17th to May 1st) and 2013 (March 6th to 12th) in influents and effluents from 3 Wastewater Treatment Plants (WWTPs), Pinedo I, Pinedo II and Quart-Benàger, that treats most of the wastewater of Valencia City and its surrounding towns. Cocaine (COC), amphetamine (AMP), methamphetamine (MAMP), ecstasy (MDMA) and ketamine (KET), Benzoylecgonine (BE), 6-acethylmorphine (6-MAM), and 11-nor-9-carboxy-delta9-tetrahydrocannabinol (THC-COOH) were analyzed using mass spectrometry techniques such as liquid chromatography triple quadrupole mass spectrometry (LC-QqQ-MS/MS) Illicit drugs were extracted using solid phase extraction (SPE) and determined by liquid chromatography tandem mass spectrometry (LC-MS/MS) in positive ionization with an electrospray ionization source (ESI). The determination of drugs of abuse in the influent of the selected WWTP shows that all compounds were detected in 100% of influents from Pinedo I, Pinedo II and Quart-Benàger in samples analyzed during three years

  10. Tuberculosis screening in a novel substance abuse treatment center in Malaysia: implications for a comprehensive approach for integrated care.

    Science.gov (United States)

    Al-Darraji, Haider Abdulrazzaq Abed; Wong, Kee Cheong; Yeow, David Gan Eng; Fu, Jeannia Jiani; Loeliger, Kelsey; Paiji, Christopher; Kamarulzaman, Adeeba; Altice, Frederick L

    2014-02-01

    People who use drugs (PWUD) represent a key high risk group for tuberculosis (TB). The prevalence of both latent TB infection (LTBI) and active disease in drug treatment centers in Malaysia is unknown. A cross-sectional convenience survey was conducted to assess the prevalence and correlates of LTBI among attendees at a recently created voluntary drug treatment center using a standardized questionnaire and tuberculin skin testing (TST). Participants (N=196) were mostly men (95%), under 40 (median age=36 years) and reported heroin use immediately before treatment entry (75%). Positive TST prevalence was 86.7%. Nine (4.6%) participants were HIV-infected. Previous arrest/incarcerations (AOR=1.1 for every entry, p<0.05) and not being HIV-infected (AOR=6.04, p=0.03) were significantly associated with TST positivity. There is an urgent need to establish TB screening and treatment programs in substance abuse treatment centers and to tailor service delivery to the complex treatment needs of patients with multiple medical and psychiatric co-morbidities.

  11. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

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    Ethy Dorrepaal

    2014-10-01

    Full Text Available Introduction: Effective first-line treatments for posttraumatic stress disorder (PTSD are well established, but their generalizability to child abuse (CA-related Complex PTSD is largely unknown. Method: A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates. Results: Only six studies with one or more cognitive behavior therapy (CBT treatment conditions and one with a present centered therapy condition could be meta-analyzed. Results indicate that CA-related PTSD patients profit with large effect sizes and modest recovery and improvement rates. Treatments which include exposure showed greater effect sizes especially in completers’ analyses, although no differential results were found in recovery and improvement rates. However, results in the subgroup of CA-related Complex PTSD studies were least favorable. Within the Complex PTSD subgroup, no superior effect size was found for exposure, and affect management resulted in more favorable recovery and improvement rates and less drop-out, as compared to exposure, especially in intention-to-treat analyses. Conclusion: Limited evidence suggests that predominantly CBT treatments are effective, but do not suffice to achieve satisfactory end states, especially in Complex PTSD populations. Moreover, we propose that future research should focus on direct comparisons between types of treatment for Complex PTSD patients, thereby increasing generalizability of results.

  12. Support after the completion of cancer treatment: perspectives of Australian adolescents and their families.

    Science.gov (United States)

    Wakefield, C E; McLoone, J; Butow, P; Lenthen, K; Cohn, R J

    2013-07-01

    Young people recovering from cancer may lack adequate support post-treatment, yet little is known about the types of support and information young Australians and their families need. This study investigated adolescent/young adult cancer survivors' and their families' perceptions of care and support needs after completing cancer treatment. Seventy semi-structured interviews were conducted with 19 survivors (mean age 16.1 years), 21 mothers, 15 fathers and 15 siblings. Interviews were recorded, transcribed and analysed using the conceptual framework of Miles and Huberman. Post-treatment, participants regarded medical staff positively but were reluctant to ask for their help fearing it may deflect resources away from patients still receiving treatment. Appraisals of social workers' and psychologists' support post-treatment were mixed. Formal emotional support was rarely accessed and participants reported that any additional funds should be directed to greater psychological support in this period. Participants also reported the need for additional financial support post-treatment. Clinicians need to be aware that while young people and their families may not demand support post-treatment, they may 'suffer in silence' or burden family members and friends with the responsibility of providing emotional support, though they may be experiencing distress also.

  13. Treatment with Ipilimumab: A Case Report of Complete Response in a Metastatic Malignant Melanoma Patient

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    Alfredo Addeo

    2013-05-01

    Full Text Available Introduction: Over the past year, 3 agents have been approved for the treatment of melanoma by the Food and Drug Administration. These include pegylated interferon α-2b for stage III melanoma, vemurafenib for unresectable or metastatic melanoma with BRAF V600E mutation, and ipilimumab for unresectable or metastatic melanoma. Case Presentation: We present here the case of a 65-year-old Caucasian male diagnosed with advanced melanoma in April 2011 and treated with ipilimumab (Yervoy®, a monoclonal antibody targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4, as second-line treatment after progression with dacarbazine, for (wild-type BRAF metastatic melanoma. The patient was referred to us for several painful lumps on his right arm. A biopsy of one of them revealed melanoma. CT and PET scans did not show any other lesions or a primary site. The patient was started on first-line chemotherapy with dacarbazine 850 mg/m2 on day 1, every 3 weeks. After 3 cycles, the patient showed disease progression with an increase in size of the skin metastasis. Second-line treatment was started with ipilimumab 3 mg/kg on day 1, every 3 weeks. At the end of the treatment, after 4 cycles, we documented a complete clinical response with total resolution of the skin metastasis. At the time of writing this paper, our patient had finished his treatment more than 9 months earlier and is still in complete remission. Conclusion: This is a paradigmatic case where, despite extensive metastatic disease, treatment with ipilimumab has confirmed its efficacy. It is still an open question why only a minority of patients have such a remarkable response, and further trials are warranted to address this important question.

  14. An Unusual Metastatic Renal Cell Carcinoma with Maintained Complete Response to Sunitinib Treatment

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    Luis Chara

    2011-12-01

    Full Text Available Recently, metastatic renal cell carcinoma (mRCC treatment has changed dramatically with the onset of new therapies against molecular targets replacing immunotherapy as standard treatment. We report the case of a 49-year-old patient with a moderately differentiated renal clear cell carcinoma without extracapsular extension who underwent radical nephrectomy. Eight months after surgery, he developed a thyroid metastasis which was also treated surgically with a hemithyroidectomy. Seventy-five months after nephrectomy, the patient presented an upper gastrointestinal bleeding due to a duodenal metastasis that infiltrates the head of the pancreas. The treatment applied was surgery by duodenopancreatectomy, with positive surgical margins in the pathologic study. In addition to this, the extension study showed lung metastases requiring initiation of systemic treatment with sunitinib. The patient presented an excellent response to treatment, showing complete clinical and radiological response at 5 months of treatment (RECIST criteria and a disease-free survival of 48 months until now, without evidence of toxicity. RCC has the potential to metastasize to almost any location, but thyroid and duodenal metastases in RCC are extremely rare. Moreover, this case also highlights the good responses that can be achieved in terms of disease-free survival, low toxicity and quality of life in this new era of therapies against molecular targets.

  15. Evaluation of treatment response for breast cancer: are we entering the era of "biological complete remission"?

    Institute of Scientific and Technical Information of China (English)

    Li Bian; Tao Wang; Yi Liu; Hui-Qiang Zhang; Jin-Jie Song; Shao-Hua Zhang; Shi-Kai Wu; San-Tai Song; Ze-Fei Jiang

    2012-01-01

    Breast cancer is one of the most common malignancies in women.The post-operative recurrence and metastasis are the leading causes of breast cancer-related mortality.In this study,we tried to explore the role of circulating tumor cell (CTC) detection combination PET/CT technology evaluating the prognosis and treatment response of patients with breast cancer; meanwhile,we attempted to assess the concept of "biological complete remission" (bCR) in this regard.A 56-year-old patient with breast cancer (T2N1M1,stage Ⅳ left breast cancer,with metastasis to axillary lymph nodes and lungs) received 6 cycles of salvage treatment with albumin-bound paclitaxel plus capecitabine and trastuzumab.Then,she underwent CTC detection and PET/CT for efficacy evaluation.CTC detection combination PET/CT is useful for the evaluation of the biological efficacy of therapies for breast cancer.The bCR of the patient appeared earlier than the conventional clinical imaging complete remission and promised the histological (pathological) complete remission.The integrated application of the concepts including bCR,imageological CR,and histological CR can achieve the early and accurate assessment of biological therapeutic reponse and prognosis of breast cancer.

  16. The Relationship between Substance Abuse Performance Measures and Mutual Help Group Participation after Treatment.

    Science.gov (United States)

    Strickler, Gail K; Reif, Sharon; Horgan, Constance M; Acevedo, Andrea

    2012-01-01

    We examined the relationship between treatment quality, using during-treatment process measures, and mutual help group (e.g., Alcoholics Anonymous) attendance after outpatient substance use disorder (SUD) treatment for 739 clients in the Alcohol and Drug Services Study. Logistic regression models estimated any and regular mutual help attendance after treatment. Clients referred to mutual help groups were significantly more likely to attend any mutual help after treatment. Results were mixed for facility offered mutual help groups; treatment engagement and retention were not significant. These findings offer treatment providers further evidence of the importance of referring clients to post-treatment mutual help groups, an effective, low-cost option.

  17. Mortality and failure among tuberculosis patients who did not complete treatment in Vietnam: a cohort study

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    Van Le N

    2007-07-01

    Full Text Available Abstract Background Tuberculosis treatment failure and death rates are low in the Western Pacific Region, including Vietnam. However, failure or death may also occur among patients who did not complete treatment, i.e. reported as default or transfer-out. We aimed to assess the proportion failures and deaths among new smear-positive pulmonary tuberculosis patients with reported default or transfer-out. Treatment outcomes rates were 1.4% default, 3.0% transfer-out, 0.4% failure and 2.6% death in northern Vietnam in 2003. Methods Tuberculosis patients in 32 randomly selected district tuberculosis units in northern Vietnam were followed up 1 to 3 years after treatment initiation for survival, recent treatment history and bacteriologically confirmed tuberculosis. Results Included were 85 transferred patients and 42 who defaulted. No information was available of 41 (32%, 28 (22% had died. Fifty-eight were available for follow-up (46%; all had sputum smear results. Tuberculosis was recorded in 11 (13%, including 6 (7% with positive sputum smears, 3 (3% with negative smears but positive culture and 2 (2% who had started re-treatment for bacteriologically confirmed tuberculosis. Fifteen (17%, 95%CI 10–27% had died within 8 months after treatment initiation. Of 86 patients with known study outcomes, 39 (45%, 95%CI 35–56% had died or had bacteriologically confirmed tuberculosis. This was recorded for 29/53 (55%, 95%CI 40–68% transferred patients and 10/33 (30%, 95%CI 16–49% patients who defaulted. Conclusion The total failure and death rates are 0.6% and 0.8% higher than based on routine reporting in northern Vietnam. Although this was a large proportion of treatment failures and deaths, failure and death rates were low. Defaulting and transfer carry a high risk of failure and in particular death.

  18. Factors influencing the selection of hydrocodone and oxycodone as primary opioids in substance abusers seeking treatment in the United States.

    Science.gov (United States)

    Cicero, Theodore J; Ellis, Matthew S; Surratt, Hilary L; Kurtz, Steven P

    2013-12-01

    The purpose of the present study was to identify the factors that influence the selection of hydrocodone and oxycodone as primary drugs of abuse in opioid-dependent subjects (n = 3520) entering one of 160 drug treatment programs around the country. Anonymous, self-administered surveys and direct qualitative interviews were used to examine the influence of demographic characteristics, drug use patterns, and decision-related factors on primary opioid selection. Our results showed that oxycodone and hydrocodone were the drugs of choice in 75% of all patients. Oxycodone was the choice of significantly more users (44.7%) than hydrocodone (29.4%) because the quality of the high was viewed to be much better by 54% of the sample, compared to just 20% in hydrocodone users, who cited acetaminophen as a deterrent to dose escalation to get high and hence, its low euphoric rating. Hydrocodone users were generally risk-averse women, elderly people, noninjectors, and those who prefer safer modes of acquisition than dealers (ie, doctors, friends, or family members). In contrast, oxycodone was a much more attractive euphorigenic agent to risk-tolerant young, male users who prefer to inject or snort their drugs to get high and are willing to use more aggressive forms of diversion. Prevention and treatment approaches, and pain physicians, should benefit from these results because it is clear that not all drug abusers share the same characteristics, and the decision to use one drug over another is a complex one, which is largely attributable to individual differences (eg, personality, gender, age, and other factors).

  19. Cost-utility analysis of different treatments for post-traumatic stress disorder in sexually abused children

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    Gospodarevskaya Elena

    2012-04-01

    Full Text Available Abstract Background Post-traumatic stress disorder (PTSD is diagnosed in 20% to 53% of sexually abused children and adolescents. Living with PTSD is associated with a loss of health-related quality of life. Based on the best available evidence, the NICE Guideline for PTSD in children and adolescents recommends cognitive behavioural therapy (TF-CBT over non-directive counselling as a more efficacious treatment. Methods A modelled economic evaluation conducted from the Australian mental health care system perspective estimates incremental costs and Quality Adjusted Life Years (QALYs of TF-CBT, TF-CBT combined with selective serotonin reuptake inhibitor (SSRI, and non-directive counselling. The "no treatment" alternative is included as a comparator. The first part of the model consists of a decision tree corresponding to 12 month follow-up outcomes observed in clinical trials. The second part consists of a 30 year Markov model representing the slow process of recovery in non-respondents and the untreated population yielding estimates of long-term quality-adjusted survival and costs. Data from the 2007 Australian Mental Health Survey was used to populate the decision analytic model. Results In the base-case and sensitivity analyses, incremental cost-effectiveness ratios (ICERs for all three active treatment alternatives remained less than A$7,000 per QALY gained. The base-case results indicated that non-directive counselling is dominated by TF-CBT and TF-CBT + SSRI, and that efficiency gain can be achieved by allocating more resources toward these therapies. However, this result was sensitive to variation in the clinical effectiveness parameters with non-directive counselling dominating TF-CBT and TF-CBT + SSRI under certain assumptions. The base-case results also suggest that TF-CBT + SSRI is more cost-effective than TF-CBT. Conclusion Even after accounting for uncertainty in parameter estimates, the results of the modelled economic evaluation

  20. Delayed but Complete Response following Oral Temozolomide Treatment in Melanoma Leptomeningeal Carcinomatosis

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    Andreas F. Hottinger

    2011-04-01

    Full Text Available Isolated leptomeningeal recurrence of melanoma is rare, occurring in 2% of patients with central nervous system involvement secondary to melanoma. The optimal treatment of leptomeningeal carcinomatosis (LMC in melanoma has not yet been determined and remains a major challenge. We report a melanoma patient who presented with isolated LMC in the form of a new-onset weakness of the lower limbs, paresthesia of the left hand and foot, lumbago and headache. A lumbar puncture and spinal MRI confirmed LMC. The patient was treated with temozolomide 75 mg/m2/day on a 4 weeks on/2 weeks off schedule. After an initial transient clinical deterioration, the patient showed a complete radiological response as well as a dramatic improvement in quality of life. The encouraging clinical response reported here suggests that dose-intensified temozolomide might have significant activity in the treatment of leptomeningeal dissemination of melanoma and may be a valid treatment option for patients who have not been previously exposed to this agent. Moreover, this treatment regimen is extremely well tolerated and obviates the need for repeated intrathecal administrations of chemotherapeutic agents, which are often not well tolerated by patients who have significant co-morbidities due to their disease. As illustrated in this case, response to temozolomide may occur in a delayed manner, highlighting the importance of following temozolomide treatment long enough before determining that it is inefficient in a given patient.

  1. Transcript Profiling Distinguishes Complete Treatment Responders With Locally Advanced Cervical Cancer

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    Jorge Fernandez-Retana

    2015-04-01

    Full Text Available Cervical cancer (CC mortality is a major public health concern since it is the second cause of cancer-related deaths among women. Patients diagnosed with locally advanced CC (LACC have an important rate of recurrence and treatment failure. Conventional treatment for LACC is based on chemotherapy and radiotherapy; however, up to 40% of patients will not respond to conventional treatment; hence, we searched for a prognostic gene signature able to discriminate patients who do not respond to the conventional treatment employed to treat LACC. Tumor biopsies were profiled with genome-wide high-density expression microarrays. Class prediction was performed in tumor tissues and the resultant gene signature was validated by quantitative reverse transcription–polymerase chain reaction. A 27-predictive gene profile was identified through its association with pathologic response. The 27-gene profile was validated in an independent set of patients and was able to distinguish between patients diagnosed as no response versus complete response. Gene expression analysis revealed two distinct groups of tumors diagnosed as LACC. Our findings could provide a strategy to select patients who would benefit from neoadjuvant radiochemotherapy-based treatment.

  2. Transcript Profiling Distinguishes Complete Treatment Responders With Locally Advanced Cervical Cancer1234

    Science.gov (United States)

    Fernandez-Retana, Jorge; Lasa-Gonsebatt, Federico; Lopez-Urrutia, Eduardo; Coronel-Martínez, Jaime; Cantu De Leon, David; Jacobo-Herrera, Nadia; Peralta-Zaragoza, Oscar; Perez-Montiel, Delia; Reynoso-Noveron, Nancy; Vazquez-Romo, Rafael; Perez-Plasencia, Carlos

    2015-01-01

    Cervical cancer (CC) mortality is a major public health concern since it is the second cause of cancer-related deaths among women. Patients diagnosed with locally advanced CC (LACC) have an important rate of recurrence and treatment failure. Conventional treatment for LACC is based on chemotherapy and radiotherapy; however, up to 40% of patients will not respond to conventional treatment; hence, we searched for a prognostic gene signature able to discriminate patients who do not respond to the conventional treatment employed to treat LACC. Tumor biopsies were profiled with genome-wide high-density expression microarrays. Class prediction was performed in tumor tissues and the resultant gene signature was validated by quantitative reverse transcription–polymerase chain reaction. A 27-predictive gene profile was identified through its association with pathologic response. The 27-gene profile was validated in an independent set of patients and was able to distinguish between patients diagnosed as no response versus complete response. Gene expression analysis revealed two distinct groups of tumors diagnosed as LACC. Our findings could provide a strategy to select patients who would benefit from neoadjuvant radiochemotherapy-based treatment. PMID:25926073

  3. Rearrest and Probation Violation Outcomes among Probationers Participating in a Jail-Based Substance-Abuse Treatment Used as an Intermediate Sanction

    Science.gov (United States)

    Linhorst, Donald M.; Dirks-Linhorst, P. Ann; Groom, Ralph

    2012-01-01

    This study compares the characteristics of two groups of probationers ordered to jail-based substance-abuse treatment as an intermediate sanction. It further reviews rearrest and probation failure outcomes of the two groups, along with the demographic, clinical, and criminal factors associated with those outcomes. Probationers jailed for probation…

  4. Substance Abuse, Coping Strategies, Adaptive Skills and Behavioral and Emotional Problems in Clients with Mild to Borderline Intellectual Disability Admitted to a Treatment Facility: A Pilot Study

    Science.gov (United States)

    Didden, Robert; Embregts, Petri; van der Toorn, Mirjam; Laarhoven, Nina

    2009-01-01

    Many clients with mild to borderline intellectual disability (ID) who are admitted to a treatment facility show serious problems in alcohol and/or drugs use. In the present case file study, we explored differences in coping strategies, adaptive skills and emotional and behavioral problems between clients who showed substance abuse and clients who…

  5. Exploring the effect of N-substitution in nor-lobelane on the interaction with VMAT2: discovery of a potential clinical candidate for treatment of methamphetamine abuse.

    Science.gov (United States)

    Zheng, Guangrong; Horton, David B; Penthala, Narsimha Reddy; Nickell, Justin R; Culver, John P; Deaciuc, Agripina G; Dwoskin, Linda P; Crooks, Peter A

    2013-03-01

    A series of N-substituted lobelane analogues was synthesized and evaluated for their [(3)H]dihydrotetrabenazine binding affinity at the vesicular monoamine transporter and for their inhibition of vesicular [(3)H]dopamine uptake. Compound 19a, which contains an N-1,2(R)-dihydroxypropyl group, had been identified as a potential clinical candidate for the treatment of methamphetamine abuse.

  6. EFFECT OF JOB SKILLS TRAINING ON EMPLOYMENT AND JOB SEEKING BEHAVIORS IN AN AMERICAN INDIAN SUBSTANCE ABUSE TREATMENT SAMPLE.

    Science.gov (United States)

    Foley, K; Pallas, D; Forcehimes, A A; Houck, J M; Bogenschutz, M P; Keyser-Marcus, L; Svikis, D

    2010-10-26

    Employment difficulties are common among American Indian individuals in substance abuse treatment. To address this problem, the Southwest Node of NIDA's Clinical Trials Network conducted a single-site adaptation of its national Job Seekers Workshop study in an American Indian treatment program, Na'Nizhoozhi Center (NCI). 102 (80% men, 100% American Indian) participants who were in residential treatment and currently unemployed were randomized to (1) a three session, manualized program (Job seekers workshop: JSW) or (2) a 40-minute Job Interviewing Video: JIV). Outcomes were assessed at 3-month follow up: 1) number of days to a new taxed job or enrollment in a job-training program, and 2) total hours working or enrolled in a job-training program. No significant differences were found between the two groups for time to a new taxed job or enrollment in a job-training program. There were no significant differences between groups in substance use frequency at 3-month follow-up. These results do not support the use of the costly and time-consuming JSW intervention in this population and setting. Despite of the lack of a demonstrable treatment effect, this study established the feasibility of including a rural American Indian site in a rigorous CTN trial through a community-based participatory research approach.

  7. Advanced gastrointestinal stromal tumor patients with complete response after treatment with imatinib mesylate

    Institute of Scientific and Technical Information of China (English)

    Kun-Chun Chiang; Tsung-Wen Chen; Chun-Nan Yeh; Feng-Yuan Liu; Hsiang-Lin Lee; Yi-Yin Jan

    2006-01-01

    AIM: Most gastrointestinal stromal tumors (GISTs)express constitutively activated mutant isoforms of kit kinase or platelet-derived growth factor receptor alpha (PDGFRA), which are potential therapeutic targets for imatinib mesylate (Glivec). Partial response occurred in almost two thirds of GIST patients treated with Glivec.However, complete response (CR) after Glivec therapy was sporadically reported. Here we illustrated advanced GIST patients with CR after Glivec treatment.METHODS: Between January 2001 and June 2005,42 advanced GIST patients were treated with Glivec.Patients were administered 400 mg of Glivec in 100-mg capsules, taken orally daily with food. The response of the tumor to Glivec was evaluated after one month, three months, and every three months thereafter or whenever medical need was indicated. Each tumor of patients was investigated for mutations of kit or PDGFRA.RESULTS: The median follow-up time of the 42 ad-vanced GIST patients treated with Glivec was 16.9 months (range, 1.0- 47.0 months). Overall, 3patients had complete response CR (7.1%), 26 partial response (67.8%), 5 stationary disease (11.9%), and 3 progressive disease (11.9%). The median duration of Glivec administration for the three patients was 36months (range, 23-36 months). The median time to CR after Glivec treatment was 20 months (range, 9-26months). Deletion and insertion mutations of c-kit exon 11 and insertion mutation of c-kit exon 9 were found in two cases and one case, respectively.CONCLUSION: Complete response (CR) can be achieyed in selected advanced GIST patients treated with Glivec. The median time to CR after Glivec treatment was 20 months. Deletion and insertion mutations of kit exon 11 and insertion mutation of kit exon 9 contribute to the genetic features in these selected cases.

  8. Early mobilization in complete spinal cord injury under conservative treatment in a developing country

    Directory of Open Access Journals (Sweden)

    Sankhadeb Acharya

    2015-01-01

    Full Text Available Background: Spinal cord injury (SCI management requires extended acute care and life-long chronic care. Aims: The present study was conducted to mobilize complete SCI patients early during conservative treatment and follow them up at the same time weekly for 6 weeks. Materials and Methods: This study was conducted in a time span of 2 years in a tertiary care hospital of Eastern India. All SCI patients admitted in the hospital for the treatment were assessed clinicoradiologically for the level of lesion. Those complete SCI patients who did not recover within 3 weeks of conservative treatment were mobilized with orthosis and efforts were done to recover the activities of daily living (ADL. The effects of early mobilization were monitored and noted at weekly interval with serial radiographs for increasing vertebral collapse and displacement and neurologically up to 6 weeks in the hospital and monthly for a time span of 1 year. Results: Results clearly indicated that guarded mobilization with braces on does not further aggravate the deformity. Bed sores occurred in 8% of cervical cord injury (CCI and 7% of D-L injury. Respiratory infections occurred in 8% of CCI and 5% of D-L injury. Urinary tract infection affected 12% of CCI and 10% of D-L injury, and the incidences were lower when compared to previous studies, and this may be attributed to early mobilization. Conclusions: Complete SCI patients may be discharged from the hospital within 6 weeks of sustaining an injury with added training for ADL to reduce the social burden in developing countries.

  9. Complete occlusion of the proximal subclavian artery post-CABG: Presentation and treatment

    Science.gov (United States)

    Sadek, Mouhannad M; Ravindran, Aravindhan; Marcuzzi, Daniel W; Chisholm, Robert J

    2008-01-01

    Atherosclerotic disease of the proximal left subclavian artery is an uncommon cause of angina in the post-coronary artery bypass graft patient, and is termed coronary-subclavian steal syndrome. Typical manifestations include cardiac symptoms of angina and noncardiac symptoms of lightheadedness, left arm numbness or weakness, and a difference in blood pressure of more than 20 mmHg between both arms. A case of complete proximal occlusion of the subclavian artery is reported. The clinical picture, investigations and treatment are described. Historical treatments of occlusive disease include surgical bypass graft and, more recently, percutaneous transluminal angioplasty. The patient underwent percutaneous transluminal angioplasty with stenting by a retrograde approach, with an excellent short-term response, but ultimately required a carotid subclavian bypass due to restenosis. PMID:18612504

  10. Minimally invasive treatment of the thoracic spine disease: completely percutaneous and hybrid approaches.

    Science.gov (United States)

    Tamburrelli, Francesco Ciro; Francesco Ciro, Tamburrelli; Scaramuzzo, Laura; Laura, Scaramuzzo; Genitiempo, Maurizio; Maurizio, Genitiempo; Proietti, Luca; Luca, Proietti

    2013-01-01

    The aim of the study was to evaluate the feasibility of a limited invasive approach for the treatment of upper thoracic spine disease. Seven patients with type-A thoracic fractures and three with tumors underwent long thoracic stabilization through a minimally invasive approach. Four patients underwent a completely percutaneous approach while the other three underwent a modified hybrid technique, a combination of percutaneous and open approach. The hybrid constructs were realized using a percutaneous approach to the spine distally to the spinal lesion and by open approach proximally. In two patients, the stabilization was extended proximally up to the cervical spine. Clinical and radiographic assessment was performed during the first year after the operation at 3, 6, and 12 months. No technically related complications were seen. The postoperative recovery was rapid even in the tumor patients with neurologic impairment. Blood loss was irrelevant. At one-year follow-up there was no loosening or breakage of the screws or failure of the implants. When technically feasible a completely percutaneous approach has to be taken in consideration; otherwise, a combined open-percutaneous approach could be planned to minimize the invasivity of a completely open approach to the thoracic spine.

  11. The Influence of Treatment Attendance on Subsequent Aggression among Severely Mentally Ill Substance Abusers

    OpenAIRE

    Zhuo, Yue; BRADIZZA, CLARA M.; Maisto, Stephen A.

    2014-01-01

    The interrelationships between severe mental illness, substance use, and aggression are of longstanding importance with implications for community treatment programs, treatment research and public policy. Through the analysis of longitudinal data collected from 278 patients over a 6-month period following admission to an outpatient dual diagnosis treatment program, this study examined the association between dual diagnosis treatment attendance and subsequent aggression among individuals diagn...

  12. Professional attitudes regarding the sexual abuse of children: comparing police, child welfare and community mental health.

    Science.gov (United States)

    Trute, B; Adkins, E; MacDonald, G

    1992-01-01

    A survey was completed involving three of the key professional groups engaged in the investigation and treatment of child sexual abuse. Police, child welfare and community mental health in a large, rural geographic area in Canada completed attitudinal items relating to professional response to child sexual abuse. An empirical scale was created which was comprised of three orthogonal factors, each with acceptable levels of internal consistency: 1) Beliefs in regard to the extensiveness and seriousness of the issue; 2) treatment versus punishment priority; and 3) view regarding identity of those who perpetrate child sexual abuse. Important gender differences were found across professional groupings in attitude toward sexual abuse. Greatest difference in attitude between service sectors was tied to emphasis placed on treatment versus punishment as a primary aspect of professional intervention. Significant differences were found between child welfare and police, the two service sectors most needing a coordinated approach during the "investigative phase" of professional intervention.

  13. Salvinorin A analogs and other κ-opioid receptor compounds as treatments for cocaine abuse.

    Science.gov (United States)

    Kivell, Bronwyn M; Ewald, Amy W M; Prisinzano, Thomas E

    2014-01-01

    Acute activation of kappa-opioid receptors produces anti-addictive effects by regulating dopamine levels in the brain. Unfortunately, classic kappa-opioid agonists have undesired side effects such as sedation, aversion, and depression, which restrict their clinical use. Salvinorin A (Sal A), a novel kappa-opioid receptor agonist extracted from the plant Salvia divinorum, has been identified as a potential therapy for drug abuse and addiction. Here, we review the preclinical effects of Sal A in comparison with traditional kappa-opioid agonists and several new analogs. Sal A retains the anti-addictive properties of traditional kappa-opioid receptor agonists with several improvements including reduced side effects. However, the rapid metabolism of Sal A makes it undesirable for clinical development. In an effort to improve the pharmacokinetics and tolerability of this compound, kappa-opioid receptor agonists based on the structure of Sal A have been synthesized. While work in this field is still in progress, several analogs with improved pharmacokinetic profiles have been shown to have anti-addictive effects. While in its infancy, it is clear that these compounds hold promise for the future development of anti-addictive therapeutics.

  14. HIV stigma among substance abusing people living with HIV/AIDS: implications for HIV treatment.

    Science.gov (United States)

    Levi-Minzi, Maria A; Surratt, Hilary L

    2014-08-01

    HIV-related stigma has a major impact on quality of life and health among people living with HIV and AIDS (PLWHA). This study examines demographic, mental health, behavioral, contextual, and HIV care-related correlates of HIV stigma among 503 substance abusing PLWHA. Stigma was measured with the HIV Internalized Stigma Measure which has four subscales: stereotypes about HIV, self-acceptance, disclosure concerns, and social relationships. Severe substance dependence (55.3%) and depression (54.7%) were associated with higher HIV stigma across all domains. 49.9% of the sample reported antiretroviral (ARV) medication diversion (the unlawful sale and trading of ARV medications); diverters endorsed significantly higher stigma related to disclosure. 54.1% of the sample reported ≥95% ARV adherence; these individuals reported significantly lower stigma for self-acceptance, disclosure, and social relationships. Multivariate linear regression showed that depression and social support demonstrated significant main effects across stigma domains. Findings suggest that interventions to decrease HIV related stigma may be an important component of initiatives to increase engagement in HIV care.

  15. Evidence-based practices, attitudes, and beliefs in substance abuse treatment programs serving American Indians and Alaska Natives: a qualitative study.

    Science.gov (United States)

    Larios, Sandra E; Wright, Serena; Jernstrom, Amanda; Lebron, Dorothy; Sorensen, James L

    2011-01-01

    Substance abuse disproportionately impacts American Indian/Alaska Native (AI/AN) communities in the United States. For the increasing numbers of AI/AN individuals who enter and receive treatment for their alcohol or other drug problem it is imperative that the service they receive be effective. This study used qualitative methodology to examine attitudes toward evidence-based practices, also known as evidence-based treatments (EBTs) in minority-serving substance abuse treatment programs in the San Francisco Bay area. Twenty-two interviews were conducted in the study, of which seven were with program directors and substance abuse counselors at two urban AI/AN focused sites. These clinics were more likely than other minority-focused programs to have experience with research and knowledge about adapting EBTs. Only in the AI/AN specific sites did an issue arise concerning visibility, that is, undercounting AI/AN people in national and state databases. Similar to other minority-focused programs, these clinics described mistrust, fear of exploitation from the research community, and negative attitudes towards EBTs. The underutilization of EBTs in substance abuse programs is prevalent and detrimental to the health of patients who would benefit from their use. Future research should explore how to use this research involvement and experience with adaptation to increase the adoption of EBTs in AI/AN serving clinics.

  16. Characteristics and Outcomes of Young Adult Opiate Users Receiving Residential Substance Abuse Treatment.

    Science.gov (United States)

    Morse, Siobhan; MacMaster, Samuel

    2015-01-01

    Opiate use patterns, user characteristics, and treatment response among young adults are of interest due to current high use prevalence and historical low levels of treatment engagement relative to older populations. Prior research in this population suggests that overall, young adults present at treatment with different issues. In this study the authors investigated potential differences between young adult (18-25 years of age) and older adult (26 and older) opiate users and the impact of differences relative to treatment motivation, length and outcomes. Data for this study was drawn from 760 individuals who entered voluntary, private, residential treatment. Study measures included the Addiction Severity Index (ASI), the Treatment Service Review (TSR), and University of Rhode Island Change Assessment (URICA). Interviews were conducted at program intake and 6-month post-discharge. Results indicate that older adults with a history of opiate use present at treatment with higher levels of severity for alcohol, medical, and psychological problems and young adults present at treatment with greater drug use and more legal issues. Significant improvement for both groups was noted at 6 months post treatment; there were also fewer differences between the two age groups of opiate users. Results suggest different strategies within treatment programs may provide benefit in targeting the disparate needs of younger opiate users. Overall, however, results suggest that individualized treatment within a standard, abstinence-based, residential treatment model can be effective across opiate users at different ages and with different issues, levels of severity, and impairment at intake.

  17. Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Milligan Karen

    2010-09-01

    Full Text Available Abstract Background The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (those with substance use treatment and pregnancy, parenting, or child services have been developed to specifically meet the needs of pregnant and parenting women with substance abuse issues. This synthesis and meta-analysis reviews research in this important and growing area of treatment. Methods We searched PsycINFO, MedLine, PubMed, Web of Science, EMBASE, Proquest Dissertations, Sociological Abstracts, and CINAHL and compiled a database of 21 studies (2 randomized trials, 9 quasi-experimental studies, 10 cohort studies of integrated programs published between 1990 and 2007 with outcome data on maternal substance use. Data were summarized and where possible, meta-analyses were performed, using standardized mean differences (d effect size estimates. Results In the two studies comparing integrated programs to no treatment, effect sizes for urine toxicology and percent using substances significantly favored integrated programs and ranged from 0.18 to 1.41. Studies examining changes in maternal substance use from beginning to end of treatment were statistically significant and medium sized. More specifically, in the five studies measuring severity of drug and alcohol use, the average effect sizes were 0.64 and 0.40, respectively. In the four cohort studies of days of use, the average effect size was 0.52. Of studies comparing integrated to non-integrated programs, four studies assessed urine toxicology and two assessed self-reported abstinence. Overall effect sizes for each measure were not statistically significant (d = -0.09 and 0.22, respectively. Conclusions Findings suggest that integrated programs are effective in reducing maternal substance use. However, integrated programs were not

  18. Treatment outcomes of patients with cervical cancer with complete metabolic responses after definitive chemoradiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Onal, Cem [Baskent University Faculty of Medicine, Department of Radiation Oncology, Adana (Turkey); Baskent University Faculty of Medicine, Adana Research and Treatment Centre, Department of Radiation Oncology, Adana (Turkey); Reyhan, Mehmet; Yapar, Ali Fuat [Baskent University Faculty of Medicine, Department of Nuclear Medicine, Ankara (Turkey); Guler, Ozan C. [Baskent University Faculty of Medicine, Department of Radiation Oncology, Adana (Turkey)

    2014-07-15

    We sought to evaluate failure patterns and prognostic factors predictive of recurrences and survival in cervical cancer patients who are treated with definitive chemoradiotherapy (ChRT), who have a subsequent complete metabolic response (CMR) with {sup 18} F-fluorodeoxyglucose positron-emission tomography (FDG-PET) after treatment. The records of 152 cervical cancer patients who were treated with definitive chemoradiotherapy were evaluated. All patients underwent pre-treatment positron emission tomography (PET-CT), and post-treatment PET-CT was performed within a median of 3.9 months (range, 3.0-9.8 months) after the completion of ChRT. The prognoses of partial response/progressive disease (PR/PD) cases (30 patients, 18 %) and CMR cases (122 patients, %82) were evaluated. Univariate and multivariate analysis effecting the treatment outcome was performed in CMR cases. The median follow-ups for all patients and surviving patients were 28.7 (range, 3.3-78.7 months) and 33.2 months (range, 6.23-78.7 months), respectively. Four-year overall survival (OS) rate was significantly better in patients with CMR compared to patients with PR/PD (66.9 % vs. 12.4 %, p < 0.001, respectively). Patients with PR/PD had higher maximum standardized uptake value (SUV{sub max}) of primary cervical tumor (26.4 ± 10.1 vs. 15.9 ± 6.3; p < 0.001) and larger tumor (6.4 cm ± 2.3 cm vs. 5.0 cm ± 1.4 cm; p < 0.001) compared to patients with CMR. Of the 122 patients with post-treatment CMRs, 25 (21 %) developed local, locoregional, or distant failure. In univariate analysis, tumor size ≥ 5 cm, 'International Federation of Obstetricians and Gynecologists' (FIGO) stage ≥ IIB, and pelvic and/or para-aortic lymph node metastasis were predictive of both overall survival (OS) and disease-free survival (DFS), while histology was predictive of only OS. In multivariate analysis, tumor size, stage and lymph node metastasis were predictive of OS and DFS. Although CMR is associated with

  19. Systematic evaluation of "compliance" to prescribed treatment medications and "abstinence" from psychoactive drug abuse in chemical dependence programs: data from the comprehensive analysis of reported drugs.

    Directory of Open Access Journals (Sweden)

    Kenneth Blum

    Full Text Available This is the first quantitative analysis of data from urine drug tests for compliance to treatment medications and abstinence from drug abuse across "levels of care" in six eastern states of America. Comprehensive Analysis of Reported Drugs (CARD data was used in this post-hoc retrospective observational study from 10,570 patients, filtered to include a total of 2,919 patients prescribed at least one treatment medication during 2010 and 2011. The first and last urine samples (5,838 specimens were analyzed; compliance to treatment medications and abstinence from drugs of abuse supported treatment effectiveness for many. Compared to non-compliant patients, compliant patients were marginally less likely to abuse opioids, cannabinoids, and ethanol during treatment although more likely to abuse benzodiazepines. Almost 17% of the non-abstinent patients used benzodiazepines, 15% used opiates, and 10% used cocaine during treatment. Compliance was significantly higher in residential than in the non-residential treatment facilities. Independent of level of care, 67.2% of the patients (n = 1963; P<.001 had every treatment medication found in both first and last urine specimens (compliance. In addition, 39.2% of the patients (n = 1143; P<.001 had no substance of abuse detected in either the first or last urine samples (abstinence. Moreover, in 2010, 16.9% of the patients (n = 57 were abstinent at first but not at last urine (deteriorating abstinence, the percentage dropped to 13.3% (n = 174 in 2011; this improvement over years was statistically significant. A longitudinal analysis for abstinence and compliance was studied in a randomized subset from 2011, (n = 511 representing 17.5% of the total cohort. A statistically significant upward trend (p = 2.353×10-8 of abstinence rates as well as a similar but stronger trend for compliance ((p = 2.200×10-16 was found. Being cognizant of the trend toward drug urine testing being linked

  20. Systematic evaluation of "compliance" to prescribed treatment medications and "abstinence" from psychoactive drug abuse in chemical dependence programs: data from the comprehensive analysis of reported drugs.

    Science.gov (United States)

    Blum, Kenneth; Han, David; Femino, John; Smith, David E; Saunders, Scott; Simpatico, Thomas; Schoenthaler, Stephen J; Oscar-Berman, Marlene; Gold, Mark S

    2014-01-01

    This is the first quantitative analysis of data from urine drug tests for compliance to treatment medications and abstinence from drug abuse across "levels of care" in six eastern states of America. Comprehensive Analysis of Reported Drugs (CARD) data was used in this post-hoc retrospective observational study from 10,570 patients, filtered to include a total of 2,919 patients prescribed at least one treatment medication during 2010 and 2011. The first and last urine samples (5,838 specimens) were analyzed; compliance to treatment medications and abstinence from drugs of abuse supported treatment effectiveness for many. Compared to non-compliant patients, compliant patients were marginally less likely to abuse opioids, cannabinoids, and ethanol during treatment although more likely to abuse benzodiazepines. Almost 17% of the non-abstinent patients used benzodiazepines, 15% used opiates, and 10% used cocaine during treatment. Compliance was significantly higher in residential than in the non-residential treatment facilities. Independent of level of care, 67.2% of the patients (n = 1963; P<.001) had every treatment medication found in both first and last urine specimens (compliance). In addition, 39.2% of the patients (n = 1143; P<.001) had no substance of abuse detected in either the first or last urine samples (abstinence). Moreover, in 2010, 16.9% of the patients (n = 57) were abstinent at first but not at last urine (deteriorating abstinence), the percentage dropped to 13.3% (n = 174) in 2011; this improvement over years was statistically significant. A longitudinal analysis for abstinence and compliance was studied in a randomized subset from 2011, (n = 511) representing 17.5% of the total cohort. A statistically significant upward trend (p = 2.353×10-8) of abstinence rates as well as a similar but stronger trend for compliance ((p = 2.200×10-16) was found. Being cognizant of the trend toward drug urine testing being linked to

  1. Attitudes of Psychologists Toward Drug Abusers

    Science.gov (United States)

    Knox, Wilma J.

    1976-01-01

    The present survey sought to define drug abuse, its causes, recommended treatments, treatment settings, prognosis, and personal commitment to treating drug abusers. The use of prison and courts was contrasted with hospitals, and willingness to treat drug abusers was contrasted with alcoholics. (Author)

  2. An unusual case of baclofen abuse

    Directory of Open Access Journals (Sweden)

    Soumitra Das

    2016-01-01

    Full Text Available Baclofen was initially used for the treatment of spastic conditions. Last decade has seen its emergence as a treatment of profound interest in alcohol dependence, opiates and cocaine abuse, and tobacco addiction. However, the published literature on baclofen abuse is sparse. Here, we report a patient with baclofen abuse.

  3. The Association between Foster Care and Substance Abuse Risk Factors and Treatment Outcomes: An Exploratory Secondary Analysis

    Science.gov (United States)

    Blome, Wendy Whiting; Shields, Joseph; Verdieck, Mary Jeanne

    2009-01-01

    The child welfare and substance abuse systems are integrally linked through the children and families they both serve. There is a dearth of knowledge, however, on how children who have experienced foster care fare when they are treated for substance abuse issues as adults. This article presents an exploratory study using the Alcohol and Drug…

  4. Cultural Considerations in the Treatment of Mental Illness among Sexually Abused Children and Adolescents: The Case of Bali, Indonesia

    Science.gov (United States)

    Lesmana, Cokorda Bagus J.; Suryani, Luh Ketut; Tiliopoulos, Niko

    2015-01-01

    Childhood and adolescence sexual abuse can have long-lasting and devastating effects on personal and interpersonal growth and development. Sexually abused children tend to exhibit higher rates of poor school performance, aggressive behavior, PTSD (posttraumatic stress disorder), or depressive symptomatology, as well as social and relational…

  5. Early Intervention and Maltreated Children: A Current Look at the Child Abuse Prevention and Treatment Act and Part C

    Science.gov (United States)

    Moxley, Kathleen M.; Squires, Jane; Lindstrom, Lauren

    2012-01-01

    Current literature regarding the prevalence of child abuse and neglect, resulting developmental impacts on children, and early intervention services for children and families involved in the child welfare system is summarized. While early intervention eligibility referrals are mandated for this population under the Child Abuse Prevention and…

  6. Using the Experience Sampling Method in the Context of Contingency Management for Substance Abuse Treatment

    Science.gov (United States)

    Husky, Mathilde M.; Mazure, Carolyn M.; Carroll, Kathleen M.; Barry, Danielle; Petry, Nancy M.

    2008-01-01

    Contingency management (CM) treatments have been shown to be effective in reducing substance use. This manuscript illustrates how the experience sampling method (ESM) can depict behavior and behavior change and can be used to explore CM treatment mechanisms. ESM characterizes idiosyncratic patterns of behavior and offers the potential to determine…

  7. History of the treatment of persons with psychological difficulties and the abuse of their civil rights

    Directory of Open Access Journals (Sweden)

    Petrović Nikola M.

    2013-01-01

    Full Text Available Treatment of persons with psychological difficulties varied in different historical periods, but in its essence remained similar until today. It included an inhumane relationship towards these persons, involuntary treatment through torture, and isolation from society as a kind of punishment for their diversity. It was not until the late 19th century that the relationship of society towards these individuals started to improve gradually, but in the 21st century isolation of these individuals still remained the dominant form of acceptable social solution for the “problem”, with a somewhat more humane attitude towards them and less cruel treatment. Serbia has followed the trends of treatment of the persons with psychological difficulties from the rest of Europe for centuries, but is still lagging behind the world in the introduction of new methods of treatment. Indeed the first legal solution to regulate the human rights of these people is currently in the process of implementation. The subject of this paper is the treatment of persons with psychological difficulties and the violation of their civil rights. In a subject specific context the goal of the analysis was the historical review of the treatment towards persons with psychological difficulties by doctors, other practicioners and the community in general, with reference to the current situation regarding their treatment within the psychiatric institutions, as well as the legal regulations and the protection of their civil rights.

  8. The importance of need for cognition and educational experience in enhanced and standard substance abuse treatment.

    Science.gov (United States)

    Czuchry, Michael; Dansereau, Donald F

    2004-06-01

    The current study examined the relationship between need for cognition (i.e., cognitive motivation or "will") and educational experience (i.e., cognitive ability or "skill") to perceived improvements during treatment of probationers receiving residential treatment within the criminal justice system. Probationers were randomly assigned to either receive motivational activities developed by the authors (the "enhanced" condition), or treatment as usual (but with access to general reading materials in lieu of the motivational activities). Need for cognition and educational experience were assessed and used as blocking variables, and ratings of progress were assessed midway and toward the end of treatment. The results indicate that both need for cognition and educational experience are important predictors of improvement during treatment, and that the motivational activities developed by the authors were particularly valuable for clients with lower levels of need for cognition.

  9. Effect of Art Production on Negative Mood and Anxiety for Adults in Treatment for Substance Abuse

    Science.gov (United States)

    Laurer, Mattye; van der Vennet, Renée

    2015-01-01

    This study investigated whether art production or viewing and sorting art reproductions would be more effective in reducing negative mood and anxiety for 28 adults with substance use disorders. Participants were randomly assigned to one of two groups and completed pre- and posttest measures of negative mood and anxiety The hypothesis that art…

  10. Overdose prevention in injecting opioid users: The role of substance abuse treatment and training programs

    Directory of Open Access Journals (Sweden)

    Ana Sarasa-Renedo

    2014-03-01

    Conclusions: These findings suggest that preventive programs would benefit from accounting for linguistic and educational limitations and from participation in every treatment episode. Comprehensiveness and broad coverage of such programs could help to maximize their impact.

  11. Substance abuse treatment and services by criminal justice and other funding sources.

    Science.gov (United States)

    Arfken, Cynthia L; Kubiak, Sheryl Pimlott

    2009-01-01

    Studies have found funding source, whether public or private, is associated with treatment and services offered in community-based agencies. However, the association of criminal justice funding with community-based treatment and services is unknown. Using a mixed method case study approach with 34 agencies within one state we assessed administrators' perspectives of the most important funding source, treatment and services offered. We found that agencies rely on multiple funding sources and the source rated most important was associated with treatment and services offered in the agency. Those agencies citing a criminal justice entity as the most important funder were more likely to offer specific ancillary services and adopt motivational interviewing than those citing private funds. Although client characteristics or training opportunities may determine these services and practices, the agency's most important funding source may have implications for services offered.

  12. Other Drugs of Abuse

    Science.gov (United States)

    ... OtherDrugsofAbuse_012017.pdf Previous Index Español English Español PDF Version Download Treatment & Recovery Information Treatment and Recovery ... the U.S. Department of Health and Human Services . PDF documents require the free Adobe Reader . Microsoft Word ...

  13. Behavioral family counseling for substance abuse: a treatment development pilot study.

    Science.gov (United States)

    O'Farrell, Timothy J; Murphy, Marie; Alter, Jane; Fals-Stewart, William

    2010-01-01

    Substance-dependent patients (N=29) living with a family member other than a spouse were randomly assigned to equally intensive treatments consisting of either (a) Behavioral Family Counseling (BFC) plus Individual-Based Treatment (IBT) or (b) IBT alone. Outcome data were collected at baseline, post-treatment, and at 3- and 6-month follow-up. BFC patients remained in treatment significantly longer than IBT patients. BFC patients improved significantly from baseline at all time periods on all outcomes studied, and had a medium effect size reflecting better primary outcomes of increased abstinence and reduced substance use than IBT patients. For secondary outcomes of reduced negative consequences and improved relationship adjustment, both BFC and IBT patients improved significantly and to an equivalent extent. The present results show BFC is a promising method for retaining patients in treatment, increasing abstinence, and reducing substance use. These results also provide support for larger scale, randomized trials examining the efficacy of behavioral family counseling for patients living with family members beyond spouses.

  14. Women’s experiences and preferences regarding breast imaging after completing breast cancer treatment

    Directory of Open Access Journals (Sweden)

    Brandzel S

    2017-02-01

    Full Text Available Susan Brandzel,1 Dori E Rosenberg,1 Dianne Johnson,1 Mary Bush,1 Karla Kerlikowske,2–5 Tracy Onega,6,7 Louise Henderson,8 Larissa Nekhlyudov,9,10 Wendy DeMartini,11 Karen J Wernli1 1Group Health Research Institute, Group Health Cooperative, Seattle, WA, 2Department of Medicine, 3Department of Epidemiology, 4Department of Biostatistics, 5Department of Veterans Affairs, University of California, San Francisco, San Francisco, CA, 6Department of Biomedical Data Science, 7Department of Epidemiology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, 8Department of Radiology, University of North Carolina, Chapel Hill, NC, 9Department of Population Medicine, Harvard Medical School, 10Department of Medicine, Brigham and Women’s Hospital, Boston, MA, 11Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA Background: After treatment for breast cancer, most women receive an annual surveillance mammography to look for subsequent breast cancers. Supplemental breast MRI is sometimes used in addition to mammography despite the lack of clinical evidence for it. Breast imaging after cancer treatment is an emotionally charged experience, an important part of survivorship care, and a topic about which limited patient information exists. We assessed women’s experiences and preferences about breast cancer surveillance imaging with the goal of determining where gaps in care and knowledge could be filled. Participants and methods: We conducted six focus groups with a convenience sample of 41 women in California, North Carolina, and New Hampshire (USA. Participants were aged 38–75 years, had experienced stage 0–III breast cancer within the previous 5 years, and had completed initial treatment. We used inductive thematic analysis to identify key themes from verbatim transcripts. Results: Women reported various types and frequencies of surveillance imaging and a range of surveillance imaging

  15. The matrix model of outpatient stimulant abuse treatment: history and description.

    Science.gov (United States)

    Obert, J L; McCann, M J; Marinelli-Casey, P; Weiner, A; Minsky, S; Brethen, P; Rawson, R

    2000-01-01

    The Matrix model was originally developed in response to the cocaine epidemic of the 1980s. The program consists of relapse prevention groups, education groups, social support groups, individual counseling, and urine and breath testing delivered in a structured manner over a 16-week period. The treatment is a directive, nonconfrontational approach which focuses on current issues and behavior change. Several evaluations of the model have supported its usefulness and efficacy with methamphetamine (MA) users. Methamphetamine users appear to respond to treatment similarly to cocaine users and many continue to show improvements at follow-up.

  16. Patients Undergoing Substance Abuse Treatment and Receiving Financial Assistance for a Physical Disability Respond Well to Contingency Management Treatment.

    Science.gov (United States)

    Burch, Ashley E; Morasco, Benjamin J; Petry, Nancy M

    2015-11-01

    Physical illness and disability are common in individuals with substance use disorders, but little is known about the impact of physical disability status on substance use treatment outcomes. This study examined the main and interactive effects of physical disability payment status on substance use treatment. Participants (N = 1,013) were enrolled in one of six prior randomized clinical trials comparing contingency management (CM) to standard care; 79 (7.8%) participants reported receiving disability payments, CM improved all three primary substance use outcomes: treatment retention, percent negative samples and longest duration of abstinence. There was no significant main effect of physical disability payment status on treatment outcomes; however, a significant treatment condition by physical disability status interaction effect emerged in terms of retention in treatment and duration of abstinence achieved. Patients who were receiving physical disability payments responded particularly well to CM, and their time in treatment and durations of drug and alcohol abstinence increased even more markedly with CM than did that of their counterparts who were not receiving physical disability assistance. These findings suggest an objectively defined cohort of patients receiving substance use treatment who respond particularly well to CM.

  17. Initial treatment of complete rotator cuff tear and transition to surgical treatment: systematic review of the evidence

    Science.gov (United States)

    Abdul-Wahab, Taiceer A.; Betancourt, Jean P.; Hassan, Fadi; Thani, Saeed Al.; Choueiri, Hened; Jain, Nitin B.; Malanga, Gerard A.; Murrell, William D.; Prasad, Anil; Verborgt, Olivier

    2016-01-01

    Summary Background rotator cuff tear affects many people. Natural history, and evidence for non-operative treatment remains limited. Our objective is to assess evidence available for the efficacy and morbidity of commonly used systemic medications, physiotherapy, and injections alongside evaluating any negative long-term effects. Methods a systematic search was performed of PubMed, Cochrane, EMBASE and CINAHL dates (1 January 1960 – 1 December 2014), search terms: ‘rotator cuff tear’, ‘natural history’, ‘atraumatic’, ‘injection’, ‘physiotherapy’ or ‘physical therapy’, ‘injection’, ‘corticosteroid’, ‘PRP‘, ‘MSC’, risk of conservative treatment’, and ‘surgical indication’. Results eleven studies were included. The mean Coleman Methodology Score modified for conservative therapy is 69.21 (range 88–44) (SD 12.31). This included 2 RCTs, 7 prospective, and 2 retrospective studies. Evidence suggests it is safe to monitor symptomatic rotator cuff tears, as tear size and symptoms are not correlated with pain, function, and/or ultimate outcome. Conclusions complete rotator cuff tears may be effectively treated with injections, exercise in the short and intermediate terms respectively. Negative effect of corticosteroids on rotator cuff tissue has not been demonstrated. Timing to end conservative treatment is unknown, but likely indicated when a patient demonstrates increased weakness and loss of function not recoverable by physiotherapy. PMID:27331030

  18. Body image among victims of sexual and physical abuse.

    Science.gov (United States)

    Kremer, Inbar; Orbach, Israel; Rosenbloom, Tova

    2013-01-01

    This study tries to understand the differences in body experience between victims of sexual abuse and physical abuse. Ninety-eight women completed questionnaires that measured personal information, body-image aberration, body sensitivity and control, and body investment. Findings indicated that victims of sexual abuse demonstrate less body maintenance and protection in addition to greater injury to body sensitivity and control than victims of physical abuse. Moreover, comparing victims of sexual abuse to physical abuse, findings revealed that only victims of sexual abuse report body-image aberrations. Thus, sexual and physical abuse should be addressed discretely because each has differential effects on bodily attitudes of victims.

  19. Decreased dopamine activity predicts relapse in methamphetamine abusers

    Energy Technology Data Exchange (ETDEWEB)

    Wang G. J.; Wang, G.-J.; Smith, L.; Volkow, N.D.; Telang, F.; Logan, J.; Tomasi, D.; Wong, C.T.; Hoffman, W.; Jayne, M.; Alia-Klein, N.; Thanos, P.; Fowler, J.S.

    2011-01-20

    Studies in methamphetamine (METH) abusers showed that the decreases in brain dopamine (DA) function might recover with protracted detoxification. However, the extent to which striatal DA function in METH predicts recovery has not been evaluated. Here we assessed whether striatal DA activity in METH abusers is associated with clinical outcomes. Brain DA D2 receptor (D2R) availability was measured with positron emission tomography and [{sup 11}C]raclopride in 16 METH abusers, both after placebo and after challenge with 60 mg oral methylphenidate (MPH) (to measure DA release) to assess whether it predicted clinical outcomes. For this purpose, METH abusers were tested within 6 months of last METH use and then followed up for 9 months of abstinence. In parallel, 15 healthy controls were tested. METH abusers had lower D2R availability in caudate than in controls. Both METH abusers and controls showed decreased striatal D2R availability after MPH and these decreases were smaller in METH than in controls in left putamen. The six METH abusers who relapsed during the follow-up period had lower D2R availability in dorsal striatum than in controls, and had no D2R changes after MPH challenge. The 10 METH abusers who completed detoxification did not differ from controls neither in striatal D2R availability nor in MPH-induced striatal DA changes. These results provide preliminary evidence that low striatal DA function in METH abusers is associated with a greater likelihood of relapse during treatment. Detection of the extent of DA dysfunction may be helpful in predicting therapeutic outcomes.

  20. Hepatitis C associated to substance abuse: ever closer to a treatment without Interferon.

    Science.gov (United States)

    Muga, Roberto; Zuluaga, Paola; Sanvisens, Arantza; Rivas, Inmaculada; Fuster, Daniel; Bolao, Ferran; Tor, Jordi

    2015-06-17

    With 3-4 million of new infections occurring annually, hepatitis C virus (HCV) infection is a global Public Health problem. In fact, hepatitis C virus infection is one of the leading causes of liver disease in the world; in Western countries, two thirds of the new HCV infections are associated with injection drug use. The treatment of hepatitis C will change in the coming years with the irruption of new anti-HCV drugs, the so called Direct Antiviral Agents (DAA) that attack key proteins of the HCV life cycle. The new antiviral drugs are effective, safer and better tolerated. The 2014 WHO HCV treatment guidelines include some of them. The new DAA are used in combination and it is expected that Interferon will be not necessary in future treatment regimens against HCV infection. The irruption of new and potent antivirals mandate the review of the current standards of care in the HCV infected population. More inclusive and proactive treatment policies will be necessary in those individuals with substance use disorders.

  1. Using Mindfulness in the Treatment of Adolescent Sexual Abusers: Contributing Common Factor or a Primary Modality?

    Science.gov (United States)

    Jennings, Jerry L.; Apsche, Jack A.; Blossom, Paige; Bayles, Corliss

    2013-01-01

    Although mindfulness has become a mainstream methodology in mental health treatment, it is a relatively new approach with adolescents, and perhaps especially youth with sexual behavior problems. Nevertheless, clinical experience and several empirical studies are available to show the effectiveness of a systematic mindfulness- based methodology for…

  2. A Comparison of Psychodynamic and Reinforcement Treatment with Sexually Abused Children.

    Science.gov (United States)

    Downing, Jerry; And Others

    1988-01-01

    Collected data from parents and school counselors of 22 sexually molested children involved in either psychodynamic or reinforcement theory treatment groups. Psychodynamic group reported slow, steady improvement in child behavior. Reinforcement theory results were more positive in terms of immediate behavior change and maintenance of change.…

  3. Psychiatric symptom typology in a sample of youth receiving substance abuse treatment services: associations with self-reported child maltreatment and sexual risk behaviors.

    Science.gov (United States)

    Oshri, Assaf; Tubman, Jonathan G; Jaccard, James

    2011-11-01

    Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.

  4. Differentiating LGBT individuals in substance abuse treatment: analyses based on sexuality and drug preference.

    Science.gov (United States)

    Cochran, Bryan N; Peavy, K Michelle; Santa, Annesa Flentje

    2007-01-01

    In a prior study (Cochran & Cauce, 2006), LGBT individuals seeking treatment demonstrated greater substance use severity, more psychosocial stressors, and increased use of psychiatric services when compared to their heterosexual counterparts. That study, and similar to others in the field of LGBT research, collapsed LGBT individuals into a single category and did not examine individual differences within this category. The present study utilizes the same sample of LGBT clients (N = 610); however, an exploratory cluster analysis was conducted, based on drug preference, to determine which subcategories exist within this unique sample. In a subsequent set of analyses, the sample was divided based on sexuality to determine if there were differences between these groups on psychosocial functioning variables. Results indicated three distinct clusters, which differed in both demographic characteristics and severity of substance use problems. Groups based on sexuality differed in terms of primary problem substance, as well as psychosocial variables. Implications for treatment of these subgroups are discussed.

  5. An Approach to Treatment of the Child Sexual Abuser in the Military.

    Science.gov (United States)

    1987-04-20

    orientation is to children. 2. Pedophilic interests begin at aaolescence. 3. No precipitating stress/no subjective distress. 4. Persistent interest and...maturation) issues. Regressed Type i. Primary sexual orientation is to agemates. 2. Pedophilic interests emerge in adulthood. 3. Precioitating stress usually...assessment of otfenoers is sea oi rnrv’ cet *een! the fixated pedophile and the rearessec oeooohile is verv imoortant in an approach to treatment ot the :7ce_

  6. The relationship between child maltreatment and substance abuse treatment outcomes among emerging adults and adolescents.

    Science.gov (United States)

    Garner, Bryan R; Hunter, Brooke D; Smith, Douglas C; Smith, Jane Ellen; Godley, Mark D

    2014-01-01

    Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment.

  7. Suicide Attempts among Drug Abusers.

    Science.gov (United States)

    Harrsi, Rachel; And Others

    1979-01-01

    The relationship between substance abuse and suicide is indicated by high rate of attempted suicide among alcoholics and drug abusers, as well as increased likelihood of repeated attempts in these populations. This study reports on psychological characteristics of male drug suicide attempters who are in treatment for their addiction problem.…

  8. A Comparison of the Structural Factors of the Propensity for Abusiveness Scale for Women and Men in a Domestic Violence Treatment Program.

    Science.gov (United States)

    Allen, Christopher T; Swan, Suzanne C; Maas, Carl D; Barber, Sara

    2015-08-01

    Court-mandated domestic violence (DV) treatment programs across the country have seen a marked increase in female clients. These programs use a variety of measurement tools to assess the needs of their clients. Increased numbers of women in treatment for DV reflect a need to address the measurement of intimate partner violence (IPV) for both males and females. Unfortunately, the reliability and validity of many of measures used to assess IPV and related constructs for women remains unknown. The current study focuses on a particular measure, the Propensity for Abusiveness Scale (PAS). The PAS is not a measure of abusive behavior per se; rather, it assesses risk factors for abuse, including affective lability, anger expression, trauma symptoms, and harsh parenting experienced by the respondent. Specifically, the current study compares the factor structure and the measurement properties of the PAS for males and females in a sample of 885 (647 female, 238 male) participants in a DV treatment program. Findings indicate that the PAS demonstrated configural, metric, and scalar invariance between the female and male samples. These results suggest that it is appropriate for researchers and clinicians to make comparisons between women and men based on PAS factor scores.

  9. Using a latent variable approach to inform gender and racial/ethnic differences in cocaine dependence: a National Drug Abuse Treatment Clinical Trials Network study.

    Science.gov (United States)

    Wu, Li-Tzy; Pan, Jeng-Jong; Blazer, Dan G; Tai, Betty; Stitzer, Maxine L; Woody, George E

    2010-06-01

    This study applies a latent variable approach to examine gender and racial/ethnic differences in cocaine dependence, to determine the presence of differential item functioning (DIF) or item-response bias to diagnostic questions of cocaine dependence, and to explore the effects of DIF on the predictor analysis of cocaine dependence. The analysis sample included 682 cocaine users enrolled in two national multisite studies of the National Drug Abuse Treatment Clinical Trials Network (CTN). Participants were recruited from 14 community-based substance abuse treatment programs associated with the CTN, including 6 methadone and 8 outpatient nonmethadone programs. Factor and multiple indicators-multiple causes (MIMIC) procedures evaluated the latent continuum of cocaine dependence and its correlates. MIMIC analysis showed that men exhibited lower odds of cocaine dependence than women (regression coefficient, beta = -0.34), controlling for the effects of DIF, years of cocaine use, addiction treatment history, comorbid drug dependence diagnoses, and treatment setting. There were no racial/ethnic differences in cocaine dependence; however, DIF by race/ethnicity was noted. Within the context of multiple community-based addiction treatment settings, women were more likely than men to exhibit cocaine dependence. Addiction treatment research needs to further evaluate gender-related differences in drug dependence in treatment entry and to investigate how these differences may affect study participation, retention, and treatment response to better serve this population.

  10. Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: a comprehensive narrative overview of English-language studies.

    Science.gov (United States)

    Fischer, Benedikt; Blanken, Peter; Da Silveira, Dartiu; Gallassi, Andrea; Goldner, Elliot M; Rehm, Jürgen; Tyndall, Mark; Wood, Evan

    2015-04-01

    There are an estimated several million crack-cocaine users globally; use is highest in the Americas. Most crack users are socio-economically marginalized (e.g., homeless), and feature elevated risks for morbidity (e.g., blood-borne viruses), mortality and crime/violence involvement, resulting in extensive burdens. No comprehensive reviews of evidence-based prevention and/or treatment interventions specifically for crack use exist. We conducted a comprehensive narrative overview of English-language studies on the efficacy of secondary prevention and treatment interventions for crack (cocaine) abuse/dependence. Literature searches (1990-2014) using pertinent keywords were conducted in main scientific databases. Titles/abstracts were reviewed for relevance, and full studies were included in the review if involving a primary prevention/treatment intervention study comprising a substantive crack user sample. Intervention outcomes considered included drug use, health risks/status (e.g., HIV or sexual risks) and select social outcome indicators. Targeted (e.g., behavioral/community-based) prevention measures show mixed and short-term effects on crack use/HIV risk outcomes. Material (e.g., safer crack use kit distribution) interventions also document modest efficacy in risk reduction; empirical assessments of environmental (e.g., drug consumption facilities) for crack smokers are not available. Diverse psycho-social treatment (including contingency management) interventions for crack abuse/dependence show some positive but also limited/short-term efficacy, yet likely constitute best currently available treatment options. Ancillary treatments show little effects but are understudied. Despite ample studies, pharmaco-therapeutic/immunotherapy treatment agents have not produced convincing evidence; select agents may hold potential combined with personalized approaches and/or psycho-social strategies. No comprehensively effective 'gold-standard' prevention/treatment

  11. A modified method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint

    Institute of Scientific and Technical Information of China (English)

    王世松; 杜敦进; 张鹏程; 杨泗华; 樊亚军

    2002-01-01

    Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewars surgical method as follows: (1) Two small incisions, a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid, were made instead of a conventional large arc incision from the acromion to coracoid. (2) The foreign body in the acromioclavicular joint was cleared out. The chondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired. (3) The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4) the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament.Results: The follow-up duration in 30 patients of the series was from 6 to 72 months (mean 41 months). Functional assessment was carried out by the criteria delineated previously by Karkson, in which Grade A was in 24 cases, Grade B in 4cases, and C in 2.Conclusions: This modified technique, having less postoperative complications and less injuries to tissues and according well with the requirement of biomechanics, can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and therefore is preferable to use clinically on a large scale.

  12. A modified method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective:To eport a new method of coracoid transpostiton for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy.Methods:We modified Eewar's surgical method as follows:(1)Two small incisions,a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid ,were made instead of a conventional large arc incision from the acromion to coracoid.(2)The foreign body in the acromioclavicular joint was cleared out.Thechondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired.(3)The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4)the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament.Results:The follow-up duration in 30patients of the series was from6to 72months(mean41months).Functional assessment was carried out by the criteria delineated previously by Karkson,in which Grade Awas in 24 cases,Grade Bin4cases,and Cin2.Conclusions:This modified technique,having less postoperative complications and less injuries to tissues and according well with the requitement of biomechanics,can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and thereore is preferable to use clinically on a large scale.

  13. Insomnia, Nightmare Frequency, and Nightmare Distress in Victims of Sexual Abuse: The Role of Perceived Social Support and Abuse Characteristics

    Science.gov (United States)

    Steine, Iris M.; Krystal, John H.; Nordhus, Inger H.; Bjorvatn, Bjorn; Harvey, Allison G.; Eid, Jarle; Gronli, Janne; Milde, Anne M.; Pallesen, Stale

    2012-01-01

    In this study of victims of sexual abuse, the aim was to investigate the role of perceived social support and abuse characteristics in self-reported insomnia, nightmare frequency, and nightmare distress. Four hundred sixty Norwegian victims of sexual abuse completed a questionnaire assessing perceived social support, abuse characteristics,…

  14. Complete histological regression of Kaposi's sarcoma following treatment with protease inhibitors despite persistence of HHV-8 in lesions

    DEFF Research Database (Denmark)

    Benfield, T L; Kirk, O; Elbrønd, B;

    1998-01-01

    There is no current curative treatment for HIV-related Kaposi's sarcoma. The identification of human herpesvirus-8 as a possible aetiological agent suggests potential efficacy of anti-viral agents. We report here on the complete histological remission of Kaposi's sarcoma following treatment...

  15. 77 FR 31858 - Draft Guidance for Industry on Pathologic Complete Response in Neoadjuvant Treatment of High-Risk...

    Science.gov (United States)

    2012-05-30

    ... certain high-risk or poor prognosis populations of early-stage breast cancer patients. This guidance is... in Neoadjuvant Treatment of High-Risk Early-Stage Breast Cancer: Use as an Endpoint To Support... entitled ``Pathologic Complete Response in Neoadjuvant Treatment of High-Risk Early-Stage Breast...

  16. Missing Data in Substance Abuse Treatment Research: Current Methods and Modern Approaches

    Science.gov (United States)

    McPherson, Sterling; Barbosa-Leiker, Celestina; Burns, G. Leonard; Howell, Donelle; Roll, John

    2013-01-01

    Two common procedures for the treatment of missing information, listwise deletion and positive urine analysis (UA) imputation (e.g., if the participant fails to provide urine for analysis, then score the UA positive), may result in significant biases during the interpretation of treatment effects. To compare these approaches and to offer a possible alternative, these two procedures were compared to the multiple imputation (MI) procedure with publicly available data from a recent clinical trial. Listwise deletion, single imputation (i.e., positive UA imputation), and MI missing data procedures were used to comparatively examine the effect of two different buprenorphine/naloxone tapering schedules (7- or 28-days) for opioid addiction on the likelihood of a positive UA (Clinical Trial Network 0003; Ling et al., 2009). The listwise deletion of missing data resulted in a nonsignificant effect for the taper while the positive UA imputation procedure resulted in a significant effect, replicating the original findings by Ling et al. (2009). Although the MI procedure also resulted in a significant effect, the effect size was meaningfully smaller and the standard errors meaningfully larger when compared to the positive UA procedure. This study demonstrates that the researcher can obtain markedly different results depending on how the missing data are handled. Missing data theory suggests that listwise deletion and single imputation procedures should not be used to account for missing information, and that MI has advantages with respect to internal and external validity when the assumption of missing at random can be reasonably supported. PMID:22329556

  17. Subliminal stimulation of symbiotic fantasies as an aid in the treatment of drug abusers.

    Science.gov (United States)

    Thornton, P I; Igleheart, H C; Silverman, L H

    1987-08-01

    Forty-seven heroin addicts being treated at the New York VA Methadone Clinic were divided into an experimental and a control group. In addition to the regular methadone treatment program, both groups received subliminal exposures to a verbal message for 24 sessions (4 times a week for 6 weeks). The messages were MOMMY AND I ARE ONE (experimental) and PEOPLE ARE WALKING (control), administered under double-blind conditions. In keeping with the main hypothesis, the experimental subjects, when compared with controls, showed a greater decrease in their use of heroin and other illicit drugs during the postintervention period. Additionally, on a follow-up questionnaire, the experimental subjects reported being more in control of their drug habits and more effective in their work than did those in the control group. Also, analysis of the patients' reported dreams revealed that the experimental group had more dreams containing positive interactions with a significant woman or son than did the control group.

  18. Treatment of Anxiety Disorders and Comorbid Alcohol Abuse with Buspirone in a Patient with Antidepressant-Induced Platelet Dysfunction: A Case Report

    Directory of Open Access Journals (Sweden)

    Mir Mazhar

    2013-01-01

    Full Text Available The risk of abnormal bleeding with serotonin reuptake inhibitors has been known, but there is insufficient evidence base to guide pharmacological treatment of anxiety in patients with underlying haematological conditions. The following case report is about a 50-year-old female with generalized anxiety disorder, social phobia, obsessive compulsive disorder, and alcohol abuse where pharmacological treatment of anxiety symptoms has been difficult as it would lead to bruising due to the patient’s underlying qualitative platelet dysfunction. Treatment with venlafaxine, citalopram, escitalopram, and clomipramine resulted in improvement and anxiety symptoms, as well as reduction in alcohol use, but pharmacological treatment has to be discontinued because of bruising and hematomas. In view of an active substance use disorder, benzodiazepines were avoided as a treatment option. The patient’s anxiety symptoms and comorbid alcohol abuse responded well to pharmacological treatment with buspirone which gradually titrated up to a dose of 30 mg BID. Patient was followed for around a six-month period while she was on buspirone before being discharged to family doctor’s care. Buspirone is unlikely to have a significant effect on platelet serotonin transponder and could be an effective alternative for pharmacological treatment of anxiety in patients with a bleeding diathesis.

  19. Research progress on treatment of affective disorder comorbid substance abuse%情感障碍共病物质滥用的治疗研究进展

    Institute of Scientific and Technical Information of China (English)

    孙霞

    2015-01-01

    情感障碍合并物质滥用在精神科临床常见,共病物质滥用的患者其症状更严重、治疗依从性及治疗效果更差、更难以康复.作者汇总情感障碍共病物质滥用的治疗方面研究和近十年来针对双相情感障碍共病物质依赖的文献,其中,使用喹硫平、丙戊酸盐、胞磷胆碱,相对于安慰剂组有效.目前,研究对于治疗重性抑郁共病物质滥用的患者的效果尚无定论,荟萃分析结果显示,抗抑郁药物对于共病的物质依赖有部分作用.基因研究提示部分基因多态性会影响共病物质依赖的情感障碍患者的治疗和恢复.总的来说,现有的证据显示药物治疗对于共病物质依赖的情感障碍患者有益,对于单药治疗还是合并用药的疗效,各项研究结果并不一致.%The affective disorder combined with substance abuse is common in psychiatric department,and the comorbid patients with substance abuse have the more serious symptoms,and poorer compliance and treatment effect,while they are more difficult to recover.The author collects the researches on treatment of affective disorder comorbid substance abuse,as well as the literatures on bipolar affective disorder and substance abuse in nearly a decade,and observes that quetiapine,valproic acid salt and citicoline have the more obvious effect than placebo.At present,no final conclusion has yet been reached on the treatment effect of major depressive patients with substance abuse.Meta-analysis shows that the antidepressants have some effect on substance abuse.Genetic studies suggest some gene polymorphism can affect the treatment and recovery of patients with affective disorder and substance abuse.In general,the existing evidences reveal the drug treatment is effective for patients with affective disorder and substance abuse.However,the researches on curative effect of monotherapy and drug combination present the different results.

  20. Treatment at the front end of the criminal justice continuum: the association between arrest and admission into specialty substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Swartz James A

    2006-07-01

    Full Text Available Abstract Background To reduce criminal recidivism and drug use, it has been proposed that the substance abuse treatment delivery system cut across different components of the criminal justice continuum. Arrest, at the front end of this continuum, may represent a critical moment to motivate people with substance use disorders (SUD to seek treatment but is often over looked as an intervention point. We used data from the 2002 National Survey on Drug Use and Health (NSDUH to compare treatment need and recent treatment admission for participants with no criminal justice (CJ involvement in the past year, past-year arrest, and CJ supervision (i.e., probation or parole status. Results Of those arrested, 44.8% met criteria for an SUD. However, only 14% of those arrested with an SUD received treatment in the year of their arrest. In multivariate modelling, arrest was an independent predictor of treatment admission (odds ratio (OR = 8.74 similar in magnitude to meeting criteria for an SUD (OR = 8.22. Those further along the continuum – under supervision – were most likely to receive treatment (OR = 22.62. Conclusion Arrest involves the largest number of individuals entering the criminal justice system. The NSDUH suggests that nearly 6 million individuals in the US experience an arrest annually and that nearly half meet criteria for an SUD. Although arrest involves the largest number of individuals entering the criminal justice system, it is also the most fleeting point as individuals can move in and out rather quickly. Minimally, arrest imposes contact between the individual and a law enforcement person and can be an opportunity for early intervention strategies such as pre-arraignment diversion into treatment or brief intervention strategies. Using brief intervention at this early point in the continuum may motivate a greater number of individuals to seek treatment or decrease drug and alcohol use. Training and procedural shifts at this point of

  1. Treatment at the front end of the criminal justice continuum: the association between arrest and admission into specialty substance abuse treatment

    Science.gov (United States)

    Kubiak, Sheryl Pimlott; Arfken, Cynthia L; Swartz, James A; Koch, Alison L

    2006-01-01

    Background To reduce criminal recidivism and drug use, it has been proposed that the substance abuse treatment delivery system cut across different components of the criminal justice continuum. Arrest, at the front end of this continuum, may represent a critical moment to motivate people with substance use disorders (SUD) to seek treatment but is often over looked as an intervention point. We used data from the 2002 National Survey on Drug Use and Health (NSDUH) to compare treatment need and recent treatment admission for participants with no criminal justice (CJ) involvement in the past year, past-year arrest, and CJ supervision (i.e., probation or parole status). Results Of those arrested, 44.8% met criteria for an SUD. However, only 14% of those arrested with an SUD received treatment in the year of their arrest. In multivariate modelling, arrest was an independent predictor of treatment admission (odds ratio (OR) = 8.74) similar in magnitude to meeting criteria for an SUD (OR = 8.22). Those further along the continuum – under supervision – were most likely to receive treatment (OR = 22.62). Conclusion Arrest involves the largest number of individuals entering the criminal justice system. The NSDUH suggests that nearly 6 million individuals in the US experience an arrest annually and that nearly half meet criteria for an SUD. Although arrest involves the largest number of individuals entering the criminal justice system, it is also the most fleeting point as individuals can move in and out rather quickly. Minimally, arrest imposes contact between the individual and a law enforcement person and can be an opportunity for early intervention strategies such as pre-arraignment diversion into treatment or brief intervention strategies. Using brief intervention at this early point in the continuum may motivate a greater number of individuals to seek treatment or decrease drug and alcohol use. Training and procedural shifts at this point of contact could have

  2. Physical Abuse

    Science.gov (United States)

    ... be acquaintances, sons, daughters, grandchildren, or others. Physical abuse that is perpetrated by spouses or intimate partners in order to gain power and control over the victim is described in ...

  3. Hippotherapy as a treatment for socialization after sexual abuse and emotional stress.

    Science.gov (United States)

    Guerino, Marcelo R; Briel, Alysson F; Araújo, Maria das Graças Rodrigues

    2015-03-01

    [Purpose] Hippotherapy is a therapeutic resource that uses the horse as a kinesiotherapy instrument to elicit motor and cognitive improvements in individuals with special needs. [Subjects and Methods] This research evaluated two women aged 18 and 21 years, who had suffered sexual violence when they were children between the ages of 6 and 7 years old. The subjects did not have mental dysfunction but they were regular students registered at a school of special education. The patients presented severe motor limitation, difficulty with coordination, significant muscular retractions, thoracic and cervical kyphosis, cervical protrusion wich was basically a function of the postures they had adopted when victims of the sexual violence suffered in childhood. The patients performed twenty sessions of 30 minutes of hippotherapy on a horse. The activities were structured to stimulate coordination, proprioception, the vestibular and motor-sensorial systems for the improvement of posture, muscle activity and cognition. [Results] The activities provided during the hippotherapy sessions elicited alterations in postural adjustment resulting in 30% improvement, 80% improvement in coordination in, 50% improvement in corporal balance and in sociability and self-esteem. [Conclusion] Hippotherapy proved to be an effective treatment method for coordination, balance and postural correction, and also improved the patients' self-esteem that had suffered serious emotional stress.

  4. Self-Reported HIV and HCV Screening Rates and Serostatus Among Substance Abuse Treatment Patients.

    Science.gov (United States)

    Hernández, Diana; Feaster, Daniel J; Gooden, Lauren; Douaihy, Antoine; Mandler, Raul; Erickson, Sarah J; Kyle, Tiffany; Haynes, Louise; Schwartz, Robert; Das, Moupali; Metsch, Lisa

    2016-01-01

    Substance users are at increased risk for HIV and HCV infection. Still, many substance use treatment programs (SUTP) fail to offer HIV/HCV testing. The present secondary analysis of screening data from a multi-site randomized trial of rapid HIV testing examines self-reported HIV/HCV testing patterns and serostatus of 2473 SUTP patients in 12 community-based sites that had not previously offered on-site testing. Results indicate that most respondents screened for the randomized trial tested more than a year prior to intake for HIV (52 %) and HCV (38 %). Prevalence rates were 3.6 and 30 % for HIV and HCV, respectively. The majority of participants that were HIV (52.2 %) and HCV-positive (40.5 %) reported having been diagnosed within the last 1-5 years. Multivariable logistic regression showed that members of high-risk groups were more likely to have tested. Bundled HIV/HCV testing and linkage to care issues are recommended for expanding testing in community-based SUTP settings.

  5. Stimulatory drugs of abuse in surface waters and their removal in a conventional drinking water treatment plant.

    Science.gov (United States)

    Huerta-Fontela, Maria; Galceran, Maria Teresa; Ventura, Francesc

    2008-09-15

    The presence of psychoactive stimulatory drugs in raw waters used for drinking water production and in finished drinking water was evaluated in a Spanish drinking water treatment plant (DWTP). Contamination of the river basin which provides raw water to this DWTP was also studied. In surface waters, illicit drugs such as cocaine, benzoylecgonine (cocaine metabolite), amphetamine, methamphetamine, MDMA (ecstasy), and MDA were detected at mean concentrations ranging from 4 to 350 ng/L. Nicotine, caffeine, and their metabolites were also found at the microg/L level. The elimination of these compounds during drinking water treatment was investigated in a real waterworks. Amphetamine-type stimulants (except MDMA) were completely removed during prechlorination, flocculation, and sand filtration steps, yielding concentrations lowerthan their limits of detection (LODs). Further, ozone treatment was shown to be effective in partially eliminating caffeine (76%), while subsequent granulated activated carbon (GAC) filtration removed cocaine (100%), MDMA(88%), benzoylecgonine (72%), and cotinine (63%). Postchlorination achieved the complete elimination of cocaine and nicotine and only one parent compound (caffeine) and two metabolites (cotinine and benzoylecgonine) persisted throughout treatment although reductions of 90% for caffeine and benzoylecgonine and 74% for cotinine were obtained.

  6. A Thermally Stable Form of Bacterial Cocaine Esterase: A Potential Therapeutic Agent for Treatment of Cocaine Abuse

    Energy Technology Data Exchange (ETDEWEB)

    Brim, Remy L.; Nance, Mark R.; Youngstrom, Daniel W.; Narasimhan, Diwahar; Zhan, Chang-Guo; Tesmer, John J.G.; Sunahara, Roger K.; Woods, James H. (Michigan); (Michigan-Med); (Kentucky)

    2010-09-03

    Rhodococcal cocaine esterase (CocE) is an attractive potential treatment for both cocaine overdose and cocaine addiction. CocE directly degrades cocaine into inactive products, whereas traditional small-molecule approaches require blockade of the inhibitory action of cocaine on a diverse array of monoamine transporters and ion channels. The usefulness of wild-type (wt) cocaine esterase is hampered by its inactivation at 37 C. Herein, we characterize the most thermostable form of this enzyme to date, CocE-L169K/G173Q. In vitro kinetic analyses reveal that CocE-L169K/G173Q displays a half-life of 2.9 days at 37 C, which represents a 340-fold improvement over wt and is 15-fold greater than previously reported mutants. Crystallographic analyses of CocE-L169K/G173Q, determined at 1.6-{angstrom} resolution, suggest that stabilization involves enhanced domain-domain interactions involving van der Waals interactions and hydrogen bonding. In vivo rodent studies reveal that intravenous pretreatment with CocE-L169K/G173Q in mice provides protection from cocaine-induced lethality for longer time periods before cocaine administration than wt CocE. Furthermore, intravenous administration (pretreatment) of CocE-L169K/G173Q prevents self-administration of cocaine in a time-dependent manner. Termination of the in vivo effects of CoCE seems to be dependent on, but not proportional to, its clearance from plasma as its half-life is approximately 2.3 h and similar to that of wt CocE (2.2 h). Taken together these data suggest that CocE-L169K/G173Q possesses many of the properties of a biological therapeutic for treating cocaine abuse but requires additional development to improve its serum half-life.

  7. Prescription Drug Abuse

    Science.gov (United States)

    ... an opportunity to confront the person about the consequences of addiction and ask him or her to accept treatment. Think of an intervention as giving your loved one a clear opportunity to make changes before things get really bad. Prescription drug abuse may occur in people who ...

  8. A Randomized Evaluation of Multidimensional Treatment Foster Care: Effects on School Attendance and Homework Completion in Juvenile Justice Girls.

    Science.gov (United States)

    Leve, Leslie D; Chamberlain, Patricia

    2007-11-01

    Despite growing evidence that child welfare youth are at increased risk for juvenile delinquency, little is known about gender-specific processes and effective treatment programs for girls. Multidimensional Treatment Foster Care (MTFC), an empirically validated intervention for child welfare and juvenile justice populations, has demonstrated efficacy in reducing arrest rates in delinquent boys and girls. In this study, the efficacy of MTFC on school attendance and homework completion was examined in juvenile justice girls who were referred to out-of-home care (N = 81). Results from this randomized intervention trial suggest that MTFC was more effective than group care in increasing girls' school attendance and homework completion while in treatment and at 12 months postbaseline. In addition, the previously reported effect of MTFC on reducing girls' days in locked settings was mediated by homework completion while girls were enrolled in the intervention setting. Implications for policy and practice are described.

  9. History of Interpersonal Violence, Abuse, and Nonvictimization Trauma and Severity of Psychiatric Symptoms among Children in Outpatient Psychiatric Treatment

    Science.gov (United States)

    Ford, Julian D.; Gagnon, Kerry; Connor, Daniel F.; Pearson, Geraldine

    2011-01-01

    In a clinical sample of child psychiatry outpatients, chart review data were collected for 114 consecutive admissions over a 1-year period at a Child and Adolescent Outpatient Psychiatry Clinic. Data included history of documented maltreatment, potentially traumatic domestic or community violence, neglect or emotional abuse, and noninterpersonal…

  10. Group Cognitive Behavioral Treatment for Parents and Children At-Risk for Physical Abuse: An Initial Study

    Science.gov (United States)

    Runyon, Melissa K.; Deblinger, Esther; Steer, Robert A.

    2010-01-01

    To compare the relative efficacy of two types of group cognitive-behavioral therapy for treating the traumatized child and at-risk or offending parent in cases of child physical abuse (CPA), 24 parents and their children were treated with Combined Parent-Child Cognitive Behavioral Therapy (CPC-CBT) and 20 parents were treated with Parent-Only CBT.…

  11. Exposing the culture of silence: Inhibiting factors in the prevention, treatment, and mitigation of sexual abuse in the Eastern Caribbean.

    Science.gov (United States)

    Jeremiah, Rohan D; Quinn, Camille R; Alexis, Jicinta M

    2017-02-24

    This article features a study that explored the presence of adverse childhood experiences (ACEs), including childhood sexual abuse and neglect, among women associated with Partnership for Peace (PfP), the first and only culturally adapted domestic violence diversion program for men in the Eastern Caribbean. Within a multiyear evaluative study that assessed the impact of the PfP intervention in reducing domestic violence in Grenada in the West Indies, life-history interviews were collected from a subsample of women (N=9) associated with men enrolled in the PfP program between 2009 and 2011. We found that the exposure to sexual abuse and neglect during childhood was evident in the histories of the women. Most perpetrators were trusted family or community members who suffered from a common set of behavioral patterns, most prominently alcohol use. Our findings reflect an evidence-based connection, as one causative factor, of a culture of silence that is related to child sexual abuse and its management. The apparent lasting effects of these traumatic childhood exposures reflect cycles of abuse in the life histories collected during the domestic violence evaluation study. Our study identified three key structural deficiencies (insufficient research, ineffective policy, and lack of public-health interventions) and one embedded cultural norm (the culture of silence) that together "inhibit current attempts to address ACEs as a means of curbing domestic violence in the Caribbean."

  12. Design paper: The CapOpus trial: a randomized, parallel-group, observer-blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis

    DEFF Research Database (Denmark)

    Hjorthøj, Carsten; Fohlmann, Allan; Larsen, Anne-Mette;

    2008-01-01

    : The major objective for the CapOpus trial is to evaluate the additional effect on cannabis abuse of a specialized addiction treatment program adding group treatment and motivational interviewing to treatment as usual. DESIGN: The trial is designed as a randomized, parallel-group, observer-blinded clinical...... trial. Patients are primarily recruited through early-psychosis detection teams, community mental health centers, and assertive community treatment teams. Patients are randomized to one of two treatment arms, both lasting six months: 1) specialized addiction treatment plus treatment as usual or 2......) treatment as usual. The specialized addiction treatment is manualized and consists of both individual and group-based motivational interviewing and cognitive behavioral therapy, and incorporates both the family and the case manager of the patient.The primary outcome measure will be changes in amount...

  13. A Randomized Clinical Trial of Methadone Maintenance for Prisoners: Prediction of Treatment Entry and Completion in Prison

    Science.gov (United States)

    Gordon, Michael S.; Kinlock, Timothy W.; Couvillion, Kathryn A.; Schwartz, Robert P.; O'Grady, Kevin

    2012-01-01

    The present report is an intent-to-treat analysis involving secondary data drawn from the first randomized clinical trial of prison-initiated methadone in the United States. This study examined predictors of treatment entry and completion in prison. A sample of 211 adult male prerelease inmates with preincarceration heroin dependence were randomly…

  14. Endobronchial valves in severe emphysematous patients: CT evaluation of lung fissures completeness, treatment radiological response and quantitative emphysema analysis

    Directory of Open Access Journals (Sweden)

    Marcel Koenigkam-Santos

    2013-02-01

    Full Text Available OBJECTIVE: To evaluate lung fissures completeness, post-treatment radiological response and quantitative CT analysis (QCTA in a population of severe emphysematous patients submitted to endobronchial valves (EBV implantation. MATERIALS AND METHODS: Multi-detectors CT exams of 29 patients were studied, using thin-section low dose protocol without contrast. Two radiologists retrospectively reviewed all images in consensus; fissures completeness was estimated in 5% increments and post-EBV radiological response (target lobe atelectasis/volume loss was evaluated. QCTA was performed in pre and post-treatment scans using a fully automated software. RESULTS: CT response was present in 16/29 patients. In the negative CT response group, all 13 patients presented incomplete fissures, and mean oblique fissures completeness was 72.8%, against 88.3% in the other group. QCTA most significant results showed a reduced post-treatment total lung volume (LV (mean 542 ml, reduced EBV-submitted LV (700 ml and reduced emphysema volume (331.4 ml in the positive response group, which also showed improved functional tests. CONCLUSION: EBV benefit is most likely in patients who have complete interlobar fissures and develop lobar atelectasis. In patients with no radiological response we observed a higher prevalence of incomplete fissures and a greater degree of incompleteness. The fully automated QCTA detected the post-treatment alterations, especially in the treated lung analysis.

  15. Endobronchial valves in severe emphysematous patients: CT evaluation of lung fissures completeness, treatment radiological response and quantitative emphysema analysis

    Energy Technology Data Exchange (ETDEWEB)

    Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br, E-mail: marcelk46@usp.b [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Hospital das Clinicas da Faculdade de Medicina; Paula, Wagner Diniz de [University of Brasilia (UnB), DF (Brazil). Brasilia University Hospital; Gompelmann, Daniela [University of Heidelberg (Germany). Department of Pneumology and Respiratory Medicine of the Chest Clinic (Thoraxklinik); Kauczor, Hans-Ulrich [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology; Heussel, Claus Peter; Puderbach, Michael [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology with Nuclear Medicine of the Chest Clinic (Thoraxklinik)

    2013-01-15

    Objective: To evaluate lung fissures completeness, post-treatment radiological response and quantitative CT analysis (QCTA) in a population of severe emphysematous patients submitted to endobronchial valves (EBV) implantation. Materials and Methods: Multi-detectors CT exams of 29 patients were studied, using thin-section low dose protocol without contrast. Two radiologists retrospectively reviewed all images in consensus; fissures completeness was estimated in 5% increments and post-EBV radiological response (target lobe atelectasis/volume loss) was evaluated. QCTA was performed in pre and post-treatment scans using a fully automated software. Results: CT response was present in 16/29 patients. In the negative CT response group, all 13 patients presented incomplete fissures, and mean oblique fissures completeness was 72.8%, against 88.3% in the other group. QCTA most significant results showed a reduced post-treatment total lung volume (LV) (mean 542 ml), reduced EBV-submitted LV (700 ml) and reduced emphysema volume (331.4 ml) in the positive response group, which also showed improved functional tests. Conclusion: EBV benefit is most likely in patients who have complete interlobar fissures and develop lobar atelectasis. In patients with no radiological response we observed a higher prevalence of incomplete fissures and a greater degree of incompleteness. The fully automated QCTA detected the post-treatment alterations, especially in the treated lung analysis. (author)

  16. Randomization in substance abuse clinical trials

    Directory of Open Access Journals (Sweden)

    Woolson Robert F

    2006-02-01

    Full Text Available Abstract Background A well designed randomized clinical trial rates as the highest level of evidence for a particular intervention's efficacy. Randomization, a fundamental feature of clinical trials design, is a process invoking the use of probability to assign treatment interventions to patients. In general, randomization techniques pursue the goal of providing objectivity to the assignment of treatments, while at the same time balancing for treatment assignment totals and covariate distributions. Numerous randomization techniques, each with varying properties of randomness and balance, are suggested in the statistical literature. This paper reviews common randomization techniques often used in substance abuse research and an application from a National Institute on Drug Abuse (NIDA-funded clinical trial in substance abuse is used to illustrate several choices an investigator faces when designing a clinical trial. Results Comparisons and contrasts of randomization schemes are provided with respect to deterministic and balancing properties. Specifically, Monte Carlo simulation is used to explore the balancing nature of randomization techniques for moderately sized clinical trials. Results demonstrate large treatment imbalance for complete randomization with less imbalance for the urn or adaptive scheme. The urn and adaptive randomization methods display smaller treatment imbalance as demonstrated by the low variability of treatment allocation imbalance. For all randomization schemes, covariate imbalance between treatment arms was small with little variation between adaptive schemes, stratified schemes and unstratified schemes given that sample sizes were moderate to large. Conclusion We develop this paper with the goal of reminding substance abuse researchers of the broad array of randomization options available for clinical trial designs. There may be too quick a tendency for substance abuse researchers to implement the fashionable urn

  17. The association between adjustment disorder diagnosed at psychiatric treatment facilities and completed suicide

    DEFF Research Database (Denmark)

    Gradus, Jaimie L; Qin, Ping; Lincoln, Alisa K;

    2010-01-01

    is associated with suicidal ideation and suicide attempt. However the association between adjustment disorder and completed suicide has yet to be examined. The current study is a population-based case control study examining this association in the population of Denmark aged 15 to 90 years. All suicides...

  18. New drugs of abuse.

    Science.gov (United States)

    Rech, Megan A; Donahey, Elisabeth; Cappiello Dziedzic, Jacqueline M; Oh, Laura; Greenhalgh, Elizabeth

    2015-02-01

    Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases.

  19. Design paper: The CapOpus trial: A randomized, parallel-group, observer-blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis

    Directory of Open Access Journals (Sweden)

    Gluud Christian

    2008-07-01

    Full Text Available Abstract Background A number of studies indicate a link between cannabis-use and psychosis as well as more severe psychosis in those with existing psychotic disorders. There is currently insufficient evidence to decide the optimal way to treat cannabis abuse among patients with psychosis. Objectives The major objective for the CapOpus trial is to evaluate the additional effect on cannabis abuse of a specialized addiction treatment program adding group treatment and motivational interviewing to treatment as usual. Design The trial is designed as a randomized, parallel-group, observer-blinded clinical trial. Patients are primarily recruited through early-psychosis detection teams, community mental health centers, and assertive community treatment teams. Patients are randomized to one of two treatment arms, both lasting six months: 1 specialized addiction treatment plus treatment as usual or 2 treatment as usual. The specialized addiction treatment is manualized and consists of both individual and group-based motivational interviewing and cognitive behavioral therapy, and incorporates both the family and the case manager of the patient. The primary outcome measure will be changes in amount of cannabis consumption over time. Other outcome measures will be psychosis symptoms, cognitive functioning, quality of life, social functioning, and cost-benefit analyses. Trial registration ClinicalTrials.gov NCT00484302.

  20. Change in parent- and child-reported internalizing and externalizing behaviors among substance abusing runaways: the effects of family and individual treatments.

    Science.gov (United States)

    Slesnick, Natasha; Guo, Xiamei; Feng, Xin

    2013-07-01

    Shelter-recruited adolescents are known to have high rates of substance abuse and co-occurring internalizing and externalizing problem behaviors. Many studies have documented these mental health concerns, but only a small number of studies have tested interventions that may be useful for ameliorating these vulnerabilities. The current study compared three empirically supported psychotherapy interventions, Motivational Interviewing (MI), the Community Reinforcement Approach (CRA), and Ecologically-Based Family Therapy (EBFT) with 179 substance abusing runaway adolescents (47 % female, 74 % minority) and their primary caretaker recruited through a Midwestern runaway crisis shelter. Examining both child and primary caretaker reports, each treatment was associated with significant reductions in internalizing and externalizing behaviors to 24 months post-baseline. However, the trajectory of change differed among the treatments. Adolescents receiving MI showed a quicker reduction in internalizing and externalizing behaviors but also a quicker increase in these behaviors compared to adolescents receiving EBFT, who continued to evidence improvements to 24 months. The findings provide support for continued evaluation of these treatments for use with this vulnerable population of adolescents.

  1. From lymph to fat: liposuction as a treatment for complete reduction of lymphedema.

    Science.gov (United States)

    Brorson, Håkan

    2012-03-01

    There is some controversy regarding liposuction for late-stage lymphedemas. Although it is clear that conservative therapies such as complex decongestive therapy and controlled compression therapy should be tried in the first instance, options for the treatment of late-stage lymphedema that is not responding to treatment is not so clear. Liposuction has been used for many years to treat lipodystrophy. Some results have been far from optimal; however, improvements in technique, patient preparation, and patient follow-up have led to a greater and a wider acceptance of liposuction as a treatment for lymphedema. This article outlines the benefits of using liposuction and presents the evidence to support its use.

  2. Deferasirox treatment improved hematopoiesis and led to complete remission in a patient with pure red cell aplasia.

    Science.gov (United States)

    Kojima, Minoru; Machida, Shinichiro; Sato, Ai; Miyamoto, Mitsuki; Moriuchi, Makiko; Ohbayashi, Yoshiaki; Ando, Kiyoshi

    2013-12-01

    A 64-year-old woman developed pure red cell aplasia (PRCA) 4 years after thymectomy for thymoma. During anti-thymocyte globulin treatment, the patient developed cytomegalovirus pneumonia and was thus unable to continue immunosuppressive therapy and became transfusion dependent. Deferasirox was started for treatment with iron overload when serum ferritin increased to >1000 ng/mL. Seven months after initiation of deferasirox treatment, serum ferritin level decreased the normal range and the patient has remained transfusion independent thereafter. Deferasirox was discontinued when serum ferritin level decreased below 500 ng/mL, and she has maintained in complete remission over the last 15 months. Hypotheses have been raised regarding the improvement of hematopoiesis by deferasirox treatment, but the mechanism whereby this might be achieved remains unclear. Deferasirox treatment may be clinically beneficial both by reducing iron overload and by improving hematopoiesis in patients with PRCA.

  3. Clinical Holistic Medicine: The Case Story of Anna. I. Long-Term Effect of Childhood Sexual Abuse and Incest with a Treatment Approach

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2006-01-01

    Full Text Available The nervous breakdown of a 22-year-old, young woman was caused by severe sexual abuse in childhood, which was repressed over many years. During therapy, the patient accumulated resources to start the painful integration of these old traumas. Using holistic existential therapy in accordance with the life mission theory and the holistic process theory of healing, she finally was able to confront her old traumas and heal her existence. She seemingly recovered completely (including regaining full emotional range through holistic existential therapy, individually and in a group. The therapy took 18 months and more than 100 hours of intensive therapy. In the beginning of the therapy, the issues were her physical and mental health; in the middle of the therapy, the central issue was her purpose of life and her love life; and at the conclusion of the therapy, the issue was gender and sexuality. The strategy was to build up her strength for several months, mobilizing hidden resources and motivation for living, before the old traumas could be confronted and integrated. The therapy was based on quality of life philosophy, on the life mission theory, the theory of ego, the theory of talent, the theory of the evil side of man, the theory of human character, and the holistic process theory of healing. The clinical procedures included conversation, philosophical training, group therapeutic tools, extended use of therapeutic touch, holistic pelvic examination, and acceptance through touch was used to integrate the early traumas bound to the pelvis and scar tissue in the sexual organs. She was processed according to 10 levels of the advanced toolbox for holistic medicine and the general plan for clinical holistic psychiatry. The emotional steps she went through are well described by the scale of existential responsibility. The case story of Anna is an example of how even the most severely ill patient can recover fully with the support of holistic medical

  4. Child abuse, a case report

    Directory of Open Access Journals (Sweden)

    Andri M.T. Lubis

    2004-03-01

    Full Text Available Child abuse is a pervasive social and medical problem that remains a major cause of disability and death among children. The annual incidence of abuse is estimated to be 15 to 42 cases per 1,000 children and appears to be increasing. Fractures are the second most common presentation of physical abuse after skin lesions, and approximately one third of abused children will eventually be seen by an orthopedic surgeon. We report a 7-month-old boy who was suspected to be abused. Our diagnosis was based on findings of multiple fractures, delay in seeking medical treatment and discrepancy between the history of illness and the clinical findings. He sustained multiple fractures in variety of healing, namely fractures on left supracondylar humeri, left radius and ulna, right radius and ulna, both femora, right tibia, and left tibia and fibula. Radiological examination was an important modality in revealing the possibility of abuse on this child. He had received medical treatment, protection, consultation team for the parents and an underway police investigation. (Med J Indones 2004; 13: 59-65 Keywords: child, abuse

  5. Drug histories and criminality of inmates of local jails in the United States (1978): implications for treatment and rehabilitation of the drug abuser in a jail setting.

    Science.gov (United States)

    Barton, W I

    1982-04-01

    A survey by the Department of Justice in 1978 of inmates of local jails in the United States found that 68% had ever used drugs like heroin, cocaine, marijuana, amphetamines, or barbiturates outside a treatment program, and without a doctor's prescription. Offenses for which relatively larger proportions of inmates reported drug use included robbery, burglary, auto theft, larceny, and drug offenses. During the month prior to jail, 44% of inmates reported using drugs. Some 21% of convicted inmates reported being under the influence of drugs at the time of an offense for which convicted. One-fourth of inmates reporting drug use had ever been enrolled in drug treatment. Treatment and rehabilitation of the drug abuser in a jail setting is discussed.

  6. UASB/flash aeration enable complete treatment of municipal wastewater for reuse.

    Science.gov (United States)

    Khan, Abid Ali; Gaur, Rubia Zahid; Lew, Beni; Diamantis, Vasileios; Mehrotra, Indu; Kazmi, A A

    2012-08-01

    A simple, efficient and cost-effective method for municipal wastewater treatment is examined in this paper. The municipal wastewater is treated using an upflow anaerobic sludge bed (UASB) reactor followed by flash aeration (FA) as the post-treatment, without implementing aerobic biological processes. The UASB reactor was operated without recycle, at hydraulic retention time (HRT) of 8 h and achieved consistent removal of BOD, COD and TSS of 60-70% for more than 12 months. The effect of FA on UASB effluent post-treatment was studied at different HRT (15, 30 and 60 min) and dissolved oxygen (DO) concentrations (low DO = 1-2 mg/L and high DO = 5-6 mg/L). The optimum conditions for BOD, COD and sulfide removal were 30-60 min HRT and high DO concentration inside the FA tank. The final effluent after clarification was characterized by BOD and COD values of 28-35 and 50-58 mg/L, respectively. Sulfides were removed by more than 80%, but the fecal coliform only by ~2 log. The UASB followed by FA is a simple and efficient process for municipal wastewater treatment, except for fecal coliform, enabling water and nutrients recycling to agriculture.

  7. Treatment of Complete Anal Stricture after Diverting Colostomy for Fournier's Gangrene

    Science.gov (United States)

    Kubota, Tadao; Lefor, Alan Kawarai; Mizokami, Ken

    2017-01-01

    Background. Anal stenosis is a rare but serious complication of anorectal surgery. Severe anal stenosis is a challenging condition. Case Presentation. A 70-year-old Japanese man presented with a ten-hour history of continuous anal pain due to incarcerated hemorrhoids. He had a history of reducible internal hemorrhoids and was followed for 10 years. He had a fever and nonreducible internal hemorrhoids surrounding necrotic soft tissues. He was diagnosed as Fournier's gangrene and treated with debridement and diverting colostomy. He needed temporary continuous renal replacement therapy and was discharged on postoperative day 39. After four months, severe anal stenosis was found on physical examination, and total colonoscopy showed a complete anal stricture. The patient was brought to the operating room and underwent colostomy closure and anoplasty. He recovered without any complications. Conclusion. We present a first patient with a complete anal stricture after diverting colostomy treated with anoplasty and stoma closure. This case reminds us of the assessment of distal bowel conduit and might suggest that anoplasty might be considered in the success of the colostomy closure. PMID:28255493

  8. Effects of Childhood Sexual Abuse on the Psychosocial Functioning of Adults.

    Science.gov (United States)

    Strean, Herbert S.

    1988-01-01

    Reviews research on effects of childhood sexual abuse in adulthood. Describes individualizing assessment of adults who have been abused and aspects of treatment illustrated by case studies. Concludes social workers need to expand definition of childhood sexual abuse. (ABL)

  9. Drug abuse in athletes

    Directory of Open Access Journals (Sweden)

    Reardon CL

    2014-08-01

    Full Text Available Claudia L Reardon, Shane Creado Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Abstract: Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions. Keywords: doping, athletes, steroids, drug abuse, mental illness

  10. Drugs of abuse and Parkinson's disease.

    Science.gov (United States)

    Mursaleen, Leah R; Stamford, Jonathan A

    2016-01-01

    The term "drug of abuse" is highly contextual. What constitutes a drug of abuse for one population of patients does not for another. It is therefore important to examine the needs of the patient population to properly assess the status of drugs of abuse. The focus of this article is on the bidirectional relationship between patients and drug abuse. In this paper we will introduce the dopaminergic systems of the brain in Parkinson's and the influence of antiparkinsonian drugs upon them before discussing this synergy of condition and medication as fertile ground for drug abuse. We will then examine the relationship between drugs of abuse and Parkinson's, both beneficial and deleterious. In summary we will draw the different strands together and speculate on the future merit of current drugs of abuse as treatments for Parkinson's disease.

  11. Predictors and moderators of outcomes of HIV/STD sex risk reduction interventions in substance abuse treatment programs: a pooled analysis of two randomized controlled trials

    Science.gov (United States)

    2014-01-01

    Background The objective of the current study was to examine predictors and moderators of response to two HIV sexual risk interventions of different content and duration for individuals in substance abuse treatment programs. Methods Participants were recruited from community drug treatment programs participating in the National Institute on Drug Abuse Clinical Trials Network (CTN). Data were pooled from two parallel randomized controlled CTN studies (one with men and one with women) each examining the impact of a multi-session motivational and skills training program, in comparison to a single-session HIV education intervention, on the degree of reduction in unprotected sex from baseline to 3- and 6- month follow-ups. The findings were analyzed using a zero-inflated negative binomial (ZINB) model. Results Severity of drug use (p < .01), gender (p < .001), and age (p < .001) were significant main effect predictors of number of unprotected sexual occasions (USOs) at follow-up in the non-zero portion of the ZINB model (men, younger participants, and those with greater severity of drug/alcohol abuse have more USOs). Monogamous relationship status (p < .001) and race/ethnicity (p < .001) were significant predictors of having at least one USO vs. none (monogamous individuals and African Americans were more likely to have at least one USO). Significant moderators of intervention effectiveness included recent sex under the influence of drugs/alcohol (p < .01 in non-zero portion of model), duration of abuse of primary drug (p < .05 in non-zero portion of model), and Hispanic ethnicity (p < .01 in the zero portion, p < .05 in the non-zero portion of model). Conclusion These predictor and moderator findings point to ways in which patients may be selected for the different HIV sexual risk reduction interventions and suggest potential avenues for further development of the interventions for increasing their effectiveness within certain

  12. Occurrence of herpes zoster varicella infections after completion of treatment for Hodgkin's disease

    Energy Technology Data Exchange (ETDEWEB)

    Pauw, B.E. de; Janssen, J.Th.P.; Vaissier, P.; Haanen, C. (Katholieke Univ. Nijmegen (Netherlands). Dept. of Internal Medicine)

    1983-01-01

    Retrospective analysis of 210 cases of patients with Hodgkin's disease revealed an overall incidence of herpes zoster varicella of 9.5 per cent. Patients with the mixed cellular histological subtype showed a significantly increased (p < 0.05) risk as compared with the total population. More than 90 per cent of the herpes zoster varicella infections occurred after termination of treatment; a combination of radiotherapy with chemotherapy proved to be a predisposing factor.

  13. School-Based Counseling of Abused Children

    Science.gov (United States)

    Brassard, Marla R.; Rivelis, Erin; Diaz, Vielka

    2009-01-01

    Abused children experience high rates of behavior, emotional, and learning problems but infrequently receive treatment. Most services provided to abused children and their families are not based on any clear evidence that they work. A number of evidence-based treatments (EBTs), demonstrated to be safe and effective in treating a range of…

  14. Complete Treatment Versus Residual Lesion - Long-Term Evolution After Acute Coronary Syndrome

    Science.gov (United States)

    Soeiro, Alexandre de Matos; Scanavini Filho, Marco Antônio; Bossa, Aline Siqueira; Zullino, Cindel Nogueira; Soeiro, Maria Carolina F. Almeida; Leal, Tatiana Carvalho Andreucci T; Serrano Jr, Carlos Vicente; Hajjar, Ludhmila Abrahão; Kalil Filho, Roberto; Oliveira Jr, Múcio Tavares

    2016-01-01

    Introduction A recently published study raised doubts about the need for percutaneous treatment of nonculprit lesions in patients with acute coronary syndromes (ACS). Methods Retrospective, unicentric, observational study. Objective To analyze the long-term outcomes in patients undergoing treatment of the culprit artery, comparing those who remained with significant residual lesions in nonculprit arteries (group I) versus those without residual lesions in other coronary artery beds (group II). The study included 580 patients (284 in group I and 296 in group II) between May 2010 and May 2013. We obtained demographic and clinical data, as well as information regarding the coronary treatment administered to the patients. In the statistical analysis, the primary outcome included combined events (reinfarction/angina, death, heart failure, and need for reintervention). The comparison between groups was performed using the chi-square test and ANOVA. The long-term analysis was conducted with the Kaplan-Meier method, with a mean follow-up of 9.86 months. Results The mean ages were 63 years in group I and 62 years in group II. On long-term follow-up, there was no significant difference in combined events in groups I and II (31.9% versus 35.6%, respectively, p = 0.76). Conclusion The strategy of treating the culprit artery alone seems safe. In this study, no long-term differences in combined endpoints were observed between patients who remained with significant lesions compared with those without other obstructions.

  15. Complete dataset for 2-treatment, 2-sequence, 2-period efavirenz bioequivalence study conducted with nightly dosing

    Directory of Open Access Journals (Sweden)

    Manuel Ibarra

    2016-06-01

    Full Text Available The efavirenz pharmacokinetic raw data presented in this article was obtained in an average bioequivalence study between a local brand and Stocrin (Merck Sharp & Dohme, purchased from Australia, batch H009175, expiration date November 2013. Dose was administered at night (9:00 p.m. two hours after food intake. Fourteen healthy subjects, 8 women and 6 men, completed the study. For each subject, 15 data points until 96 h post-administration are included. Subject demographic characteristics and sequences of administration are provided along with individual pharmacokinetic profiles of efavirenz obtained for both formulations after a single oral dose of 600 mg. This data provides information in support of the research article “Sex-by-formulation interaction assessed through a bioequivalence study of efavirenz tablets” [1].

  16. Complete dataset for 2-treatment, 2-sequence, 2-period efavirenz bioequivalence study conducted with nightly dosing.

    Science.gov (United States)

    Ibarra, Manuel; Magallanes, Laura; Lorier, Marianela; Vázquez, Marta; Fagiolino, Pietro

    2016-06-01

    The efavirenz pharmacokinetic raw data presented in this article was obtained in an average bioequivalence study between a local brand and Stocrin (Merck Sharp & Dohme, purchased from Australia, batch H009175, expiration date November 2013). Dose was administered at night (9:00 p.m.) two hours after food intake. Fourteen healthy subjects, 8 women and 6 men, completed the study. For each subject, 15 data points until 96 h post-administration are included. Subject demographic characteristics and sequences of administration are provided along with individual pharmacokinetic profiles of efavirenz obtained for both formulations after a single oral dose of 600 mg. This data provides information in support of the research article "Sex-by-formulation interaction assessed through a bioequivalence study of efavirenz tablets" [1].

  17. Complete Resolution of a Case of Calcific Tendinitis of the Longus Colli with Conservative Treatment

    Science.gov (United States)

    Sakai, Toshinori; Miyagi, Ryo; Takata, Yoichiro; Higashino, Kosaku; Katoh, Shinsuke; Sairyo, Koichi; Yasui, Natsuo

    2014-01-01

    Acute calcific tendinitis of the longuscolli is a self-limiting inflammatory condition caused by calcium hydroxyapatite deposition in the longuscolli tendon. Although several case reports have described its radiological presentation, few reports provide detailed chronological accounts through symptomatic and radiologic resolution. A 59-year-old woman presented with severe neck pain and stiffness of a few days duration as well as moderate discomfort when swallowing. Lateral radiographs revealed a large calcium deposit anterior to the C1.C2 joint and swelling of the prevertebral soft tissue from C1 to C5. CT and magnetic resonance imaging showed fluid in the retropharyngeal gap.A soft collar and non-steroidal anti-inflammatory drug were prescribed, without antibiotics. At 4 months after presentation, the calcium deposit and all symptoms had resolved completely. Although this disease is comparatively rare, physicians should keep it in mind when a patient presents with acute severe neck pain. PMID:25346822

  18. [Successful treatment with reduced-intensity cord blood transplantation for acute myeloid leukemia with complete tetraploidy (92, XXXX)].

    Science.gov (United States)

    Iwasaki, Junko; Onozawa, Masahiro; Takahashi, Shojiro; Okada, Kohei; Takahata, Mutsumi; Shigematsu, Akio; Kahata, Kaoru; Kondo, Takeshi; Hashino, Satoshi; Imamura, Masahiro; Asaka, Masahiro

    2011-03-01

    A 56-year-old female was diagnosed with acute myeloid leukemia (FAB: AML-M1). G-banding karyotype of her bone marrow showed complete tetraploidy (92, XXXX [24/24]). Although she achieved complete remission (CR) after induction therapy and maintained CR during consolidation therapy, relapse occurred only 2 months after discharge. When the relapse occurred, bone marrow karyotypic analysis showed complete tetraploidy again. The patient received reduced-intensity cord blood transplantation (RI-CBT), which induced CR for the second time. The patient is currently alive 24 months after transplantation and there have not been any signs of recurrence to date. There have been a few reports of AML with near-tetraploidy, but cases of AML with complete tetraploidy are extremely rare. Tetraploid AML has been reported to have a poor prognosis and there have been very few cases maintaining CR over the long term after chemotherapy alone. This is the first case of complete tetraploid AML successfully treated by RI-CBT. The clinical course of this case suggests that hematopoietic stem cell transplantation during the first CR phase should be considered a treatment option for tetraploid AML.

  19. Carcinogenicity and teratogenicity vs. psychogenicity: Psychological characteristics associated with self-reported Agent Orange exposure among Vietnam combat veterans who seek treatment for substance abuse

    Energy Technology Data Exchange (ETDEWEB)

    Robinowitz, R.; Roberts, W.R.; Dolan, M.P.; Patterson, E.T.; Charles, H.L.; Atkins, H.G.; Penk, W.E. (Univ. of Texas Health Science Center, Dallas (USA))

    1989-09-01

    This study asked, What are the psychological characteristics of Vietnam combat veterans who claim Agent Orange exposure when compared with combat-experienced cohorts who do not report such contamination The question was researched among 153 heroin addicts, polydrug abusers, and chronic alcoholics who were seeking treatment: 58 reported moderate to high defoliant exposure while in combat; 95 reported minimal to no exposure while in Vietnam. The null hypothesis was accepted for measures of childhood and present family social climate, premilitary backgrounds, reasons for seeking treatment, patterns and types of illicit drug and alcohol use, interpersonal problems, intellectual functioning, and short-term memory. The null hypothesis was rejected for personality differences, however, those who self-reported high Agent Orange exposure scored significantly higher on MMPI scales F, Hypochondriasis, Depression, Paranoia, Psychasthenia, Schizophrenia, Mania, and Social interoversion. The results suggest that clinicians carefully assess attributional processing of those who report traumatic experience.

  20. Freqüência de jogo patológico entre farmacodependentes em tratamento Frequency of pathological gambling among substance abusers under treatment

    Directory of Open Access Journals (Sweden)

    Simone Villas Boas de Carvalho

    2005-04-01

    Full Text Available OBJETIVO: Investigar a freqüência de jogo patológico entre dependentes de álcool e/ou outras drogas que procuraram tratamento em serviço especializado. MÉTODOS: Foram entrevistados 74 pacientes de três serviços especializados em tratamento de farmacodependência. Para diagnóstico de jogo patológico foi utilizada a escala SOGS (South Oaks Gambling Screen. O diagnóstico de dependência de álcool e de outras drogas foi estabelecido a partir dos critérios do DSM-IV e da escala SADD (Short Alcohol Dependence Data. Foram aplicadas as versões brasileiras das escalas SRQ (Self Report Questionnaire para detecção de sintomas de psiquiátricos e CES-D (Center for Epidemiological Studies Depression Scale para sintomas depressivos. As médias da pontuação obtida nessas escalas foram comparadas pelo teste t de Student. RESULTADOS: Todos os sujeitos preencheram critério para farmacodependência, sendo que 61,6% preencheram critérios para dependência de álcool 60,3% para cocaína/crack, e 34,2% para maconha. Segundo a escala SOGS, a maioria dos farmacodependentes (70,3% foi classificada como jogador social, 10,8% como "jogador problema" e 18,9% como jogador patológico. Confirmou-se a presença de sintomas psiquiátricos e depressão na amostra. Pacientes jogadores patológicos apresentaram mais sintomas depressivos que pacientes não jogadores patológicos. CONCLUSÕES: Foi encontrada alta freqüência de jogo patológico entre os farmacodependentes entrevistados. Os resultados mostram a importância da investigação de jogo patológico em pacientes farmacodependentes e inclusão de estratégias para o tratamento desse transtorno nos programas de tratamento.OBJECTIVE: To investigate the frequency of pathological gambling among alcohol and other substance abusers who sought specialized treatment. METHODS: Seventy-four outpatients from three different substance abuse treatment services were interviewed. The South Oaks Gambling Screen (SOGS

  1. Moving toward a "third generation" of contingency management studies in the abuse treatment field: comment on Silverman et al. (2001).

    Science.gov (United States)

    McLellan, A T

    2001-02-01

    The power of positively reinforced contingency management procedures has been definitively proven in the drug abuse field-even among the most severely affected clients. This study by K. Silverman, D. Svikis, E. Robles, M. L. Stitzer, and G. E. Bigelow (2001) and other studies like it have clearly moved the contingency management work out of controlled, contrived settings and into the real world. Suggestions are offered for moving the next generation of studies toward less complicated populations and using more robust reinforcements within the constraints of contemporary financial and administrative boundaries.

  2. Personality Disorders in Substance Abusers: A Comparison of Patients Treated in a Prison Unit and Patients Treated in Inpatient Treatment

    DEFF Research Database (Denmark)

    Hesse, Morten; Stefánsson, Ragnar

    2008-01-01

    Abstract  A large body of literature has shown a high prevalence of personality disorders in substance abusers. We compared a sample of substance abusers treated in a prison setting with substance abusers treated in a non-prison inpatient setting rated with the Millon Clinical Multiaxial Inventory...

  3. Comparison of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion in the treatment of ingrown toenails.

    Science.gov (United States)

    Huang, Jia-Zhang; Zhang, Yi-Jun; Ma, Xin; Wang, Xu; Zhang, Chao; Chen, Li

    2015-01-01

    The present retrospective study compared the efficacy of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion for the treatment of ingrown toenails (onychocryptosis). Two surgical methods were performed in 95 patients with a stage 2 or 3 ingrown toenail. Each patient was examined weekly until healing and then at 1, 6, and 12 months of follow-up. The outcomes measured were surgical duration, healing time, recurrence rate, the incidence of postoperative infection, and cosmetic appearance after surgery. Of the 95 patients (115 ingrown toenails) included in the present study, 39 (41.1%) underwent wedge resection (Winograd procedure) and 56 (59%), wedge resection plus complete nail plate avulsion. The mean surgical duration for wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion was 14.9 ± 2.4 minutes and 15.1 ± 3.2 minutes, respectively (p = .73). The corresponding healing times were 2.8 ± 1.2 weeks and 2.7 ± 1.3 weeks (p = .70). Recurrence developed in 3 (3.2%) patients after wedge resection (Winograd procedure) and in 4 (4.2%) after wedge resection plus complete nail plate avulsion. In addition, postoperative infection occurred in 3 (3.2%) patients after wedge resection (Winograd procedure) and 2 (2.1%) after wedge resection plus complete nail plate avulsion. Both of the surgical procedures were practical and appropriate for the treatment of ingrown toenails, being simple and associated with low morbidity and a high success rate. However, cosmetically, wedge resection (Winograd procedure) would be the better choice because the nail plate remains intact.

  4. Interferon alpha therapy for hepatitis C: treatment completion and response rates among patients with substance use disorders

    Directory of Open Access Journals (Sweden)

    Loftis Jennifer M

    2007-01-01

    Full Text Available Abstract Background Individuals with substance use disorders (SUDs are at increased risk for hepatitis C viral infection (HCV, and few studies have explored their treatment responses empirically. The objective of this study was to assess interferon alpha therapy (IFN completion and response rates among patients with HCV who had a history of comorbid SUDs. More data is needed to inform treatment strategies and guidelines for these patients. Using a medical record database, information was retrospectively collected on 307,437 veterans seen in the Veterans Integrated Service Network 20 (VISN 20 of the Veterans Healthcare Administration (VHA between 1998 and 2003. For patients treated with any type of IFN (including regular or pegylated IFN or combination therapy (IFN and ribavirin who had a known HCV genotype, IFN completion and response rates were compared among patients with a history of SUD (SUD+ Group and patients without a history of SUD (SUD- Group. Results Odds ratio analyses revealed that compared with the SUD- Group, the SUD+ Group was equally likely to complete IFN therapy if they had genotypes 2 and 3 (73.1% vs. 68.0%, and if they had genotypes 1 and 4 (39.5% vs. 39.9%. Within the sample of all patients who began IFN therapy, the SUD- and SUD+ groups were similarly likely to achieve an end of treatment response (genotypes 2 and 3, 52.8% vs. 54.3%; genotypes 1 and 4, 24.5% vs. 24.8% and a sustained viral response (genotypes 2 and 3, 42.6% vs. 41.1%; genotypes 1 and 4: 16.0% vs. 22.3%. Conclusion Individuals with and without a history of SUD responded to antiviral therapy for HCV at similar rates. Collectively, these findings suggest that patients who have co-morbid SUD and HCV diagnoses can successfully complete a course of antiviral therapy.

  5. FTY720 treatment prolongs skin graft survival in a completely incompatible strain combination.

    Science.gov (United States)

    Lima, R S M; Nogueira-Martins, M F; Silva, H T; Pestana, J O M; Bueno, V

    2004-05-01

    FTY720 has shown potent immunomodulatory activity in a variety of animal organ transplant models. However, the in vivo immunosuppressive mechanism of FTY720 is still not fully understood. It has been suggested that the marked decrease in the number of peripheral blood lymphocytes during FTY720 administration could be responsible for its immunosuppressive effects. Our aims were: (1) to study the effects of FTY720 treatment on skin graft survival using a fully mismatched strain combination and (2) to evaluate lymphocyte numbers in different sites at 5 days after skin transplant. C57BL/6 mice and BALB/c mice were the donors and recipients respectively. BALB/c mice received FTY720 (1 mg/kg/d) orally for 4 consecutive days. Drug administration started 1 day before skin transplants. A small segment of tail skin was affixed on the right dorsal side of the mouse via sutures. The administration of FTY720 (4 mg/kg) prolonged skin graft survival from 12.6 +/- 2.2 days (no treatment) to 16.6 +/- 4.2 days. The histologic findings of rejection were similar for all groups. Five days after transplant, lymphocyte numbers were significantly increased in lymph nodes compared with nontransplanted or isogenic graft mice. FTY720 decreased lymphocyte numbers only in the spleen. In conclusion, FTY720 prolonged skin graft survival in a fully mismatched strain combination when administered for 4 days (day -1 to day +2) at a dose of 1 mg/kg/d. The decreased number of lymphocytes in the spleen suggests that the spleen may be a target of FTY720 activity, during the early posttransplant period.

  6. Substance Abuse and Prison Recidivism: Themes from Qualitative Interviews

    Science.gov (United States)

    Phillips, Lindsay A.

    2010-01-01

    This qualitative analysis explores the role of substance abuse in reentry from prison to society. Participants who recidivated (N = 20) in an urban prison system identified substance abuse as their primary reason for recidivism. Treatment implications are discussed.

  7. Long-Term Maintenance of Complete Response after Sorafenib Treatment for Multiple Lung Metastases from Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Eisuke Katafuchi

    2015-08-01

    Full Text Available Sorafenib is an effective treatment for unresectable hepatocellular carcinoma (HCC characterized by disease stabilization. However, the response rates are very low (<9%, and a complete response is rarely achieved. We report an extremely rare case of a HCC patient with multiple lung metastases treated with sorafenib who achieved a complete response for a long period. A 77-year-old woman was diagnosed with chronic hepatitis C in 1990. In 2007, a HCC detected in the liver was treated with percutaneous ethanol injection therapy. Subsequently, recurrence of HCC in the liver was treated with microwave coagulonecrotic therapy in 2010. In April 2011, a computed tomography (CT scan revealed innumerable multiple metastases spread diffusely in both lungs. Tumor marker levels were extremely high [α-fetoprotein (AFP 76,170 ng/ml, lens culinaris agglutinin-reactive fraction of AFP 7.5%, des-γ-carboxyprothrombin (DCP 63,400 mAU/ml]. Sorafenib was administered at a reduced dose of 400 mg/day because of old age. Four months after sorafenib treatment, AFP and DCP had decreased to within normal levels, and the multiple lung metastases had disappeared. Currently, sorafenib is administered at a reduced dose of 400 mg/day, and the complete response has been maintained for 48 months.

  8. Prescription Drug Abuse

    Science.gov (United States)

    ... Whether they're using street drugs or medications, drug abusers often have trouble at school, at home, with ... a short period of time may make a drug abuser aggressive or paranoid. Although stimulant abuse might not ...

  9. Prevent Child Abuse America

    Science.gov (United States)

    ... call the police . Crisis and support contacts For Child Abuse Reporting Numbers in your State please visit: Child ... suspected child abuse and neglect. Parent Resources Prevent Child Abuse America (800) CHILDREN A resource for tips, referrals, ...

  10. SEM-EDS-Based Elemental Identification on the Enamel Surface after the Completion of Orthodontic Treatment: In Vitro Studies

    Science.gov (United States)

    Seeliger, Julia; Lipski, Mariusz; Wójcicka, Anna; Gedrange, Tomasz; Woźniak, Krzysztof

    2016-01-01

    Braces as foreign bodies in the mouth carry a risk of side effects and toxicity to the human body. This article presents the results indicating the possible toxic effects of tools used for cleaning the enamel after the completion of orthodontic treatment. The studies were carried out in vitro. The procedure of enamel etching, bonding orthodontic metal brackets, and enamel cleaning after their removal was performed under laboratory conditions. The enamel microstructure and elements present on its surface were evaluated using the scanning electron microscope (SEM). Silicon and aluminium were found in addition to the tooth building elements.

  11. Gender differences in problem severity at assessment and treatment retention.

    Science.gov (United States)

    Arfken, C L; Klein, C; di Menza, S; Schuster, C R

    2001-01-01

    Women in treatment for substance abuse have been reported to have more severe problems at assessment than men but not to differ in treatment retention. To examine gender differences in problems at assessment, 30-day retention, and treatment completion, data from Detroit's publicly funded substance abuse treatment system were used. Women had significantly more severe problems at assessment, lower 30-day retention, and lower treatment completion rates than men. These gender differences in retention remained significant even after controlling for problem severity, primary drug of abuse, and referred treatment setting. There was no evidence of improvements in women's problems at assessment or retention over time during this period. Women presented with more severe problems at assessment and were less likely to stay in treatment for 30 days or to complete treatment than men. Monitoring gender differences in problems at presentation and retention outcomes is recommended to assess local need for interventions.

  12. Pathologic complete response confirmed by surgical resection for liver metastases of gastrointestinal stromal tumor after treatment with imatinib mesylate

    Institute of Scientific and Technical Information of China (English)

    Seiji Suzuki; Shotaro Maeda; Takashi Tajiri; Koji Sasajima; Masayuki Miyamoto; Hidehiro Watanabe; Tadashi Yokoyama; Hiroshi Maruyama; Takeshi Matsutani; Aimin Liu; Masaru Hosone

    2008-01-01

    A 39-year-old male underwent distal gastrectomy for a high grade gastrointestinal stromal tumor (GIST). Computed tomography (CT) and magnetic resonance imaging (MRI) 107 mo after the operation, revealed a cystic mass (14 cm in diameter) and a solid mass (9 cm in diameter) in the right and left lobes of the liver, respectively. A biopsy specimen of the solid mass showed a liver metastasis of GIST. The patient received imatinib mesylate (IM) treatment, 400mg/day orally. Following the IM treatment for a period of 35 mo, the patient underwent partial hepatectomy (S4+S5). The effect of IM on the metastatic lesions was interpreted as pathologic complete response (CR). Pathologically verified cases showing therapeutic efficacy of IM have been rarely reported.

  13. History of early abuse as a predictor of treatment response in patients with fibromyalgia : A post-hoc analysis of a 12-week, randomized, double-blind, placebo-controlled trial of paroxetine controlled release

    NARCIS (Netherlands)

    Pae, Chi-Un; Masand, Prakash S.; Marks, David M.; Krulewicz, Stan; Han, Changsu; Peindl, Kathleen; Mannelli, Paolo; Patkar, Ashwin A.

    2009-01-01

    Objectives. We conducted a post-hoc analysis to determine whether a history of physical or sexual abuse was associated with response to treatment in a double-blind, randomized, placebo-controlled trial of paroxetine controlled release (CR) in fibromyalgia. Methods. A randomized, double-blind, placeb

  14. Comprehensive treatment for co-occurring child maltreatment and parental substance abuse: outcomes from a 24-month pilot study of the MST-Building Stronger Families program.

    Science.gov (United States)

    Schaeffer, Cindy M; Swenson, Cynthia Cupit; Tuerk, Elena Hontoria; Henggeler, Scott W

    2013-08-01

    This manuscript presents outcomes from a pilot study of Multisystemic Therapy-Building Stronger Families (MST-BSF), an integrated treatment model for the co-occurring problem of parental substance abuse and child maltreatment among families involved in the child welfare system. Participants were 25 mother-youth dyads who participated in MST-BSF and an additional 18 families with similar demographic and case characteristics who received Comprehensive Community Treatment (CCT). At post-treatment, mothers who received MST-BSF showed significant reductions in alcohol use, drug use, and depressive symptoms; they also significantly reduced their use of psychological aggression with the youth. Youth reported significantly fewer anxiety symptoms following MST-BSF treatment. Relative to families who received CCT, mothers who received MST-BSF were three times less likely to have another substantiated incident of maltreatment over a follow-up period of 24 months post-referral. The overall number of substantiated reabuse incidents in this time frame also was significantly lower among MST-BSF families, and youth who received MST-BSF spent significantly fewer days in out-of-home placements than did their CCT counterparts. These promising preliminary outcomes support the viability of a more rigorous (i.e., randomized) evaluation of the MST-BSF model.

  15. The evaluation of sexual abuse in children.

    Science.gov (United States)

    Kellogg, Nancy

    2005-08-01

    This clinical report serves to update the statement titled "Guidelines for the Evaluation of Sexual Abuse of Children," which was first published in 1991 and revised in 1999. The medical assessment of suspected sexual abuse is outlined with respect to obtaining a history, physical examination, and appropriate laboratory data. The role of the physician may include determining the need to report sexual abuse; assessment of the physical, emotional, and behavioral consequences of sexual abuse; and coordination with other professionals to provide comprehensive treatment and follow-up of victims.

  16. Benzodiazepine use, abuse, and dependence.

    Science.gov (United States)

    O'brien, Charles P

    2005-01-01

    Although benzodiazepines are invaluable in the treatment of anxiety disorders, they have some potential for abuse and may cause dependence or addiction. It is important to distinguish between addiction to and normal physical dependence on benzodiazepines. Intentional abusers of benzodiazepines usually have other substance abuse problems. Benzodiazepines are usually a secondary drug of abuse-used mainly to augment the high received from another drug or to offset the adverse effects of other drugs. Few cases of addiction arise from legitimate use of benzodiazepines. Pharmacologic dependence, a predictable and natural adaptation of a body system long accustomed to the presence of a drug, may occur in patients taking therapeutic doses of benzodiazepines. However, this dependence, which generally manifests itself in withdrawal symptoms upon the abrupt discontinuation of the medication, may be controlled and ended through dose tapering, medication switching, and/or medication augmentation. Due to the chronic nature of anxiety, long-term low-dose benzodiazepine treatment may be necessary for some patients; this continuation of treatment should not be considered abuse or addiction.

  17. Sexual Abuse and Sexual Functioning in a Chronic Pelvic Pain Sample

    Science.gov (United States)

    Randolph, Mary E.; Reddy, Diane M.

    2006-01-01

    Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index…

  18. Does Writing about Past Childhood Abuse Reduce Psychological and Physical Symptoms?

    Science.gov (United States)

    Antal, Holly M.; Range, Lillian M.

    2009-01-01

    To see if writing about former abuse reduced depression, somatic, and sleep complaints, 664 undergraduates were screened for past physical or sexual abuse. Of those abused, 88 consenting students were randomly assigned to no-writing control or writing (20 minutes on 4 different days) about abuse or trivial topics. All completed pre-, post-, and…

  19. Methylphenidate abuse in Texas, 1998-2004.

    Science.gov (United States)

    Forrester, Mathias B

    2006-06-01

    Methylphenidate is a stimulant used in the treatment of attention deficit hyperactivity disorder in children and is subject to abuse. This study describes the patterns of methylphenidate abuse and drug identification (ID) calls received by several poison control centers in Texas. Cases were calls involving methylphenidate received by Texas poison control centers during 1998-2004. Drug ID and drug abuse calls were assessed by call year and geographic location. Drug abuse calls were then compared to all other human exposure (nonabuse) calls with respect to various factors. Of 6798 calls received involving methylphenidate, 35% were drug IDs and 56% human exposures. Of the human exposures, 9% involved abuse. The number of drug ID calls and drug abuse calls received per year both declined during the first part of 7-yr period but then increased. Male patients accounted for approximately 60% of both drug abuse and nonabuse calls. Adolescent patients comprised 55% of drug abuse calls and children less than 13 yr old comprised 62% of nonabuse calls. Although the majority of both types of human exposures occurred at the patient's own residence, drug abuse calls were more likely than non-abuse calls to involve exposures at school (15% vs. 6%) and public areas (3% vs. 0.4%). While drug abuse calls were less likely than nonabuse calls to present with no clinical effects (29% vs. 52%), they were more likely to show more serious medical outcomes. Methylphenidate abusers are more likely to be adolescents. Methylphenidate abuse as compared to other exposures is more likely to occur outside of the person's home and to involve more serious medical outcomes.

  20. Aging and Alcohol Abuse: Increasing Counselor Awareness

    Science.gov (United States)

    Williams, June M.; Ballard, Mary B.; Alessi, Hunter

    2005-01-01

    Alcohol abuse in older adulthood is a rapidly growing but often hidden problem. The authors provide an overview of the issues related to older adult alcohol abuse through a discussion of physiological, psychological, and social risk factors; an examination of appropriate assessment procedures; and an overview of factors related to treatment.

  1. Parent’s Addiction and Child Abuse

    Directory of Open Access Journals (Sweden)

    Alireza Jazayeri

    2002-10-01

    The aim of this study is review the theorical approches of child abuse and its prevalency, ethiology, prevention, assessment and treatment. Also, we try to difine the relationship between child abuse and parents addiction and their side effects in different areas of childs life .

  2. Qualifications, training, and perceptions of substance abuse counselors who work with victims of incest.

    Science.gov (United States)

    Janikowski, Timothy P; Glover-Graf, Noreen M

    2003-08-01

    The study was an initial investigation into substance abuse counselors' qualifications and their training related to providing counseling for incest. Perceptions regarding the incidence of incest and insights into the difficulties of serving this subpopulation were also gathered. A total of 121 practicing substance abuse counselors, randomly sampled from treatment facilities across the United States, completed the "Substance Abuse Counselor Survey on Clients with Incest Histories" (SACSCIH). Participants estimated that, on average, about 24% of their clients were victims of incest. They also suspected that, on average, an additional 14% of their clients were victims of incest but did not report this information to the treatment staff. Participants revealed how they collected incest-related information and the various challenges they face in treating these clients. Data are analyzed descriptively and recommendations for future research are presented.

  3. PATTERN OF SHIFTING OF SUBSTANCE ABUSE AMONG DRUG ADDICTS UNDERGOING TREATMENT AT DDCS (DRUG DEADDICTION CENTERS IN PUNJAB

    Directory of Open Access Journals (Sweden)

    Vikram Kumar

    2015-05-01

    Full Text Available SUMMARY: In India , drug addiction has reached very alarming levels in the state of Punjab . The data from a cross - sectional study in two of the DDCs in district Gurdaspur and three of the DDCs in district Hoshiarpur revealed that about 26 patients had history of shifting pattern of substance abuse . The reasons cited by the patients were of affordability , the ease of availability , the job plac e , the locality and the peer groups , in which they were hanging out . Studies also confirm the fact , that tighter control over one drug in India forced some drug users to switch to use other drugs . So , uprooting of this evil from any society needs multipron ged strategy comprising of , total supply breakdown of all types of drugs , breaking down the nexus of suppliers and the drug peddlers , support of the family and the community towards addicts , encouraging them to come out in the open for deaddiction , improvi sation of the services at DDCs , vocational rehabilitation wherever needed and integration in mainstream of the society with open arms and hearts .

  4. Integrating Art into Group Treatment for Adults with Post-Traumatic Stress Disorder from Childhood Sexual Abuse: A Pilot Study

    Science.gov (United States)

    Becker, Carol-Lynne J.

    2015-01-01

    Current research supports the use of exposure-based treatments for posttraumatic stress disorder (PTSD) and integrated treatments show potential for enhanced symptom reduction. This pilot study developed a manualized group treatment integrating art interventions with exposure, grounding, and narrative therapy for five adults with PTSD who were…

  5. Common presentations of elder abuse in health care settings.

    Science.gov (United States)

    Powers, James S

    2014-11-01

    Health care professionals encounter elder abuse in the community and in medical offices, emergency rooms, hospitals, and long-term care facilities. Keen awareness of risk factors for elder abuse and the variety of presentations in different health settings helps promote detection, treatment, and prevention of elder abuse.

  6. The Self-Image of Physically Abused Adolescents.

    Science.gov (United States)

    Hjorth, Craig W.; Ostrov, Eric

    1982-01-01

    Physically abused and nonabused adolescents from similar backgrounds were compared via the Offer Self-Image Questionnaire. Abused adolescents were shown to feel worse in family relations, emotional stability, psychopathology, impulse control, coping skills, and overall self-image. Implications for the professional's treatment of abused children…

  7. Complete Maxillary Crossbite Correction with a Rapid Palatal Expansion in Mixed Dentition Followed by a Corrective Orthodontic Treatment

    Directory of Open Access Journals (Sweden)

    Orlando Motohiro Tanaka

    2016-01-01

    Full Text Available This case report presents the interceptive orthodontic treatment of a boy, aged 8 years 4 months with a Class I malocclusion with severe transverse maxillary deficiency and complete maxillary crossbite and correction using Haas expansion and fixed appliance. The treatment goals were to correct the posterior crossbite and anterior crossbite and restore the normality of the dentition and occlusion. In phase I, the patient was treated with a modified Haas-type palatal expander, which provided a clinically significant palatal expansion and increased the maxillary arch perimeter with favorable conditions for orthodontic treatment with fixed appliances in phase II. The optimization of E-space and the use of intermaxillary Class III elastics helped to maintain the mandibular incisors upright. A removable wraparound type appliance and a bonded lingual canine-to-canine retainer were used as retention. Although the literature has reported a high rate of relapse after palatal expansion, after 2 years 9 months of posttreatment follow-up, the occlusal result was stable and no skeletal reversals could be detected.

  8. Shame, guilt, and posttraumatic stress disorder in adult survivors of childhood sexual abuse at risk for human immunodeficiency virus: outcomes of a randomized clinical trial of group psychotherapy treatment.

    Science.gov (United States)

    Ginzburg, Karni; Butler, Lisa D; Giese-Davis, Janine; Cavanaugh, Courtenay E; Neri, Eric; Koopman, Cheryl; Classen, Catherine C; Spiegel, David

    2009-07-01

    This study evaluated the effectiveness of group psychotherapy in reducing levels of shame and guilt in adult survivors of childhood sexual abuse at risk for HIV, and whether such reductions would mediate the effects of treatment on posttraumatic stress disorder (PTSD) symptoms. One hundred sixty-six women were randomized into 3 conditions: a trauma-focused group, a present-focused group, and a waitlist group. Women received 6 months of treatment and were assessed at pretreatment (T1), immediately posttreatment (T2), and 6 months posttreatment (T3). Both treatment conditions resulted in reduced shame and guilt. The treatment effect on PTSD symptoms was mediated by changes in shame, but it was not associated with changes in guilt. These findings suggest that, when treating childhood sexual abuse survivors' PTSD, it is important to address the negative self-appraisals, such as shame, that commonly accompany such symptoms.

  9. Mono- versus polydrug abuse patterns among publicly funded clients

    Directory of Open Access Journals (Sweden)

    Relyea George

    2007-11-01

    Full Text Available Abstract To examine patterns of mono- versus polydrug abuse, data were obtained from intake records of 69,891 admissions to publicly funded treatment programs in Tennessee between 1998 and 2004. While descriptive statistics were employed to report frequency and patterns of mono- and polydrug abuse by demographic variables and by study years, bivariate logistic regression was applied to assess the probability of being a mono- or polydrug abuser for a number of demographic variables. The researchers found that during the study period 51.3% of admissions reported monodrug abuse and 48.7% reported polydrug abuse. Alcohol, cocaine, and marijuana were the most commonly abused substances, both alone and in combination. Odds ratio favored polydrug abuse for all but one drug category–other drugs. Gender did not affect drug abuse patterns; however, admissions for African Americans and those living in urban areas exhibited higher probabilities of polydrug abuse. Age group also appeared to affect drug abuse patterns, with higher odds of monodrug abuse among minors and adults over 45 years old. The discernable prevalence of polydrug abuse suggests a need for developing effective prevention strategies and treatment plans specific to polydrug abuse.

  10. A multiple case study comparison of normal private preparatory school and substance abusing/mood disordered adolescents and their families.

    Science.gov (United States)

    Yeh, L S; Hedgespeth, J

    1995-01-01

    This multiple case study of ten families of normal private preparatory school adolescents and five families of substance abusing/mood disordered adolescents was an effort to identify factors that may suggest a relationship between the abuse of substances in adolescents who also have mood disorders and the following family factors: parental marital discord, degree of family satisfaction, and family problem-solving styles. The fifteen families completed four assessment instruments and participated in a videotaped problem-solving exercise. The results of this study showed that all members of the substance abusing/mood disordered adolescents' families rated themselves as dysfunctional in all major areas of family life. In contrast, the normal private preparatory school families reported satisfaction with most areas of family functioning. Communication styles also differed considerably between the two small groups of families. These results appear to support the importance of family evaluation and treatment when addressing the issue of adolescent substance abusers with mood disorders.

  11. Does group cognitive-behavioral therapy module type moderate depression symptom changes in substance abuse treatment clients?

    Science.gov (United States)

    Paddock, Susan M; Hunter, Sarah B; Leininger, Thomas J

    2014-07-01

    Little is known about the effect of group therapy treatment modules on symptom change during treatment and on outcomes post-treatment. Secondary analyses of depressive symptoms collected from two group therapy studies conducted in substance use treatment settings were examined (n=132 and n=44). Change in PHQ-9 scores was modeled using longitudinal growth modeling combined with random effects modeling of session effects, with time-in-treatment interacted with module theme to test moderation. In both studies, depressive symptoms significantly decreased during the active treatment phase. Symptom reductions were not significantly moderated by module theme in the larger study. However, the smaller pilot study's results suggest that future examination of module effects is warranted, given the data are compatible with differential reductions in reported symptoms being associated with attending people-themed module sessions versus thoughts-themed sessions.

  12. Oral and dental aspects of child abuse

    Directory of Open Access Journals (Sweden)

    Arlette Suzy Puspa Pertiwi

    2006-06-01

    Full Text Available Child abuse is defined as those acts or omissions of care that deprive a child from the opportunity to fully develop his or her unique potentials as a person either physically, socially or emotionally. The overall incidence of child abuse is not really clear. Statistical data do not show the actual rate because of the unreported cases. Dentists are in a strategic position to recognize and report the children being abused because they often see the child and parents interacting during multiple visits and over a long period of time. The orofacial region is commonly traumatized during episodes of child abuse. The characteristics and diagnostic finding of child abuse, and the protocol of reporting such cases, should be familiar to the dentist so that appropriate notification, treatment and prevention of further injury can be instituted. Dentists with experience or expertise in child abuse and neglect will strengthen their ability to prevent and detect child abuse and neglect and enhance the ability to care for and protect children. This paper discusses the oral and dental aspects of child abuse and the dentist role in evaluating this situation including prevention of child abuse.

  13. Work as An Effective Intervention Strategy and Rehabilitation Treatment Program for People Who Abuse Drugs And Alcohol%工作作为药物及酒精滥用者有效的干预策略和治疗方法

    Institute of Scientific and Technical Information of China (English)

    Lucy Wong-Hernandez; Daniel W. Wong; G. Ben Selby

    2006-01-01

    Despite years of interventions in the United States, substance abuse continues to be a major national problem in our society. For individuals affected, it can constitute a major disability and a decrease in quality of life. Current American societal expectations are that individuals who identify they are involved in substance abuse will go to treatment, eventually recover, get off public assistance straightaway, and return to work. Most rehabilitation professionals also maintain the same expectations. The reality is that efforts of prevention do not appear to diminish the number of people with substance abuse. Traditional treatment appears to have minimal, if any, influence upon the cessation of substance abuse, and traditional vocational rehabilitation practices appear unsuited for the unique problems and types of symptoms experienced by substance abusers. Creative, yet sound, alternatives that combine effective treatment strategies and non-traditional vocational rehabilitation methods need to be explored and tested for effectiveness, and applied.

  14. Impulsivity and voucher versus money preference in polydrug-dependent participants enrolled in a contingency-management-based substance abuse treatment program.

    Science.gov (United States)

    Reilly, M P; Roll, J M; Downey, K K

    2000-10-01

    Thirty-four polydrug-dependent participants enrolled in a voucher-based substance abuse treatment program were given choices between hypothetical amounts of money and hypothetical amounts of vouchers, which are traded for goods and services, to determine their preferences for the two payment modalities. It was hypothesized that the majority of participants would prefer money to voucher because under the circumstances of the treatment program, the delay associated with money exchange is shorter than the delay associated with voucher exchange. It was further hypothesized that those participants who selected money over voucher also would have greater levels of impulsivity as assessed by the Barratt Impulsiveness Rating Scale (BIS) (Barratt, 1965). The results show large individual differences in money/voucher preference with approximately half of the participants preferring money to voucher when the two amounts are equivalent. In addition, as the magnitude of the money/voucher comparisons increased from 0.50 dollars to 32.00 dollars, the percentage of participants that preferred money increased. No correlations were found between money/voucher preference and impulsivity scores.

  15. Educational Attainment and Child Abuse Potential: Implications for Adult Educators.

    Science.gov (United States)

    Osborne, Sandy; Seibel, Donnie

    1990-01-01

    Analysis of data from 138 women, infants, children participants who completed Child Abuse Potential Inventory showed mothers with higher educational attainment appeared less likely to be abusive regardless of such factors as low income, single parenthood, or large family size. Mothers who did not complete high school were at greater risk for…

  16. INFECTIVE ENDOCARDITIS IN INTRAVENOUS DRUGS ABUSED PATIENT

    Directory of Open Access Journals (Sweden)

    E. Y. Ponomareva

    2011-01-01

    Full Text Available Three-year observation of acute tricuspid infective endocarditis in intravenous drug abused patient: diagnosis, clinical features, visceral lesions, the possibility of cardiac surgery and conservative treatment, outcome.

  17. Distal and proximal factors associated with aggression towards partners and non-partners among patients in substance abuse treatment.

    Science.gov (United States)

    Epstein-Ngo, Quyen M; Walton, Maureen A; Sanborn, Michelle; Kraus, Shane; Blow, Fred; Cunningham, Rebecca; Chermack, Stephen T

    2014-10-01

    Studies of violence in substance use disorder (SUD) treatment settings typically focus on partner aggression (PA) although non-partner aggression (NPA) is also a common problem. This study examines potentially distinct paths of distal and proximal risk factors related to aggression towards non-partners (NPA) and partners (PA) among a SUD treatment sample. The sample included 176 adults reporting past-year violence. Bivariate analyses indicated several distal and proximal factors were associated with NPA and PA. According to multivariate, multiple mediation analyses youth aggression history was a factor for both NPA and PA. Alcohol and cocaine use and psychological distress were associated with NPA; marijuana use was associated with PA. There also was evidence of indirect effects of distal factors on NPA and PA. The results suggest that there may be substantially different dynamics associated with NPA and PA, and have implications for developing screening, assessment and treatment protocols targeting violence among individuals in SUD treatment.

  18. Misuse and abuse of quetiapine

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    Agnieszka Piróg-Balcerzak

    2015-02-01

    Full Text Available Quetiapine is an atypical antipsychotic agent, frequently used in psychiatry, often for symptomatic treatment against a number of mental disorders differing from the registration indications. One of the use is to soothe the clinical conditions caused by the use of various psychoactive substances. The paper presents and discusses the reports of quetiapine misuse, abuse, and even mental addiction, as well as symptoms similar to the so-called discontinuation syndrome, often mixed with withdrawal syndrome occurring in the course of addiction. Most reports concern males, and especially those with a history of other psychoactive substance abuse, and personality disorders, often in conflict with the law. Therefore, clinicians should be cautious when prescribing quetiapine to such patients. The article discusses potential mechanisms responsible for quetiapine abuse. This is probably related to its sedative and anxiolytic activity which results in the frequent use with stimulants. Also, high affinity for the H1 receptor, as antihistamines agents causes rewarding action.

  19. Tuberculosis screening in a novel substance abuse treatment center in Malaysia: Implications for a comprehensive approach for integrated care☆

    OpenAIRE

    Al-Darraji, Haider Abdulrazzaq Abed; Wong, Kee Cheong; Yeow, David Gan Eng; Fu, Jeannia Jiani; Loeliger, Kelsey; Paiji, Christopher; Kamarulzaman, Adeeba; Altice, Frederick L.

    2013-01-01

    People who use drugs (PWUD) represent a key high risk group for tuberculosis (TB). The prevalence of both latent TB infection (LTBI) and active disease in drug treatment centers in Malaysia is unknown. A cross-sectional convenience survey was conducted to assess the prevalence and correlates of LTBI among attendees at a recently created voluntary drug treatment center using a standardized questionnaire and tuberculin skin testing (TST). Participants (N = 196) were mostly men (95%), under 40 (...

  20. 42 CFR Appendix to Part 54a - Model Notice of Individuals Receiving Substance Abuse Services

    Science.gov (United States)

    2010-10-01

    ..., ET SEQ., FOR SUBSTANCE ABUSE PREVENTION AND TREATMENT SERVICES Pt. 54a, App. Appendix to Part 54a—Model Notice of Individuals Receiving Substance Abuse Services Model Notice to Individuals Receiving Substance Abuse Services No provider of substance abuse services receiving Federal funds from the...

  1. 75 FR 14175 - National Institute on Drug Abuse; Notice of Closed Meeting

    Science.gov (United States)

    2010-03-24

    ... HUMAN SERVICES National Institutes of Health National Institute on Drug Abuse; Notice of Closed Meeting... Committee: National Institute on Drug Abuse Special Emphasis Panel; Substance Abuse Treatment Referral..., National Institute on Drug Abuse, NIH, DHHS, Room 220, MSC 8401, 6101 Executive Boulevard, Bethesda,...

  2. Adolescent Drug Abuse and Alcoholism: Directions for the School and the Family.

    Science.gov (United States)

    Smith, Elsie J.

    1981-01-01

    Examines the extent of adolescent drug abuse and alcoholism, psychological factors that lead to drug abuse and drinking, and treatment approaches that have been used with young people. Focuses on drug-abusing family systems and the roles of the school and the community in combatting drug abuse. (Author/GC)

  3. Substance abusers' personality disorders and staff members' emotional reactions

    Directory of Open Access Journals (Sweden)

    Hesse Morten

    2008-04-01

    Full Text Available Abstract Background Previous research has indicated that aggressive behaviour and DSM-IV cluster B personality disorders (PD may be associated with professionals' emotional reactions to clients, and that cluster C PD may be associated with positive emotional reactions. Methods Staff members recruited from workshops completed a self-report inventory of emotional reactions to patients, the Feeling Word Checklist-58, and substance abusers completed a self-report of DSM-IV personality disorder, the DSM-IV and ICD-10 Personality Disorder Questionnaire. Correlational analysis and multiple regression analysis was used to assess the associations between personality disorders and emotional reations. Results Cluster B disorder features were associated with feeling distance to patients, and cluster C disorder features were associated with feeling helpful towards patients. Cluster A disorders had no significant impact on emotional reactions. Conclusion The findings confirm clinical experiences that personality disorder features in patients with substance abuse have an impact on staff members reactions to them. These reactions should be considered in supervision of staff, and in treatment models for patients with co-morbid personality disorders and substance abuse.

  4. Substance abuse on the college campus.

    Science.gov (United States)

    Rimsza, Mary Ellen; Moses, Karen S

    2005-02-01

    Substance abuse is a major health and behavioral concern in college students. Alcohol and marijuana are the most commonly abused drugs on college campuses. Others include tobacco, 3,4-methylenedioxymethamphetamine, gamma-hydroxybutyrate, flunitrazepam (Rohypnol), lysergic acid, ketamine, methamphetamine, phencyclidine, cocaine, and psilocybin mushrooms. This article reviews the use of these drugs by college students. Substance use is a major contributing factor in poor academic performance and failure to successfully complete a college education.

  5. Alcoholism and Alcohol Abuse

    Science.gov (United States)

    ... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... groups. NIH: National Institute on Alcohol Abuse and Alcoholism

  6. Prescription Drug Abuse

    Science.gov (United States)

    ... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that ... purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, ...

  7. What is Elder Abuse?

    Science.gov (United States)

    ... Strategic Plan Federal Initiatives Career Opportunities Contact Us Administration on Aging (AoA) What is Elder Abuse? What ... Elder Justice & Adult Protective Services Elder Justice Coordinating Council Prevention of Elder Abuse, Neglect and Exploitation (Title ...

  8. Child abuse - physical

    Science.gov (United States)

    ... way Uses harsh discipline Was abused as a child Alcohol or drug problems Emotional problems or mental illness ... Physical abuse - children References Berkowitz CD, Stewart ST. Child maltreatment. In: Marx JA, Hockberger RS, Walls RM, eds. ...

  9. Cough & Cold Medicine Abuse

    Science.gov (United States)

    ... A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold Medicine Abuse ... DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  10. Application of the social action theory to understand factors associated with risky sexual behavior among individuals in residential substance abuse treatment.

    Science.gov (United States)

    Reynolds, Elizabeth K; Magidson, Jessica F; Bornovalova, Marina A; Gwadz, Marya; Ewart, Craig K; Daughters, Stacey B; Lejuez, C W

    2010-06-01

    Risky sexual behavior (RSB) is a leading cause of HIV/AIDS, particularly among urban substance users. Using the social action theory, an integrative systems model of sociocognitive, motivational, and environmental influences, as a guiding framework, the current study examined (1) environmental influences, (2) psychopathology and affect, (3) HIV-related attitudes and knowledge, and (4) self-regulatory skills/deficits as factors associated with event-level condom use (CU) among a sample of 156 substance users residing at a residential substance abuse treatment center (M age = 41.85; SD = 8.59; 75% male). RSB was assessed using event-level measurement of CU given its advantages for improved accuracy of recall and ability for an examination of situational variables. A logistic regression predicting event-level CU indicated the significant contribution of partner type (environmental influences), less favorable attitudes towards condoms (HIV-related attitudes and knowledge), and higher levels of risk-taking propensity (self-regulatory skills/deficits) in predicting greater likelihood of not having used a condom at one's most recent sexual encounter. This study contributes to the literature examining HIV risk behaviors among substance users within a theory-driven model of risk.

  11. Predictors of Abstinence: National Institute of Drug Abuse Multisite Buprenorphine/Naloxone Treatment Trial in Opioid-Dependent Youth

    Science.gov (United States)

    Subramaniam, Geetha A.; Warden, Diane; Minhajuddin, Abu; Fishman, Marc J.; Stitzer, Maxine L.; Adinoff, Bryon; Trivedi, Madhukar; Weiss, Roger; Potter, Jennifer; Poole, Sabrina A.; Woody, George E.

    2011-01-01

    Objective: To examine predictors of opioid abstinence in buprenorphine/naloxone (Bup/Nal)-assisted psychosocial treatment for opioid-dependent youth. Method: Secondary analyses were performed of data from 152 youth (15-21 years old) randomly assigned to 12 weeks of extended Bup/Nal therapy or up to 2 weeks of Bup/Nal detoxification with weekly…

  12. Closing the Need-Service Gap: Gender Differences in Matching Services to Client Needs in Comprehensive Substance Abuse Treatment

    Science.gov (United States)

    Marsh, Jeanne C.; Cao, Dingcai; Shin, Hee-Choon

    2009-01-01

    Despite the broad recognition in social work that services are more effective when they are tailored to individual client needs, we have only limited evidence of the impact that services matched to client needs have on treatment outcomes. This study examines gender differences in the impact of matched services, access services, and…

  13. Antisocial Behavior and Psychoactive Substance Involvement among Hispanic and Non-Hispanic Caucasian Adolescents in Substance Abuse Treatment.

    Science.gov (United States)

    Stewart, David G.; Brown, Sandra A.; Myers, Mark G.

    1997-01-01

    Compared conduct disorder behaviors and substance involvement of Hispanic (n=34) and non-Hispanic Caucasian (n=34) adolescents so as to determine pre-treatment problem behavior. Results indicate that non-Hispanic Caucasian youth were three times as likely to be diagnosed with conduct disorder prior to substance involvement than were their Hispanic…

  14. Increased FGF19 copy number is frequently detected in hepatocellular carcinoma with a complete response after sorafenib treatment.

    Science.gov (United States)

    Kaibori, Masaki; Sakai, Kazuko; Ishizaki, Morihiko; Matsushima, Hideyuki; De Velasco, Marco A; Matsui, Kosuke; Iida, Hiroya; Kitade, Hiroaki; Kwon, A-Hon; Nagano, Hiroaki; Wada, Hiroshi; Haji, Seiji; Tsukamoto, Tadashi; Kanazawa, Akishige; Takeda, Yutaka; Takemura, Shigekazu; Kubo, Shoji; Nishio, Kazuto

    2016-08-02

    The multi-kinase inhibitor sorafenib is clinically approved for the treatment of patients with advanced hepatocellular carcinoma (HCC). We previously reported that fibroblast growth factor 3 and 4 (FGF3/FGF4) amplification is a predictor of a response to sorafenib. This study aims to analyze the relationship between FGF-FGF receptor (FGFR) genetic alterations and the response to sorafenib. Formalin-fixed, paraffin-embedded tissue specimens from HCC patients who had achieved a complete response (CR, N=6) or non-CR (N=39) to sorafenib were collected and were examined for FGF-FGFR gene alterations using next generation sequencing and copy number assay. FGFR mutations were detected in 5 of 45 (11.1%) cases. There was no significant association between FGFR mutation status and the response to sorafenib. We detected no increase in the FGF3/FGF4 copy number in CR cases. An FGF19 copy number gain was detected more frequently among CR cases (2/6, 33.3%) than among non-CR cases (2/39, 5.1%) (P = 0.024, Chi-squared test). In conclusion, a copy number gain for FGF19 may be a predictor of a response to sorafenib, in addition to FGF3/FGF4 amplification.

  15. Substance abuse and first-episode schizophrenia-spectrum disorders. The Danish OPUS trial

    DEFF Research Database (Denmark)

    Petersen, Lone; Jeppesen, Pia; Thorup, Anne;

    2007-01-01

    To evaluate whether integrated treatment (given by OPUS), in comparison with standard treatment, significantly reduced the number of patients with substance abuse and improved clinical and social outcome in the group of substance abusers after 2 years.......To evaluate whether integrated treatment (given by OPUS), in comparison with standard treatment, significantly reduced the number of patients with substance abuse and improved clinical and social outcome in the group of substance abusers after 2 years....

  16. Early Relapse of Unresectable Gallbladder Cancer after Discontinuation of Gemcitabine Monotherapy Administered for 5 Years in a Patient Who Had Complete Response to the Treatment

    Directory of Open Access Journals (Sweden)

    Koichi Suyama

    2013-10-01

    Full Text Available The tumor shrinkage effect of gemcitabine is considered to be limited in cases of advanced gallbladder cancer, and there are few reports of complete response to gemcitabine therapy in patients with this cancer. Therefore, the treatment continuation strategy in these patients, after a complete response has been achieved, still remains to be established. Here, we present the case of a 77-year-old patient with unresectable gallbladder cancer, who after showing complete response to gemcitabine monotherapy administered for 5 years, showed early relapse within only 11 months of discontinuation of the drug. Thus, it is necessary to establish a suitable treatment continuation strategy for patients who show complete response to gemcitabine treatment.

  17. What Sex Abusers Say about Their Treatment: Results from a Qualitative Study on Pedophiles in Treatment at a Canadian Penitentiary Clinic

    Science.gov (United States)

    Drapeau, Martin; Korner, Annett C.; Granger, Luc; Brunet, Louis

    2005-01-01

    This exploratory study used qualitative methodology to examine what pedophiles think about treatment, as well as their daily experience of a treatment program. To this end, twenty-three offenders receiving treatment from the La Macaza federal penitentiary clinic were interviewed using non-directive semi-structured interviews. Comparative analysis…

  18. Childhood physical abuse and differential development of paranormal belief systems.

    Science.gov (United States)

    Perkins, Stefanie L; Allen, Rhiannon

    2006-05-01

    This study compared paranormal belief systems in individuals with and without childhood physical abuse histories. The Revised Paranormal Belief Scale and the Assessing Environments III Questionnaire were completed by 107 University students. Psi, precognition, and spiritualism, which are thought to provide a sense of personal efficacy and control, were among the most strongly held beliefs in abused subjects, and were significantly higher in abused versus nonabused subjects. Superstition and extraordinary life forms, thought to have an inverse or no relation to felt control, were the least strongly held beliefs in abused subjects, and, along with religious beliefs, did not differ between the two abuse groups. Witchcraft was unexpectedly found to be the most strongly held belief among those with abuse histories. Results suggest that by providing a sense of control, certain paranormal beliefs may offer a powerful emotional refuge to individuals who endured the stress of physical abuse in childhood.

  19. A reinforcement-based therapeutic workplace for the treatment of drug abuse: three-year abstinence outcomes.

    Science.gov (United States)

    Silverman, Kenneth; Svikis, Dace; Wong, Conrad J; Hampton, Jacqueline; Stitzer, Maxine L; Bigelow, George E

    2002-08-01

    Long-term Therapeutic Workplace effects were evaluated in heroin- and cocaine-dependent, unemployed, treatment-resistant young mothers. Participants were paid to work or to train in the Therapeutic Workplace but had to provide drug-free urine samples to gain daily access. Participants (N = 40) were randomly assigned to a Therapeutic Workplace or usual care control group. Therapeutic Workplace participants could work for 3 years. Relative to controls, Therapeutic Workplace participants increased cocaine (28% vs. 54% negative; p = .04) and opiate (37% vs. 60% negative; p = .05) abstinence on the basis of monthly urine samples collected until 3 years after intake. The Therapeutic Workplace can be an effective long-term treatment of cocaine and heroin addiction in poor and chronically unemployed young mothers.

  20. Prospective Memory in Substance Abusers at Treatment Entry: Associations with Education, Neuropsychological Functioning, and Everyday Memory Lapses

    Science.gov (United States)

    Weinborn, Michael; Woods, Steven Paul; O'Toole, Stephanie; Kellogg, Emily J.; Moyle, Jonson

    2011-01-01

    Individuals with substance use disorders (SUDs) commonly report lapses in prospective memory (PM) in their daily lives; however, our understanding of the profile and predictors of laboratory-based PM deficits in SUDs and their associations with everyday PM failures is still very preliminary. The current study examined these important questions using well-validated measures of self-report and laboratory-based PM in a mixed cohort of 53 SUD individuals at treatment entry and 44 healthy adults. Consistent with prior research, the SUD group endorsed significantly more self-cued and environmentally based PM failures in their daily lives. Moreover, the SUD group demonstrated significantly lower time-based PM performance, driven largely by cue detection errors. The effect of SUDs on PM was particularly strong among participants with fewer years of education. Within the SUD cohort, time-based PM was correlated with clinical measures assessing executive functions, retrospective memory, and psychomotor speed. Importantly, time-based PM was uniquely associated with elevated PM failures in daily lives of the SUD participants, independent of current affective distress and other neurocognitive deficits. Findings suggest that individuals with SUD are vulnerable to deficits in PM, which may in turn increase their risk for poorer everyday functioning outcomes (e.g., treatment non-compliance). PMID:21903701