Search PubMed⌕ Search

Biomedical subjects

A M Washton

Publications and source records attributed to A M Washton.

At least 19 recordsLinked to original sources
PubMed1990

Structured outpatient treatment of alcohol vs. drug dependencies.

This chapter describes the rationale, indications, design, and use of a structured outpatient treatment approach as an effective alternative to residential treatment for alcohol and drug dependencies. An increasing demand for outpatient treatment services is being created by a combination of clinical and economic factors, including the influx of employed drug abusers who do not need or desire residential care and mounting financial pressures to contain health care costs. To be effective as a primary treatment modality, outpatient programs must be highly structured and intensive and able to deal with the full spectrum of alcohol and drug addictions. Perpetuating the historical separation between alcoholism and drug abuse treatment programs is unnecessary and counterproductive, although certain modifications in treatment approaches are needed to accommodate the distinctive characteristics of particular classes of drugs and the people who use them. The "outpatient rehab," a treatment model that approximates the intensity of inpatient treatment on an outpatient basis, may help to maximize the clinical efficacy and cost-effectiveness of outpatient treatment as a viable alternative to residential care. Initial treatment results with this model are encouraging.

Adolescent↗
PubMed1988

Preventing relapse to cocaine.

An effective treatment program for cocaine addiction must incorporate education and counseling. Education is a key element in preventing relapse; patients must be taught to understand the subtle cues by which they are affected, the multiple factors that drive their cocaine use, and the need for complete abstinence from all mood-altering substances, including alcohol and marijuana. Although abstinence is essential to relapse prevention, it is not the only issue. Recovery can be achieved only when patients change their attitudes and behaviors that led to and/or were associated with drug use. Patients must learn: (1) that relapse begins long before drug use occurs, (2) to anticipate high-risk situations, and (3) to develop alternative coping skills to manage the stress and frustration of daily life. Moreover, if relapse does occur, it must be viewed as a learning event rather than as a negative, guilt-provoking disaster in order to avoid recurrences. Analytically oriented psychotherapy is contraindicated early in therapy; counseling and self-help groups must provide support that is reality-based.

Alcohol Drinking↗
PubMed1986

Crack.

Explore the source record for details and available documents.

Adult↗
PubMed1986

Recent trends in cocaine abuse: a view from the National Hotline, "800-COCAINE".

A series of research surveys of callers to the "800-COCAINE" National Hotline over the past three years has revealed shifting patterns of cocaine use in the U.S. In addition to showing the geographic spread of cocaine use to virtually all parts of the country, the surveys provide evidence of increased cocaine use among women, adolescents, minorities, and lower socioeconomic groups. Increases have also been seen in individual levels of cocaine consumption, the popularity of freebase smoking, concomitant use of other drugs, cocaine-related automobile accidents, and the use of cocaine in the workplace. Despite inherent limitations, data from the Hotline are highly consistent with large-scale government surveys and predictive of clinical trends.

Adolescent↗
PubMed1986

Structured outpatient treatment of cocaine abuse.

This article describes specific clinical techniques for treating the cocaine abuser in a structured outpatient program. The advantages, limitations, and indications for such a program are discussed in addition to issues of treatment planning, relapse prevention, recovery groups, urine testing, family involvement, medication, and success rates.

Ambulatory Care↗
PubMed1986

Nonpharmacologic treatment of cocaine abuse.

This article describes nonpharmacologic techniques for treating the cocaine abuser on an outpatient basis. Key issues in assessment and treatment planning are discussed as well as specific relapse prevention strategies and success rates.

Cocaine↗
PubMed1985

Opiate and cocaine dependencies. Techniques to help counter the rising tide.

Clonidine (Catapres) is a safe and effective agent for detoxification of selected opiate addicts. It seems best suited for transitional treatment between opiate dependency and aftercare with naltrexone (Trexan). The current epidemic of cocaine abuse in the United States is associated with intensified usage patterns and an increased prevalence of adverse medical consequences. Successful treatment of the cocaine abuser may require either hospitalization or structured outpatient treatment in a specialized program.

Ambulatory Care↗
PubMed1984

The sequential use of clonidine and naltrexone in the treatment of opiate addicts.

The efficacy of clonidine in the management of opiate withdrawal states has improved and refined the medical approach to this condition. In addition, the use of clonidine for opiate detoxification paves the way for naltrexone maintenance. Naltrexone, by providing chronic opiate receptor blockade, prevents opiate intoxication and subsequent readdiction in recovered addicts. The sequential use of clonidine and naltrexone, in conjunction with drug rehabilitation, appears to represent a viable and effective treatment for opiate addiction in motivated patients. The development of clonidine and naltrexone as treatment agents for opiate addiction also demonstrates that neurobiological advances can be translated into new and effective clinical approaches. This paper summarizes some of our experiences with the clonidine/naltrexone approach in motivated opiate addicts.

Adult↗
PubMed1984

Clonidine hydrochloride detoxification from methadone treatment--the value of naltrexone aftercare.

Treatment outcomes were compared for 2 groups of subjects detoxified from methadone using clonidine. One group of 12 subjects was encouraged to continue in treatment with naltrexone, while the other 12 subjects did not have naltrexone treatment available. Results suggested that those subjects who had naltrexone available were more successful at completing the 10 day detoxification treatment and that the relapse rate at 30 days post-treatment was significantly reduced by naltrexone treatment.

Adult↗
PubMed1984

Upper-income cocaine abusers.

Seventy upper-income cocaine users who called the 800-COCAINE helpline received an extensive telephone interview to assess the nature, extent, and consequences of their cocaine use. The data revealed a high incidence of dysfunctional cocaine use associated with numerous physical, psychological, and social problems. Comparison with an earlier study of middle-income cocaine users highlights the role of drug access as a contributor to intensified use patterns and drug-related consequences. Issues pertaining to treatment of the upper-income cocaine abuser are discussed.

Administration, Intranasal↗
PubMed1984

Successful use of naltrexone in addicted physicians and business executives.

Naltrexone was administered to 114 opiate-dependent business executives and 15 opiate-dependent physicians as part of a comprehensive outpatient aftercare program following inpatient detoxification using clonidine. Over 80% of patients successfully completed at least 6 months of treatment without relapse or re-addiction and were still drug-free at 12-18 month follow-up. Patients who completed at least 6 months of treatment were more likely to be opiate free at follow-up than patients who had dropped out at an earlier point in the program. This study demonstrates that naltrexone can be an extremely useful and appropriate treatment for highly motivated middle/upper class addicts when administered within the context of an intensive high-expectation program.

Adult↗