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Biomedical subjects

C D Kaplan

Publications and source records attributed to C D Kaplan.

36 records · Page 2Linked to original sources
PubMed1991

Changing cocaine smoking rituals in the Dutch heroin addict population.

Recently the use patterns, circumstances and consequences of cocaine have become of interest to both researchers and policy makers in Europe. Currently only a few studies have been conducted of the social epidemiology of cocaine. In this article, focus is placed upon the use of cocaine in one subpopulation, heroin addicts. Based mainly upon ethnographic research conducted in the city of Rotterdam it can be estimated that the prevalence of cocaine use in this population has reached a very high level. The mode of ingesting cocaine parallels that of heroin; Injecting Drug Users inject cocaine-hydrochloride, heroin smokers smoke cocaine base. This cocaine base is mainly processed by users themselves. An exception to this rule of self-processing can be found in the most marginalized addicts who do not have access to the house addresses where both heroin and cocaine-hydrochloride are sold. In this group the selling of 'cooked cocaine', a crack-like product, has occurred. The circumstances and potential consequences of the emergence of 'cooked cocaine' are discussed.

Cocaine↗
PubMed1991

What works in drug abuse epidemiology in Europe.

This paper discusses what works and what does not work in drug abuse epidemiology in Europe. Given the tradition in European countries of defining the drug abuse problem in terms of social and medical interventions, epidemiological research is also tied to these interventions, and consequently to community-based research. What seems not to work, and what is generally suspect are grand legal designs to solve the drug problem. Promising initiatives are going towards a compromise between a relaxation of legal sanctions but a tendency away from legalization. What is recommended is striving towards a more analytic and multidisciplinary epidemiology that can help society critically evaluate the truth-value of its moral prerogatives.

Community Health Services↗
PubMed1991

Needle sharing in The Netherlands: an ethnographic analysis.

BACKGROUND: Needle sharing has been reported to be the main cause of the rapid spread of the human immunodeficiency virus (HIV) among injecting drug users. Risk behaviors such as needle sharing are, however, the end result of complicated interaction patterns in drug user networks, which have their specific rules and rituals, and larger social structures and official drug policy. METHODS: To study these interaction patterns we examined the drug administration rituals of heroin addicts in Rotterdam, The Netherlands. Intensive ethnographic descriptions were collected by participant observation. RESULTS: In less than 10% of the observed self-injections unsafe syringes were used. In 68% of the self-injections new, sterile syringes were used. Needle sharing as a planned sequence was not observed. Sharing was determined primarily by the availability of syringes, experience with the injecting ritual, and drug craving. In all observed needle-sharing events, subjects were aware of the risks involved and undertook efforts to clean the injection equipment. CONCLUSIONS: In contrast to psychological approaches aimed at reducing individual "risk behavior," these findings suggest that HIV prevention can be made more effective if active drug injectors are organized to help themselves and their peers prevent high-risk exchange situations.

Adult↗
PubMed1989

The Addiction Severity Index: reliability and validity in a Dutch addict population.

In order to meet the need for a multidimensional diagnostic instrument in the field of drug addiction in The Netherlands, the Addiction Severity Index (ASI) has been applied to a sample of Dutch drug addicts. In this article the usefulness and psychometric characteristics of the Dutch version of the ASI are discussed. Overall, there was no evidence of a general relationship between the ASI ratings of problem severity. The severity ratings showed good concurrent validity, and subscales of selected items in each problem area of the ASI were demonstrated to have good internal consistency reliability. Regression analysis indicated that the ASI items accounted for a considerable proportion of the variance in the severity ratings, indicating a strong relationship between "subjective" rating and "objective" data. On the basis of the general concept of the ASI and the satisfactory psychometric characteristics, implementation of the instrument in The Netherlands is advocated.

Adult↗
PubMed1988

The pleasure dome with caves of ice. Cerebral lateralization, creativity, and the drug experience.

The drug experience is not a phenomenon of isolated interest to the neurosciences. The investigation of the phases of the drug experience can tell us much about the process of stimulating and losing creativity. This paper aimed to present a human model of creativity and the drug experience to complement the existing animal models. It remains for future research to reject or confirm the hypotheses sketched here. The exploration of these hypotheses would give us better insight into the control mechanisms determining the delicate process of creating functional forms that link words and images to feelings (for example, art). The examination of the drug experience from the point of view of cerebral lateralization provides a better understanding of how the quest for art may be tied up with the consequences of self-destruction. As Luria has noted, the gnostic disturbances associated with damages of the right hemisphere are "the remarkable absence of perception of the patient of his own defects; . . . such patients have unimpaired speech but they lack the precise analysis of the direct flow of information about their own body." Perhaps this was intuitively known by Coleridge, who in 1803 had already passed into the maintenance phase and wrote the fragment "Reality's Dark Dream": I know 'tis but a dream, yet feel more anguish Than if 'twere truth. It has been often so: Must I die under it? Is no one near? Will no one hear these stifled groans and wake me?

Animals↗
PubMed1987

Temporal and social contexts of heroin-using populations. An illustration of the snowball sampling technique.

Snowball sampling is a method that has been used in the social sciences to study sensitive topics, rare traits, personal networks, and social relationships. The method involves the selection of samples utilizing "insider" knowledge and referral chains among subjects who possess common traits that are of research interest. It is especially useful in generating samples for which clinical sampling frames may be difficult to obtain or are biased in some way. In this paper, snowball samples of heroin users in two Dutch cities have been analyzed for the purpose of providing descriptions and limited inferences about the temporal and social contexts of their lifestyles. Two distinct heroin-using populations have been discovered who are distinguished by their life cycle stage. Significant contextual explanations have been found involving the passage from adolescent peer group to criminal occupation, the functioning of network "knots" and "outcroppings," and the frequency of social contact. It is suggested that the snowball sampling method may have utility in studying the temporal and social contexts of other populations of clinical interest.

Activities of Daily Living↗
PubMed1981

Lateralized differences associated with semantically varied auditory material.

EEGs were recorded from 13 subjects while they listened to four tape-recorded passages differing in semantic content. The distribution of alpha band power over the two hemispheres, measured at T3/T4, was found to show significant task-dependent shifts. More reality-oriented passages tended to be processed with greater left-hemisphere involvement, while "pleasurable" material showed significant right-hemisphere involvement. Since the differences in laterality were not related to grammatical measures of linguistic complexity, the apparent shifts were attributed to semantic differences between the tasks. Explanation of the results is made in terms of a theory of the metacontrol of cerebral processing.

Dominance, Cerebral↗
PubMed1977

Hemispheric specialization of language: an EEG study of bilingual Hopi indian children.

Electroencephalographic (EEG) recordings were obtained from electrode placements over the left and right frontal and parietal lobes of the brain in sixteen Hopi Indian children listening to tape recorded children's stories in the Hopi and English languages. Spectral analysis of the EEG data revealed that, for the parietal leads, alpha desynchronization was relatively greater over the right hemisphere for listening to Hopi than for listening to English, which indicates a greater right hemisphere participation in the processing of the Hopi speech. The results of the experiment are directionally consistent with our hypothesis, and imply that linguistic relativity may exist on a neurolinguistic level, such that languages can differ in the relative degree to which they serve as instruments of thought in a propositional, left hemisphere mode, or in an appositional, right hemisphere mode.

Arizona↗
PubMedDate not supplied

Drug sharing and HIV transmission risks: the practice of frontloading in the Dutch injecting drug user population.

Injecting drug users may now be the largest group at risk for contracting HIV, mainly through the sharing of drug injection equipment (including lending, borrowing, and renting). This article presents the results of an ongoing ethnographic study into the drug-taking rituals of heroin addicts. A possible additional route of HIV contamination is presented, namely the ritual sharing of drugs through a practice termed "frontloading," which is embedded in a broader pattern of the sharing of resources among addicts. It is hypothesized that in the Netherlands this practice may be responsible for a substantial proportion of HIV spread among injecting drug users.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Reaching the unreached: targeting hidden IDU populations with clean needles via known user groups.

Needle exchange is a practical and important part of the Dutch prevention strategy to check the spread of HIV among injecting drug users (IDUs). However, needle-exchange programs are often tied to drug treatment programs that only reach a limited number of IDUs. To overcome this limitation, alternative designs are considered and initiated. This article describes a community-based approach to needle exchange that is built on empowerment of, and intense participation by, known IDUs to target unknown IDUs for delivery of clean needles. The needle-exchange patterns of the IDUs participating in this collective scheme are compared to those of other users who exchanged needles on an individual basis. It was found that this approach extended the reach of the program to a great degree and that it was well received in the IDU community. However, the results were negatively influenced by police activities aimed at closing down places where drugs were used and sold. It is concluded that engaging IDUs in peer-group-directed prevention efforts is both feasible and promising.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Illegal drug use, alcohol and aggressive crime among Mexican-American and white male arrestees in San Antonio.

This research explores the relationship between use of certain drugs and aggressive crimes among Mexican-American and White male arrestees in San Antonio, Texas, for 1992. This is based on a Drug Use Forecasting (DUF) sample of 534 male arrestees administered a drug urine analysis test and questionnaire by the Department of Justice and the city of San Antonio. Using a four-way asymmetrical analysis, logit-models were tested to examine the relationships between the response variable, the types of crimes charged (nonaggressive versus aggressive) and a set of exploratory variables, ethnicity (White versus Hispanic), drug test results (positive versus negative), and alcohol use (infrequent versus frequent). The logit-analysis allows the specification of a subset of relevant models to be tested for their adequacy of fit. Findings indicate a complex but interpretable pattern between drug use, alcohol use patterns, and aggressive crimes. A surprising finding was that more aggressive crimes were committed by all men testing negative for drugs. Mexican-Americans with frequent alcohol use and testing positive for drugs were twice as likely to commit an aggressive crime (a crime associated with violence) than Whites in the same subgroup. The implication of these findings for prevention strategies aimed at alcohol and other drug users involved in violent behavior is discussed.

Adult↗
PubMedDate not supplied

Management of pain through cerebral activation. An experimental analogue of alexithymia.

The present experiment was designed to explore the relationship between pain, language and cerebral functioning in normal subjects, as an analogue to alexithymia. Left hemisphere cerebral activation, as measured by an EEG-alpha ratio score, was found to be associated with a reported increase in painful sensation during painful stimulation. Right hemisphere activation was found to be associated with a decrease in reported pain. The results were interpreted in terms of the mobilization of fantasy processes, following experimental instructions, which seem to be mediated by right hemisphere activation. Uninstructed subjects, lacking a stable visualization, utilize a left-hemisphere, verbal mode to cope with the pain. It is suggested that left-hemisphere mobilization, and a lack of right-hemisphere processing of painful stimulation may be in part responsible for the alexithymic patients' psychosomatic symptoms.

Brain↗
PubMedDate not supplied

Effect of ibogaine on naloxone-precipitated withdrawal syndrome in chronic morphine-dependent rats.

Ibogaine, an indole alkaloid, administered intracerebroventricularly 4-16 micrograms, attenuated a naloxone-precipitated withdrawal syndrome in chronic morphine-dependent rats. It appears that ibogaine has a more consistent effect on certain selective withdrawal signs related to the locomotion. This might explain an attenuating effect of ibogaine on some withdrawal signs. However, due to complex interaction of ibogaine with serotonin and other neurotransmitter systems, the mechanism of ibogaine antiwithdrawal effect remains unknown and requires further elucidation.

Alkaloids↗