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Biomedical subjects

C P O'Brien

Publications and source records attributed to C P O'Brien.

At least 199 records · Page 11Linked to original sources
PubMed1981

Propoxyphene form maintenance treatment of narcotic addiction.

Two studies compared propoxyphene napsylate (Darvon-N) with methadone hydrochloride as maintenance treatment for narcotic addicts. Most measures indicated that methadone was more effective than propoxyphene as a maintenance drug. Patients receiving propoxyphene reported more withdrawal-related symptoms early in treatment, tended to drop out sooner than patients receiving methadone, and were more likely to abuse heroin. Nevertheless, follow-up interviews at one and six months after treatment indicated no between-group differences in adjustment.

Adult↗
PubMed1981

The effects of methadone on cortical and subcortical EEG in the rat.

(1) Administration of methadone in rats elicited high voltage, slow activity in the cerebral cortex and low voltage irregular waves in the hippocampus. Intravenous administration of methadone (0.2-0.5 mg/kg) markedly increased the threshold for cortical desynchronization by stimulation of the MRF. This increase by methadone was dose dependent. (2) Cortical desynchronization following mechanical stimulation of the tail or foot was blocked by methadone at a dose level of 0.5 mg/kg. At this dose level, the cortical desynchronizing threshold for MRF stimulation increased more than 8-fold whereas the threshold for MT and DH stimulations showed only small but measurable increases. A minimum dose of 0.5 mg/kg was needed to raise the threshold of these structures significantly (3) The increased threshold following injection of methadone was completely blocked by prior injection of the antagonist naloxone, indicating this response to be specific. Naloxone alone had no effect on electrical activity at any site. (4) The incidence of dissociation of the cortical response from the limbic system response after stimulation of the dorsal hypothalamus was approximately 4 times greater in methadone-treated than in untreated animals.

Animals↗
PubMed1981

Psychological severity and response to alcoholism rehabilitation.

This study examines the problem of effective treatment for alcoholic patients with concurrent psychopathology. The subjects were 131 male veterans admitted to the Coatesville Veterans Administration Medical Center. They remained in an alcohol rehabilitation program at least five days following detoxification and were successfully followed up six months after admission. Subjects were divided into LOW, MID, and HIGH groups based on their psychological severity score. The Addiction Severity Index (ASI) was then used to assess problem severity in six areas (medical, legal, family, substance abuse, employment and psychological) at admission and 6-month follow-up. All groups showed significant improvement in several areas, especially alcohol use. However, between-groups analyeses of the outcome measures (adjusted for pre-treatment differences) showed significantly poorer status in the HIGH group on 10 of 17 criteria. The authors conclude that a general assessment of psychological status at admission can effectively predict response to alcoholism rehabilitation. Finally, the authors suggest that, despite the relatively poor results of alcohol rehabilitation for the HIGH patients, this type of treatment may provide a necessary and beneficial basis for subsequent treatment in a conventional psychiatric setting.

Adult↗
PubMed1981

Are the "addiction-related" problems of substance abusers really related?

The "addiction-related" medical, social, and psychological problems of substance abusers are often considered by-products of prolonged alcohol or drug abuse which will be generally improved following achievement of abstinence. As a test of this view, measures of problem severity in six areas commonly related to addiction were intercorrelated in 460 alcoholic and 282 drug addicted male veterans. Both before and after treatment, the low intercorrelations in each sample indicated little relation between the severity of alcohol or drug use and the severity of the other problem areas. Intercorrelations among residualized admission to follow-up change scores were similarly low, also showing the lack of a general relationship between improvement in substance abuse and improvement in other areas. However, there was one exception: improvement in psychological function was clearly related to general improvement in most other areas, including chemical abuse, indicating the potential importance of psychologically oriented therapy in substance abuse treatment. Most of the evidence suggests that addiction may be a common pathway for a variety of specific disorders, rather than a general, progressive disease.

Alcoholism↗
PubMed1981

Psychotherapy for opiate addiction: some preliminary results.

In summary, this preliminary analysis suggests two important points. First, that narcotic addicts enrolled in a methadone treatment program are receptive to psychotherapy. Secondly, that psychotherapy may add something to routine counseling services. As seen, the psychotherapy patients, in this very preliminary analysis, are using fewer drugs (including prescription drugs, methadone and illicit drugs) and they report fewer psychiatric symptoms than those receiving drug counseling alone. We do not think that the design of this project rules out the possibility that these results are nonspecific effects (seeing a "doctor," having an opportunity to see two helpers rather than one), however, we also see nothing here to support the idea that narcotic addicts cannot benefit from the services of professionally trained psychotherapists. These early analyses represent only a very small portion of the entire range of data collected. We will be especially interested in identifying reasons for improvement in those patients who respond. Preliminary analysis of segments of tapes by the independent rates shows that the raters correctly identified 80% of the therapy tapes. Comparing these independent taped ratings with outcome measures may be a valuable way to assess possible relationships between amount and kind of therapy and treatment outcome. Finally, patient ratings of therapists including the patient's views of the helping relationship may supply additional important information regarding why improvement occurs.

Adolescent↗
PubMed1981

A clinical, controlled study of l-alpha-acetylmethadol in the treatment of narcotic addiction.

The authors compared l-alpha-acetylmethadol (LAAM) with methadone for clinical effectiveness in the treatment of narcotic addiction. LAAM was as effective as methadone on all outcome measures, including length of stay in treatment. Two clinicopharmacologic properties of LAAM caused some patients to ask for a switch to methadone. The authors describe these phenomena and discuss their impact on the clinical effectiveness of LAAM.

Adult↗
PubMed1981

Pretreatment source of income and response to methadone maintenance: a follow-up study.

The authors assessed the relationship between source of pretreatment income and response to treatment at 6-month follow-up in 165 male veterans admitted to a methadone maintenance treatment program. Subjects were grouped according to whether the majority of their pretreatment income was based on job earnings, public assistance, or criminal activity. Significant improvements in drug use, legal status, and psychological functioning were found in the employed group. The group supported by criminal activity showed the most significant and pervasive improvements, especially in the areas of drug use and family, legal, and employment problems. The group receiving public assistance showed no significant improvements on any of the 16 criterion measures, including drug use.

Adult↗
PubMed1981

Naltrexone: a short-term treatment for opiate dependence.

The narcotic antagonist, naltrexone, was studied in 242 patients during a 6-year period. Although a large number of subjects discontinued naltrexone abruptly, treatment was related to a significant decrease in opiate and nonopiate drug use. Methods for improving retention during induction and maintenance are discussed and posttreatment outcome results are presented. The authors conclude that naltrexone may be a useful short-term treatment option for opiate dependence.

Adult↗
PubMed1980

Predicting the outcome of psychotherapy. findings of the Penn Psychotherapy Project.

Our study of predictability of outcomes of psychotherapy used predictions of two kinds: (1) direct predictions by patients, therapists, and clinical observers; and (2) predictive measures derived from the same sources. Seventy-three nonpsychotic patients were treated in psychoanalytically oriented psychotherapy (mean, 44 sessions). Two thirds of the therapists were residents in psychiatry; one third were more experienced. The two main composite outcome measures, measured at termination, were Raw Gain (residualized) and Rated Benefits, which intercorrelated at .76. Most patients improved and showed a considerable range of benefits. The clinical observers' direct predictions of Rated Benefits were highest (.27, P less than 905). The success of the predictive measures were generally insignificant, and the best of them were in the .2 to .3 range meaning that only 5% to 10% of the outcome variance was predicted. The Prognostic Index Interview variables did the best (eg, emotional freedom composite, .30; a crossvalidation for 30 patients was .39 (P less than .05). Neither the therapist measures nor the early psychotherapy session measures predicted significantly. Reanalysis of the similar Chicago Counseling Center study, in our terms, showed a similar low level of prediction success, eg, adequacy of functioning, marital status match, and length of treatment predicted significantly in both studies.

Adolescent↗