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Biomedical subjects

C P O'Brien

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

At least 217 records · Page 12Linked to original sources
PubMed1980

Follow-up of Vietman veterans. I. Relapse to drug use after Vietnam service.

A sample of 202 former army enlisted men who served in Vietnam between 1971 and 1972 were studied 28 months after their return to a large metropolitan area. Subjects were divided into three groups, frequent (n = 98), occasional (n = 55) and nonusers (n = 49) according to their inservice narcotics use. Results indicated that in spite of high rates of inservice narcotics use, only 39% of those addicted in Vietnam, and 11% of those who used narcotics occasionally, continued to use narcotics after returning to the United States. However, other types of substances, such as alcohol and marijuana, were used more heavily in all groups. A series of multiple correlations indicated that preservice variables also played a significant role in determining postservice drug involvement.

Alcoholism↗
PubMed1980

Matching substance abuse patients to appropriate treatments: a conceptual and methodological approach.

The paper describes a non-intrusive, computer assisted, program evaluation design for matching sub-types of substance abuse patients to appropriate treatment programs in any multi-modal treatment network. The design incorporates the methodological advantages of an experimental paradigm without the administrative and clinical problems of random patient assignment, and untreated control groups. The specific objectives of this design are: (1) The development of a generalizable evaluation process to efficiently match patients with programs. (2) An overall increase in treatment success through improvement of treatment assignment procedures. (3) A general improvement in cost-effectiveness through reductions in patient drop-out, recidivism, and treatment overlap.

Computers↗
PubMed1980

Follow-up of Vietnam veterans II. Social adjustment.

Vietnam veterans were divided into three groups according to their inservice narcotics use: frequent users (n = 98), occasional users (n = 55) and nonusers (n = 49). Using a blind interview procedure the three groups were found to differ in the areas of employment/education, family adjustment, physical health, and depression. A composite "Social Adjustment Factor" was derived from these four areas, and a series of multiple correlations were computed in order to assess the effect of Vietnam drug use on the Social Adjustment Factor when preservice variables were held constant. Both the Social Adjustment Factor and two of its components, family adjustment and depression, continued to correlate significantly with the Vietnam drug group after the influence of preservice variables had been accounted for. Correlations between the two components employment/education and physical health and Vietnam drug group were no longer significant. The authors conclude that current social adjustment is determined by the interaction of preservice conditions and the Vietnam experience itself.

Education↗
PubMed1980

Clinical and morphological features of gold neuropathy.

Three cases of gold-related neuropathy are reported. Clinical features include an acute, symmetrically progressive polyneuropathy, focal or generalized myokymia and a tendency for initial neurological deterioration followed by improvement, after cessation of chrysotherapy. The degree of clinical recovery related to maximal disability. Morphological findings on sural nerve biopsies revealed both axonal degeneration and segmental remyelination. Similar peripheral nerve histology was seen in a parallel animal study in which the severity of the neuropathy was dose-related.

Adult↗
PubMed1980

An improved diagnostic evaluation instrument for substance abuse patients. The Addiction Severity Index.

The Addiction Severity Index (ASI) is a structured clinical interview developed to fill the need for a reliable, valid, and standardized diagnostic and evaluative instrument in the field of alcohol and drug abuse. The ASI may be administered by a technician in 20 to 30 minutes producing 10-point problem severity ratings in each of six areas commonly affected by addiction. Analyses of these problem severity ratings on 524 male veteran alcoholics and drug addicts showed them to be highly reliable and valid. Correlational analyses using the severity ratings indicated considerable independence between the problem areas, suggesting that the treatment problems of patients are not necessarily related to the severity of their chemical abuse. Cluster analyses using these ratings revealed the presence of six subgroups having distinctly different patterns of treatment problems. The authors suggest the use of the ASI to match patients with treatments and to promote greater comparability of research findings.

Alcoholism↗
PubMed1980

Risk for alcoholism and methadone treatment. A longitudinal study.

To investigate the relationship between methadone and alcohol abuse, 60 male veteran narcotic addicts entering a methadone maintenance program were divided into either a problem drinker group (N = 21) or a normal drinker group (N = 39) based on their drinking histories and Breathalyzer tests at admission. Their performance was monitored throughout methadone treatment. Results showed no systematic changes in alcohol use. Problem drinkers tended to be involved in more criminal activity, showed more evidence of depression and anxiety, and were more likely to continue abuse of illicit drugs. These results suggest that stabilization was not etiologically associated with alcohol abuse.

Adult↗
PubMed1980

Psychotropic agents in opiate addiction: a brief review.

Psychotropic agents are frequently utilized in the detoxification and maintenance of opiate addicts as well as in the treatment of their underlying psychopathology. Review of reports of studies conducted to data indicates that schizophrenia, depression, and anxiety in opiate addicts appear to respond to appropriate treatment with psychotropic drugs. Although nonaddictive psychoactive compounds cannnot be completely substituted for methadone in detoxification, their effects on the rate of methadone withdrawal warrant further study. To evaluate the results of treatment of addicts with psychoactive compounds, parameters that should be studied include the effects of these compounds on illicit drug use, methadone requirements, relapse and dropout rates, and social behavior.

Anti-Anxiety Agents↗
PubMed1980

The impact of the interview method on reported symptoms of narcotic addicts.

Male veterans applying for outpatient treatment of narcotic addiction were interviewed as to symptoms of withdrawal and overdose using a two-phase procedure. First they were asked how they felt, with no specific symptoms mentioned by the interviewer. Then a list of 28 symptoms was read. Symptoms reports increased dramatically. Every symptom was reported more frequently when patients were specifically asked. Correlations indicated fairly good agreement on severe symptom levels, but poor agreement on mild and moderate symptoms. Standardization of method of inquiry seems essential for valid comparison of studies of addiction.

Adult↗
PubMed1979

Development of psychiatric illness in drug abusers. Possible role of drug preference.

The origin of the psychiatric illnesses observed in drug abusers is often unclear. This study examines the causal relation between drug abuse and specific psychiatric disorders. Fifty-one male veterans first seen in 1972, who were admitted at least once per year for six consecutive years for inpatient drug-abuse treatment, underwent psychiatric assessments at each admission. Eleven men mainly used stimulants, 14 depressants, and 26 opiates. Initial psychiatric examinations showed low symptom levels in all groups but no statistically significant differences among them. By the end of six years, five of the stimulant users had psychoses, and eight of the depressant users had serious depression. The narcotics users showed no change in psychopathology. Differences between the groups were significant at the 0.01 level. These changes were not due to acute toxic reactions, but our data suggest that abuse of particular drugs has a major role in the development of specific psychiatric illnesses. The possibility that different preexisting personality disorders lead to different kinds of drug abuse cannot be excluded.

Adult↗
PubMed1979

Effects of contingent payment on compliance with a naltrexone regimen.

The effects of several schedules of payment on duration and patterns of compliance with a naltrexone regimen were examined. Patients were paid under contingencies based on either number of doses ingested or on a fixed time schedule. Reinforcement schedules based on number of doses ingested produced more consistent treatment-oriented behavior than a time-based schedule. Covariation between behavior and alternating contingencies (A-B-A) indicated that the schedules contributed to increased duration of treatment compared to previous noncontingent payment. The issue of using extrinsic reinforcers such as monetary payment to enhance compliance is discussed and additional procedures are suggested.

Adult↗
PubMed1979

The impact of Vietnam service on heroin-addicted veterans.

Age-matched samples of Vietnam veterans and veterans who did not serve in Vietnam were surveyed at the time that they applied for treatment of heroin addiction. Vietnam veterans were more likely to have begun using heroin during their military service, and they were more likely to say that their service experiences had affected their use of drugs, usually citing relief of fear and tensions of war. Veterans who had not been in Vietnam were somewhat more likely to have begun using drugs after service, and generally indicated that their military experiences had not affected their drug use. When they did cite an effect of service, the factors usually indicated were boredom and a lack of meaningful activity. Attitudes toward narcotic use were negative in both groups, but significantly less so among Vietnam veterans. However, these attitudes did not relate to patterns of current or past drug use. Groups did not differ in the extent of or reasons for current illicit drug use, but non-Vietnam veterans reported more alcohol use. The Vietnam war was mentioned by one Vietnam veteran and by no non-Vietnam veterans as a reason for continuing narcotic use. Few other differences were found. Notably, typical treatment course over a 5-year follow-up period was similar in the two study groups.

Adult↗
PubMed1979

Depression in treated narcotic addicts, ex-addicts, nonaddicts, and suicide attempters: validation of a very Brief Depression Scale.

Samples of heroin-addicted veterans in treatment at a VA drug clinic, ex-addict and nonaddict Vietnam veterans followed-up after return to the United States, and male suicide attempters who were not drug abusers completed a very short (five item) form of the Beck Depression Inventory developed for screening and research purposes. Results confirmed prior findings of high rates of depression among narcotic addicts in treatment. Two samples of patients assessed at intake to treatment did not differ significantly from the suicide patients in BDI-5 scores. Methadone maintenance patients and ex-addicts scored below those groups, but higher than nonaddicts. Relief of inner tensions or worries was chosen most frequently as the reason for continuing use of narcotics by patients in treatment, suggesting that self-medication for psychiatric problems may be common. The BDI-5 proved to be an efficient method for screening for depression in these samples, and thus might be useful in clinical or research settings when a very brief method is needed.

Depression↗