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Biomedical subjects

E Gottheil

Publications and source records attributed to E Gottheil.

At least 37 records · Page 2Linked to original sources
PubMed1994

Psychiatric symptomatology in crack cocaine abusers.

Many substance abusers present with elevated scores on self-report measures of psychopathological symptoms. We decided to examine this in a sample of 194 crack cocaine abusers. Results indicated that these individuals reported significantly greater psychopathological distress than manual-provided norms, and that this distress was not related to recency of cocaine use. Rank order correlation suggests that a pattern of scores specific to cocaine abusers may exist. Finally, while intake scores of psychopathological distress did not predict treatment retention/outcome, those successfully completing 12 weeks of outpatient treatment were both cocaine abstinent and less psychiatrically distressed.

Adult↗
PubMed1994

The effect of a no-smoking policy on recruitment and retention in outpatient cocaine treatment.

Historically, directors of substance abuse treatment programs have been reluctant to adopt a smoke-free policy because of the fear of patient attrition. According to a recent survey, however, a number of program directors now believe that such fears may be unwarranted. The purpose of the present study was to examine the impact on admissions and attendance of adopting a smoke-free policy at a cocaine treatment program offering outpatient group therapy sessions 3 half days a week. Results indicated that implementation of this policy had no impact on the number of patients who sought treatment at the facility or the number of group sessions patients attended. It was also noteworthy that for a sample of cases active in the month prior to and the month following the ban there were no changes in attendance patterns or in the proportion of patients failing to return from a 10-15 minute therapy break despite the fact that 89% of these patients were cigarette smokers.

Adult↗
PubMed1994

Therapist/patient matching and early treatment dropout.

This study of intake procedures was initiated with a view towards reducing the early dropout rate of substance abusers. Eight different therapists conducted intake interviews of 634 cocaine dependent, first admissions to an outpatient cocaine treatment program. No significant differences in return rate were found across either the eight therapists or their level of academic training. We found that matching therapists and patients with respect to gender and race for the intake interview did not increase the proportion of patients returning for a second visit. In addition, the hypothesis that providing a sense of continuity by having the therapist who conducted the intake interview become the treatment therapist did not result in a higher return rate than if the patient was assigned to a different treatment therapist. Although the results do not indicate methods of further reducing early treatment dropouts they are helpful in reducing concerns about who conducts intake interviews and how patients are assigned.

Adult↗
PubMed1993

Diminished illicit drug use as a consequence of long-term methadone maintenance.

In the twenty-five years since its introduction as a treatment for opiate addiction, methadone maintenance has generated considerable controversy regarding both its appropriateness as a treatment modality and its efficacy in diminishing opiate abuse. Given current concerns regarding the spread of HIV amongst IV drug abusers, the role of methadone maintenance may be more important than ever. The present study was designed to examine continued illicit substance abuse by 229 patients enrolled in methadone treatment as a function of time in treatment (three months to over 10 years). Patients' urinalysis results collected over a 3 month period indicated that (a) cocaine use is a problem amongst methadone maintained individuals and does not appear to be related to length of time on the program, (b) cocaine use did not lead to escalated opiate and other illicit drug abuse, and (c) opiate abuse decreased significantly with time in treatment. Specifically, while 35% of the patients enrolled for less than 12 months were opiate free for the 3 month period, that value increased to 71% for patients enrolled for more than 4 years, and 85% for patients remaining in treatment for over 10 years. These results based on urinalysis support the conclusion of Ball and Ross (1991), based on ASI scores and criminality data, that methadone is an effective treatment modality for opiate addicted individuals.

Cocaine↗
PubMed1992

Length of stay, patient severity and treatment outcome: sample data from the field of alcoholism.

Lengths of stay (LOS) have been markedly reduced since the institution of diagnosis-related groups (DRGs). To determine whether such reductions represent increased efficiency or undertreatment, however, requires that LOS be examined in relation to (1) severity of patient's impairment and (2) treatment outcome. Accordingly, a retrospective analysis was conducted using a data set in which initial severity assessments and 6-month outcome results were available for 126 male veterans treated for alcohol dependence. Greater improvement was found in patients with less severe impairment, and in such patients longer periods of treatment resulted in better outcomes than shorter periods of the same treatment.

Adult↗
PubMed1992

Cocaine users in medical practice: a five-year follow-up.

Prompted by the discontinuity between the number of estimated cocaine users in epidemiologic studies and the small number entering the substance abuse treatment system in the early 1980s, Weinstein et al. surveyed physicians practicing in a variety of specialties and found sizable numbers of cocaine-using patients being seen by physicians not in the substance abuse treatment system. Since the number of cocaine abusers has steadily increased during the decade, a 5-year follow-up of that research was conducted to determine if physicians in private practice have continued to see increasing numbers of cocaine-using patients. A survey of Philadelphia area physicians indicates that these physicians have continued to see growing numbers of cocaine-using patients, and that those numbers have increased dramatically. While an average of 0.61 patients per physician was noted in the early 1980s, by 1987 that value had increased over 200% to 1.84. Since physicians outside the traditional substance abuse system have continued to see increasing numbers of cocaine-using patients, a need remains for increased physician education in the recognition, referral, and treatment of drug-dependent patients.

Adult↗
PubMed1989

Effect of psychosocial treatment on survival of patients with metastatic breast cancer.

The effect of psychosocial intervention on time of survival of 86 patients with metastatic breast cancer was studied prospectively. The 1 year intervention consisted of weekly supportive group therapy with self-hypnosis for pain. Both the treatment (n = 50) and control groups (n = 36) had routine oncological care. At 10 year follow-up, only 3 of the patients were alive, and death records were obtained for the other 83. Survival from time of randomisation and onset of intervention was a mean 36.6 (SD 37.6) months in the intervention group compared with 18.9 (10.8) months in the control group, a significant difference. Survival plots indicated that divergence in survival began at 20 months after entry, or 8 months after intervention ended.

Actuarial Analysis↗
PubMed1986

Cocaine abuse and dependence: the scope of the problem.

The dramatic increase in cocaine use over the past 20 years has been of epidemic proportions. Cocaine is an extremely attractive and captivating drug that is a powerful reinforcer, induces strong psychological dependence and produces marked adverse behavioral changes. These characteristics, for planning purposes, would seem to suggest that the problem will continue to expand in scope. What we still do not know is the extent to which this increased use translates into a need for treatment. If as few as 10% of the users become problem users, as occurs with alcohol, we may be faced with a tremendous surge in demand for services such as occurred in the late sixties and for which we are similarly unprepared. We need to launch a major national effort to gain much more basic epidemiologic data, monitor the course of the epidemic, and support the development of new preventive and treatment approaches specifically tailored to cocaine, based on its particular advantages and disadvantages and the characteristics of its user population.

Cocaine↗
PubMed1986

Cocaine users seen in medical practice.

Cocaine use and the public's awareness of cocaine abuse problems have escalated sharply in the past several years and yet little is known of the users direct contact with medical providers. A questionnaire was designed, mailed to 2,422 physicians in general and family practice, internal medicine, emergency medicine, and psychiatry. The results indicated that many more cocaine users were presently being seen than had been seen in the same month in the previous year. Most of the cocaine patients were seen by psychiatrists, and contrary to popular myth, only a small percentage had high incomes. Most were young male, polydrug users who had been using for more than several months. Few seemed to want treatment. The responding physicians who saw cocaine patients almost always commented on how they managed such patients. Physician involvement varied from almost none (drug use was seen as incidental) to brief advice, referral, or direct treatment. Physician's comments provide a mirror of problems and feelings surrounding this patient population. Contrasts and similarities with hotline data are discussed. The growth of physician recognition of this problem population clearly indicates a treatment need.

Adult↗
PubMed1985

Biochemical and behavioral changes in rats during and after chronic d-amphetamine exposure.

Two groups of rats were implanted with ALZET minipumps to deliver vehicle or a theoretical amount of 1 mg/kg per h of d-amphetamine (A) for 12 days. After 3 days of A-exposure, motor movements and stereotypic behavior were markedly increased. Subsequent testing during A-exposure showed that motor movements and stereotypic behavior remained significantly increased but declined. After removal of the pumps, these effects disappeared and no differences at rest, during stress or A challenge, were apparent in either group. Animals sacrificed after 3 days of drug exposure, showed a drastic decrease in cardiac, but not adrenal, catecholamine levels. In the brain, norepinephrine (NE) levels were markedly decreased in the frontal cortex, hypothalamus, caudate, pons-medulla and cerebellum. Epinephrine (E) levels were unaffected and dopamine (DA) levels were decreased in most areas without reaching statistical significance. Plasma corticosterone levels were similar in both groups. Animals in both groups sacrificed about 25 days after pump removal were biochemically similar. Under our conditions, A-exposure produced marked behavioral and biochemical changes but there was no evidence of residual abnormalities after cessation of drug treatment.

Animals↗
PubMed1983

Contributions to behavioral treatment from studies on programmed access to alcohol.

Major developments in research involving the alcohol-alcoholic interaction are presented against a backdrop of the traditional perspective of alcoholism. Studies explaining the effects of alcohol, factors influencing drinking patterns, the significance of alcohol for the alcoholic, expectations regarding alcohol use and its affective and social consequences, the parameters of alcohol use, the question of control of alcoholism, and a number of treatment related issues are reviewed. It is concluded that much of this research is provocative and may recommend a reassessment of current thinking about the nature of alcohol abuse and dependence. Such a reassessment, however, is seen to be difficult to make, for the task likely will require a paradigmatic shift.

Affect↗
PubMed1982

Follow-up of abstinent and nonabstinent alcoholics.

Despite differences in samples and designs, follow-up studies of alcoholic patients by the Rand Corporation, the state of Oklahoma, and the Veterans Administration (VA) revealed more similarities than differences in outcome and relapse. In the VA study at 6, 12, and 24 months' follow-up, it was found that drinking status and psychosocial adjustment were significantly correlated, the percentage of patients drinking moderately varied from 33% to 47% and did not decrease over time, and the percentage of patients in remission remained constant at 55% over the 2-year period. These data appear to support the inclusion of moderate drinking in the definition of remission.

Alcohol Drinking↗