Conditioned drug responses to naturalistic stimuli.
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Conditioning, Psychological↗
Biomedical subjects
J Grabowski
Publications and source records attributed to J Grabowski.
[Experimental investigations on the effects of low temperature on corneal changes after corneal dehydration (author's transl)].
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Animals↗
Influence of cyclic 3',5'-adenosine monophosphate and adenosine on vascular reactivity.
cAMP, 5'-AMP and adenosine in doses of 1, 2 and 5 mg/kg i.v. in rats diminish vascular resistance in the hind limbs in vivo and in isolated limbs perfused with nutrient fluid containing adrenaline (A) (10(-3) M), slowing action of the heart and lowering blood pressure. After administration of cAMP, 5'-AMP and adenosine (5 mg/kg), vasoconstricting action of noradrenaline (NA) and A was depressed, and the vasodilating action of isoprenaline (I) was enhanced. The changes in blood pressure observed after administration of the tested adenosine compounds were not blocked by phentolamine, but after I were blocked by propranolol. cAMP, 5'-AMP and adenosine had no influence on the drop in blood pressure elicited by acetylcholine. The results indicate that cAMP, 5'-AMP and adenosine increase reactivity of beta-receptors of the sympathetic system in the blood vessels and modify the action of catecholamines on blood vessels.
Adenosine↗
Response patterning on an avoidance schedule as a function of time-correlated stimuli.
Control of avoidance response patterning by time-correlated stimuli was studied in rhesus monkeys. At several shock-shock = response-shock intervals, the intervals were divided into 8, 4, or 2 time segments by correlating, respectively, 1, 2, or 4 discrete lights of an eight-light display with each successive segment. A further condition examined response patterning when the avoidance interval was not segmented: all eight lights of the display were lit throughout the interval. Reversal of the order in which the lights were lit in sequence was also examined. Generally, increasing the number of lights lit at one time (decreasing the number of signalled time segments) increased response rates and shifted interresponse time distributions to the left. When the lights were lit one at a time, signalling eight discrete time segments of the interval, response rates were consistently low.
Journal Article↗
Contingent reinforcement for reduced carbon monoxide levels in methadone maintenance patients.
Five cigarette smoking methadone maintenance patients (MMP) participated in a within-subjects (A-B-A-B) study involving repeated application of carbon monoxide (CO)-contingent payments for reductions in smoke intake. To replicate and extend findings from an earlier study in non-drug-abusing smokers (Stitzer & Bigelow, 1982), we used the same contingent reinforcement procedure that involved the delivery of a monetary payment ($5) for CO readings which were 50% or less than the average value of readings obtained during the prior noncontingency period. Although four of the five subjects earned the contingent payment on at least three of the eight occasions, the overall effect of the intervention on CO level was nonsignificant. Daily smoking records revealed significantly lower rates during the first contingency intervention for the group as a whole. Significant correlations between CO and the time interval since smoking prior to CO measurement were found. The rather modest intervention effects suggest that important parameters be considered when designing contingency management procedures to reduce cigarette smoking in this difficult population of drug abusers.
Breath Tests↗
Behavioral treatment of cocaine-dependent pregnant women and TB-exposed patients.
Health-compromised drug-dependent patients require specialized treatment that addresses both drug use and health risks. This preliminary study examines the efficacy of a contingency management procedure (shaping) on decreasing cocaine use and increasing compliance with the prescribed treatment regimens in two health-compromised cocaine-dependent populations: (i) tuberculin (TB) exposed patients (n = 5) and (ii) pregnant women (n = 7). A multiple-baseline across-subjects design was used. There were no contingencies on cocaine use during baseline. During the contingent phase, patients received a monetary reinforcer for (a) successive decreases in the quantity of cocaine and (b) cocaine-free samples. They received a weekly reinforcer if all samples per week met criteria for (a) or (b). During the contingent phase, there was a significant decrease in cocaine metabolite levels and an increase in cocaine-free samples in both populations, with a more robust effect in the TB-exposed group. There was an increase in compliance with prenatal visits among the pregnant women during the contingent phase. Implications for health care are discussed.
Adult↗
Cessation of cocaine use during pregnancy: a preliminary comparison.
This preliminary study examined differences between cocaine-dependent pregnant women who received "baseline" drug treatment (N = 13) and those requiring additional "intensive" treatment (N = 9). Baseline drug treatment consisted of weekly individual counseling sessions. Intensive treatment, in the form of contingency management procedures, was added for patients who showed no reduction in cocaine use during the first 4 weeks of treatment. There were no differences between the two groups in terms of demographic and pregnancy characteristics or history of cocaine use. Significantly more patients in the baseline treatment group were cocaine-free at intake and had a higher rate of compliance with scheduled prenatal clinical visits. These findings may indicate a decision to cease cocaine use prior to entering treatment, and a high degree of motivation to remain drug-free. Despite the small sample size, the finding that a substantial proportion of cocaine-dependent pregnant women remain cocaine-free during treatment is encouraging.
Cocaine↗
A substance-abuse research-treatment clinic: effective procedures and systems.
Drug abuse treatment clinics vary widely. This article presents a model of a research-treatment clinic in which effective procedures and systems were instituted. These systems produce an environment in which both excellent research can be conducted and effective treatment provided, by a team of researchers and clinicians. Many of the procedures overcome frequently occurring problems at drug treatment clinics. The potential applicability of these procedures and systems to standard drug treatment clinics is discussed.
Adult↗
Compliance with tuberculosis treatment in methadone-maintained patients: behavioral interventions.
UNLABELLED: Tuberculosis has increased dramatically in the United States. Noncompliance with treatment is high. The purpose of this investigation was to achieve compliance with prophylactic TB treatment and simultaneously decrease drug use in a high-risk group of intravenous drug users. Two studies were conducted. Study 1: Subjects were 9 chronic opiate users who tested positive for tuberculosis and were placed on isoniazid (INH) and methadone. Methadone was dispensed contingent upon INH ingestion throughout. A within-subject, A-B design with contingency management interventions on drug use was implemented. RESULTS: Compliance with INH was 100% in 8 patients. Cocaine use remained high. Study 2: Two patients, meeting same criteria as Study 1, participated in a within-subject A-B multiple baseline design. Methadone was dispensed contingent upon INH ingestion throughout. Successive decreases in cocaine use were reinforced in the contingent phase. RESULTS: Compliance with INH was high. During contingency, both patients had over 40% cocaine-free urine samples compared with 0% at baseline. This investigation serves as a model for achieving compliance with TB treatment in opiate users.
Adult↗
A menu of potential reinforcers in a methadone maintenance program.
This study demonstrates the use of paired comparisons and interval scaling techniques for measuring the relative priority of program privileges available at a methadone maintenance clinic. Fifteen methadone program privileges were combined in all possible pairs (N = 105) on a reinforcer menu and administered to a group of 12 methadone patients and a second group of counselors (N = 4). Data were converted to interval scales using the law of comparative judgment to form a quantitative continuum from least to most preferable. Free methadone, free dental service, and more take-homes were ranked highest in both groups; however, patients showed less differentiation in their preference for these privileges. Dose decreases were least preferred. Results are discussed in terms of their clinical applicability in identifying privileges for potential use in modifying the behavior of drug abusers. The method of paired comparisons has excellent psychometric properties and may offer some advantages over other response scale formats.
Adult↗
Naltrexone and relapse prevention treatment for cocaine-dependent patients.
A double-blind, placebo-controlled clinical trial examining the joint action of naltrexone (NTX) in combination with relapse prevention (RP) therapy for the treatment of cocaine dependence was conducted. Eighty-five participants who achieved initial abstinence during the intake evaluation and detoxification phase of the study were randomized into 1 of 4 combined NTX (0 vs. 50 mg) by therapy (RP vs. Drug Counseling) experimental conditions for the 12-week outpatient treatment phase of the study. A random effects regression model to test for group differences on percentage of cocaine-positive urines indicated a significant time by medication by therapy interaction, suggesting less cocaine use over time among subjects receiving RP-50 mg than those in the other conditions. No differences were found for retention or time until first cocaine-positive urine. Naltrexone was well tolerated by participants, with acceptable rates of medication compliance observed. Treatment integrity measures confirmed successful manipulation of the psychotherapy. These results are consistent with the notion that substance use in dependent patients can be reduced with a combination of coping skills training and pharmacologic treatments.
Adaptation, Psychological↗
Relapse prevention treatment for cocaine dependence: group vs. individual format.
To investigate the role of treatment modality in relapse prevention treatment, 32 cocaine-dependent subjects were randomly assigned by cohorts to group-based relapse prevention (G-RP) or individually based RP (I-RP). The two RP formats were identical in content, consisting of 12 outpatient treatment sessions over a 2-month period immediately following hospitalization. The proportion of subjects providing cocaine-free urines at the end of RP treatment did not differ between formats; however, G-RP subjects reported using cocaine on significantly fewer days during treatment, and experiencing fewer cocaine-related problems than did I-RP subjects. Follow-up data collected at 12 and 24 weeks' posttreatment revealed no significant differences between RP formats on any cocaine-use outcome measures. Regardless of therapy format. RP treatment was related to statistically significant and sustained improvements in other areas of psychosocial functioning, including addiction severity, coping, and craving for cocaine. The overall findings suggest that the efficacy of relapse prevention training is not limited by therapy format.
Adaptation, Psychological↗
Cessation of cocaine use during pregnancy: effects of contingency management interventions on maintaining abstinence and complying with prenatal care.
Previous studies have reported cessation of cocaine use in pregnant women prior to treatment entry. This study examined the relative effectiveness of adjunctive contingency management interventions in maintaining abstinence and enhancing compliance with prenatal care in this unique population. Pregnant cocaine-dependent women who had used the drug during this pregnancy but had ceased use prior to study entry (N = 12) were randomly assigned to one of two treatment groups. All patients received a multifaceted treatment including behaviorally based drug counseling and weekly prenatal visits. Patients in the experimental condition also received contingent reinforcement for cocaine abstinence and attendance at prenatal visits. There was a high rate of retention and abstinence from cocaine in both groups. However, patients in the experimental group had a higher rate of attendance at prenatal visits, and none of the patients in this group experienced adverse perinatal outcome(s), compared to 80% of patients in the control group. This finding has important implications for cost-effective treatments and prevention of illness.
Adult↗
Cocaine: an overview of current issues.
A period of ascendancy of cocaine use has had implications in matters of science, public health, and national and international politics and has been the subject of numerous reviews. The present paper provides a critical overview concerning use and prevalence, and addresses a range of current issues of interest. Patterns of use, dose, tolerance, sensitization, routes of administration, and hazards of use are considered based on laboratory, epidemiological, and clinical data. Aspects of treatment are discussed. The need for developing a model of drug abuse recognizing pharmacological-neurochemical-behavioral-environmental interactions is noted. Suggestions are made concerning future directions of policy and research. The need to develop scientific goals and public policy vis-à-vis cocaine, and other stimulants, based on a historical perspective as well as current concerns is emphasized.
Cocaine↗