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Biomedical subjects

M Gossop

Publications and source records attributed to M Gossop.

At least 127 records · Page 7Linked to original sources
PubMed1987

Beware cocaine.

Explore the source record for details and available documents.

Cardiovascular Diseases↗
PubMed1987

What happens to opiate addicts immediately after treatment: a prospective follow up study.

In the first British study to investigate systematically what happens to opiate addicts after treatment 50 opiate addicts admitted for inpatient treatment of their drug dependence were followed up for six months after discharge. All had been withdrawn from opiates before follow up. Six months later 26 were not using opiates: 12 had not used opiates at any time since discharge. When subjects in hospital or in prison were excluded from the analysis 21 (47%) of the subjects living in the community were not taking opiates. Many subjects used opiates within days of leaving the inpatient unit, but this first lapse did not necessarily lead to a full relapse into addictive use. During the six months after discharge several subjects used opiates on a less than daily basis. During each two month period throughout the six months of follow up the proportion of subjects who were occasional users fell, the proportion of abstinent subjects grew, and the proportion of daily users (assumed to be readdicted) remained constant. Although many of the addicts relapsed soon after treatment, it was encouraging that almost half were opiate free after six months. These results have important implications for the treatment of drug addicts.

Adolescent↗
PubMed1987

An investigation of withdrawal symptoms shown by opiate addicts during and subsequent to a 21-day in-patient methadone detoxification procedure.

Methadone detoxification procedures are widely accepted as a satisfactory way of withdrawing opiate addicts from drugs. There have, however, been comparatively few empirical studies which have examined the development and course of withdrawal symptoms in opiate addicts in response to such detoxification procedures. This study investigates the opiate withdrawal syndrome in a group of 116 opiate addicts during and subsequent to a gradual oral methadone detoxification programme. Withdrawal symptoms peak at the end of the methadone schedule and decline steadily thereafter. Not until 40 days after the beginning of the withdrawal regime have symptom levels returned to normal. It is suggested that this protracted withdrawal response is not entirely satisfactory and alternative clinical and research options are proposed. The results fail to support the accepted view that dose is a major determinant of withdrawal severity. Low dose users did not experience less severe withdrawal symptoms than high dose users. This finding together with those of a previous study suggest that this issue also warrants further research attention.

Adult↗
PubMed1986

Opiate withdrawal: inpatient versus outpatient programmes and preferred versus random assignment to treatment.

The relative effectiveness of an inpatient and an outpatient withdrawal programme for opiate addicts was studied. Forty five men and 15 women (mean age 26.13 (SD 5.12) years) took part in the study, all of whom were voluntary patients at the drug dependence clinic of the Maudsley Hospital in London between 1984 and 1985. Subjects were asked if they were prepared to accept either inpatient or outpatient withdrawal, and those who were willing to do so were assigned randomly to the randomised outpatient group or the randomised inpatient group. Those who expressed a strong preference were assigned, as appropriate, to the preferred outpatient group or the preferred inpatient group. Addicts in the inpatient group were more likely to achieve complete withdrawal (25 out of 31, 81%) than those in the outpatient group (five out of 29, 17%). This difference could not be attributed to pretreatment factors related to drugs or to social or psychological differences between the groups. These results have clinical and policy implications for the treatment of opiate addicts.

Adult↗
PubMed1986

The influence of psychological factors on the opiate withdrawal syndrome.

Psychological and drug-related variables and their effect on the severity of withdrawal symptoms were examined in a group of addicts being withdrawn from opiates on an in-patient drug dependence unit. Two psychological factors--neuroticism and the degree of distress expected by the patient--were related to subsequent severity of symptoms. Both are anxiety-related, and may serve to amplify withdrawal symptoms. Surprisingly, drug dose was unrelated to symptom severity.

Adolescent↗
PubMed1985

Prescribing methadone for the opiate addict: a problem of dosage conversion.

This study examines the relationship between self-reported use of opiates and the dose of oral methadone found to be needed on admission to an in-patients drug dependence unit. The sample consisted of all opiate addicts admitted in a 12-month period. For methadone addicts there was a close relationship between the two dose measures: for heroin addicts there was no relationship. Users of illicit heroin who generally state doses in 'grammes', reported a mean daily dose of 312.5 mg, but needed only 43 mg of oral methadone. Mean values for methadone addicts were 56 mg self-reported use, and 49 mg needed on the drug unit. Some of the reasons for the discrepancy in the two doses for the heroin addicts are discussed and clinical implications with regard to prescribing for opiate addicts are drawn.

Adult↗
PubMed1984

Insomnia among addicts during supervised withdrawal from opiates: a comparison of oral methadone and electrostimulation.

Measures of sleep disturbance were taken among drug-dependent inpatients being withdrawn from opiates using either a conventional oral methadone regime or electrostimulation (ES). Sleep was found to be disturbed in both groups. Subjects receiving ES showed the more marked sleep reduction and higher levels of night time waking during withdrawal: insomnia was most evident during the first 14 days of withdrawal. The degree of sleep disturbance among the methadone subjects was less severe but there were also sleep difficulties in this group. As late as 1 month after admission there was considerable night-to-night variability in sleep times with mean values between 4 h and 6 h in both groups. The ES procedure was unsatisfactory for managing insomnia during opiate withdrawal, but neither can methadone be regarded as fully satisfactory in this respect. An incidental finding to emerge from this study is that those subjects in the ES group who remained in treatment experienced more sleep disturbance than those who dropped out prematurely.

Adult↗
PubMed1984

The clinical effectiveness of electrostimulation vs oral methadone in managing opiate withdrawal.

A group of 24 opiate addicts admitted to an in-patient drug dependence unit received either electrostimulation or graduated oral methadone withdrawal. Addicts treated with electrostimulation showed high levels of withdrawal symptoms during the first week of treatment: these reached a peak on Day 3. In this respect electrostimulation was markedly inferior to methadone withdrawal treatment. However, although progressive methadone withdrawal quickly reduced symptoms to a moderate or low level, there was no reduction in symptomatology as late as one month after admission (i.e. after ten days without methadone). The implications of these findings are discussed.

Adult↗
PubMed1983

Drug dependence, who gets treated?

Despite the fact that decisions about whether or not to admit patients to inpatient facilities are often made on the basis of "clinical judgment," there is little evidence to support the validity of this process. The present study investigates the ability of the staff at a London drug clinic to predict how addicts would behave after admission to an inpatient treatment unit, and the bases upon which decisions were reached. The results indicate that predictions on almost all measures of future behavior showed very little interrater reliability, and there was no way of knowing in advance who would do well and who would do badly. The predictions were not random guesses; they reflected "implicit theories" held by each rater about the sort of factors that they believed to operate in such circumstances. Some implications of these findings for the treatment of addicts are discussed.

Humans↗