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Biomedical subjects

M Y Iguchi

Publications and source records attributed to M Y Iguchi.

At least 37 records · Page 2Linked to original sources
PubMed1995

Cocaine use and HIV risk behavior in methadone maintenance patients.

This study examined sexual and drug use behavior in 247 methadone maintenance patients, to explore the association of cocaine use with human immunodeficiency virus (HIV) risk behavior. In univariate analyses, cocaine use was positively associated with any drug injection, number of injections, and sexual intercourse without condoms. These relationships remained significant after controlling for other drug use and demographic factors. Heroin use also contributed to injection-related risk. We conclude that cocaine use represents a continued source of risk for exposure to HIV in this population, and that more aggressive efforts are warranted to reduce illicit drug use, particularly of heroin and cocaine, in methadone patients.

Adult↗
PubMed1995

Stages and processes of change among polydrug users in methadone maintenance treatment.

We applied the stages-of-change model of Prochaska and DiClemente to the problem of drug use among methadone maintenance patients to examine correlates of different stages of treatment readiness. The 276 subjects were divided into stage categories based on self-reported drug use and questionnaire responses regarding plans to discontinue unauthorized drug use in the future. Confirmatory factor analytic procedures validated four process scales derived from a 60-item questionnaire. Each stage was characterized by a profile of change-process scores largely consistent with predictions, though these scores did not distinguish stages as clearly as has been reported in previous research. Analysis of subject characteristics revealed that those in the Precontemplation stage reported significantly longer treatment tenures than subjects in any other stage besides Maintenance.

Adult↗
PubMed1995

Prospective evaluation of a model of risk for HIV infection among injecting drug users.

Data on 3016 out-of-treatment injecting drug users (IDUs) were analyzed in order to replicate findings from an earlier study on risk factors for HIV infection (Iguchi et al., 1992) and evaluate a model for estimating probability of infection. Logistic regression analyses yielded a set of risk factors highly consistent with previous findings. A logistic function was used to estimate subjects' probabilities of infection, and these estimates were strongly correlated with actual HIV prevalence in both the original and current samples. The current study represents a successful replication of earlier findings and supports the validity of the risk model.

Adult↗
PubMed1995

Situations occasioning cocaine use and cocaine abstinence strategies.

We interviewed 265 cocaine-experienced methadone patients about situations that occasioned their cocaine use and strategies they used to avoid cocaine use. Subjects identified an average of 15 situations that occasioned cocaine use. The three most frequently identified were having the drug present (86% of subjects), being offered the drug (85%) and having money available (83%). Subjects reporting fewer situations also reported longer periods of lifetime abstinence (p < 0.01). A principal components analysis extracted 10 groups of situations that were most frequently identified in combination. Subjects identified a median of seven strategies for avoiding cocaine use; however, there was large inter-subject variability. This variance was not accounted for by demographic variables, employment status or treatment experience. The three strategies identified most frequently were avoiding people and places (81%), thinking about what they could lose (76%) and leaving the situation (66%). The total number and type (reactive vs. proactive) of strategies identified by subjects had no relationship to cocaine abstinence, although four specific strategies (thinking about what could be lost, leaving the situation, moving to a new area and using a different drug) were positively correlated with cocaine abstinence. We discuss implications of these results for clinical practice.

Adult↗
PubMed1995

Comparison of MMPI-2 and MMPI clinical scales and high-point scores among methadone maintenance clients.

Methadone client volunteers completed the Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1967) and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) on consecutive days. MMPI-2 T-scores were lower by a mean of 4.7 on the clinical scales; when 5 points were added to MMPI-2 T-scores the mean difference was 2.3. Rank order of subjects on scale T-scores was not significantly different between the two instruments. High-point similarity for clinically elevated profile pairs ranged from 61% to 92%, depending upon definition of similarity.

Adult↗
PubMed1994

Hopelessness in i.v. drug users not in treatment and seeking HIV testing and counselling.

The Beck Hopelessness Scale (BHS) was administered to 2379 intravenous drug users who were not in treatment, unaware of their human-immunodeficiency-virus (HIV) status and seeking HIV testing and counselling. Three BHS principal components were identified reflecting resignation to the futility of changing the future, rejection of the possibility of a hopeful future, and acceptance of the inevitability of a hopeless future. The principal component scores representing these three dimensions were positively related to self-reported depression and suicidal ideation; the rejection scores were positively correlated with confirmed HIV seropositivity.

AIDS Serodiagnosis↗
PubMed1994

Interpreting HIV seroprevalence data from a street-based outreach program.

A total of 4,375 subjects were recruited through continuous street outreach over 31 months for interviews on HIV-related risk behavior and HIV-antibody testing. Changes over time among sampled subjects with respect to HIV infection and HIV-risk behavior have been examined retrospectively, and significant and consistent trends noted across successive cohorts. Although overall 42% of the sample tested HIV antibody-positive, HIV infection exhibited a consistent downward trend from 60% in the first quarter year of interviewing to 22% in the final quarter year. Scores on a multivariate index of HIV risk also declined significantly. Mean age, proportion of Black subjects, mean length of drug injection career, frequency of drug injection, and the use of shooting galleries all declined significantly across quarters as well. We argue that these observed differences result from a systematic sampling bias inherent in our outreach-driven sampling procedures, which initially favored recruitment of IDUs with greater behavioral and demographic risk for HIV.

Adult↗
PubMed1993

Benzodiazepine and sedative use/abuse by methadone maintenance clients.

Clients at three geographically separate methadone maintenance clinics were surveyed regarding their lifetime use of ten commonly used benzodiazepines and barbiturates. In Baltimore (n = 50), 94% reported use of one or more of these drugs in their lifetime, with 66% reporting use in the last 6 months. In Philadelphia (n = 218), 78% reported use in their lifetime, with 53% reporting use in the last 6 months. In New York City (The Bronx) (n = 279), 86% reported use in their lifetime, with 44% reporting use in the last 6 months. Subjects reporting a history of use of at least 7 of 10 of the named sedatives were recruited for a more detailed interview. They reported that, among the benzodiazepines, diazepam, lorazepam, and alprazolam were frequently used for their 'high' producing effects, and for selling to produce income. In contrast, chlordiazepoxide, oxazepam, and phenobarbital, had much lower ratings of 'high' and were much less likely to be obtained for getting 'high' or for resale.

Alprazolam↗
PubMed1993

Participation in an outreach-based coupon distribution program for free methadone detoxification.

OBJECTIVE: The purpose of the study was to identify characteristics of injection-drug users that predicted whether subjects would redeem a coupon for free methadone detoxification and to determine whether they were more likely to participate in a 90-day detoxification program than in a 21-day program. METHODS: A total of 4,390 current heroin users recruited through street-based outreach programs in Newark and Jersey City, New Jersey, accepted coupons for either 21 or 90 days (randomly determined) of methadone detoxification after they were interviewed about drug use and sexual behavior. Subjects also gave blood samples for HIV testing. Multiple regression analysis was used to determine variables associated with coupon redemption. RESULTS: Of 4,390 coupons distributed, 58.5 percent were redeemed; the 90-day coupons were redeemed at a significantly higher rate (59.9 percent) than the 21-day coupons (56.9 percent). Among coupon redeemers, 43.6 percent had never received formal drug treatment, and 44.9 percent were HIV seropositive. Frequent heroin use, previous drug detoxification, frequent drug injection, cleaning needles with bleach, nonblack race, Hispanic ethnicity, and Newark residence each significantly predicted coupon redemption. CONCLUSIONS: Outreach-based coupon distribution may be used to recruit large numbers of never-treated and HIV-infected drug users into treatment. The 90-day coupon was more effective in facilitating treatment entry.

AIDS Serodiagnosis↗
PubMed1992

Contingent take-home incentive: effects on drug use of methadone maintenance patients.

This study examined contingent methadone take-home privileges for effectiveness in reducing on-going supplemental drug use of methadone maintenance patients. Fifty-three new intakes were randomly assigned to begin receiving take-home privileges after 2 consecutive weeks of drug-free urines or to a noncontingent procedure in which take-homes were delivered independently of urine test results. The contingent procedure produced more individuals with at least 4 consecutive weeks of abstinence (32% vs. 8%); 28% of noncontingent subjects also achieved abstinence after shifting to the contingent procedure. Lower baseline rate of drug-free urines was strongly associated with successful outcome, whereas the type of drug abused (cocaine vs. benzodiazepines) did not influence outcomes. Findings support a recommendation for using contingent take-home incentives to motivate abstinence during methadone maintenance treatment.

Adult↗
PubMed1991

Predictors of opiate drug abuse during a 90-day methadone detoxification.

The behavioral circumstances related to opiate drug use were examined during a 90-day out-patient methadone detoxification. Seventy-one subjects (55 male and 16 female) were followed from the day of intake to treatment termination. Data were collected by means of a weekly structured interview. Questions were asked about each occasion of opiate use in the previous week with respect to time, source, cost, social circumstance, etc. Monitored urine samples were tested x 3/week to verify verbal reports. The study demonstrated beneficial effects of the detoxification treatment by showing dramatic decreases in rates and amounts of opiate drug use during treatment. The study also identified race (p less than .0008; t = -3.522; beta = -0.366), gender (p less than .0243; t = 2.305; beta = 0.222), and the number of opiate use episodes/week at baseline (p less than .0013; t = -3.364; beta = -0.338) as significant and independent predictors of treatment outcome. Current duration of regular and continuous opiate use was also found to be marginally significant. The overall regression was highly significant (p less than .0001; F = 9.176; df = 4,66). A second regression analysis with race, age, and gender excluded as independent variables was conducted in order to derive indices which were related to behavioral and environmental characteristics versus global physical/cultural identification. With race and gender removed, the overall regression was still highly significant, although less than a fifth of the variance was accounted for. The number of opiate use episodes/week at baseline and the total number of drug-related stimulus cue exposures at baseline were found to be independently significant variables in the analysis. Knowledge of the impact of such behavioral factors on the treatment process may enable us to better understand the role of environmental contributors to opiate use. Such information may also help us to direct our limited resources and to better focus our treatment interventions.

Adult↗
PubMed1988

Contingency management in methadone maintenance: effects of reinforcing and aversive consequences on illicit polydrug use.

Treatment outcomes were compared for an intervention emphasizing reinforcement for abstinence from illicit drug use and an alternative intervention which combined the same reinforcement contingencies with aversive consequences for unauthorized drug use. Sixteen polydrug abusing methadone maintenance patients were randomly assigned to one of two treatment groups. Both groups received the opportunity to take methadone doses away from the clinic (take-home dose) as reinforcement for submitting urines testing negative for illicit substances. A regular weekly take-home dose of methadone could be earned for every 2 weeks of verified abstinence from unauthorized drugs, up to a maximum of three take-home doses per week. The combined intervention group had an additional contingency which involved a reduction in methadone dose as an aversive consequence for submitting urine samples testing positive for illicit substances. Specifically, 10% of the patient's daily methadone dose was lost for each week in which two of three urines tested positive for illicit drugs. An examination of the urinalysis results indicated no between group differences. Overall, 8% of the 12-week baseline urinalysis results tested negative for illicit substances while 42% tested negative for unauthorized substances during the 20 weeks of treatment intervention. At the end of the intervention period, nine subjects remained in treatment with three patients in each group receiving at least once weekly take-home privileges. Of the seven subjects no longer in treatment, five were in the combined intervention group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Coping strategies and continued drug use among methadone maintenance patients.

Drug addiction has been conceived as a maladaptive means of coping utilized by individuals unable or unwilling to deal with stresses in more adaptive ways. Although a growing body of evidence supports the link between alcohol abuse and maladaptive coping styles, there is relatively little empirical support for the connection between maladaptive coping and other kinds of drug use. The present study employed a cross-sectional design to assess coping and drug use in a sample of 276 methadone maintenance patients. Structural equation modeling was used to assess the factor structure of the coping measure and the relationship between coping and unauthorized drug use. The results suggest that coping and drug use are related in this population and that this relationship is different for Black patients than for White patients.

Adaptation, Psychological↗