Biomedical subjects
Publications and source records attributed to T F Babor.
In a study of social interaction during an experimental addiction cycle, male narcotic addicts expressed more hostility after higher doses of heroin. No consistent role variations were observed in dominance, friendliness, or therapeutic-orientation.
The relation between marijuana consumption and the development of tolerance was investigated during a 31-day study. Volunteers with a history of moderate or heavy marijuana use were given access to one-gram (2.1% delta9 tetrahydrocannabinol [THC]) marijuana cigarettes during a 21-day smoking period. Both groups tended to increase consumption during this time. Heavy users averaged 5.7 cigarettes per day and indicated a progressive decline in ratings of intoxication and duration of pulse rate effect. Moderate users averaged 3.2 cigarettes per day but showed no changes in either of these reactions during this time. Results suggested that tolerance does not develop to the two most reliable indexes of marijuana intoxication unless heavy doses of delta9 THC are self-administered repeatedly. Also, the tendency to increase consumption during this time is not necessarily associated with the development of tolerance.
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Subjective and behavioral reasons for drinking alcohol were elicited from 26 female social drinkers for 3 points in time by means of standardized questionnaire items selected from the Alcohol Use Inventory and the Alcoholic Stages Index. The 26 women resided for 35 days on a clinical research unit and could consume alcohol on 21 days. On the first study day subjects recalled subjective and behavioral reasons for drinking for the 21 days immediately prior to admission to the study and the 21 days of greatest alcohol consumption during the previous year. On the day after the end of the alcohol acquisition phase of the study, subjects responded to questions about their reasons for alcohol consumption during 21 days on the research unit. Each subject was classified as a heavy, moderate, or occasional drinker on the basis of observed alcohol intake. The heavy, moderate, and occasional drinkers differed significantly in history of alcohol use, and differences in questionnaire response patterns were reported for all 3 time intervals. In contrast to moderate and occasional drinkers, heavy social drinkers had significantly elevated questionnaire item scores for the 21 days of heaviest alcohol consumption during the past year and for the 21 days immediately prior to the study. However, both heavy drinkers and occasional social drinkers had significantly elevated scores for the 21-day alcohol acquisition phase on the research unit. Scores for moderate social drinkers were similar for each of the 3-time intervals.
Although structured diagnostic interviews are increasingly being used in substance abuse treatment settings, there has been limited systematic evaluation of their ability to enhance reliability and validity of psychiatric diagnoses. The present report provides data on the concurrent, discriminant, and predictive validity of current substance use disorders and common comorbid diagnoses in a sample of 100 substance abuse patients. Diagnoses formulated primarily by master's-level clinicians in the usual course of their duties were compared with diagnoses formulated by research technicians using a semistructured interview. Results indicated that the validity of clinician diagnoses was good for substance use disorders, moderate for personality disorders, and poor for anxiety disorders and major depression. Greater validity was observed for substance abuse diagnoses formulated by research technicians using the semistructured interview. Based on these findings, we conclude that psychiatric diagnosis in substance abuse patients may be improved by adding elements of structured interviews to the clinician's usual assessment.
While overall alcohol consumption and alcohol-related automobile deaths have declined, rates of alcohol dependence, liver cirrhosis, and alcohol-related problems remain high among adults, and binge drinking continues as a major health risk for high school and college students. Some individual-level downstream interventions have been evaluated with sufficient rigor to recommend widespread dissemination, and widened availability of new pharmacotherapies could further increase effectiveness. Midstream population-based programs, such as screening and brief interventions in hospitals and managed care organizations, may have greater public health impact than tertiary treatment because of early identification and low cost. Upstream programs and policies that place limits on alcohol availability (e.g., higher legal purchasing age) have the greatest potential to reduce morbidity and mortality at the least cost to society.