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PubMed1981

Are the "addiction-related" problems of substance abusers really related?

The "addiction-related" medical, social, and psychological problems of substance abusers are often considered by-products of prolonged alcohol or drug abuse which will be generally improved following achievement of abstinence. As a test of this view, measures of problem severity in six areas commonly related to addiction were intercorrelated in 460 alcoholic and 282 drug addicted male veterans. Both before and after treatment, the low intercorrelations in each sample indicated little relation between the severity of alcohol or drug use and the severity of the other problem areas. Intercorrelations among residualized admission to follow-up change scores were similarly low, also showing the lack of a general relationship between improvement in substance abuse and improvement in other areas. However, there was one exception: improvement in psychological function was clearly related to general improvement in most other areas, including chemical abuse, indicating the potential importance of psychologically oriented therapy in substance abuse treatment. Most of the evidence suggests that addiction may be a common pathway for a variety of specific disorders, rather than a general, progressive disease.

Alcoholism↗
PubMed1999

[Biological hallucinogens. New patterns of substance abuse in young addicts?].

Among young patients with multiple substance abuse, a high level of abuse of natural products was noticed. In a rehabilitation clinic for young addicts 180 patients filled out a questionnaire regarding drugs they regularly consumed. It was discovered that the patients consumed high levels of Psilocybe, Amanita and Datura. The natural drugs of the 70's, Ayahuasco and Cactus, are now rarely seen. The toxicological basis of the frequently used biological drugs is discussed. The results imply that a specific exploration of patients with multiple substance abuse in regard to the use of biological drugs is necessary.

Adolescent↗
PubMed1993

Treatment Issues in Adolescent Substance Use and Addictions: Options, Outcome, Effectiveness, Reimbursement, and Admission Criteria.

Cost-reduction strategies and a lack of overall perspective have created a potentially dangerous climate for the treatment of the various forms of adolescent substance abuse. The authors argue for a holistic approach that focuses on demographics, family issues, school functioning, and other related problems as well as on careful evaluation of treatment outcome and criteria for admission, continued stay, and discharge from treatment programs.

Journal Article↗
PubMed1993

Substance use and addiction among medical students, residents, and physicians.

When turning to our original questions, we offer the following tentative conclusions: 1. Although medical students as a group have a slightly higher percentage of use of alcohol, the pattern and prevalence of alcohol dependence is very consistent with their age mates in the general population. 2. There appears to be a pattern of increased alcohol problems with age among physicians and attorneys, as opposed to the general US population, which shows a diminution of alcohol-related problems over time. 3. There is no evidence for a marked increase in drug addiction and use of other prescription drugs among physicians. In fact, with the exception of tranquilizers and alcohol and psychedelics, which were used equally by physicians, medical students, residents, and their age mates, most other drug usage was slightly more prevalent in the general population than among students and residents. 4. Of particular concern is the finding of a lack of gender differences in problematic drinking with the pattern of female drinking rates for women approximating that of men by the end of medical school. 5. The most consistent predictive factor in alcoholism among physicians is the same as that in the general population: a family history of alcoholism. 6. Additional predictive factors of physician alcohol-related problems include a narcissistic type personality style that endorses the exploitation of others, a perception of low parental warmth in childhood, and particular stressors in the working or student environment such as being abused by others. Further predictive factors related to occupational stress await the results of ongoing perspective studies. 7. Physicians as a group probably respond more favorably to alcohol and drug addiction programs than do members of the general population. To a great extent, this is directly or indirectly due to the dire consequences of continued use, which include loss of hospital privileges and state licensure. It also would appear that required treatment and monitoring for alcohol and substance abuse has a positive effect on abstinence rates.

Alcoholism↗
PubMed1999

Impact of addictive and harmful substances on fetal brain development.

Animal models of alcohol, nicotine, and cocaine exposure have provided convincing evidence for prenatal effects on brain development caused by alterations in cell migration, signal transduction, and neurotransmitter function. The extrapolation to effects on the human nervous system is confounded by the multiplicity of factors affecting central nervous system development.

Animals↗
PubMed1992

A multicomponent model for substance abuse treatment. The Addiction Research and Treatment Corporation.

This paper reviews the activities of the Addiction Research and Treatment Corporation (ARTC), a substance abuse treatment agency, located in Brooklyn, New York, which services approximately 2,300 patients annually. ARTC's history, treatment, and research activities are first described. We then proceed to detail the ARTC's employee health maintenance and community relations programs. A multicomponent treatment model is then outlined, which emphasizes the interactive role of the above functions within an optimal treatment network.

Female↗
PubMed2002

A review of chemical agents in the pharmacotherapy of addiction.

Chemical substance abuse has tormented mankind throughout history. A number of chemical approaches have been employed in an attempt to treat chemical addiction. Unfortunately, most of these have proven unsuccessful though several chemical entities have been shown to be moderately effective. The naturally occurring alkaloid ibogaine has been reported to interrupt the cravings for alcohol, cocaine and opiates. Other alkaloids from Tabernanthe iboga, such as ibogamine and tabernanthine, provide insight into the structure activity relationship at the different receptors believed to be involved in addiction. The synthetic iboga alkaloid congener, 18-MC, also shows potential as an anti-addictive agent without the hallucinogenic effects of ibogaine. Additionally, acamprosate, BP 897, GBR12909, lofexidine and memantine have shown promising results in the treatment of addiction. All of these leads provide a start for the medicinal chemist to design anti-addictive agents, since currently no drugs are approved in the U.S. for the treatment of addictions to cocaine, methamphetamine, other stimulants or PCP.

Alcohol Deterrents↗
PubMed2005

Personality and problem gambling: a prospective study of a birth cohort of young adults.

CONTEXT: Individual differences in dimensions of personality may play an important role in explaining risk for disordered gambling behavior as well as the comorbidity between disordered gambling behavior and other substance-related addictive disorders. OBJECTIVES: To identify the personality correlates of problem gambling in a representative non-treatment-seeking sample, as well as to determine whether these are similar to the personality correlates of other substance-related addictive disorders and whether individual differences in personality might account for the comorbidity between disordered gambling behavior and other substance-related addictive disorders. DESIGN: Longitudinal population-based study. PARTICIPANTS: A complete birth cohort of young adults born in Dunedin, New Zealand, between April 1, 1972, and March 31, 1973 (N = 939; 475 men, 464 women). MAIN OUTCOME MEASURES: Multidimensional Personality Questionnaire assessments of personality were obtained at age 18 years; structured interview-based diagnoses of past-year problem gambling and alcohol, cannabis, and nicotine dependence were obtained at age 21 years. RESULTS: Problem gambling at age 21 years was associated with higher scores on the higher-order personality dimension of negative emotionality (d = 0.90) and with lower scores on the personality dimension of constraint (d = -0.72) measured at age 18 years compared with control subjects who did not have a past-year addictive disorder at age 21 years. Problem gambling was also associated with Multidimensional Personality Questionnaire indicators of risk-taking (d = 0.50) and impulsivity (d = 0.56). The personality profile associated with problem gambling was similar to the profiles associated with alcohol, cannabis, and nicotine dependence. The relations between problem gambling and the substance-related addictive disorders (odds ratios = 3.32-3.61) were reduced after controlling for individual differences in personality (odds ratios = 1.90-2.32). CONCLUSIONS: From the perspective of personality, problem gambling has much in common with the addictive disorders, as well as with the larger class of "externalizing" or "disinhibitory" disorders. Knowledge gained from the study of common personality underpinnings may be helpful in determining where disordered gambling behavior should reside in our diagnostic classification system.

Adult↗
PubMed2004

Pharmacologic management of relapse prevention in addictive disorders.

Substance use disorders are an important public health problem associated with significant mortality and morbidity. Effective maintenance pharmacotherapies are available for tobacco, alcohol, and opioid use disorders. For optimum treatment response, these medications should be used in conjunction with behavioral interventions. For other drugs of abuse, especially for cocaine, medication development is an active area of research. Further research is needed to develop new pharmacotherapies for substance use disorders and establish clinical guidelines on how to use these medications most effectively.

Administration, Cutaneous↗
PubMed1992

More data on the Addiction Severity Index. Reliability and validity with the mentally ill substance abuser.

The Addiction Severity Index (ASI) is a semistructured interview that collects data from substance abusers in seven problem areas: medical, employment, legal, alcohol, other drug use, family-social functioning, and psychological status. In each area, the clients provide an estimate of the seriousness of the problem and their need for treatment. It has been demonstrated in a number of studies to be reliable, valid, and useful in monitoring treatment changes and in matching substance-abusing clients to treatments. This study investigates the usefulness of the ASI with male and female substance abusers who suffer a concurrent major psychiatric disorder (N = 152). Data on the independence of the problem scales, their internal consistency, interrater reliability, and concurrent validity are presented. It is concluded that: a) the problem areas are independent from each other, underscoring the need for multidimensional assessment; b) interviewer severity ratings provide information in addition to that provided by clients; c) the reliability of the composite scores is generally adequate, with the exception of the legal and family-social scales; and d) further examination of the employment scores is required.

Adult↗
PubMed2000

[Self-poisonings of the addicted persons with corrosive substances].

In this paper we present two cases of suicidal behaviour; case (1)--patient dependent to medicines and case (2)--patient co-dependent, related with alcohol addicted person. Both of them combine suicidal corrosive substances consumption, but differ clinical course, finished by recover of addicted person and death of co-dependent person. In this paper we also present chemical burns of gastrointestinal tract algorithm procedure.

Caustics↗