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At least 307 records · Page 17Linked to original sources
PubMed2003

Integrating medical and substance abuse treatment for addicts living with HIV/AIDS: evidence-based nursing practice model.

Forty-five active substance abusers with HIV/AIDS voluntarily participated in a substance abuse treatment research study with interviews at intake, 6 months and 12 months. These participants were engaged in treatment for a minimum of 45 days and a maximum of 90 days. The study used a nursing model of care, The Personalized Nursing LIGHT model, to integrate treatment for HIV/AIDS with substance abuse treatment. The LIGHT model seeks to enhance patient well being directly and thereby to support interventions that decrease substance use and improve management of chronic disease. The substance abuse treatment team included a nurse who used the LIGHT model and coordinated an integrated care protocol. The nurse accompanied clients on visits to their physicians for HIV treatment and facilitated the integration of medical recommendations with the substance abuse treatment. Six-month posttest data were gathered on all 45 participants and 12-month posttest interviews were accomplished with 29 of them. At 6 months, 78% of the respondents (35/45) reported no drug use in the past 30 days, and, at 12 months, 79% (23/29) were drug free for the past month. Significant decreases from intake to 6 months were detected on Addiction Severity Index (ASI) composite scores for drug use (p < 0.01), alcohol use (p < 0.04), medical severity (p < 0.02), psychiatric severity (p < 0.01), legal problems (p < 0.04), and employment difficulty (p < 0.01). Improvement of 6-month drug use composite scores was related significantly to treatment duration (R = 0.42; p < 0.01). Significant decreases in ASI measures of drug use (p < 0.01), alcohol use (p < 0.01), employment difficulty (p < 0.01), and family/social problems (p < 0.01) also occurred at 12 months. Well being, as measured by a Global Well Being Index, was found to improve significantly at 6 months (p < 0.02) and 12 months (p < 0.07). Concurrently, significant improvement was observed on Medical Outcomes Study-36-Item Short-Form Health Survey (SF-36) measures of general health and health functioning. These changes were noted at 6 months in the general health (p < 0.02), mental health (p < 0.01), social functioning (p < 0.01), role/emotional status (p < 0.04), and vitality (p < 0.01) subscales. At 12 months, the social functioning (p < 0.01) subscale responses were further decreased.

Adult↗
PubMed2006

Impaired decision-making in psychopathic heroin addicts.

Substance-dependent individuals (SDIs) often show neurocognitive deficits in decision-making, such that their choices are biased toward the greatest immediate reward rather than the optimal future outcome. However, studies of SDIs are often hampered by two significant methodological challenges: polysubstance dependence and comorbid conditions, which are independently associated with neurocognitive impairments. We addressed these methodological challenges by testing heroin addicts in Bulgaria, where heroin addiction is highly prevalent but polysubstance dependence is rare. The goal of the current study was to evaluate the potential contribution of psychopathy to decision-making processes among this group of Bulgarian heroin addicts. We tested 78 male currently abstaining heroin addicts, classified as psychopathic or non-psychopathic using the Hare Psychopathy Checklist, Revised (PCL-R). Psychopathic heroin addicts showed notable deficits in decision-making in that they made significantly more disadvantageous decisions relative to non-psychopathic heroin addicts. Results indicate that the presence of psychopathy may exacerbate decision-making deficits in heroin addicts.

Adolescent↗
PubMed2005

[Addiction--who is not affected?].

Addiction and addiction-related behaviour increased during the past decades. Several substances with psychoactive attributes, like opioids, cocaine or alcohol, can lead to dependence with physical and/or mental symptoms. In addition to substance-related addiction, non-substance-related dependence requires special attention. Increasing numbers of workaholics and patients suffering from internet-addiction, gambling or eating-disorders can be observed. To meet international treatment standards for addiction, diversification of therapy is necessary and, additionally, gender-related aspects in development and treatment of dependence and addiction-related behaviour are essential for state-of-the-art therapy of this patient population.

Behavior, Addictive↗
PubMed2004

Experiences and perspectives in using telematic prevention on sensitive health issues.

The new information and communication technologies, telematics - such as the Internet, telephone services and videoconferencing - are simultaneously both an instrument and a symbol - a sign of progress - but also a potential addiction problem. Sensitive topics - like substances or mental health - bring out all these characteristics of telematics. Therefore the computer world, substances and addictions are closely connected.

Attitude to Computers↗
PubMedDate not supplied

Recovering substance abuse staff members' beliefs about addiction.

This study of 329 substance abuse treatment staff assessed how recovery status, in combination with other variables, influences beliefs about the causes and treatment of substance abuse. About 15% (n = 47) of participants were "in recovery" from substance abuse problems; these staff members were not significantly different than nonrecovering staff members on education, age, race/ethnicity, years of clinical experience, or amount of client contact. When examined in a multiple regression equation that also included age, education, and treatment program goals and activities, staff members' recovery status was not associated with endorsement of disease and psychosocial models of substance abuse. However, being in recovery was associated with endorsing an eclectic approach to substance abuse treatment. The importance of recognizing the diversity of beliefs about substance abuse among recovering staff and of acknowledging that multiple influences affect all staff members viewpoints on treatment is discussed.

Adult↗
PubMedDate not supplied

Effect of counselor and client education in nicotine addiction on smoking in substance abusers.

Smoking cessation has received little attention in substance abuse programs. The present study analyzed the effect that counselor and client education in nicotine addiction had on clients' treatment readiness for a smoking cessation program. Thirty-eight smoking clients and two counselors from a short-term residential alcohol treatment facility participated in this study. Counselors served in both the treatment and control conditions in this 2x2 mixed factorial design by first participating in the control condition (general substance abuse education) and then in the treatment condition (smoking education). Counselors proceeded to work (for 6 weeks) with clients who had participated in the control education in general substance abuse issues and with clients who participated in the treatment education series in smoking issues. Clients completed the Fagerstrom Test for Nicotine Dependence and Stages of Change Ladders pre- and posttest. Results indicated that counselor and client education was effective in significantly changing the clients' thoughts toward smoking cessation and their smoking behaviors. Implications for instituting a smoking education program involving counselors, as well as clients, are discussed.

Adult↗
PubMedDate not supplied

[Development, validity and reliability of a general addiction scale. A preliminary study].

INTRODUCTION: The authors develop a General Scale to measure the intensity of the addiction to substances (not alcohol, not opiates) and addictive behaviors. METHODS: The General Scale is a self-scale compound by eleven ítems that was delivered to fifty and five students of the courses 5 masculine and 6 masculine of the Medicine of the University of Alcalá (Madrid, Spain), and was them requested that applied said scale from different supposed addictive: tobacco; tea, coffee or cola drinks; chocolate; others sweet; alcohol; sex; use of the personal computer and/or Internet and/or videoplay; and to practice sports. Of that manner, each subject provided a total of 440 complimented scales.Finally, it was requested the subjects that indicated in a scale apart, their degree of addiction from the different exposed concepts. Those data served of external criterion. RESULTS AND DISCUSSION: The Scale is monodimensional, and shows a high construct validity (account 63% of the total variance obtained by a Factorial Analysis), a high alpha reliability (alpha: 0.94) and a good internal consistency (split-half method with the Spearman-Brown correction; R: 0.92). All items share with the general addiction concept that represents the total score of the Scale, an common variance proportion equal or over the 52%. CONCLUSION: The Scale seems be a valid and reliable instrument to compare groups of the calls new addictions of a measurable manner.

Adult↗
PubMedDate not supplied

Drug addiction. Part I. Psychoactive substances in the past and presence.

Substances capable of changing the functions of the central nervous system are widely distributed in plant kingdom, and many of them were discovered by ancient food-gatherers at the dawn of humanity. In the Old World only a few substances producing euphoria or altered states of consciousness and having habit-forming properties are still widely used. They are the products of poppy (opium, morphine), hemp (hashish, marijuana), and of fermentation of various organic materials alkohol. This list has recently been joined by the psilocybin-containing mushrooms. The addiction-forming compounds originated in the New World and widely spread are tobacco (nicotine) and cocaine. In the 19th and 20th, century the development of medicinal chemistry resulted in several synthetic compounds, originally proposed as therapeutics, such as barbiturates, benzodiazepines and amphetamines. Due to legal problems, to avoid production of the substances already prohibited, many designer drugs were manufactured. In addition, several compounds were synthesized as recreational drugs. Also some compounds that were not regarded as drugs, such as aromatic hydrocarbons and other cleansing agents, as well as steroids were found to have properties of dangerous, habit-forming agents. The attitude of society and the pattern of use of psychoactive substances have changed with time, particularly in the last decades. The active principles are now more addictive because of concentration, purification, chemical modifications and the way of ingestion, which now favors most rapid transport to the central nervous system. The substance abuse approaches the level of global epidemics, and the recent usage of drugs of addition is also reviewed.

Anabolic Agents↗
PubMed2005

Challenges in coming of age in Korea.

Nurses in the field of addictions and substance abuse have assumed, along with most of medicine, that alcohol abuse is a multifactoral health problem. The narratives of two college student's comments about their experiences of excessive drinking are considered from the human becoming theory as an alternative perspective to the causal theories which are dominant in the addictions and substance abuse fields. These issues are also considered from a human becoming perspective.

Adult↗
PubMedDate not supplied

Hallucinogens and redemption.

This article examines drug substitution with regard to hallucinogens (ayahuasca, ibogaine, peyote and LSD) set within the concept of redemption. The model examines both religious and secular approaches to the contemporary use of hallucinogens in drug substitution, both by scientists and in religious settings worldwide. The redemptive model posits that the proper use of one psychoactive substance within a spiritual or clinical context helps to free an individual from the adverse effects of their addiction to another substance and thus restores them as functioning members of their community or group. Data is drawn from the U.S., Brazil, Peru, and West Africa. Two principle mechanisms for this are proposed: the psychological mechanism of suggestibility is examined in terms of the individual reaching abstinence goals from addictive substances such as alcohol and opiates. Neurophysiological and neurochemical mechanisms to understand the efficacy of such substitution are highlighted from ongoing research on hallucinogens. Research by two of the authors with the Uñaio do Vegetal (UDV) Church in Brazil is examined in terms of the model.

Africa, Western↗
PubMed2003

Effect of primary medical care on addiction and medical severity in substance abuse treatment programs.

OBJECTIVE: To examine whether the availability of primary medical care on-site at addiction treatment programs or off-site by referral improves patients' addiction severity and medical outcomes, compared to programs that offer no primary care. DESIGN: Secondary analysis of a prospective cohort study of patients admitted to a purposive national sample of substance abuse treatment programs. SETTING: Substance abuse treatment programs in major U.S. metropolitan areas eligible for demonstration grant funding from the federal Substance Abuse and Mental Health Services Administration. RESPONDENTS: Administrators at 52 substance abuse treatment programs, and 2,878 of their patients who completed treatment intake, discharge, and follow-up interviews. MEASUREMENTS: Program administrators reported whether the program had primary medical care available on-site, only off-site, or not at all. Patients responded to multiple questions regarding their addiction and medical status in intake and 12-month follow-up interviews. These items were combined into multi-item composite scores of addiction and medical severity. The addiction severity score includes items measuring alcohol and drug use, employment, illegal activities, legal supervision, family and other social support, housing, physical conditions, and psychiatric status. The medical severity score includes measures of perceived health, functional limitations, and comorbid physical conditions. MAIN RESULTS: After controlling for treatment modality, geographic region, and multiple patient-level characteristics, patients who attended programs with on-site primary medical care experienced significantly less addiction severity at 12-month follow-up (regression coefficient, -25.9; 95% confidence interval [95% CI], -43.2 to -8.5), compared with patients who attended programs with no primary medical care. However, on-site care did not significantly influence medical severity at follow-up (coefficient, -0.28; 95% CI, -0.69 to 0.14). Referral to off-site primary care exerted no detectable effects on either addiction severity (coefficient, -9.0; 95% CI, -26.5 to 8.5) or medical severity (coefficient, -0.03; 95% CI, -0.37 to 0.44). CONCLUSIONS: On-site primary medical care improves substance abuse treatment patients' addiction-related outcomes, but not necessarily their health-related outcomes. Further study is needed to discern the mechanism through which on-site primary care might improve the addiction-related outcomes of substance abuse treatment.

Adult↗
PubMed1980

An improved diagnostic evaluation instrument for substance abuse patients. The Addiction Severity Index.

The Addiction Severity Index (ASI) is a structured clinical interview developed to fill the need for a reliable, valid, and standardized diagnostic and evaluative instrument in the field of alcohol and drug abuse. The ASI may be administered by a technician in 20 to 30 minutes producing 10-point problem severity ratings in each of six areas commonly affected by addiction. Analyses of these problem severity ratings on 524 male veteran alcoholics and drug addicts showed them to be highly reliable and valid. Correlational analyses using the severity ratings indicated considerable independence between the problem areas, suggesting that the treatment problems of patients are not necessarily related to the severity of their chemical abuse. Cluster analyses using these ratings revealed the presence of six subgroups having distinctly different patterns of treatment problems. The authors suggest the use of the ASI to match patients with treatments and to promote greater comparability of research findings.

Alcoholism↗
PubMedDate not supplied

Use of capillary electrophoresis and poly(ethylene oxide) as the coating agent for the determination of substances related to heroin addiction and treatment.

The purpose of this study was to identify and quantify morphine, codeine, methadone, and 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine using capillary electrophoresis in urine specimens. Adequate peak separation was achieved using nearly neutral pH phosphate buffer and poly(ethylene oxide) as the coating agent. This dynamic coating of the inner surface of the capillary was obtained by rinsing with a solution containing this compound. The electroosmotic flow and the interactions between analytes and the capillary wall surface were reduced, while resolution and reproducibility were thus improved. Detection limits were appropriate for usual analytical requirements in forensic laboratories.

Codeine↗
PubMed2003

Prevalence of substance use among offspring of opioid addicts.

AIMS: This study assessed the prevalence of substance use in sons and daughters of opioids addicts in Iran. MEASUREMENTS: A confidential semistructured interview and DSM-IV criteria were used. Data were gathered from 500 subjects (225 men and 275 women). These subjects were selected randomly from sons and daughters of 500 opioids addicts (out of 1500 opioids addicts) who sought treatment in 2000. RESULTS: Of these subjects, 33.8% were in the age range of 20-29, 33.1% in 30-39, 28% were >40, and 7.1% were <20 years; of them, 81.6% were married and 18.4% were single. The majority (36.2%) used cigarettes, 19% used opium, 18.2% used alcohol, 2.6% used hashish, and 1.6% used marijuana once or more at some time in their lives. Nobody used cocaine or psychedelics. Of the current substance dependents, using DMS-IV criteria, 46.7% of men and 5.5% of women were nicotine dependent, 12.9% of men and 1.1% of women were opium dependent, and 0.9% of men and 0.7% of women were heroin dependent. (Some used or were using more than one substance.) Enjoyment (56.8%) was the first and modeling (49.6%) was the second most common reason reported for substance use. CONCLUSIONS: Substance use was significantly higher in men, in single, and also in illiterate subjects. There was a nonsignificant relation between age group and substance use. Cultural attitudes toward drug use quite likely affect the type and amounts of use. These findings can be considered when planning preventive programs.

Adolescent↗
PubMedDate not supplied

Alcohol and drug use and sexual behaviors placing runaways at risk for HIV infection.

Lifetime and current alcohol and drug use and sexual risk acts were examined among 154 male and 148 female runaways, aged 11-19, predominantly Black and Hispanic, residing at four residential shelters in the New York City area. Most runaways reported alcohol (71%) and drug use (46%), with about a quarter (27%) using either alcohol or drugs at least once a week during the past 3 months. Physical symptoms of substance abuse were reported by 47%; 17% reported addiction. Current substance use was higher among males and Hispanics, and increased with age. Substance use was significantly related to reporting more sexual partners and less frequent condom use. The results suggest that HIV/AIDS prevention programs must target the reduction of alcohol and drug use as well as sexual risk acts.

Adolescent↗