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PubMed2004

The role of family history in addiction severity and treatment response.

This study examined the relationship between familial history of substance use and addiction severity and treatment outcomes of opiate-dependent patients. The sample was comprised of 281 methadone maintenance patients at a VA or community-based clinic. Using the family history section of the Renard Diagnostic Interview, three familial risk groups were identified based on patients' self-report of their relatives' substance use. The three groups considered both the number and type (e.g., first vs. second degree) of biological relatives with a substance use problem. These three risk groups included: (1) high risk (HR, n = 111), (2) medium risk (MR, n = 80), and (3) low risk (LR, n = 90). HR patients reported a history of more severe asocial behavior at baseline and they reported more medical problems and a greater degree of concurrent alcohol use both prior to and after 6 months of treatment compared to LR patients. In addition, the HR group reported more family/social problems at baseline compared to the MR and LR group and both HR and MR patients reported more psychological problems than LR patients after 6 months of treatment. However, when accounting for baseline differences, the regression analyses demonstrated that familial risk was not predictive of drug treatment outcomes after 6 months of methadone maintenance treatment.

Adolescent↗
PubMed1963

Tests for addiction (chronic intoxication) of morphine type.

A survey is presented of laboratory and clinical methods for the determination of addiction liability of substances with morphine-like effects. Since physical dependence is the outstanding pharmacological criterion of addiction of morphine type, the procedures for its qualitative and quantitative assessment are described in detail.

Humans↗
PubMed1999

Studies of the 48 bp repeat polymorphism of the DRD4 gene in impulsive, compulsive, addictive behaviors: Tourette syndrome, ADHD, pathological gambling, and substance abuse.

Prior studies have reported an association between the presence of the 7 repeat allele of the 48 bp repeat polymorphism of the third cytoplasmic loop of the dopamine D4 receptor gene (DRD4) and novelty seeking behaviors, attention deficit hyperactivity disorder (ADHD), Tourette syndrome (TS), pathological gambling, and substance abuse. However, other studies have failed to replicate some of these observations. To determine whether we could replicate these associations we genotyped 737 individuals from four different groups of control subjects, and 707 index subjects from four different groups of impulsive, compulsive addictive behaviors including substance abuse, pathological gambling, TS, and ADHD. Chi-square analysis of those carrying the 7 allele versus non-7 allele carriers was not significant for any of the groups using a Bonferroni corrected alpha of.0125. However, chi-square analysis of those carrying any 5 to 8 allele versus noncarriers was significant for pathological gambling (p <.0001), ADHD (p </=.01) and the total index group (p </=.0004). When the comparison included all 7 alleles the results were significant for gamblers (p <.0001), TS (p </=.003), ADHD (p </=.003), and the total group (p </=.0002). There was a significant increase in the frequency of heterozygosity versus homozygosity for all alleles for pathological gamblers (p </=.0031) and the total index group (p </=.0015), suggesting that heterosis played a role. In the substance abuse subjects a quantitative summary variable for the severity of drug dependence, based on the Addiction Severity Index, showed that the scores varied by increasing severity across the following genotypes: 44 </= heterozygotes </= 77 </= 22. Studies of other quantitative traits indicated an important role for the 2 allele and the 22, 24, and 27 genotypes. All studies indicated that the role of the DRD4 gene in impulsive, compulsive, addictive behaviors is more complex than a sole focus on the 7 versus non-7 alleles.

Alleles↗
PubMed1995

Gender differences in drug addiction and treatment: implications for social work intervention with substance-abusing women.

This article draws on current addiction research to describe the unique characteristics and treatment needs of chemically dependent women and how they differ from those of chemically dependent men. It explores similarities between women who are drug addicted and all women who experience gender-based oppression. The authors suggest that drug use is a coping strategy that some women adopt to manage this oppression. Finally, the article looks at traditional drug treatment programs, which have been designed to treat male addicts and fail to address the treatment needs of women. The authors offer an alternative treatment model designed to meet those needs. Parallels between characteristics of this alternative treatment model and social work practice are drawn, and opportunities and strategies for social workers to intervene with female addicts are identified.

Female↗
PubMedDate not supplied

A bi-directional theory of addiction: examining coping and the factors related to substance relapse.

The results from this study supported a bi-directional theory of addiction for a sample of Black, inner-city, working-class, male substance abusers. Using structural equations modeling, at 6 months posttreatment we found that (a) the reciprocal effect emotional and psychological distress and substance relapse had on one another existed within the context of their bi-directional relationship with social instability, and (b) effective coping skills and resources moderated the negative effects that emotional and psychological distress, social structure, and substance relapse had on one another. These findings led us to three suggestions treatment professionals can use to counteract recidivism.

Adaptation, Psychological↗
PubMed1997

Pregnancy and addiction: translating research into practice.

In some areas of the United States pregnant women are incarcerated if they are addicted to illegal substances, particularly crack cocaine. However, incarceration does not happen to all pregnant addicts, but instead reflects racial/ethnic and socioeconomic categories of prejudice. In the following article, the authors suggest that analysis of this pattern of incarceration is clarified by the use of critical medical anthropology perspective with its explicit historical, political and economic foci. In addition, the authors introduce a program for addicted women that incorporates into practice the findings of the initial research and demonstrates how research can be translated into practice.

Adult↗
PubMedDate not supplied

What general psychiatrists ask addiction psychiatrists: a review of 381 substance abuse consultations in a psychiatric hospital.

We reviewed the records of 381 consecutive substance abuse consultations completed by the Substance Abuse Consultation Service (SACS) of McLean Hospital to ascertain 1) the most frequent reasons why general psychiatrists consulted the SACS, and 2) the clinical characteristics of these patients. The most frequent reasons for consultation were to make aftercare recommendations (66.1%) or to make (19.7%) or clarify (6.3%) a substance use disorder (SUD) diagnosis. Mood disorders were the most prevalent co-occurring psychiatric disorder; alcohol use disorders were the most prevalent SUDs. The findings indicate the potential utility of a substance abuse consultation service in a psychiatric hospital.

Adult↗
PubMed1998

[Is caffeine addictive? The most widely used psychoactive substance in the world affects same parts of the brain as cocaine].

Caffeine is the most widely used psychoactive substance in the world. In Western society, at least 80 per cent of the adult population consumes caffeine in amounts large enough to have an effect on the brain. Is this due to caffeine dependence? The article reviews the abuse potential of caffeine in relation to its mechanisms of action. Caffeine affects the same parts of the brain as cocaine, but in completely different ways. There is evidence for caffeine withdrawal symptoms, and caffeine does act as a weak reinforcer, but neither effect is as pronounced as those associated with cocaine. Nor does caffeine use appear to pose any threat to the individual or to society. There is thus no need to add diagnosis "caffeine dependence" to the psychiatric manuals.

Adult↗
PubMed1997

Reducing parental risk factors for children's substance misuse: preliminary outcomes with opiate-addicted parents.

Parents in methadone treatment were offered an experimental intervention, Focus on Families, designed to reduce their risk of relapse and their children's risk of substance use. Experimentally assigned volunteers participated in systematic group training in relapse prevention and parenting skills, and received home-based case management services. Immediate posttreatment outcome results reported here include analyses of covariance controlling for baseline measures. Analyses show experimental parents held more family meetings to discuss family fun, displayed stronger refusal/relapse coping skills, demonstrated stronger sense of self-efficacy in role-play situations, and had lower levels of opiate use than control subjects. No significant differences in family bonding, family conflict, or other measures of drug use were found. The utility of intervening with drug-addicted parents in methadone treatment is discussed in light of these findings.

Adolescent↗
PubMedDate not supplied

Ego function as a correlate of addiction.

Eighty-nine substance abusers in an urban treatment facility completed the self-report version of the Ego Function Assessment as well as the Addiction Severity Index. Statistical analyses delineate ego functions that relate to specific disruptions in the social and psychological adaptation of the substance abuser. Distinct profiles of ego functions are highlighted based on patterns of intravenous drug injection. Education levels are showen to correlate with ego function strengths. Results are interpreted from the social perspective of drug abuse.

Adult↗
PubMed2002

Assessing the diversity of personal beliefs about addiction: development of the addiction belief inventory.

Previous work in the field of substance use/misuse has suggested that client beliefs about addiction are quite diverse, and may influence the effectiveness of various treatment approaches. This paper presents an Addiction Belief Inventory (ABI) that was developed and evaluated to assess personal beliefs about addiction and substance use problems. The ABI is a 40-item instrument developed using two clinical samples: an alcohol user treatment group (N = 134) and a dual diagnosis treatment group (N = 536). Confirmatory factor analysis revealed seven stable subscales: inability to control, chronic disease, reliance on experts, responsibility for actions, responsibility for recovery, genetic basis, and coping. Multivariate analyses provided preliminary reliability and validational support. The utility of the ABI for clinical and research purposes is discussed, along with suggestions for future research and improvements to the instrument.

Adult↗
PubMed1990

Personality, addiction and anesthesia.

While substance abuse problems in the health care profession are not new, little documentation exists as to their prevalence among nurse anesthetists. There already exists considerable evidence that physician specialists in anesthesia are overrepresented in the population of physicians seeking treatment for drug and alcohol use. The purpose of this research was to explore factors related to personality and addictive tendencies that might predispose nurse anesthetists to substance abuse as well. Of the 150 graduate nursing students in the study, those specializing in anesthesia (n = 81) formed the study group while those pursuing general nursing graduate degrees (n = 69) comprised the control group. Differences in the personality facets of impulsiveness, assertiveness and excitement seeking were measured using the NEO Personality Inventory. The addictive tendencies of the subjects were measured using the MacAndrew Scale taken from the Minnesota Multiphasic Personality Inventory. In comparative analyses of the two groups, the anesthesia subjects exhibited a higher mean score for excitement seeking and a greater number of positive MacAndrew (addictive tendency) scores (22.2% versus 5.9%). The findings also showed that subjects with positive MacAndrew scores generally had higher excitement seeking scores. It may be possible that this higher level of excitement seeking predisposes future nurse anesthetists to the development of addictive disorders.

Adult↗
PubMed2005

Factors associated with the transition from abuse to dependence among substance abusers: implications for a measure of addictive liability.

This study was conducted to test the validity of a measure that has potential to bridge research on the addictive liability of drugs and on individuals' liability to addiction, which to date have evolved in largely parallel arenas. The length of time between onset of abuse and dependence (LOTAD) has evolved from recent findings on transitions through levels of addiction; it was hypothesized that shorter LOTAD is indicative of greater addictive liability. Hypotheses were based on animal studies and human studies. Retrospective data from the DSM-IV Substance Use Disorders Work Group were reanalyzed using configural frequency analysis, survival curves, bivariate Kendall's tau associations, and linear regression. The sample consisted of participants recruited from community and clinical settings. The measure was the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). The shortest LOTADs were observed for disorders related to use of cocaine and opiates, followed by cannabis and then alcohol regardless of the subsample that was analyzed. As hypothesized, females and early initiators of drug use had shorter LOTADs compared to men and other initiators of drug use; no consistent differences in LOTAD were observed between African-Americans and Caucasians. None of the LOTAD variance associated with differences between drugs could be accounted for by gender, early use of the drug, or ethnicity. Specific areas of research where LOTAD might be useful as well as how LOTAD might be improved are discussed.

Age Factors↗
PubMed2003

Anxiety sensitivity, controllability, and experiential avoidance and their relation to drug of choice and addiction severity in a residential sample of substance-abusing veterans.

The aim of the present study was to evaluate anxiety-related psychological risk factors (e.g., anxiety sensitivity, perceived uncontrollability, emotional avoidance) and their relation to drug of choice and addiction severity in an inpatient residential substance abuse population. Fully detoxified veterans (N=94) meeting criteria for Axis I substance abuse disorders were enrolled in a 28-day residential substance abuse treatment program and completed the following measures at intake and discharge: Anxiety Sensitivity Index, Body Sensations Questionnaire (BSQ), Acceptance and Action Questionnaire (AAQ), Beck Depression Inventory (BDI; intake only), and the Anxiety Control Questionnaire (ACQ). Consistent with the expectation, veterans who reported more distress over bodily sensations (anxiety sensitivity, BSQ) and depressive symptoms (BDI) were more likely to avoid experiencing negative affect (AAQ) and perceived themselves as lacking in control (ACQ). Further, extent of avoidance, and to a lesser extent, controllability, discriminated between participants as a function of primary and comorbid diagnostic status, whereas anxiety sensitivity did not. No relation was found between anxiety sensitivity and drug of choice, and relations between assessed psychological factors and domains of addiction severity were mixed. Findings suggest that heightened bodily sensitivity, emotional avoidance, and perceived uncontrollability are common sequelae of patients seeking residential substance abuse treatment, but they do not contribute uniquely to drug of choice and measures of addiction severity. Theoretical and treatment implications are discussed with particular emphasis on approaches that may increase coping with untoward bodily cues, decrease avoidance of negative affect, and improve patient's sense of personal control over their responses and the environment.

Adult↗
PubMed1990

Substance abuse and child abuse. Impact of addiction on the child.

At least 1 in 10 children in the United States is born into a chemically dependent family. Parental addiction has long-lasting detrimental effects on the health and safety of children. We must mobilize to free children from the double jeopardy of substance abuse and child abuse, and interrupt the multigenerational pattern of both problems. The short-term costs may be high, but the long-term costs will be much higher if we do not act. Simultaneous efforts are needed to prevent and treat both addiction and its too frequent consequence, child maltreatment.

Child↗
PubMed2003

The Italian Association on Addiction Psychiatry (SIPDip), formerly The Italian Association on Abuse and Addictive Behaviours.

The Italian Association on Addiction Psychiatry (SIPDip) is a special section of the Italian Psychiatric Association (SIP). It started, under the name of the Italian Association on Abuse and Addictive Behaviours (SICAD), in 1989 from the awareness that the addiction field had been starved of a psychiatrists' contribution since 1975. SIPDip aims to improve and implement study, clinical, research and educational topics about substance abuse and addictive behaviours. The National Board composition aims to provide an equal distribution of psychiatrists working in psychiatric and addiction facilities inside the National Health System, and private non-profit agencies. All psychiatrists and members of the Italian Psychiatric Association can become SIPDip ordinary members, while other health professionals working in psychiatric and addiction fields can become associate members. SIPDip has its National Congress every second year. In 2001 it promoted a network called the National Council of Addiction Disorders. It is recognized officially by the Drug Policy National Department and was created under the direct authority of the Prime Minister. In this, SIPDip is particularly involved in review groups relating to ethical issues, substitutive therapies and dual diagnosis. Furthermore, it organized the first Consensus Conference on Dual Diagnosis, under the sponsorship of the Italian Psychiatric Association. This was held in June 2003 to implement relevant national guidelines. The SIPDip main topics that will be addressed in the near future are: psychiatric comorbidity in substance related disorders; intervention efficacy assessment; and special populations and novel addictions. The National Board meeting on 15 December 2002 decided to submit to the General Assembly in April 2003, a motion to modify the Association's byelaws and to rename the organization 'The Italian Association of Addiction Psychiatry'.

Health Policy↗
PubMedDate not supplied

Overlapping addictions and self-esteem among college men and women.

To examine whether there is a tendency for individuals to be multiply addicted, overlapping addictions to common substances (alcohol, caffeine, chocolate, cigarettes) and activities (exercise, gambling, Internet use, television, video games) were studied in 129 college men and women. Contrary to previous research, moderate to large correlations were found, both within and between substances and activities. Self-esteem was positively related to exercise but unrelated to the remaining addictions. Several gender differences in addictive tendencies were also revealed: Men scored higher than women on addiction to alcohol, cigarettes, gambling, television, and Internet use, but women scored higher on caffeine and chocolate. The results have implications for theories of addiction and suggest new directions for the study of addiction among normally functioning young adults.

Activities of Daily Living↗