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PubMed2005

[Assessment of legal awareness regarding illicit drug use among Kraków university students].

Social survey is a very important source of information concerned with planing the preventive strategy and protecting against problems relevant to the use of psychoactive substances. The survey covered a group of 211 first-year students from five colleges in Kraków. The students showed weak awareness of law. The respondents are of the opinion that the rules dealing with the addiction issue have been too liberal thus far. The emphasis should be put on enforcing the anti-drug law. Otherwise it will not became a powerful weapon to counteract the drug addiction. According to the opinion of respondents the trade and delivery of drugs are highly disapproving and they require inflicting stringent punishments. The results of our analysis are the integral part of Kraków model to help addicted to psychoactive substances and of prevention activities referred to the students of colleges.

Adult↗
PubMed1990

Eating disorders in women who abuse alcohol.

It has been suggested that various forms of addictive behaviour and substance abuse co-exist more frequently than would be expected by chance. Such co-morbidity may lessen the effectiveness of treatment, and may not be recognized by clinicians who specialize in one particular form of addiction. This study addresses one aspect of this issue: the co-existence of eating disorders and alcohol abuse. Women attending an alcohol treatment unit completed a self-report measure of the clinical features of eating disorders. Thirty-six per cent of the sample reported the symptom of binge-eating, 26% fulfilled diagnostic criteria for a probable current clinical eating disorder, and 19% had a history of probable anorexia nervosa. The findings suggest that the behaviour and attitudes characteristic of clinical eating disorders are over-represented in women receiving treatment for an alcohol problem, and further study of such co-morbidity is merited.

Adolescent↗
PubMedDate not supplied

Michigan assessment-screening test for alcohol and drugs (MAST/AD): evaluation in a clinical sample.

In this study, we sought to evaluate a modification of the Michigan Alcohol Screening Test designed to include problems associated with other drug abuse/dependence besides alcohol. Scores of the lifetime Michigan Assessment-Screening Test/Alcohol-Drug (MAST/AD) were compared to other lifetime measures of substance abuse and dependence and to psychiatric scales reflecting current or recent symptoms. Two university medical centers with alcohol-drug programs located within departments of psychiatry hosted 520 patients with alcohol-drug-related diagnoses. Patients completed their own MAST/AD using a paper-and-pencil format. Based on interviews with the patient, a research associate rated the patients' substance-related problems on the Minnesota Substance Abuse Problem Scale (M-SAPS) and obtained information on lifetime treatment for substance abuse. An addictions psychiatrist determined abuse or dependence and made a current diagnosis of alcohol abuse/dependence only, drug abuse/dependence only, and alcohol plus drug abuse/dependence. The MAST/AD was highly correlated with the M-SAPS and several other measures of substance abuse morbidity. Patients with alcohol-only and drug-only diagnoses did not differ from one another on the MAST/AD, although both groups had lower scores than those with alcohol plus drug diagnoses. Current psychosocial morbidity as assessed by the patient and the psychiatrist was associated with the MAST/AD, although less strongly than with lifetime substance abuse measures. The lifetime MAST/AD demonstrates reliability as a severity measure for alcohol and/or drug abuse. With minor modification, this standard measure can be expanded from alcohol diagnoses to all substance diagnoses. This study in a clinical population did not demonstrate its utility as a screening instrument; additional work is needed to reveal its utility for this purpose.

Adult↗
PubMed1999

Do antidepressants have any potential to cause addiction?

Addiction/dependence is a syndrome in which the hallmark is a compulsive pattern of drug use. Most authorities do not regard antidepressants as causing addiction but this has been challenged. This debate is explored drawing on case reports and related clinical and pharmacological data. An extensive literature review identified 21 English language case reports of antidepressant addiction (DSM-IV 'substance dependence' criteria) published since 1963. Sixteen involved tranylcypromine or amineptine and may reflect their dopaminergic and stimulant properties. Subject characteristics included male sex (14/21), personality problems (10/21) and prior substance misuse (14/21). Withdrawal or discontinuation symptoms have long been recognized with antidepressants but other features of addiction such as tolerance and compulsive use are exceptionally rare. Common clinical problems are patients taking subtherapeutic dosages and prematurely stopping antidepressants. The pharmacodynamic profiles of most antidepressants and the absence of acute 'desirable' effects make addiction theoretically unlikely. It is concluded that, with the exception of tranylcypromine and amineptine, antidepressants do not have a clinically significant liability to cause addiction. Tranylcypromine and amineptine should be avoided in those with a history of substance misuse. Patients prescribed other antidepressants should be told that they are not addictive.

Antidepressive Agents↗
PubMed1999

Working and "drugging" in the city: economics and substance use in a sample of working addicts.

Employment status is often treated as a "risk factor" in epidemiologic studies of drug use. The process that underlies the supposed relationship has remained, however, essentially unexamined. This article uses life history data to look at the relationship between work and drug use in a sample of addicts from Baltimore City, Maryland. The narratives constructed by these individuals demonstrate that the processes involved in creating and maintaining drug- and nondrug-related identities are neither linear nor straightforward. Rather, managing complex, emergent identities is a product of the economic situation, the organization of the drug scene, and the larger milieu in which these addicts operate.

Adult↗
PubMed1995

Addiction medicine.

Diagnoses for substance dependence and abuse have been modified in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders. The Food and Drug Administration approved marketing of naltrexone as a medication for alcohol-dependence treatment.

Humans↗
PubMed1994

Abuse of inhalants: a review.

Inhalants, a chemically heterogeneous group of psychoactive substances found in adhesives, lighter fluids, spray paints, cleaning fluids and typewriter correction fluid, may be used by up to 10% of young people. This article reviews the health effects, epidemiology, risk of other substance use and addiction and psychiatric co-morbidity associated with the practice of inhalant use.

Adolescent↗
PubMed1993

Nursing and substance misuse: responding to the challenge.

The widespread use and misuse of alcohol, drug and other psychoactive substances are major health and social concerns that affect the lives of many. The social and health sequelae of psychoactive drugs and alcohol are preventable and manageable with minimal interventions. Nurses and other health workers can effectively respond to substance misuse problems and their existing generic skills can be easily adapted in working with substance misusers. This paper considers some of the issues such as the extent of the problem, attitudinal considerations, response to substance misusers and a brief outline of the role of the nurse. The urgent need for education and training in substance misuse and addictive behaviour for nurse practitioners is also addressed.

Attitude to Health↗
PubMed2005

Efficacy of acupuncture for treating cocaine addiction: a review paper.

Acupuncture is being used in more than three hundred treatment facilities for treating substance abuse including cocaine addiction. Previous review papers could not evaluate the role of acupuncture for treating cocaine addiction because of lack of clinical trials at the time. Since then, several important studies were conducted in the field. This paper reviews existing clinical trials using acupuncture to treat cocaine addiction. The existing evidence fails to document the benefit of acupuncture in treating cocaine addiction as the sole treatment. Further efforts to document the efficacy of the NADA protocol to treat cocaine addiction as the sole treatment should be re-evaluated. There is a limited amount of evidence showing possible benefits of acupuncture when used as an adjunctive therapy to complement existing substance abuse treatment program. Future efforts should concentrate on systematic studies investigating the role of acupuncture as an adjunctive treatment for cocaine addiction. In addition, more formative research exploring the efficacy of different types and protocols of acupuncture treatments for cocaine addiction should be thoroughly investigated.

Acupuncture Therapy↗
PubMed2006

Changing patterns of addiction and public aid receipt: tracking the unintended consequences of welfare reform.

Sharp declines in welfare rolls since the passage of welfare reform legislation have led many to label it a social policy success. Using data from prereform and postreform samples of welfare applicants and recipients, as well as ethnographic data on welfare reform implementation, we examine three hypotheses based on concerns raised during the welfare reform debate about the possible effects of new policies on substance abusers and addicts: First, they would be "scared off," or discouraged from applying to aid by welfare's new requirements surrounding work and treatment. Second, they might be "weeded out," or face discrimination in the application process because of concerns about the difficulty of moving them successfully from welfare to work. Third, they might be "bumped down," or shifted to local aid programs rather than moving from welfare to self-sufficiency. Our empirical analysis finds no evidence of scaring off or weeding out, and some evidence of bumping down. Using ethnographic data, we offer some possible explanations for these findings by placing them in the context of policy change and implementation in the years following welfare reform.

Adult↗
PubMed1996

Codependency and family cohesion and adaptability: changes during treatment in a therapeutic community.

Codependency is a significant factor in the understanding of addiction to psychoactive substances. The present study examined changes in the level of codependency and perceived family relationships of drug-using residents in the three therapeutic communities in Israel in the course of their treatment. The findings indicate significant changes in both the level of codependency and the residents' perceptions of their family relationships between the beginning and the reentry stages of their treatment. On the other hand, no significant associations were found between their level of codependency and their perceptions of their family relationships. The findings are discussed in relation to the nature of addiction, the family processes, the treatment in the therapeutic community, and the addicted person's perseverance in that community.

Adaptation, Psychological↗
PubMed2006

Knowledge and use of the internet as a source of controlled substances.

Despite growing evidence that the internet is a source of controlled substances for nonmedical use, there is a lack of information about who is using it to obtain these drugs. One hundred adult drug-dependent inpatients in a private residential treatment program participated in a semistructured interview regarding how they obtained their drugs. Twenty-nine percent reported knowledge of the internet as a source of drugs, and 11% reported that they had used the internet to either buy drugs or locate a drug dealer. The results of this preliminary study suggest that the internet has become a source of controlled substances for some addicted individuals. Considerations for future research and clinical practice are described.

Adult↗
PubMed2006

Impulsive-compulsive sexual behavior.

Impulsive-compulsive sexual behavior is a little studied clinical phenomenon which affects approximately 5% to 6% of the population. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision, it is classified as an impulse control disorder not otherwise specified or a sexual disorder not otherwise specified. It may be placed in a possible new category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition called substance and behavioral addictions. This clinical entity is reviewed and the merit of classifying it as an addiction is assessed. Information is presented regarding its diagnostic criteria, epidemiology, types of behavior it can involve, relationship to hypersexuality, comorbidities, treatment, and etiology. The data regarding this disorder and its overlap with chemical addiction is limited. If the two disorders are to be grouped together, further data are needed.

Adolescent↗
PubMed2004

Pleasure: from onthogenesis to addiction.

Among the various models proposed for understanding the dynamics of addiction to psychoactive substances, no single one succeeds in explaining how the three dimensions--biological, psychological, and social--interact. The physio-pathological models proposed so far suffer from too reductive a vision of the notion of pleasure to hope to supply this explanation. Studies in the neurosciences and genetics indicate that cerebral function, and hence pleasure itself, is determined less by our genes than by the continuous interaction that occurs between every organism and its environment, including other individuals. These indications make it possible to propose an integrated model capable of answering the main questions posed by all types of addiction.

Animals↗
PubMed2000

Medical education in substance-related disorders: components and outcome.

AIMS: To analyze the process of acquisition by physicians of a body of knowledge and skills in the management of substance abuse. DESIGN: A comprehensive search of English-speaking literature was conducted over 20 years. Articles assessing the outcome of educational strategies in undergraduate, graduate and continuing medical education were examined to determine the targeted sample, the educational strategies involved and the outcomes assessed. FINDINGS: Nine studies in undergraduate education, 11 in graduate and 11 in continuing education met the inclusion criteria. They were generally difficult to compare in design, strategy and outcome analysis. Cognitive knowledge and behavioral skills appear to be easier to obtain compared to more complex attitudinal shifts. CONCLUSIONS: There is growing consensus in the selection of a combined didactic and interactive educational strategy but few empirical data as to the more cost-effective learning interventions. Training must be reinforced at regular intervals. While the expanding panoply of interventions available to physicians should enhance the perceptions of role legitimacy and treatment optimism, cohort studies across levels of education, specialty groups and across-substance and other addictive behaviors are required to determine cost-effective educational strategies.

Education, Medical↗
PubMed2000

Sexual Trauma, Substance Abuse, and Treatment Success in a Sample of African American Women Who Smoke Crack Cocaine.

The purpose of this descriptive study was to examine the relationship among sexual trauma, severity of substance use, and treatment success for African American women who smoke crack cocaine. Using a convenience sample of 208 African American women with a history of crack smoking, participants were interviewed for 2 to 4 hr and asked a variety of questions about their health, relationships, sexuality, and drug use. Women with a history of sexual trauma (N = 134) reported being addicted to more substances than women who had not been sexually traumatized (N = 74), despite the fact that the two groups did not differ on the number of substances used. Differences in the self-reported level of substance abuse was corroborated with external evidence of group differences in substance abuse severity. Women with a history of sexual trauma, compared to women without such a history, were admitted to the hospital or emergency room more often for health issues related to their substance use and were more likely to be negligent in caring for their children because of their drug use. We also found evidence to suggest that there are differences in treatment success between the two groups; women with a history of sexual trauma reported having been to substance abuse treatment programs more often than women without such a history. These findings are discussed in light of the particular treatment needs of women with a history of sexual trauma.

Journal Article↗
PubMed1998

Genetic influences on smoking: candidate genes.

Twin studies consistently indicate important genetic influences on multiple aspects of smoking behavior, including both initiation and cessation; however, knowledge regarding the role of specific genes is extremely limited. Habit-forming actions of nicotine appear to be triggered primarily at nicotinic receptors on the cell bodies of dopaminergic neurons in the mesolimbic "reward" system of the brain, a region implicated in addiction to other substances including cocaine, opiates, and alcohol. Important aspects of the dopaminergic pathway include synthesis of dopamine in dopaminergic neurons, release of dopamine by presynaptic neurons, receptor activation of postsynaptic neurons, dopamine re-uptake by presynaptic neurons, and metabolism of released dopamine. Research examining the role of allelic variation in genes involved in these functions is being actively pursued with respect to addictive behavior as well as personality traits and psycho- and neuropathologic conditions and has implications for smoking research. In addition, genetic differences in nicotinic receptors or nicotine metabolism might reasonably be hypothesized to play a role in smoking addiction. A role of dopaminergic or other genes in smoking cessation is of particular potential importance, as research in this area may lead to the identification of subgroups of individuals for whom pharmacologic cessation aids may be most effective.

Behavior, Addictive↗