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PubMed1979

The frequency of narcotic use before and after admission to a methadone maintenance program.

A total of 453 program participants of the Narcotic Abuse Treatment Program, San Diego Country, a methadone maintenance program, were asked to report their use of heroin prior to and after program participation. Results indicated a significant reduction in reported heroin use, suggesting that the program has affected change in the quantity of heroin used by participants and that heroin use of program participants is not sufficient by itself to motivate other criminal involvement. A program may be effecting a reduction in heroin use by clients as well as criminal activity, but the effects may be totally unrelated.

California↗
PubMed1979

Alcohol and narcotic abuse: variations on an addictive theme.

A treatment system developed to treat individuals abusing both narcotics and alcohol is described. The primary goal of treatment is change in the alcohol/drug abuse life-style which is seen as the major obstacle to successful treatment.

Alcoholism↗
PubMed1980

Ego functions and psychopathology in narcotics and polydrug users.

The literature reporting on aspects of ego functioning and psychopathology among narcotics and polydrug dependent individuals is reviewed. Data are presented which indicate impairment in ego functioning and evidence of considerable psychopathology in three groups of drug-dependent individuals entering an inpatient detoxification/treatment unit. The data support the view that drug misuse of any sort does not result in a homogeneous group. The Psychiatric Status Schedule of Spitzer and Endicott was the instrument used in gathering the data. Recommendations for discriminate thinking in diagnostic evaluation and treatment planning for any drug-dependent individuals are made.

Ego↗
PubMed1980

The role of race and social class in the psychiatric disorders of treated narcotic addicts.

To test a clinical impression that lower-class Black narcotic addicts from a ghetto "welfare" setting primarily manifest reactive schizophrenia when they become mentally ill, whereas White lower-middle- or working-class addicts primarily manifest reactive depression when they become neurotic or psychotic, a series of 20 consecutive mentally ill addicts from each group were compared with respect to diagnosis. The two groups were matched for age and sex. The findings overwhelmingly supported the hypothesis and are interpreted as confirming it insofar as the nature of our two populations permitted. It was impossible, for example, to separate the effects of racial membership from those of social class or from an interaction between the two variables.

Adjustment Disorders↗
PubMed1980

The impact of the interview method on reported symptoms of narcotic addicts.

Male veterans applying for outpatient treatment of narcotic addiction were interviewed as to symptoms of withdrawal and overdose using a two-phase procedure. First they were asked how they felt, with no specific symptoms mentioned by the interviewer. Then a list of 28 symptoms was read. Symptoms reports increased dramatically. Every symptom was reported more frequently when patients were specifically asked. Correlations indicated fairly good agreement on severe symptom levels, but poor agreement on mild and moderate symptoms. Standardization of method of inquiry seems essential for valid comparison of studies of addiction.

Adult↗
PubMed1981

Family structures of narcotic addicts.

Seventy-five families of former narcotic addicts were studied in New York City and Los Angeles. All patients were in residential treatment at the time of the study and they and their families participated in a multiple family group which was the major source of data. The most common familial pattern seen was that of a mother enmeshed with her addicted son. The father feels excluded by this dyad and reacts with disengagement, brutality, or increased consumption of alcohol. However, in certain ethnic groups the entire family including the father is quite enmeshed with each other and their addict sons. Siblings were either fellow addicts whose drug abuse is fused with that of the identified patient or, to the contrary, "good' children who were parental figures and quite successful. Addict spouse pairs tend to duplicate patterns which they have developed in their family of origin. Male addicts frequently dominate their addicted or drug-free spouse to assure themselves of being cared for. The female addict population in this study was too small (N = 16) for generalization but observed patterns are discussed.

Dependency, Psychological↗
PubMed1983

An empirical typology of narcotic addicts.

On the basis of structured interview data concerning their life-styles, behaviors, circumstances, and activities during their most recent periods of addiction, 460 male narcotic addicts (230 Black and 230 White) were empirically classified, or "typed," using factor and cluster analytic techniques in a multistage process. Mean factor score profiles for each of the eight types derived are presented, along with provisional labels and verbal descriptions. It is believed that this classification is descriptive of the major addict types to be encountered in a large urban population.

Adult↗
PubMed1985

Narcotic drug abuse in 152 countries: social and economic conditions as predictors.

This study examines the relationships between the level of narcotic drug abuse and the prevailing socioeconomic and health conditions and education levels in 152 countries. Drug abuse, as classified in this paper, is related to socioeconomics, health, and education in complex ways. The data do not support the proposition that drug abuse is more common among technologically developed societies than among developing ones. The best predictors of drug abuse were those related to health.

Cross-Cultural Comparison↗
PubMed1987

Similarity of behavior within addict couples. Part I. Methodology and narcotics patterns.

The development and initial assessment of a methodology for measuring the similarity of behavioral patterns within addicted couples over the duration of a relationship is presented. Two subsamples of addicts from methadone maintenance programs in southern California were established: one of couples who had a real relationship during their addiction and treatment careers, and a group of pseudocouples (matched as closely as possible) created from unrelated clients in the same programs. Narcotics use, abstinence, and support patterns are analyzed for couples before, during, and after their relationship. When it occurs during the relationship, treatment effects are also analyzed.

Adult↗
PubMed1988

Ethnic differences in narcotics addiction. II. Chicano and Anglo addiction career patterns.

Part I of this series compared characteristics of 546 Chicanos and Anglo men and women methadone maintenance (MM) clients. In Part II, specific differences between Chicanos and Anglos are analyzed, by sex, for each of five stages in the addiction career: preexperimentation, experimentation addiction, initial MM treatment, and posttreatment. The analysis examines narcotic and other drug use, arrest, incarceration and legal supervision histories, criminal involvement, employment, interpersonal relationships, and treatment history. Whereas preaddiction differences between addicts parallel ethnic differences found in the general population, after addiction occurs the similarities are greater than the dissimilarities between ethnic groups, except for Chicanas. Chicanos appear to continue to function as part of their community after addiction, but Chicanas appear to risk becoming marginal. Treatment outcomes for Chicanos were, in general, less successful than for Anglos.

Adult↗
PubMed1988

Ethnic differences in narcotics addiction. I. Characteristics of Chicano and Anglo methadone maintenance clients.

This paper reviews the research literature comparing Chicano (Mexican American) to Anglo heroin addicts. In addition, characteristics of 546 Chicano and Anglo men and women who had been clients of southern California methadone maintenance programs in 1978 are compared. Background factors examined include nativity, family socioeconomic status (SES) and family interpersonal relationships, education, and gang membership. Lifetime characteristics and status at follow-up interview are reported with particular attention to legal status, criminality, employment, and interpersonal relationships. Drug experimentation history and circumstances surrounding narcotics initiation are also compared. Most observed differences prior to addiction are similar to ethnic differences found in the general population. Part II analyzes ethnic differences progressing through five stages of the addiction career.

Adult↗
PubMed1989

The MMPI profiles of narcotics addicts. I. A review of the literature.

This paper reviews three approaches to using the Minnesota Multiphasic Personality Inventory (MMPI) in the assessment of narcotics addicts' psychopathology. Two approaches examine the relationship of MMPI profiles to established sociodemographic or psychiatric typologies; the third pertains solely to MMPI-derived personality typologies. Findings from the research literature are presented and their implications for clinical assessment and treatment are discussed.

Heroin Dependence↗
PubMed1996

Pattern reliability of narcotics addicts' self-reported data: a confirmatory assessment of construct validity and consistency.

Pattern reliability, or the invariance of relationships among variables, was investigated in this study. The consistency of theoretical constructs reflected by measures taken at two separate occasions can be tested using confirmatory factor analysis. Self-report data were obtained from 323 narcotics addicts in two face-to-face interviews conducted in 1974/75 and 1985/86. The two interviews overlapped approximately 4 years between 1970 and 1974/75. Through the testing of the invariance of measurement and structural models, pattern reliability was confirmed in one of the models developed. Explication of pattern reliability offers an alternative means of assessing validity of self-report data.

Adult↗
PubMed1987

Intraspinal narcotic anesthesia in open heart surgery.

Intraspinal narcotic anesthesia was performed in 180 open heart surgery patients. 0.1 mg/Kg of morphine or 1.5 mg/Kg of meperidine was administered as the primary anesthetic in the subarachnoid space using the barbotage technique. Of the 180 patients scheduled for open heart surgery, morphine was administered to 95 patients, meperidine to 55 and a mixture of morphine and meperidine to 30 patients. From a clinical point of view, there were no significant cardiovascular problems, however, respiratory depression seemed to be most serious after morphine administration. Mild complications such as pruritus (11.1%), voiding difficulty (10.6%), intraoperative awareness (4.4%) and spinal headache were observed, however these were mild, not major clinical problems and were acceptable. Postoperative analgesic effect and respiratory controllability were excellent.

Anesthesia, Spinal↗
PubMed2004

Effects of narcotic analgesic drugs on human Oddi's sphincter motility.

AIM: To assess the effects of intramuscular analgesics (morphine, Ap-237, pethidine and tramadol) on human Oddi's sphincter motility with choledochoscope manometry. METHODS: A total of 70 patients having T tubes after cholecystectomy and choledochotomy were assessed by choledochoscope manometry. They were randomly divided into morphine group, Ap-237 group, pethidine group and tramadol group. Basal pressure of Oddi's sphincter (BPOS), amplitude of phasic contractions (SOCA), frequency of phasic contractions (SOF), duration of phasic contractions(SOD), duodenal pressure (DP) and common bile duct pressure (CBDP) were scored and analyzed. All narcotic analgesic drugs were administered intramuscularly. RESULTS: Levels of BPOS, SOCA and SOF were increased after injection of morphine and Ap-237 (P<0.05), level of CBDP was increased from 4.97+/-3.87 mmHg to 8.62+/-7.43 mmHg (10 min later) and 7.32+/-5.95 mmHg (20 min later) after injection of morphine (P<0.01). No apparent change occurred after intramuscular injection of pethidine. Level of BPOS was increased from 7.01+/-5.50 mmHg to 2.87+/-2.78 mmHg 10 min after injection of tramadol and SOCA was decreased from 63.34+/-35.29 mmHg to 45.90+/-27.86 mmHg (10 min later,P<0.05) and 35.97+/-24.30 (20 min later,P<0.01) after administration of tramadol. CONCLUSION: All these findings indicate that Oddi's sphincter manometry via choledochoscope is a practical and new way to study the dynamics of Oddi' s sphincter. The regular dose of morphine and Ap-237 could increase BPOS, SOF and SOCA. Morphine could increase the level of CBDP, demonstrating an excitatory effect on the sphincter of Oddi. Pethidine had no effect on Oddi's sphincter motility. Tramadol shows an inhibitory effect on the motility of the sphincter of Oddi and decreases levels of BPOS and SOCA.

Adult↗
PubMed1985

Fungal endophthalmitis in narcotic abusers. Medical and surgical therapy in 10 patients.

The presentation and management of 10 cases of proven or presumptive fungal endophthalmitis in narcotic-drug abusers is described. Miconazole was found to be an effective agent in some patients when administered in a dosage of 2400 mg/day. Eight patients received treatment with a combination of miconazole and flucytosine (5-fluorocytosine). Regression of the infection with preservation of the eye was observed in each case. However, visual acuity in the affected eye improved only in four of the eight patients; it was unchanged in two and had deteriorated in the other two. In two patients, who received amphotericin B and flucytosine as initial treatment, control of the infection was achieved, but vision remained unchanged. Vitrectomy was performed in three patients to remove residual sites of infection. However, vision remained unchanged in two of these patients and worsened in the third. The selection of individual modalities of therapy and responses to treatment are discussed.

Adult↗
PubMed1985

Thrombocytopenic purpura in narcotics addicts.

Since November 1982 we have seen an association of thrombocytopenic purpura with chronic narcotic addiction in 70 patients with a mean platelet count of 53000 +/- 4000 (SE); 33 had stopped taking intravenous drugs for an average of 21.2 +/- 4.7 months; 13 of 15 had elevated antibody titers for a virus related to the acquired immunodeficiency syndrome. Platelet-bound IgG, IgM, and complement levels were 16.7-, 5.6-, and 3.1-fold greater than control values, respectively, and 2.6-, 1.9-, and 2.4-fold greater than values in 25 patients with classic autoimmune thrombocytopenic purpura studied at the same time. Thirty-three of thirty-six addicts had elevated circulating immune complexes, whereas 8 patients with autoimmune thrombocytopenia had no elevation. Eleven of eighteen addicts had positive serum platelet-reactive IgG titers, compared to 5 of 19 patients with classic autoimmune thrombocytopenia. The platelet-reactive IgG in sera of addicts was composed of 7S IgG antibody as well as high molecular weight (immune complex) IgG. Thus, chronic addicts appear to have a new immunologic platelet disorder associated with the presence of 7S IgG antiplatelet antibody, like patients with classic autoimmune thrombocytopenic purpura, and immune complex associated nonspecific platelet IgG, like male homosexual patients with thrombocytopenia.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Agonist narcotics.

Pain management has been shown to be an area that has been neglected in health care. Health care professionals need to become educated in the importance of addressing and managing pain. Narcotic pain relievers carry many negative connotations to both patients and health care staff. While there are many non-pharmacologic methods of pain management that should be incorporated into patient care, medication management is an area with which we must be comfortable.

Analgesics, Opioid↗