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Drug
and Alcohol Dependence
Volume 80, Number 1,
October 2005
(Updated 11/26/2005)
 Home Page
Ty A. Ridenour, Mildred Maldonado-Molina, Wilson M. Compton, Edward L.
Spitznagel, and Linda B. Cottler. Factors
associated with the transition from abuse to dependence among substance
abusers: Implications for a measure of addictive liability.
Drug and
Alcohol Dependence
80(1):1-14,
October 2005.
Address correspondence to Ty A. Ridenour,
Pennsylvania State
University, Prevention Research Center, 135 East Nittany Avenue, Suite
402, State College, PA 16801, USA. Tel: 814-865-4122; Fax:
814-865-6004.
Summary:
The objective was to test the validity of a potential measure for
bridging research on the addictive liability of drugs and research on
individual addiction liability. It was hypothesized that shorter length
of time between abuse onset and dependence (LOTAD) is
an indicator of greater addictive liability. Hypotheses were based on
animal studies and human studies. Retrospective data from the Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV)
Substance Use Disorders Work Group were reanalyzed using configural
frequency analysis, survival curves, bivariate Kendall's tau
associations, and linear regression. Participants in the study were
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,
then ethanol, 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
and ways it might be improved are discussed.
NIAAA
Glossary Terms:
addiction, AOD dependence, AOD abuse, validation study,
individual as study subject, hypothesis testing,
disease onset, early AOD onset, diagnosis, diagnostic criteria,
disease course, statistical
estimation, regression analysis, cocaine, opiates, marijuana in any
form, alcoholic beverage, gender differences,
ethnic differences, racial differences, human study
|
Cuneyt Evren and Bilge Evren. Self-mutilation
in substance-dependent patients and relationship with childhood abuse
and neglect, alexithymia and temperament and character dimensions of
personality. Drug
and Alcohol Dependence 80(1):15-22,
October 2005.
Address correspondence to Cuneyt Evren,
AMATEM, Bakirkoy State
Hospital for Psychiatric and Neurological Disorders, 34747 Bakirkoy,
Istanbul, Turkey.
|
Summary:
The authors evaluated the prevalence of
self-mutilation
in Turkish male substance-dependent patients and investigated
the relationship of self-mutilation with childhood abuse and neglect,
alexithymia,
and temperament and character dimensions of personality. Consecutively
admitted males with substance dependence (N = 136; 96
alcohol and 40 drug) participated. Substance dependence was diagnosed
with
the Structured Clinical Interview (SCID-I) for
the Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition (DSM-IV), Turkish
version.
Patients were investigated with the Childhood
Abuse and Neglect Questionnaire, Toronto Alexithymia Scale
(TAS-20), and Temperament and
Character Inventory (TCI). Among
substance-dependent patients 34.6% were considered to be
self-mutilators.
Rates of being single and unemployed, histories of physical and sexual
abuse, and suicide attempts were higher in the self-mutilation group.
Current age,
age at first substance use, and age at regular substance use were lower
in the self-mutilation group. Mean of TAS-20 and "Difficulty in
Identifying Feelings" (DIF) and "Difficulty in Describing Feelings"
(DDF) subscales
of TAS-20 were higher in the self-mutilation group.
No significant
differences were found between groups in terms of TCI subscales. Age,
childhood
physical abuse, and suicide attempt history predicted self-mutilation
in logistic
regression. Young substance users with
childhood physical abuse histories could be the target population to
prevent self-mutilating behavior. The findings also suggests that
whenever self-mutilating behavior is present, the possibility of
childhood abuse, alexithymia, and suicide attempts must be evaluated.
NIAAA
Glossary Terms:
prevalence,
self-destructive behavior, Turkey, AOD abuse, AOD dependence, abused as
child, alexithymia,
personality trait,
variable, characteristic, factor,
marital status,
employment status, unemployed,
patient history, sexual abuse,
physical abuse, victim of abuse, suicidal behavior, age of AODU onset,
AOD use pattern, regression analysis, human study
|
Joan S. Tucker, Elizabeth J. D’Amico, Suzanne L. Wenzel, Daniela
Golinelli, Marc N. Elliott, and Stephanie Williamson. A
prospective study of risk and protective factors for substance use
among impoverished women living in temporary shelter settings in Los
Angeles County. Drug and Alcohol Dependence 80(1):35-43, October 2005.
Address correspondence to RAND Corporation,
Health, 1776 Main
Street, PO Box 2138, Santa Monica, CA 90407-2138, USA. Tel:
310-393-0411 x7519; Fax: 310-260-8159.
Summary:
Few prospective studies have examined risk and
protective factors for substance use among homeless women, although
alcohol and drug use are significant problems in this population. This
6-month
prospective study identified psychosocial, behavioral, and economic
predictors of drinking to intoxication, crack cocaine use, and
marijuana use in
a probability sample of women (N
= 402) living in temporary shelters
in Los Angeles County, California. Sexual risk
behavior and depressive symptoms were risk factors for more
frequent intoxication, marijuana use, and crack use. Drinking to
intoxication was additionally predicted by perceived human
immunodeficiency virus (HIV), lower social support, more
avoidant and less active
coping, and lower self-esteem. Additional predictors of marijuana use
included partner alcohol misuse and less social support, whereas more
frequent crack use was additionally predicted by partner alcohol
misuse, lack of economic resources, and more avoidant and less active
coping. The findings suggest that effective substance use programs
may need an integrative approach that addresses other types of risk
behaviors, assists women in strengthening their support networks and
learning effective coping skills, and provides access to basic services
such as housing and health care. For women in relationships, there may
be
a further need to address issues of partner substance use.
NIAAA
Glossary Terms:
homeless, homelessness, female,
alcoholic beverage, AOD use for intoxication, predictive factor, risk
factors,
psychosocial environment, behavior,
economic aspects of AOD and AOD use, human immunodeficiency virus,
disease susceptibility,
social support, emotional and psychiatric depression, coping,
loss of self-esteem, crack cocaine, marijuana in any form, poverty,
coping skills,
housing,
health care availability and access, spouse or significant other, human
study
|
Miriam Bottlender and Michael Soyka. Outpatient
alcoholism treatment: Predictors of outcome after 3 years.
Drug and
Alcohol Dependence
80(1):83-89,
October 2005.
Address correspondence to Miriam Bottlender,
Department of
Psychiatry, Ludwig-Maximilians University, Munich, Nussbaumstr. 7,
80336 Munich, Germany. Tel: +49-89-5160-2777; Fax:
+49-89-5160-5748.
|
Summary:
Predictors of
relapse after completion of an intensive outpatient treatment program
for
alcoholism were investigated in a 3-year prospective study of
consecutively recruited participants (N = 103). Since
previous studies mainly revealed
that alcohol dependence severity and comorbid psychopathology were
predictive of subsequent relapses, the impact of these and other
pre-treatment variables on the 36-month outcome was evaluated using
logistic regression analysis. Variables were assessed using a
structured interview. Patients were personally interviewed at entry to,
and
the end of, an outpatient treatment program and 6, 12, 24, and 36
months after treatment completion. The treatment program was completed
by 74 patients. At the 36-month follow-up, 2 patients had died (after
heavy alcohol relapse) and 88 (88%)
of the remaining patients were located and personally
re-interviewed. Forty-four (43%) patients were abstinent, 46 (45%) had
relapsed, and 12 (12%) were classified as improved for the total
follow-up period. Logistic regression analysis revealed that
significant predictors of relapse were treatment drop-outs, female
sex, and sum of positive life events prior to treatment (relapsers had
significantly fewer positive life events). In
contrast to previous studies, this study could not confirm the
importance of
risk factors for relapse such as dependence severity. Treatment
drop-out was the strongest predictor for post-treatment relapse. Since
women were at an increased risk for relapse,
gender-specific treatment approaches should be considered. In summary,
the effectiveness of this intensive outpatient treatment
program is favorable, although selection criteria of must be
taken into account.
NIAAA
Glossary Terms: AODD
relapse, predictive factor, AOD dependence, disease severity,
comorbidity, predictive factors, risk factors, evaluation study,
regression analysis, outpatient care, treatment outcome, follow-up
study, interview,
program dropout, gender differences,
life circumstances, life events, human study
|
Andrew Rosenblum, Stephen Magura, Deborah J. Kayman, and Chunki
Fong. Motivationally
enhanced group counseling for substance users in a soup kitchen: A
randomized clinical trial. Drug and Alcohol Dependence 80(1):91-103, October 2005.
Address correspondence to Andrew Rosenblum,
National Development
and Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New
York, NY 10010, USA. Tel: 212-845-4528; Fax: 917-438-0894.
Summary:
Soup
kitchens tend to serve residentially unstable adults with a high
prevalence of substance abuse. In this study, soup
kitchen guests (N = 289) who
reported drug or alcohol problems were randomly
assigned to information and referral (I&R) plus peer advocacy
(peers encouraging subjects to participate in other services) (n
= 139)
or to an experimental 12-session motivational group (three sessions a
week for 4 weeks) followed by a 36-session cognitive-behavioral group
(three sessions a week for 12 weeks), plus I&R and peer advocacy.
The mean age was 42; 82% were male; 68% were African-American; 81% had
unstable
residence; and 14% were positive for human immunodeficiency virus.
Intervention subjects were significantly more likely than
controls to have increased their participation in some type of
substance abuse intervention during follow-up and were also
significantly more likely than controls to have
reduced both drinking and heavy drinking at follow-up (the groups did
not differ in reduction of cocaine use). Interaction
analysis indicated that the experimental intervention was more
effective for participants with higher rather than lower substance
abuse severity at baseline. The results support the concept that
motivationally enhanced group counseling, provided as a low-threshold
outreach intervention, can help increase participation in formal
treatment and 12-step groups and reduce substance abuse,
particularly for those starting with high severity of use.
NIAAA
Glossary Terms: AOD
abuse, homelessness, group therapy,
peer counseling,
advocacy,
intervention referral,
motivation, HIV infection, controlled study, follow-up study, treatment
outcome, AOD intake per occasion, AOD consumption, heavy AOD use,
disease severity, human study
|
Frederick S. Stinson, Bridget F. Grant, Deborah A. Dawson, W. June
Ruan, Boji Huang, and Tulshi Saha. Comorbidity
between DSM-IV alcohol and specific drug use disorders in the United
States: Results from the National Epidemiologic Survey on Alcohol and
Related Conditions. Drug and Alcohol Dependence 80(1):105-116, October 2005.
Address correspondence to Frederick S.
Stinson, Laboratory of
Epidemiology and Biometry, Room 3075, Division of
Intramural Clinical and Biological Research, National Institute on
Alcohol Abuse and Alcoholism, National Institutes of Health, M.S. 9304,
5635 Fishers Lane, Bethesda, MD 20892-9304, USA. Tel: 301-443-4898;
Fax: 301-443-1400.
|
Summary:
This study investigated the
prevalence and comorbidity of alcohol and specific drug use disorders
and identified sociodemographic and psychopathologic correlates and
treatment seeking among three groups of respondents: those with
alcohol use disorders only, those with drug use disorders only, and
those with comorbid alcohol and drug use disorders. Information
on 12-month alcohol and specific drug use disorders in the United
States was obtained in personal interviews in the National
Institute on Alcohol Abuse and Alcoholism's (NIAAA) 2001–2002 National
Epidemiologic Survey on Alcohol and Related Conditions (NESARC: N = 43,093).
Prevalences
were: alcohol use disorder only, 7.35%; drug use disorder only, 0.90%;
and comorbid alcohol and drug use disorder, 1,10%. of these The
three groups differed in sociodemographic and
psychopathologic correlates, with the drug use disorder
and comorbid groups
significantly more likely to be young, male, never married, and of
lower
socioeconomic status than the alcohol use disorder only group.
Associations between current alcohol use disorders and 25 specific drug
use disorders were generally positive and statistically significant.
The 12-month prevalence of treatment seeking significantly increased
from 6.06% for those with an alcohol use disorder only, to 15.63% for
those with a drug use disorder only, and to 21.76% for those with
comorbid alcohol and drug use disorders. The
study provides detailed data on the homotypic comorbidity of alcohol
use disorders and 25 different drug use disorders and confirms the high
levels of association seen in previous studies based on lifetime
measures. Implications are discussed in terms of
integrating alcohol and drug treatment services and refining prevention
and intervention efforts.
NIAAA
Glossary Terms:
prevalence, comorbidity, AOD abuse, AOD dependence,
alcohol use disorder classification, interview, survey, demographic
characteristics, psychopathology, statistical association,
help-seeking behavior,
co-treatment,
AOD prevention, intervention (persuasion to treatment), human study
|
Deborah S. Hasin, Mark Hatzenbueler, Sharon Smith, and Bridget F.
Grant. Co-occurring
DSM-IV drug abuse in DSM-IV drug dependence: Results from the National
Epidemiologic Survey on Alcohol and Related Conditions.
Drug and Alcohol
Dependence 80(1):117-123,
October 2005.
Address correspondence to Bridget F. Grant,
Laboratory of
Epidemiology and Biometry, Room 3077, Division of
Clinical and Biological Intramural Research, National Institute on
Alcohol Abuse and Alcoholism, National Institutes of Health, M.S. 9304,
5635 Fishers Lane, Bethesda, MD 20893-7003, USA. Tel:
301-443-7370; fax: 301-443-1400.
Summary:
A potential exists for underestimation and biased estimates in
surveys that rely on abuse as a screening method for drug dependence,
making it important to determine the extent to which dependence
occurs with or without abuse. This study estimated the prevalence of
DSM-IV (Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition) drug dependence with
and without drug
abuse in a nationally representative sample, as well as in subgroups
defined by sex, age, and race or ethnicity. Among all drug-dependent
respondents, 22.0% (19.5% of males and 27.8% of females)
did not additionally meet criteria for
abuse. Current drug
dependence without abuse was especially common among females aged 45–64
years (52.6% of all cases). Among those with lifetime diagnoses of drug
dependence, a small proportion overall, 5.0% had no symptoms of abuse,
with the highest proportion again found among females 45–64 years old
(19.5%
of all cases). It was concluded that choosing drug abuse as a
screening method for drug
dependence in large epidemiologic studies will differentially
underestimate the prevalence of dependence by subgroup, affecting many
types of research. Dependence with and without abuse may represent
heterogeneous phenotypes for genetic and gene-environment research,
which should be explored.
NIAAA
Glossary Terms: AOD
abuse, AOD dependence,
AODR behavioral markers,
identification and screening for AODD, diagnostic criteria, gender
differences, prevalence, statistical estimation, epidemiology,
epidemiological indicators, phenotype, genetic trait,
gene-environment interaction,
research issue, human
study
|
Drug
and Alcohol Dependence
Volume
79, Number 3, September 2005
(Updated 10/21/2005)
Home Page
Héctor
M. Manrique, Marta Miquel, and Carlos M.G. Aragon. Brain
catalase mediates potentiation of social recognition memory produced by
ethanol in mice. Drug and Alcohol Dependence 79(3):343-350, September 2005.
Address correspondence to Carlos M.G. Aragon,
Area de
Psicobiologia, Universitat Jaume I, Campus de Riu Sec, 12071
Castelló, Spain. Tel.: +34 964 729835; fax: +34 964 729267,
e-mail: aragon@psb.uji.es.
Summary:
This
study used the social recognition test (SRT) to evaluate ethanol's
effects on memory and the mediating role of catalase. In the SRT, the
reduction in investigation time of
a juvenile of the same species, when this social stimulus is presented
for the
second time, is considered a reliable index of memory. The recognition
capacity of mice was evaluated by calculating exploration
ratios (ER). Ethanol (0.0, 0.5, 1.0, or 1.5 g/kg) was administered
intraperitoneally immediately after the first juvenile presentation,
and 2 hours later
the
juvenile was re-exposed to the adult. Additionally, adult mice received
the catalase inhibitor aminotriazole (AT) 5 hours before juvenile
presentation or sodium azide
30 minutes before juvenile presentation. Ethanol (1.0
and
1.5 g/kg) reduced ER, indicating improved
memory. The improvement was prevented by pretreatment with either AT or
sodium azide. Neither AT nor sodium azide attenuated the
memory-enhancing capacity of N-methyl-D- aspartate or
nicotine, which suggests a specific
interaction between catalase inhibitors and ethanol in their effects on
memory. These results suggest that brain catalase activity can
mediate the memory-enhancing capacity of ethanol and add further
support to the idea that this enzyme mediates some of ethanol's
psychopharmacological effects.
NIAAA
Glossary Terms:
ethanol,
intraperitoneal
administration, memory, catalase, enzyme inhibitors,
azide,
N methyl D aspartate, nicotine, brain, laboratory mice, animal study
|
G. Bischof, S. Reinhardt, J. Grothuesa, I. Dybek, C. Meyer, U. Hapke,
U. John, and H.-J. Rumpf. Effects of
item sequence on the performance of the AUDIT in general practices.
Drug and
Alcohol Dependence 79(3):373-377,
September 2005.
Address correspondence to G. Bischof,
Department of Psychiatry
and Psychotherapy, Research Group Substance Abuse: Treatment,
Epidemiology and Prevention (S:TEP), University of Luebeck, Ratzeburger
Allee 160, 23538 Luebeck, Germany. Tel.: +49 451 500 4860; fax: +49 451
500 3480, e-mail: gallus.bischof@ukl.uni-luebeck.de.
Summary:
The effects of item sequence on the performance of the Alcohol Use Disorders Identification Test
(AUDIT) in general practices were evaluated by comparing two randomly
applied versions of the AUDIT
with different item sequence. The participants were recruited from
general practices in two northern
German cities and divided into two groups. One
group received the original version of the AUDIT, which starts with
three items
addressing frequency and quantity of alcohol use (AUDIT1). The other
group received a version of the AUDIT in which these items were put at
the end of
the questionnaire (AUDIT2). In total, 10.803 screenings were conducted
(refusal rate: 5%). Alcohol use disorders were diagnosed using the Munich-Composite International Diagnostic
Interview (M-CIDI). Logistic
regression analysis revealed that AUDIT1 subjects had higher
scores in the consumption items of the AUDIT, whereas AUDIT2 subjects
scored higher on items focusing on symptoms of alcohol dependence or
abuse. Thus the sequence of AUDIT items does influence the
report of drinking patterns and symptoms of alcohol use disorders in
general practice patients.
NIAAA
Glossary Terms:
alcohol use test, questionnaire, evaluation study, comparative study,
AOD use frequency, AOD consumption, AOD intake per occasion, AOD abuse,
symptom, regression analysis,
alcohol use disorder classification,
primary health care,
general practitioner, human
study
|
Bradley T. Conner, Ernest P. Noble, Steven M. Berman, Tulin Ozkaragoz,
Terry Ritchie, Tim Antolin, and Courtney Sheen. DRD2
genotypes and substance use in adolescent children of alcoholics.
Drug and
Alcohol Dependence 79(3):379-387,
September 2005.
Address correspondence to Ernest P. Noble,
Department of
Psychiatry and Biobehavioral Sciences, University of California, Los
Angeles, Los Angeles, CA 90024, USA. Tel.: +1 310 825 1891; fax:
+1 310 206 7309, e-mail: epnoble@ucla.edu.
Summary:
Children of alcoholics (COAs) are a population
at increased risk for developing substance use problems. Genetic
studies support the A1 allele of the D2 dopamine receptor gene (DRD2)
as a marker of risk for alcoholism and substance use disorders. This
study assessed substance use in adolescent sons of alcoholics
(N = 48) with the DRDR A1+
allele (A1A1/A1A2 genotypes) or the A1− allele (A2A2 genotype). The
results showed that boys with the A1+
allele tried (p = 0.0001) and got intoxicated on
alcohol more often (p = 0.009)
than boys with the A1− allele. A1+ allele tried more (p = 0.004)
and used more substances overall (p = 0.008) than boys
with the A1− allele. Boys with the A1+ allele
became habitual tobacco users more often (p = 0.03)
and
experienced marijuana high at an earlier age (p = 0.001)
than boys with the A1− allele. The best predictors of
substance use severity in boys with the A1+ allele were
Psychoticism (p = 0.01) and Negative Affect (p = 0.04).
The results support the DRD2 A1 allele as a marker
identifying a subgroup of COAs at high risk for developing substance
use problems.
NIAAA
Glossary Terms:
children of alcoholics,
AOD effects and AODR problems, familial alcoholism,
risk factors,
predictive factor, AOD intoxication, multiple drug use, tobacco in any
form, problem severity, dopaminergic receptors, allele,
genetic markers, genotype, adolescent, male,
mood and affect disturbance, human study
|
Evelien A.P. Poelen, Ron H.J. Scholte, Rutger C.M.E. Engels, Dorret I.
Boomsma, and Gonneke Willemsen. Prevalence
and trends of alcohol use and misuse among adolescents and young adults
in the Netherlands from 1993 to 2000. Drug and Alcohol Dependence79(3):413-421, September 2005.
Address correspondence to Evelien A.P. Poelen,
Behavioural
Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE
Nijmegen, The Netherlands. Tel.: +31 24 361 57 67; fax: +31 24
361 27 76; e-mail: e.poelen@pwo.ru.nl.
Summary:
An overview of Dutch studies on the prevalence of alcohol
use is presented, with added findings from the authors' own study on
the prevalence of drinking
among adolescents and young adults aged 12–30 years in the Netherlands.
Data were collected as part of a longitudinal study by the Netherlands
Twin Register in 1993 (n =
3,885), 1995 (n = 4,814), 1997
(n = 3,772), and
2000 (n = 4,090). Lifetime
alcohol use, drinking frequency, drinking quantity, lifetime
drunkenness, frequency of
drunkenness, and problem drinking were measured. The main findings
were: (1) alcohol
use increased with age until age 25 years, then decreased;
(2) males exceeded females on all aspects of alcohol use, except for
the youngest age group and lifetime alcohol use; (3) time
trends indicated an increase in frequency and quantity of drinking
among 12–15-year-old adolescents during the 1990s; and (4)
21–25-year-old females drank more frequently, consumed more drinks a
week, had more experience with lifetime drunkenness, and were
intoxicated more
often in 2000 than in 1993. Among 21–25-year-old males, there was an
increase of
drunkenness and problem drinking during the 1990s.
NIAAA
Glossary Terms:
underage drinking, adolescent, young adult, prevalence, Netherlands,
AOD use, AOD use frequency, AOD consumption, AOD intake per occasion,
AOD intoxication, AOD
effects and AODR problems, gender differences, trend,
human study
|
Drug
and Alcohol Dependence
Volume
79, Number 2, August 2005
(Updated 8/27/2005)
Home Page
Hendree
E. Jones, Conrad J. Wong, Michelle Tuten, and Maxine L.
Stitzer. Reinforcement-based
therapy: 12-month evaluation of an outpatient drug-free treatment for
heroin abusers. Drug and Alcohol Dependence 79(2):119-128, August 2005.
Address correspondence to Hendree E. Jones,
Cornerstone
Treatment Research Clinic, Department of Psychiatry and
Behavioral Sciences, Johns Hopkins Bayview Medical Center, Cornerstone
D-3-E, 4940 Eastern Avenue, Baltimore, MD 21224, USA. hendreejones@yahoo.com
Summary:
A controlled study of opioid-dependent patients was carried out to
assess the efficacy of reinforcement-based therapy (RBT) in producing
enhanced abstinence outcomes. After a
brief residential detoxification and completion of medically managed
taper, patients were randomly assigned to RBT (n = 66)
or to usual care (n = 64) in community treatment programs.
The 6-month RBT program
offered an array of abstinence-based incentives including rent payment
for recovery housing, program-led recreational activities, and skills
training for getting employment. Compared to usual care, RBT produced
significantly higher
abstinence rates (self-reported and urinalysis-confirmed) from opioids
and cocaine at 1 month (42% versus 15%) and 3
months (38%
versus 17%) during treatment, but not at 6 or 12 months after
enrollment. The RBT group also showed significant
increases in the number of days worked and the amount of legal income
earned at 3, 6, and 12 months. The results suggest that an intensive
reinforcement-based therapy that includes
abstinence-based recovery housing is a promising approach, but
further research is needed to determine the role of treatment intensity
and the specific efficacy of RBT's components.
NIAAA
Glossary Terms: AOD dependence, reinforcement,
psychosocial treatment method, treatment outcome, AOD abstinence,
community-based treatment, controlled study, comparative study, self
report, urinalysis, opioids, opiates, cocaine, employment, income,
human study
|
Louisa Degenhardt, Elizabeth Conroy, Carolyn Day, Stuart Gilmour,
and Wayne Hall. The impact
of a reduction in drug supply on demand for and compliance with
treatment for drug dependence. Drug and Alcohol Dependence 79(2):129-135, August 2005.
Address correspondence to Louisa Degenhardt,
National Drug and
Alcohol Research Centre, University of New South Wales, Sydney, NSW
2052, Australia. l.degenhardt@unsw.edu.au
|
Summary:
In early 2001, Australia experienced a sudden,
dramatic and sustained decrease in heroin availability that was
accompanied by sharp increases in price and decreases in street level
purity. Because these unprecedented changes
occurred in a context of widespread treatment availability, this study
was able to examine, for the first time, the impact of a sharp
reduction in heroin supply in New South Wales (NSW) on entry to and
adherence with treatment for heroin dependence. Since there is evidence
of
drug substitution by some users, the study also examined the
effects of the shortage on entry to treatment for other forms of drug
dependence. Interrupted time-series analysis was used to examine
the number of persons entering opioid pharmacotherapy and other
treatment modalities in NSW for heroin dependence and for treatment of
other types of drug dependence. The heroin
shortage was associated with a reduction in the number of younger
persons entering opioid pharmacotherapy, the number of persons entering
heroin withdrawal or “assessment
only” treatment episodes decreased dramatically, and there appeared to
have been small improvements
in adherence to and retention in heroin treatment after the reduction
in heroin supply. Relatively small increases occurred in numbers
being treated for cocaine dependence. In the
context of good treatment provision, a reduction in heroin supply
appeared to produce modest improvements in intermediate outcomes.
Supply and demand reduction measures, when both are implemented
successfully, may be complementary.
NIAAA
Glossary Terms: heroin, opioids, opiates, AOD
dependence, AOD availability,
help-seeking behavior, treatment factors, treatment
method, treatment outcome, patient compliance,
patient retention, drug therapy, cocaine, human study
|
Jürgen Rehm, Ulrich Frick, Christina Hartwig, Felix Gutzwiller,
Patrick Gschwend, and Ambros Uchtenhagen. Mortality
in heroin-assisted treatment in Switzerland 1994–2000.
Drug and
Alcohol Dependence 79(2):137-143,
August 2005.
Address correspondence to Jürgen Rehm,
Addiction Research
Institute, Konradstr. 32, CH 8031 Zurich, Switzerland. jtrehm@aol.com
Summary:
Mortality of participants in heroin-assisted treatment
in Switzerland over a 7-year period (1994 to 2000) was assessed and
compared
to reported mortality in the general population and other populations
of
opioid users. Methods used included estimation of person-years under
heroin-assisted treatment based on
the complete case registry of heroin-assisted treatment in Switzerland,
and estimation of standardized mortality ratios comparing the
population in
treatment to the Swiss population (standardized to the year 2000). Over
the 7-year period, the crude death rate of patients in
heroin-assisted treatment, and including 1 month after discharge from
treatment, was 1% per year. The standardized mortality ratio (SMR) for
the
entire observation period was 9.7 (95% confidence interval [CI],
7.3–12.8), with females
having higher SMRs than males (17.2 versus 8.4). There was no clear
temporal trend. Mortality in heroin-assisted treatment was low compared
to
the estimated mortality of Swiss opioid users in the 1990s (2.5% to
3%). It was also low compared to mortality rates of opioid
users in other maintenance treatments in other countries as reported in
the literature. The SMR was also lower than that reported in the only
meta-analysis in the literature: 13.2 (95% CI, 12.3–14.1). The low
mortality rate is all the more noteworthy as heroin-assisted treatment
in Switzerland included only refractory opioid addicts with existing
severe somatic or mental problems.
NIAAA
Glossary Terms: mortality, heroin, AOD dependence,
addiction, treatment method, drug therapy, risk analysis, relative
risk, gender differences, human study
|
Douglas B. Marlowe, David S. Festinger, Karen L. Dugosh, and Patricia
A. Lee. Are
judicial status hearings a “key component” of drug court?
Drug and Alcohol Dependence 79(2):145-155, August 2005.
Address correspondence to Douglas B. Marlowe,
Treatment Research
Institute at the University of Pennsylvania School of Medicine, 600
Public Ledger Building, 150 South Independence Mall West, Philadelphia,
PA 19106-3475, USA. Marlowe@Tresearch.org
Summary:
The superiority of drug courts to traditional
probation programs for enhancing treatment retention and reducing
substance use and crime among drug offenders is supported by
substantial evidence. Few studies have isolated
the effects of the hypothesized critical components of drug courts to
determine their contributions to outcomes. This study assessed
outcomes at 6 and 12 months post-admission for misdemeanor drug court
clients who were randomly assigned to different dosages of judicial
status hearings. Although earlier work (Festinger, D.S. et al. Drug
and Alcohol Dependence 68:151–157, 2002) revealed superior
effects
during treatment for high-risk participants who were assigned to more
frequent bi-weekly
hearings, those effects did not extend beyond treatment. The results
did
reveal significant pre-to-post improvements for participants, as a
whole, in self-reported drug use, alcohol use, and criminal recidivism;
however, without a no-drug court control condition, it is not possible
to determine the magnitude of the drug court program's effect.
Approximately half of the participants resumed drug or alcohol use
within 12 months of admission to drug court, and approximately 10%–15%
resumed illegal activities. These findings lend credence to the
potential effectiveness of drug courts, but continuing-care
strategies are needed to extend the effects of drug courts beyond the
initial active phases of the program.
NIAAA
Glossary Terms:
drug court,
illicit drug, alcoholic beverage, AOD use, patient retention, crime,
treatment factors, treatment outcome,
randomized controlled trial, self report,
aftercare, human study |
Alison Oliveto, James Poling, Kevin A. Sevarino, Kishorchandra R.
Gonsai, Elinore F. McCance-Katz, Susan M. Stine, and Thomas R.
Kosten. Efficacy of
dose and contingency management procedures in LAAM-maintained
cocaine-dependent patients. Drug and Alcohol Dependence 79(2):157-165, August 2005.
Address correspondence to Alison Oliveto,
Department of
Psychiatry, Yale School of Medicine and the VA CT Healthcare System,
West Haven, CT, USA. olivetoalison@uams.edu
Summary:
A 12-week clinical trial was conducted to examine the efficacy of
maintenance drug dose and contingency management (CM) procedures in
opioid- and cocaine-dependent patients maintained on levo-alph-acetyl-methadol
(LAAM). Opioid-
and cocaine-dependent participants (N
= 140) were randomly assigned to
one of the following treatment conditions: LAAM (30,
30, 39
mg/MWF) with CM procedures (LC group); LAAM (30, 30,
39 mg/MWF) without CM (LY group); LAAM (100, 100, 130 mg/MWF) with CM
(HC group);
LAAM (100, 100, 130 mg/MWF) without CM (HY group). Urine samples were
collected three times a week. In CM, each urine negative for both
opioids
and cocaine resulted in a voucher worth a certain monetary value that
increased for consecutively drug-free urines. Subjects not assigned to
CM received vouchers according to a yoked schedule. Vouchers were
exchanged for mutually agreed upon goods and services. Groups generally
did not differ on retention and baseline characteristics. Overall
opioid use was lowest in the HC and HY groups; opioid use decreased
most
rapidly over time in the HC group relative to the HY, LC and LY groups.
Overall cocaine use was lowest in the HC group relative to the HY, LC,
and LY groups; cocaine use decreased over time most rapidly in the HC
and LY groups. Abstinence from both was greatest in the HC group.
Opioid withdrawal symptoms decreased fastest in the high-dose
groups relative to the low-dose groups. These results suggest that an
efficacious maintenance dose is necessary for contingencies to be
effective in facilitating both opioid and cocaine abstinence.
NIAAA
Glossary Terms: LAAM,
drug therapy, contingency management, treatment and maintenance, AOD
dependence, opioids, opiates, cocaine, urinalysis, comparative study,
AOD withdrawal syndrome, dose-response relationship, human study
|
Robert G. Carlson, Jichuan Wang, Russel S. Falck, and Harvey A.
Siegal. Drug use
practices among MDMA/ecstasy users in Ohio: a latent class analysis.
Drug and
Alcohol Dependence 79(2):167-179,
August 2005.
Address correspondence to Robert G. Carlson,
Center for
Interventions, Treatment and Addictions Research, Wright State
University School of Medicine, 143 Biological Sciences Building, 3640
Colonel Glenn Highway, Dayton, OH 45435, USA. robert.carlson@wright.edu
Summary:
This
study describes the drug use practices among recent users (N = 402) of
3,4-methelyenedioxymethamphetamine (MDMA; "ecstasy") recruited in
Ohio using
respondent-driven sampling. Of the participants, ~64% were men and
81.6% were white; the mean age was 20.9 years. Latent class
analysis was used to identify subgroups of MDMA users, with
classification based on use of cocaine,
opioids, amphetamines, tranquilizers, inhalants, marijuana, and
hallucinogens during the previous 6 months, and days of alcohol
intoxication
in the past 30. A three-class model was
preferable and reflected "Limited range" (Class 1), "Moderate range"
(Class 2), and "Wide
range" (Class 3) drug use patterns. For example, the conditional
probability of
using opioids during the previous 6 months was 0.07 in Class 1, 0.59 in
Class 2, and 0.88 in Class 3. Other substances followed similar
patterns. Predictors of class membership were examined in a multinomial
logit model in which Class 1 ("Limited range") was treated as the
reference group. Participants who were white, younger, and who reported
more than 10 occasions of MDMA use were more likely to be in the “Wide
range” drug use class (Class 3). Latent class analysis is a useful
method to help
describe and understand variability in multiple-drug use patterns.
NIAAA
Glossary Terms: MDMA, cocaine, opioids, opiates,
amphetamines,
tranquilizers,
inhaled substance, marijuana in any form,
hallucinogens, alcoholic beverage, multiple drug use, AOD intoxication,
AOD use pattern, predictive factor, comparative study, racial
differences, age differences, human study |
Melissa Tracy, Tinka Markham Piper, Danielle Ompad, Angela Bucciarelli,
Phillip O. Coffin, David Vlahov, and Sandro Galea. Circumstances
of witnessed drug overdose in New York City: implications for
intervention. Drug
and Alcohol Dependence 79(2):181-190,
August 2005.
Address correspondence to Sandro Galea, Center
for Urban
Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue,
New York, NY 10029, USA. sgalea@nyam.org
Summary:
Drug
users frequently witness the nonfatal and fatal drug overdoses of their
peers, but often fail to intervene effectively to reduce morbidity and
mortality. This study assessed the circumstances of witnessed
heroin-related
overdoses in New York City among a predominantly minority
population of drug users. Heroin, crack, and cocaine users (N = 1,184) were
interviewed between Nov. 2001 and Feb. 2004. Witnessing at least one
nonfatal or fatal heroin-related overdose was reported by 672 (56.8%)
respondents. Of
those, 444 (67.7%) reported that they or someone else present called
for medical help for the overdose victim at the last witnessed
overdose. In multivariable models, the likelihood of calling for
medical help was associated with the respondent never having
experienced an
overdose personally and the witnessed overdose occurring in a public
place.
The most commonly cited reason for not
calling for help or delaying before doing so was fear of police
response (52.2%). Attempts to revive
the overdose victim through physical stimulation (e.g., applying ice,
causing pain) were reported by 59.7% of respondents, while first aid
measures were attempted in only 11.9% of events. Efforts to equip drug
users to manage overdoses effectively, including training in first aid
and the provision of naloxone, and the reduction of police involvement
at overdose events may have a substantial impact on overdose-related
morbidity and mortality.
NIAAA
Glossary Terms:
AOD overdose mortality, AOD poisoning, morbidity, heroin, crack cocaine, cocaine, interview, self
report, minority group,
multivariate analysis,
help-seeking behavior,
medically necessary care,
law enforcement worker, naloxone,
human study |
Anna Maria Bargagli, Patrizia Schifano, Marina Davoli, Fabrizio
Faggiano, Carlo A. Perucci, and The VEdeTTE Study Group. Determinants
of methadone treatment assignment among heroin addicts on first
admission to public treatment centres in Italy. Drug and Alcohol Dependence 79(2):191-199, August 2005.
Address correspondence to Anna Maria Bargagli,
Department of
Epidemiology, ASL Rome E, Via di S. Costanza 53, 00198 Rome,
Italy. bargagli@asplazio.it
Summary:
The aims were to identify factors associated with entering any
methadone treatment at
first admission at a treatment center in Italy and to investigate
determinants of receiving detoxification or maintenance methadone
treatments.
Data were analyzed from heroin addicts (N = 565) who entered for the
first time one of 90 National Health Service (NHS) treatment centers in
12 Italian regions
between September 1998 and March 2001. Subjects were interviewed at
admission by the center's staff and followed-up for 18 months. Details
on treatments provided were recorded using a standardized form. Random
effects logistic regression analysis was applied. Factors positively
associated with any methadone
treatment
assignment were being younger than 25 years and using heroin more than
twice a day, having been recently incarcerated, and living with a
partner. Independent predictors of admission to methadone maintenance
were injecting heroin, having sex without a condom in the previous 6
months, being human immunodeficiency virus-positive, and having been
enrolled at a NHS treatment center where a
psychiatrist was present. Using heroin once a day or more and using
cocaine were factors associated with enrolment into detoxification
treatment. A significant heterogeneity between centers was observed.
These results provide an insight into the different
profiles of patients who are enrolled in methadone treatments. The
observed
heterogeneity between centers indicates the need to develop and
implement common guidelines for the access of heroin addicts to
substitution treatment.
NIAAA
Glossary Terms: methadone, Italy,
treatment and maintenance, interview, follow-up study, regression
analysis, treatment factors, age differences, heroin, AOD use
frequency, intravenous injection, HIV infection, cocaine,
detoxification, AODD treatment unit, recommendations or guidelines,
human study |
Alecia D. Schweinsburg, Brian C. Schweinsburg, Erick H. Cheung, Gregory
G. Brown, Sandra A. Brown, and Susan F. Tapert. fMRI
response to spatial working memory in adolescents with comorbid
marijuana and alcohol use disorders. Drug and Alcohol Dependence 79(2):201-210, August 2005.
Address correspondence to Susan F. Tapert,
University of
California San Diego Department of Psychiatry, 9500 Gilman Dr., La
Jolla, CA 92037-0603, USA. stapert@ucsd.edu
Summary:
Although alcohol
and marijuana use are prevalent in adolescence, the neural impact
of their combined use remains unclear. The authors previously
demonstrated
functional magnetic resonance imaging (fMRI) response to spatial
working memory (SWM) among adolescents with alcohol use disorders (AUD)
compared to controls, and predicted that adolescents with marijuana and
alcohol use disorders would show additional abnormalities. Their
present study tested that prediction. Three groups of adolescents
(15–17 years old) participated: non-abusing controls (n = 19), AUD
with limited exposure to drugs (n
= 15), and comorbid
marijuana and alcohol use disorders (MAUD) and minimal other drug
experience (n =
15). After >2 days’ abstinence, participants
performed a SWM
task during fMRI acquisition. fMRI brain response patterns differed
between groups, despite similar performance on the task. MAUD youths
showed less activation in inferior frontal and temporal regions than
controls, and more response in other prefrontal regions. Compared to
AUD adolescencts, MAUD youths also showed less inferior frontal and
temporal
activation, but more medial frontal response. Overall, MAUD youths
showed different brain response abnormalities than those with AUD
alone, despite relatively short histories of substance involvement.
This pattern could suggest compensation for marijuana-related attention
and working memory deficits. However, relatively recent use and
premorbid features may influence results, and should be examined in
future studies.
NIAAA
Glossary Terms: marijuana in any form, illicit drug,
underage drinking, adolescence, magnetic resonance imaging, brain
imaging, alcohol use disorder classification, comorbidity, multiple
drug use, controlled study, comparative study, cerebral cortex,
frontal cortex,
attention,memory, human
study |
David M. Penetar, Elena M. Kouri, Michelle M. Gross, Elissa M.
McCarthy, Christina K. Rhee, Erica N. Peters, and Scott E. Lukas.
Transdermal
nicotine alters some of marihuana's effects in male and female
volunteers. Drug
and Alcohol Dependence 79(2):211-223,
August 2005.
Address correspondence to David M. Penetar,
Behavioral
Psychopharmacology Research Laboratory, McLean Hospital/Harvard Medical
School, 115 Mill Street, Belmont, MA 02478, USA. dpenetar@mclean.harvard.edu
Summary:
The effects of nicotine on marijuana-induced intoxication were
investigated in a double blind, crossover study using nicotine
transdermal patches. The participants (10 males and 10 females)
received
either placebo or a 21-mg transdermal nicotine patch 4 hours before
smoking
one of two marijuana cigarettes (1.99% or 3.51%
delta-9-tetrahydrocannabinol content). Measurements of physiological
activity -- heart rate, blood
pressure, and skin temperature -- and subjective effects --
self-reports of
drug effects on visual analog scales (VAS) and the Addiction Research
Center Inventory (ARCI) -- were made periodically before and for
3
hours
after smoking. Nicotine pretreatment enhanced several responses to
marijuana, in particular, heart rate, reports of "stimulated" on the
visual analog scales, and scores on the Amphetamine scale of the ARCI.
Compared to female participants, male participants reported a more
pronounced and longer-lasting effect of marijuana. Compared to the
male participants, female participants experienced an attenuated
response to marijuana and were less affected by the drug combination.
The results of this study show that nicotine can have an important
influence on the subjective and physiological effects of smoked
marijuana. These effects have safety and efficacy
implications for marijuana smokers who use the nicotine
transdermal patch to manage their tobacco dependence.
NIAAA
Glossary Terms: nicotine, marijuana in any form,
smoking, AOD intoxication, multiple drug use, heart rate, blood
pressure, temperature, gender differences, controlled study, human study
|
Ilsemarie Kurzthaler, Markus Wambacher, Karl Golser, Gernot Sperner,
Barbara Sperner-Unterweger, Alexander Haidekker, Marion Pavlic, Georg
Kemmler, and W. Wolfgang Fleischhacker. Alcohol and
benzodiazepines in falls: An epidemiological view. Drug and Alcohol Dependence 79(2):225-230, August 2005.
Address correspondence to Ilsemarie
Kurzthaler, Department of
Biological Psychiatry, Medical University Innsbruck, Anichstrasse 35,
A-6020 Innsbruck, Austria. ilsemarie.kurzthaler@uibk.ac.at
Summary:
Concentrations of blood alcohol (BAC) and benzodiazepines (BZD) were
studied in patients
attending an emergency department because of a fall over a 1-year
period. Of the 615
patients tested, 22% were positive for alcohol, 55% were positive for
BZD, and 1.5% were positive for both alcohol and BZD. A
significantly larger proportion of males tested positive for alcohol
than females (40.2% versus 7.6%). Both in males and females the
percentage
as well as the extent of blood alcohol levels decreased significantly
with age. Benzodiazepines were also consumed more frequently in males
(8.5%) than in females (3.2%, p
= 0.007). There was no
difference in BAC between males and females (1.75
± 0.81 g/l versus 1.66
± 0.91 g/l). In patients older than 70 years the BAC (1.30
± 0.80 g/l) was lower compared to younger patients. All
BZD-positive blood samples could be traced back to diazepam
consumption. A high number of young and middle aged patients
using alcohol was found (49.7% of males, 18.9% of females); a lower but
still
relevant number of benzodiazepine users was also found (9.5% of males,
2.4% of females). The study shows that alcohol plays a more important
role
in fall-related accidents in patients up to 70 years old when compared
to
accidents from other causes.
NIAAA
Glossary Terms:
accidental fall, injury, BAC, benzodiazepines, diazepam, emergency
care, multiple drug use, prevalence, gender differences, age
differences, human study
|
Fabian Termorshuizen, Anneke Krol, Maria Prins, Ronald Geskus, Wim van
den Brink, and Erik J.C. van Ameijden. Prediction
of relapse to frequent heroin use and the role of methadone
prescription: An analysis of the Amsterdam Cohort Study among drug users.
Drug and
Alcohol Dependence 79(2):231-240,
August 2005.
Address correspondence to Fabian
Termorshuizen, Municipal Health
Service, Amsterdam, Cluster Infectious Diseases, Department of HIV
& STI Research, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The
Netherlands. ftermorshuizen@gggd.amsterdam.nl
Summary:
The
risk of relapse into frequent heroin use was studied among participants
(N = 732) in the Amsterdam
Cohort Study (ACS) on human immunodeficiency virus/acquired
immunodeficiency syndrome (HIV/AIDS) among drug
users, who experienced an episode of abstinence from or occasional use
of heroin. The participants were recruited mainly from easy
access ("low-threshold") methadone programs. The duration of
abstinence/occasional use and relative risks (RR) of relapse were
estimated by survival analysis
of 1,577 episodes, using patient's characteristics and methadone
treatment as
covariates. The majority of episodes (85.8%) were followed by relapse
within 5 years. Less education, intense use of heroin prior to the
episode of abstinence or well-controlled use, occasional use of heroin
and intense use of cocaine during the episode, and having a drug-using
partner or having no partner were significantly associated with higher
risk of relapse. Among frequent attendees of a "low-threshold"
methadone program, relapse was associated with the daily dose of
methadone: RR for dosages <40 and 40–60 mg, compared with doses of
>100 mg, were 1.45 (p <
0.01) and 1.59 (p < 0.01)
respectively. There was no evidence of a beneficial influence of
methadone dosage
or program attendance per se
on the risk of relapse into cocaine.
High doses of methadone in a harm-reduction setting extend the duration
of an episode of no or occasional use of heroin. Other factors, such as
no occasional use of heroin during the episode, no use of cocaine, and
having a non-using partner, seem to be equally important.
NIAAA
Glossary Terms: heroin, AOD user, AOD dependence, AOD
use pattern, AOD abstinence, methadone, AODD relapse, HIV infection,
acquired immunodeficiency syndrome, risk factors, risk analysis,
relative risk, cocaine, human study
|
Tracy L. Simpson, Daniel R. Kivlahan, Kristen R. Bush, and Miles E.
McFall. Telephone
self-monitoring among alcohol use disorder patients in early recovery:
A randomized study of feasibility and measurement reactivity.
Drug and
Alcohol Dependence 79(2):241-250,
August 2005.
Address correspondence to Tracy L. Simpson, VA
Puget Sound
Health Care System, Seattle, WA 98108, USA. tracy.simpson@med.va.gov
Summary:
This pilot study with patients in early recovery from an
alcohol use disorder evaluated compliance with two Interactive
Voice Response (IVR)
monitoring protocols, subjective experiences with monitoring, and
change in symptoms associated with monitoring (i.e., measurement
reactivity). Participants (n = 98) were
randomly assigned to call an IVR system
daily for 28 days, once per week for 4 weeks, or only to complete
28-day follow-up assessment including retrospective drinking reports.
Monitoring calls assessed alcohol craving, substance use, emotional
well-being, and post-traumatic stress disorder (PTSD) symptoms. Most
monitoring participants completed
calls on at least 75% of scheduled days (72.2% and 59.2% for daily and
weekly respectively). Including reconstructed data from follow-up of
missed calls yielded 77.8% and 74.1% of maximum data points
respectively. Most monitoring participants indicated the protocol was
manageable and reported positive or no effects of monitoring on urges
to use alcohol, actual drinking, and PTSD symptoms. Analyses of
measurement reactivity based on assessment 1 month after
randomization found no significant group differences on drinking,
craving for alcohol, or PTSD-related symptoms. The results suggest that
IVR
technology is feasible and appropriate for telephone symptom monitoring
in similar clinical samples.
NIAAA
Glossary Terms: AOD
abuse, AOD dependence,
pilot study, patient compliance, patient monitoring, patient
assessment, AOD craving, AOD use,
emotional adjustment,
posttraumatic stress disorder, human study |
Evgeny M. Krupitsky, Nicholas J. Horton, Emily C. Williams, Dmitri
Lioznov, Maria Kuznetsova, Edwin Zvartau, and Jeffrey H. Samet. Alcohol use
and HIV risk behaviors among HIV-infected hospitalized patients in St.
Petersburg, Russia. Drug and Alcohol Dependence 79(2):251-256, August 2005.
Address correspondence to Jeffrey H. Samet,
Department of Social
and Behavioral Sciences, Boston University School of Public Health, 91
East Concord Street, Suite 200, Boston, MA 02118, USA. jsamet@bu.edu
Summary:
Although Russia has high per capita alcohol consumption and an epidemic
of human immunodeficiency virus (HIV) infection driven by injection
drug use, the
role of alcohol in
the spread of HIV in the country is largely unexplored. This
study
assessed recent alcohol use and associated HIV risk behaviors among
HIV-infected persons in St. Petersburg, Russia. HIV-infected
hospitalized patients were recruited from an infectious disease
hospital between June 2001 and March 2002. Interviewers assessed
alcohol and drug use, and lifetime abuse or dependence diagnoses for
alcohol and drugs were
established by a physician with addiction medicine training. Among the
subjects (N = 201), diagnoses
of abuse or dependence (Ab/Dep) were
common: 9% had only alcohol Ab/Dep; 39%
had alcohol
and drug Ab/Dep; 47% had only drug Ab/Dep;
and 4% had
no diagnosis of alcohol or drug Ab/Dep.
Sex- and drug-risk behaviors
varied significantly by substance use diagnosis. Subjects with any
alcohol Ab/Dep had higher sex-risk
scores than those with drug only Ab/Dep
(6.1 versus 3.9, p <
.0001). Among subjects with any
diagnosis of drug Ab/Dep, having in
addition an alcohol diagnosis was
associated with unclean needle use in the last 6 months (33% versus
21%, p = 0.08). In
conclusion, lifetime alcohol diagnoses
of abuse or dependence were present in nearly -half of hospitalized
HIV-infected patients in St. Petersburg and were associated
with significantly higher sex-risk behaviors and borderline
significantly higher drug-risk behaviors. As HIV infection spreads
rapidly in Russia and Eastern Europe, these data support the need for
HIV risk-reduction interventions in alcohol abusing populations and
raise the potential of benefit by addressing alcohol use in
HIV-infected populations.
NIAAA
Glossary Terms:
Russia, AOD consumption, AOD abuse, AOD dependence, HIV infection,
risk-taking behavior, sexual behavior, intravenous injection,
patient
assessment, prevalence, human study
|
Suzanne K. Vosburg, Carl L. Hart, Margaret Haney, and Richard W.
Foltin. An
evaluation of the reinforcing effects of memantine in cocaine-dependent
humans. Drug
and Alcohol Dependence 79(2):257-260,
August 2005.
Address correspondence to Suzanne K. Vosburg,
College of
Physicians and Surgeons of Columbia University, New York State
Psychiatric Institute, New York, NY 10032, USA. skv2001@columbia.edu
Summary:
The
reinforcing and subjective effects of the uncompetitive
N-methyl-D-aspartate (NMDA) antagonist memantine was
evaluated in a double-blind, outpatient study of cocaine-dependent
individuals (N = 8; 2 females,
6 males). The
study consisted of three blocks of seven sessions, with each block
testing a different dose of memantine. During the first two sessions of
each block, participants "sampled" the memantine capsule (10, 20, or 30
mg) and the placebo capsule that were available for the next five
sessions. During the five subsequent sessions, participants had an
opportunity to self-administer either the active or placebo capsule.
Memantine was not reinforcing and subjective-effects ratings were not
altered as a function of dose. The results suggest that these doses of
memantine do not have abuse liability in cocaine-dependent individuals.
NIAAA
Glossary Terms: antagonists,
N methyl D aspartate, reinforcement,
subjective variables,
double-blind study, controlled study, cocaine, AOD dependence,
AOD abuse potential, human study |
Brice M.R. Appenzeller, Serge Schneider, Armand Maul, and Robert
Wennig. Relationship
between blood alcohol concentration and carbohydrate-deficient
transferrin among drivers. Drug
and Alcohol Dependence 79(2):261-265,
August 2005.
Address correspondence to Brice M.R.
Appenzeller, Centre de
Recherche Public de la Santé, Laboratoire National de
Santé, Division de Toxicologie, Université du Luxembourg,
Campus Limpertsberg, 162a, avenue de la Faïencerie, L-1511
Luxembourg. brice.appenzeller@cu.lu
Summary:
Carbohydrate-deficient
transferrin (CDT) was measured in 408 blood specimens, randomly
selected from drivers (N =
1,260) apprehended and submitted to blood alcohol
concentration (BAC) determination. The first step of the study was to
observe whether a BAC-based pre-evaluation was relevant for deciding to
test drivers for chronic alcohol abuse. For this purpose, the diagnosis
of chronic alcohol abuse was verified by CDT determination, with a
high positive cut-off selected at 3% for high specificity. The
results showed a significant increase in the part of chronic alcohol
abusers with respect to increasing BAC: a few alcohol abusers were
present in the BAC category below 0.5 g/L, and their frequency
increased to 47% when BAC was between 3 and 3.5 g/L and
67% when BAC was above
3.5 g/L. Secondly, the usefulness of the biomarker CDT in
the traffic safety context was investigated by observing whether
drivers with abnormally increased CDT value had also higher BAC. The
average BAC was 1.32 g/L in drivers with CDT below 1%, and increased to
2.28 g/L in drivers with CDT above 3%. Statistical analysis showed
evidence of a monotonic increasing link between BAC and CDT (p <
0.0001). The results confirm the relevance of BAC-based pre-evaluation
before testing chronic alcohol abuse among drivers, and demonstrate
that CDT is a suitable biomarker in the context of traffic safety, as
drivers
with increased CDT had significantly higher BAC.
NIAAA
Glossary Terms: carbohydrate-deficient
transferrin,
BAC level, chronic AODE, prevalence, AODR biological markers,
highway safety, statistical association, human study |
Marilyn W. Lewis and Nancy M. Petry. Contingency
management treatments that reinforce completion of goal-related
activities: Participation in family activities and its association with
outcomes. Drug
and Alcohol Dependence 79(2):267-271,
August 2005.
Address correspondence to Nancy M. Petry,
School of Medicine,
Department of Psychiatry, University of Connecticut
Health Center, 263 Farmington Avenue, Farmington, CT 06030-3944, USA. petry@psychiatry.uchc.edu
Summary:
Although contingency
management (CM) techniques that reinforce completion of nondrug related
activities may be effective in treating substance dependence, no
studies have evaluated whether involvement in particular kinds
of activities reduces problems associated with those activities. In
this
study, cocaine-abusing adults (N
= 159) who had been randomized to a CM intervention
were classsified according to whether they engaged (n = 29) or did not engage (n = 130) in three or more
family-related activities during the 12-week treatment period.
The groups were evaluated for differences in treatment
retention, length of continuous abstinence, and changes from baseline
to the end of the intervention in Addiction
Severity Index-family scores and days of family
conflict. Participants who engaged in family activities remained in
treatment longer, were abstinent for more weeks, and
reported greater reduction in family conflict compared to participants
who did not engage in family activities. The results suggest
that participants who elect to complete family related activities
during CM treatments may have improved outcomes and reduced family
conflict.
NIAAA
Glossary Terms: contingency
management, AOD abuse, cocaine,
patient retention,
AOD abstinence, psychiatric status rating scales, family relations,
family conflict, human study |
John R. Monterosso, Adam R. Aron, Xochitl Cordova, Jiansong Xu, and
Edythe D. London. Deficits in
response inhibition associated with chronic methamphetamine abuse.
Drug and
Alcohol Dependence 79(2):273-277,
August 2005.
Address correspondence to John R. Monterosso,
Department of
Psychiatry and Biobehavioral Sciences, University of California Los
Angeles, Los Angeles, CA 90024-1759, USA. jmont@ucla.edu
Summary:
Chronic
methamphetamine abuse is associated with cerebral deficits
involving frontal/basal-ganglia regions that are important for
inhibitory control. Using the Stop-Signal Task, this study measured
response
inhibition in 11 methamphetamine abusers
(5–7 days abstinent) and two groups of
control subjects who did not use methamphetamine
(14 tobacco smokers and 29
non-smokers). Stop-signal reaction time (SSRT), which indicates the
latency to inhibit an initiated motor response, was significantly
longer for methamphetamine abusers than
for either control group (p
values < 0.01). In
contrast, the methamphetamine abusers
did not differ from either group on Go trial
reaction time (RT), which reflects motor speed, or number of
discrimination errors, which reflects decision-processes. Methamphetamine
abuse was therefore associated with a specific deficit in inhibiting a
pre-potent response. The authors suggest that future research could
examine whether SSRT is
different for methamphetamine abusers
who respond to treatment compared to those who
do not. If such differences are established, response inhibition
may serve as a marker for investigating methamphetamine
abuse in basic research and
clinical trials.
NIAAA
Glossary Terms:
methamphetamine, AOD abuse, cerebrum, inhibition,
disinhibition,
reaction time,
decision making, AODR behavioral markers, human study |
Drug
and Alcohol Dependence
Volume
79, Number 1, July 2005
(Updated 6/29/2005)
Home Page
Hendree
E. Jones, Rolley E. Johnson, Donald R. Jasinski, Kevin E.
O’Grady, Christian A. Chisholm, Robin E. Choo, Michael Crocetti, Robert
Dudas, Cheryl Harrow, Marilyn A. Huestis, Lauren M. Jansson, Michael
Lantz, Barry M. Lester, and Lorraine Milio. Buprenorphine
versus methadone in the treatment of pregnant opioid-dependent
patients: Effects on the neonatal abstinence syndrome.
Drug and Alcohol
Dependence 79(1):1-10,
July 2005.
Summary:
The neonatal abstinence syndrome (NAS) was compared in
neonates of opioid-dependent women maintained on methadone or
buprenorphine during pregnancy. The study was a randomized,
double-blind,
double-dummy, flexible dosing, parallel-group controlled trial
conducted in a comprehensive drug-treatment facility that included
residential and ambulatory care. Preliminary
safety and efficacy
data were also obtained for a larger multi-center trial. Treatment
involved daily flexible
dosing with either sublingual buprenorphine (4–24 mg)
or oral methadone (20–100 mg). Primary
outcome measures were: (1) number of neonates treated for NAS;
(2) amount of opioid agonist medication used to treat NAS; (3) length
of neonatal hospitalization; and (4) peak NAS score. Two of 10 (20%)
buprenorphine-exposed and 5 of 11 (45.5%) methadone-exposed neonates
were treated for NAS (p
= 0.23). Methadone-exposed neonates required
three times more total opioid-agonist medication to treat their NAS
than buprenorphine-exposed neonates (93.1
versus 23.6; p =
0.13). Length of hospitalization was shorter for
buprenorphine-exposed than for methadone-exposed neonates (p = 0.021).
The two groups did not differ significantly in peak NAS total scores (p =
0.25). These findings suggest that buprenorphine is not inferior to
methadone
on outcome measures assessing NAS and maternal and neonatal safety when
administered starting in the second trimester of pregnancy.
NIAAA
Glossary Terms:
AODR neonatal disorder, AOD withdrawal syndrome, AOD dependence,
buprenorphine, mother,
prenatal chemical exposure, prenatal care, drug therapy, methadone, buprenorphine,
opioids, addiction, clinical study, controlled study, comparative
study, agonists, hospital, length of stay, second trimester, human study
|
Chuan-Yu Chen, Megan S. O’Brien, and James C. Anthony. Who becomes
cannabis dependent soon after onset of use? Epidemiological evidence
from the United States: 2000–2001. Drug and Alcohol Dependence 79(1):11-22, July 2005.
Summary:
The aims were to estimate the risk of becoming cannabis dependent
within
24 months after first use of cannabis and to examine subgroup variation
in
this risk. The estimates were based on the National Household
Survey on Drug Abuse conducted during 2000–2001 with a
representative
sample of U.S. residents ages 12 and older (N = 114,241). First-time use
of cannabis within the 24 months prior to assessment was found in 3,352
respondents. An estimated 3.9%
of these recent-onset users developed a cannabis dependence syndrome
during the interval since first use. Excess risk of cannabis
dependence was found
for those with cannabis onset before late adolescence, those with
family income under US$ 20,000, and those who had used three or
more drugs before the first use of cannabis (i.e., tobacco, alcohol,
and other drugs). While these findings generally support previous
results, the study's focus on recent-onset users, thus removing
the influence of users with long-sustained or persistent
cannabis dependence developed years ago, more closely
approximates prospective and longitudinal research on the risk of
becoming cannabis dependent soon after onset of cannabis use.
NIAAA
Glossary Terms: AOD dependence, risk analysis, risk
factors, marijuana in any form, household survey,
recent onset of AOD use, early
AODU onset, adolescence,
income effect, multiple drug use, human study |
Elizabeth R. Disney, Michael Kidorf, Van L. King, Karin Neufeld, Ken
Kolodner, and Robert K. Brooner. Prevalence
and correlates of cocaine physical dependence subtypes using the DSM-IV
in outpatients receiving opioid agonist medication. Drug and Alcohol Dependence 79(1):23-32, July 2005.
Summary:
The relationship
between endorsement of physiological dependence to cocaine and lifetime
and current problem severity was examined in a cross-sectional study of
opioid and cocaine dependent
individuals newly admitted to a treatment program based on
opioid-agonist
medication. All participants (N
= 719) completed the structured clinical
interview for the Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)
(SCID-IV)
and the Addiction Severity Index
(ASI). Participants were first
classified into physiological (n
= 549) versus non-physiological (n
=
170) cocaine dependence groups for one set of analyses and then
categorized into one of four groups for further analyses: (1) tolerance
only (n = 215), (2) tolerance
plus withdrawal (n = 279), (3)
withdrawal
only (n = 55), or (4) no
physiological dependence (n =
170). The
participants who endorsed physiological dependence reported higher
rates of lifetime psychiatric and substance use disorders, higher rates
of current drug use, and more current problems. The four-group analyses
showed that endorsement of withdrawal, with or without tolerance, was
associated with the most severe problems. The results suggest that
physiological dependence to cocaine (particularly the presence of
withdrawal) is a marker for a more severe substance use disorder and
higher rates of comorbid psychopathology and other problems.
NIAAA
Glossary Terms:
AOD dependence, cocaine, opioids, agonists, interview, psychiatric
status rating scales, questionnaire, addiction, disease severity, AOD
tolerance, AOD withdrawal syndrome, AOD use disorder classification,
comorbidity, psychopathology, problem severity, clinical study, human
study
|
Johanna M. Lewis-Esquerre, Suzanne M. Colby, Tracy O’Leary Tevyaw,
Cheryl A. Eaton, Christopher W. Kahler, and Peter M. Monti. Validation
of the timeline follow-back in the assessment of adolescent smoking.
Drug and
Alcohol Dependence 79(1):33-43,
July 2005.
Summary:
The
timeline follow-back instrument (TLFB) validly and reliably quantifies
alcohol use patterns. Its use has
been expanded to assess other behaviors, such as drug use, sexual
behavior, binge eating, and panic attacks. Some evidence for the
validity and reliability of this assessment instrument has emerged in
the area of adult smoking, but to date there is no published
evidence of its validity and reliability in the assessment of
adolescent smoking. This study sought early
evidence of the utility of the TLFB for collecting information on
adolescent smoking behavior. Through secondary data analysis of four
studies on adolescent smokers, the authors examined the associations
between the
TLFB and measures of dependence, smoking history, respiratory symptoms,
and saliva cotinine. They also examined the stability of the TLFB
data across two 15-day time periods. Preliminary
evidence was obtained for the validity and reliability of the TLFB in
the assessment
of adolescent smoking. In particular, the TLFB instrument offered
important data on the heterogeneity of adolescent smoking patterns
beyond a global measure of cigarettes per day, and the reduction of
digit bias. Implications for the assessment of
adolescent smoking are discussed.
NIAAA
Glossary Terms:
patient assessment, timeline followback, AOD use pattern, AOD use
behavior, AOD dependence, sexual behavior, eating disorder, panic
disorder,
validation study, underage AOD use, adolescence, smoking, drug metabolism, respiratory disorder, symptom, saliva analysis, patient AODU history, human study
|
Saul Shiffman and Michael A. Sayette. Validation
of the nicotine dependence syndrome scale (NDSS): A criterion-group
design contrasting chippers and regular smokers. Drug and Alcohol Dependence 79(1):45-52, July 2005.
Summary:
The
nicotine dependence syndrome scale (NDSS), a new multi-dimensional
measure of nicotine dependence, yields five scores for different
aspects of dependence as well as a total score. This study
tested the NDSS in a young adult sample (mean age 24 years), using an
extreme-groups comparison between non-dependent smokers (chippers, n =
123) and regular smokers (n =
130). Scores on each NDSS subscale
strongly discriminated between the two groups, with the NDSS total
score discriminating almost perfectly. The subscales were generally
independent discriminators, demonstrating the discriminant validity of
the subscales. NDSS scales also discriminated levels of intake and
dependence within the chippers group, suggesting that the scales were
sensitive to individual differences even at the very low end of the
dependence continuum.
NIAAA
Glossary Terms: AOD dependence, nicotine,
AOD use pattern, AOD intake per occasion, heavy AOD use, moderate AOD
use, light AOD use, comparative study, validation study, discriminant analysis, discriminant
validity, human study |
Sean Esteban McCabe. Correlates
of nonmedical use of prescription benzodiazepine anxiolytics: Results
from a national survey of U.S. college students. Drug and Alcohol Dependence 79(1):53-62, July 2005.
Summary:
The prevalence and correlates associated with the
nonmedical use of prescription benzodiazepine anxiolytics was examined
among college students in the United States. The study analyzed data
from a nationally
representative sample of 10,904 randomly selected students attending
4-year U.S. colleges (N = 119)
in 2001. The lifetime prevalence of
nonmedical use of prescription benzodiazepine anxiolytics was 7.8%,
past-year prevalence was 4.5%, and past-month prevalence was 1.6%.
Past-year rates of
nonmedical use of prescription anxiolytics ranged from 0% at
the lowest-use schools to 20% at the highest-use school. Multivariate
regression analyses indicated nonmedical use was more likely to occur
among college students who were white, had both male and female sex
partners, and reported higher rates of substance use and other risky
behaviors. Nonmedical use of prescription benzodiazepine
anxiolytics was less likely to occur among college students in the
North Central region and
in historically black colleges and universities. The study
provides evidence that the nonmedical use of prescription
benzodiazepine anxiolytics represents a problem on some American
college
campuses and among certain subgroups of college students. Implications
for developing prevention efforts
while not hindering the effective
clinical treatment for various anxiety disorders are discussed.
NIAAA
Glossary Terms:
benzodiazepines, prescription drug, prevalence, correlation analysis,
undergraduate student, random sample, regression analysis, multivariate
analysis, racial differences, White, bisexual, risk factors,
risk-taking behavior, regional differences, prevention effort directed at people at
risk, human study |
Andreas Büttner, Claus Kroehling, Gita Malla, Randolph Penning,
and Serge Weis. Alterations
of the vascular basal lamina in the cerebral cortex in drug abuse: A
combined morphometric and immunohistochemical investigation.
Drug and
Alcohol Dependence 79(1):63-70,
July 2005.
Summary:
White matter hyperintensities, perfusion deficits, and
metabolic disturbances in drug abusers are detected by neuroimaging
analyses in
different brain regions. This study examined
changes of the cerebral microvasculature as a possible morphological
substrate of the neuroimaging findings in brain specimens obtained at
autopsy from 12 multiple drug
abusers and 8 controls. The basal lamina of
blood vessels from the frontal, temporal, parietal, and occipital lobes
was analysed by means of immunohistochemistry for collagen type IV. The
numerical density of vessels was determined in the gray and white
matter, and their staining intensity was rated on a three-point
scale. Compared to controls, the number of
vessels showing strong immunoreactivity for collagen type IV was
significantly reduced in the gray and white matter of multiple drug
abusers, while the number of vessels with mild and
moderate immunoreactivity was increased. The
total numerical density of vessels was not significantly changed. The
authors suggest that the significant reduction in immunoreactivity for
collagen type IV in the brains from multiple drug abusers may be due to
a thinning of the basal lamina of
cerebral vessels, which might represent the
morphological substrate of a disturbed blood-brain barrier. However, it
is not yest established whether the observed changes are responsible
for the alterations seen in different neuroimaging analyses and which
drug might be of major pathogenetic significance.
NIAAA
Glossary Terms:
neuroimaging, brain
imaging, autopsy, AOD abuse, multiple drug use, controlled study, cerebral blood flow, collagen,
immunoassay,
histologic study, blood-brain
barrier, human study |
Rosa M. Crum, Carla L. Storr, and Ya-Fen Chan. Depression
syndromes with risk of alcohol dependence in adulthood: A latent class
analysis. Drug
and Alcohol Dependence 79(1):71-81,
July 2005.
Summary:
Using prospectively collected data, this study assessed whether
depression is
associated with risk of late-onset alcohol dependence, and whether
that
relationship differs by gender. The baseline interview was completed
in 1981 (mean age = 41.7 years, standard deviation = 17.0, range
18–86) on a probability sample of Baltimore residents as part of the Epidemiologic Catchment Area
Program. Between 1993 and 1996, the
original cohort was traced (73% of the survivors were re-interviewed, N
= 1,920). Baseline depression items were subjected to gender-specific
latent class analyses prior to exploring associations between class
membership and two classifications of alcohol dependence, namely
lifetime
prevalence and new onset assessed at follow-up. A depression
syndrome class was identified (24% of the females and 20% of the
males). The odds of lifetime alcohol dependence among those in the
depressive syndrome class was significantly elevated for both sexes,
relative to the non-depressed class. No appreciable
association was found for depressive syndrome with the development of
alcohol dependence.The evidence
supports an association for the presence of a depressive syndrome with
lifetime alcohol dependence, but not for the new onset of alcohol
dependence. Other predictors of alcohol dependence identified in the
analyses are discussed.
NIAAA
Glossary Terms: AOD dependence, late AODD onset, survey, cohort study, follow-up study,
emotional and psychiatric depression, gender differences, predictive
factor, human study |
Mimy Y. Eng, Marc A. Schuckit, and Tom L. Smith. The level
of response to alcohol in daughters of alcoholics and controls.
Drug and
Alcohol Dependence 79(1):83-93,
July 2005.
Summary:
Low level of response (LR) to alcohol is a genetically influenced
characteristic related to the development of alcohol use disorders
(AUDs). This phenotype is found in men with a family history (FH) of
alcoholism, predicts future AUDs, and has heritabilities as high as
60%. Despite evidence of genetic influences for AUDs in both
sexes, the majority of studies evaluating differences in LR across
high- and low-risk groups have been conducted on males, and it is
unclear how generalizable these results are to women. In this study, 25
women family history positive (FHPs) for alcohol
dependence were matched with 25 women with no FH of alcoholism (FHNs)
on
factors that may impact LR. Using an alcohol challenge paradigm, data
on the reaction to a moderate dose of alcohol were gathered over a
period of 3.5 hours. Assessments included breath alcohol concentrations
(BrACs), the Subjective High
Assessment Scale (SHAS), as well as body
sway or static ataxia. FHPs reported lower subjective intoxication than
FHNs. In addition, when body sway scores were corrected for skewness,
FHPs had significantly lower scores on alcohol-related changes in
lateral sway. These differences remained after considering the effects
of drinking history and BrAC values. This study evaluated the LR to
alcohol in the largest sample of alcohol
challenges in matched FHP and FHN women to date. The findings
overall are consistent with most data from earlier investigations of
smaller
samples of FHP women. The results suggest that, like sons
of alcoholics, a low LR to alcohol might also be characteristic of
daughters of alcoholics.
NIAAA
Glossary Terms: level of response (to AOD), AOD
dependence,
family AODU history, familial alcoholism, high-risk group, low-risk
group, gender differences, female, breath alcohol analysis, ataxia, AOD intoxication, self report,
subjective variables, adult children of alcoholics, human study
|
Suzanne Nielsen and David A. Taylor. The effect
of buprenorphine and benzodiazepines on respiration in the rat.
Drug and
Alcohol Dependence 79(1):95-101,
July 2005.
Summary:
The two main opioid substitution treatments for
heroin dependence currently offered in Australia are methadone and
buprenorphene. Several reports have implicated buprenorphine as
potentially
dangerous in combination with benzodiazepines, but there has been no
comparison of the relative dangers of buprenorphine- and
methadone-benzodiazepine combinations. This study assessed the effect
of intravenous methadone and
buprenorphine on respiration in rats by evaluating arterial
blood pCO2, pO2, and pH and measuring respiratory
rate.
Measurements were made at 0, 15, 30, 60, 120, 180, and 240 minutes
after
methadone or buprenorphine administration. Effects on
respiration were greatest 15 minutes after drug administration. The
effects of methadone and buprenorphine on respiration were compared
with
and without diazepam pretreatment (20 mg/kg). Buprenorphine alone
showed a bell-shaped dose-response inhibition of respiration, but the
plateau of this inhibition on respiration was
lost when the drug was administered in combination with diazepam.
Methadone showed a
dose-dependent inhibitory effect on respiration that was potentiated
with diazepam pretreatment. While the effect of diazepam pretreatment
was elimination of the protective bell-shaped dose-response effect
on respiration, the effect of buprenorphine plus diazepam was not
greater than that of methadone plus diazepam.
NIAAA
Glossary Terms:
methadone, buprenorphine, benzodiazepines, diazepam, adverse drug
interaction, comparative study, laboratory rat, intravenous
administration, respiration, blood
chemistry,
carbon dioxide, oxygen, pH, dose-response relationship, respiratory
disorder, animal study |
Danhua Lin, Xiaoming Li, Hongmei Yang, Xiaoyi Fang, Bonita Stanton,
Xinguang Chen, Antonia Abbey, and Hongjie Liu. Alcohol
intoxication and sexual risk behaviors among rural-to-urban migrants in
China. Drug
and Alcohol Dependence 79(1):103-112,
July 2005.
Summary:
The
migrant population in China is at high risk for hazardous sexual
behavior
and alcohol intoxication. To obtain Information about the prevalence of
alcohol
intoxication and its association with sexual risk behavior among
migrants, this study collected cross-sectional data from sexually
experienced,
young, rural-to-urban migrants (N
= 2,153) in Beijing and Nanjing, China, in 2002. Approximately
one-third of the participants reported being intoxicated with
alcohol at least once during the previous month (40.2% of males and
23.7% of males, p <
0.001).
Compared to non-intoxicated participants, respondents reporting alcohol
intoxication in the previous 30 days also reported more psychological
problems,
including higher depression scores, lower levels of satisfaction with
life and work, and higher perception of peer involvement in risk
behavior. Respondents reporting intoxication were more likely to engage
in
premarital sex than non-intoxicated respondents (76% versus 60.2%, p
< 0.001), to have multiple sexual partners (13.4% versus 5.2%, p <
0.001), to purchase sex (12.6% versus 4.9%, p < 0.001), and to sell sex
(10.1% versus 3.7%, p <
0.001). However, there was no association
between alcohol intoxication and inconsistent or non-use of condoms.
Multivariate analysis controlling for depression, peer risk
involvement, age, gender, and other sociodemographic variables
indicated that alcohol intoxication was independently correlated with
premarital sex, multiple sexual partners, and buying and selling sex.
Compared to the general Chinese population, levels of intoxication were
elevated among Chinese rural-to-urban migrants. Alcohol intoxication
was associated with sexual risk behaviors. Implications for prevention
and
intervention for HIV and AIDS in this population are discussed.
NIAAA
Glossary Terms: migrant
worker, China, AOD intoxication, AOD use pattern, risk analysis, risk
factors, sexual behavior, risk-taking behavior, cross-sectional study,
AODR behavioral problem, emotional and psychiatric depression,
job satisfaction,
multiple sexual partners, prostitution,
condom use, multivariate analysis,
sexually transmitted disease, human immunodeficiency virus, acquired
immunodeficiency syndrome,
prevention effort directed at people at risk, intervention (persuasion
to treatment), human study
|
Lynn E. Sullivan, Marek Chawarski, Patrick G. O’Connor, Richard S.
Schottenfeld, and David A. Fiellin. The
practice of office-based buprenorphine treatment of opioid dependence:
Is it associated with new patients entering into treatment?
Drug and Alcohol
Dependence 79(1):113-116,
July 2005.
Summary:
Patients entering a clinical trial
of buprenorphine in a primary care clinic (PCC) and those entering a
local opioid treatment program (OTP) were compared in a cross-sectional
and longitudinal analysis. The clinical
characteristics and treatment outcomes of PCC patients with no history
of methadone treatment (new-to-treatment) were also compared to those
with prior methadone
treatment. PCC subjects (n =
96) were enrolled in a 26-week randomized
clinical trial of office-based buprenorphine and naloxone provided in a
PCC. OTP subjects (n = 94)
were enrolled in methadone maintenance
during the same period. Compared to OTP subjects, PCC subjects
were more likely to be male (77% vs. 55%, p < 0.01), to be employed
full-time (46% vs. 15%, p
< 0.001), to have no history of methadone
treatment (46% vs. 61%, p
< 0.05), to have fewer years of opioid
dependence (10 vs. 15, p <
0.001), and to have lower rates of injection
drug use (IDU) (44% vs. 60%, p
= 0.03). The new-to-treatment PCC
subjects were younger (36 years vs. 41 years, p = 0.001), more
likely to be white (77% vs. 57%, p
= 0.04), had fewer years of
opioid dependence (7 vs. 14, p
< 0.001), were less likely to have
a history of IDU (35% vs. 54%, p
= 0.07), and had lower rates of
hepatitis C (25% vs. 61%, p =
0.002) than subjects with prior
methadone treatment. Abstinence and treatment retention were comparable
in both groups. These findings suggest that office-based treatment of
opioid dependence is associated with new types of patients entering
into treatment. Treatment outcomes with buprenorphine in a PCC do not
vary based on history of prior methadone treatment.
NIAAA
Glossary Terms: buprenorphine, AOD dependence,
opioids, clinical trial, primary health care, methadone, treatment
program,
history of AODD treatment, cross-sectional study,
longitudinal study, comparative study,
treatment method,
intermethod comparison,randomized
controlled trial, clinical trial, treatment factors, gender
differences, patient history, intravenous injection, age differences,
hepatitis C, AOD abstinence,
patient retention, treatment outcome, human study |
Drug
and Alcohol Dependence
Volume
78, Number 3, June 2005
(Updated 5/25/2005)
Home Page
Robert
L. Balster (Editor-in-Chief). Drug
and Alcohol Dependence adopts new
editorial structure. (Editorial). Drug and Alcohol Dependence 78(3):233-234, June 2005.
T.M. Heffernan, J. Ling, A.C. Parrott, T. Buchanan, A.B. Scholey, and
J. Rodgers. Self-rated
everyday and prospective memory abilities of cigarette smokers and
non-smokers: A Web-based study. Drug and Alcohol Dependence 78(3):235-241, June 2005.
Summary:
Self-ratings of two aspects of everyday memory
performance were measured in cigarette smokers and nonsmokers:
long-term prospective memory, measured by the Prospective Memory
Questionnaire (PMQ), and everyday memory—measured by the Everyday
Memory Questionnaire (EMQ). Other substance use was also
measured and used as covariates in the study. For confidentiality
and expanding the numbers used in previous studies, an Internet study
was carried out, gathering data from 763 participants. After
controlling for other drug use and strategy use, the PMQ
data revealed that smokers reported a greater number of long-term
prospective memory errors than nonsmokers. There were also differences
between light and heavier smokers in long-term prospective memory,
suggesting that nicotine may have a dose-dependent impact on
long-term prospective memory performance. There was also a significant
analysis of variance (ANOVA) group effect on the EMQ, although the
trend for more memory
errors among the heavier smokers had only borderline significance (p
= .057). The results of this study suggest there are selective memory
deficits
associated with smoking and that long-term prospective memory deficits
should be added to the growing list of problems associated with
cigarette use.
NIAAA
Glossary Terms: cigarette, smoking, long-term memory,
short-term memory, questionnaire, analysis of covariance, Internet,
controlled study, multiple drug use, light AOD use, heavy AOD use,
nicotine, dose-response relationship,
|
James P. Zacny, Sandra Gutierrez, and Shahla A. Bolbolan. Profiling
the subjective, psychomotor, and physiological effects of a
hydrocodone/acetaminophen product in recreational drug users.
Drug and Alcohol
Dependence 78(3):243-252,
June 2005.
Summary:
Compounds of the mu (µ)-opioid
agonist hydrocodone with acetaminophen (Hyd/Acet)
are widely prescribed and widely abused prescription
painkillers in the United States. This study profiled the
subjective, psychomotor, and physiological effects of Hyd/Acet
and examined whether the compound had abuse
liability-related subjective effects in a population of recreational
drug users. Volunteers (N =
18) participated in a crossover, randomized,
double-blind study in which they received placebo; 5 mg
Hyd/500 mg Acet; 10 mg Hyd/500 mg Acet; 20 mg Hyd/1000 mg Acet; 40 mg
morphine sulfate; and 1000 mg Acet (all orally). Measures were assessed
before
drug administration and for 300 minutes after. Hyd/Acet produced
dose-related effects, and the effect of the highest dose was similar in
magnitude that of morphine. There were some
abuse liability-related subjective effects produced by 20 mg Hyd/Acet
and morphine, but there were also unpleasant effects. Some unpleasant
subjective effects were experienced only by females. Overall liking and
“take again” ratings assessed 24 hours post-session were not
significant,
but several subjects had elevated liking and “take again” ratings at
this time in one or more of the Hyd/Acet conditions or in the morphine
condition. Both 20 mg Hyd/1000 mg Acet and morphine impaired
psychomotor
performance. Hyd/Acet and morphine produced miosis (constriction of the
pupil). In conclusion, Hyd/Acet produced some abuse liability-related
subjective effects in
recreational drug users, which is consistent with the widespread
nonmedical use and abuse of this product.
NIAAA
Glossary Terms: AOD
user, hydrocodone, acetaminophen,
morphine,
narcotic analgesics, subjective variables, psychomotor impairment, physiological
AODE, AOD use, AOD abuse
potential, euphoria, dysphoria,
randomized
controlled trial, gender differences, eye function, human study
|
Carla L. Storr, Ryan Westergaard, and James C. Anthony. Early onset
inhalant use and risk for opiate initiation by young adulthood.
Drug and
Alcohol Dependence 78(3):253-261,
June 2005.
Summary:
A hypothesized link from early onset inhalant
use to later use of opiates by young adulthood was estimated using data
from an
epidemiological sample of first graders (N = 2,311; 49.8% female; 67.1%
ethnic minority) who entered an urban
public school system in 1985 or 1986 and were studied
longitudinally to young
adulthood. An estimated 9% had initiated inhalant use before the age of
14 and at follow-up in young adulthood an estimated 3% (n = 66) of the
sample had tried opiates at least once. Youth who used inhalants prior
to age 14 were twice as likely to initiate opiate use, compared to
those who had never tried (relative risk = 2.2; 95% confidence interval
[CI], 1.4-3.3).
Statistical adjustment for other covariates attenuated this
relationship but did not eliminate it. The results help confirm
reported evidence that the use of inhalants might be an early marker of
vulnerability for future involvement with illegal drugs such as heroin.
However, an exploratory analysis suggests that there may be no direct
link between inhalants and opiates if a general early onset
susceptibility trait
is taken into account.
NIAAA
Glossary Terms:
inhaled substance, opiates, illicit drug, gateway theory of AODU,
early AODU onset, longitudinal
study, follow-up study, child, adolescent, young adult, risk analysis,
relative risk, epidemiology, human study |
Stefan Gazdzinski, Timothy C. Durazzo, and Dieter J. Meyerhoff. Temporal
dynamics and determinants of whole brain tissue volume changes during
recovery from alcohol dependence. Drug and Alcohol Dependence 78(3):263-273, June 2005.
Summary:
Brain shrinkage and its partial reversibility with abstinence is
commonly
found
in neuroimaging studies of alcoholics. This study used an
automated three-dimensional whole brain magnetic resonance imaging
method (boundary shift integral) in alcohol dependent individuals (N = 23) to
measure the temporal dynamics of cerebral tissue and spinal fluid
volume changes over a 12-month interval and to examine the major
determinants of brain tissue change rates during abstinence and
nonabstinence. More rapid brain tissue gain was seen during the first
month of sobriety than in the following months. The most rapid volume
recovery occurred in abstinent individuals with the greatest
baseline brain shrinkage and drinking severity. The rapid reversal of
brain volume gains in nonabstinent individuals and tissue volume
changes are modulated by duration of abstinence and nonabstinence
periods, as well as recency of nonabstinence. Age, family history
density of alcoholism, relapse severity, and duration or age of onset
of heavy drinking were not major determinants of brain shrinkage and
brain volume recovery rates. This information may be useful to
treatment providers for reinforcing the biomedical benefits of
sobriety. Previous
quantitative measurements of brain volumes in alcoholics performed
after several weeks of abstinence probably
underestimated the full extent of chronic alcohol-associated brain
shrinkage.
NIAAA
Glossary Terms: AOD dependence,AOD
abstinence, brain atrophy, neuroimaging, brain imaging, magnetic
resonance imaging, cerebrum, cerebrospinal fluid, disease severity,
human study |
David S. Festinger, Douglas B. Marlowe, Jason R. Croft, Karen L.
Dugosh, Nicole K. Mastro, Patricia A. Lee, David S. DeMatteo, and
Nicholas S. Patapis. Do
research payments precipitate drug use or coerce participation?
Drug and Alcohol
Dependence 78(3):275-281,
June 2005.
Summary:
Providing large cash incentives to substance abuse clients to
participate in research is often considered unethical because of
concerns that it might precipitate new drug use or be perceived as
coercive. In this study, consenting drug abuse outpatients were
randomly assigned to
receive payments of $10, $40, or $70 in either cash or gift certificate
for attending a 6-month research follow-up assessment. At the 6-month
follow-up, participants received their randomly determined incentive
and were then scheduled for a second follow-up appointment 3 days later
to detect new instances of drug use. It was found that neither
the size nor the mode of the incentives had a significant effect on
rates of new drug use or perceptions of coercion. Consistent with the
contingency management literature, higher payments and cash payments
were associated with increased follow-up rates. The results
also suggest that by reducing the need for more intensive follow-up
efforts, higher payments may be more cost-effective.
NIAAA
Glossary Terms:
research issue, research ethics,
participation for remuneration, AOD abuser, outpatient care, patient compliance, follow-up
study, human study |
Antonio Verdejo, Inmaculada Toribio, Carmen Orozco, Krista Lee Puente,
and Miguel Pérez-García. Neuropsychological
functioning in methadone maintenance patients versus abstinent heroin
abusers. Drug
and Alcohol Dependence 78(3):283-288,
June 2005.
Summary:
Neuropsychological status is an important
contributing variable in drug abuse rehabilitation outcomes according
to several studies. However,
few studies have dealt with cognitive impairment in methadone
maintenance patients (MMPs), even though methadone is the most
frequently used opioid substitution treatment in Europe.
The aim of this study was to contrast the
neuropsychological performance of MMPs with that of abstinent heroin
abusers (AHAs). Participants matched on age,
education, premorbid IQ, employment status and lifetime drug abuse
were given a set of tests to assess visuo-spatial
attention, processing speed, and executive functions. Although
processing speed and attention deficits have previously been the focus
of studies with MMPs, executive functions have not received similar
attention. Comparing matched MMPs and AHAs had a two purposes: (1) to
test the differential effects of current opioid
consumption and past opioid abuse on cognitive-executive performance
and (2) to assess the potential consequences of opioid-related
neuropsychological deficits. Results showed a significantly slower
performance by MMPs on processing speed, visuo-spatial attention, and
cognitive flexibility tests (Five
Digit Test (FDT) parts 1 and 3; Oral
Trails (OT) parts 1, 2; Interference
2–1), and less accuracy in working
memory and analogical reasoning tests extracted from the Wechsler Adult
Intelligence Scale (WAIS III). Effect sizes for significant
comparisons
ranged from 0.67 to 1. The results suggest that methadone
induces significant cognitive impairments that
could compromise drug-treatment outcomes in MMPs.
NIAAA
Glossary Terms: neuropsychological assessment,
methadone, drug therapy, opiates, heroin, controlled study,
comparative study, cognitive ability, cognitive and memory disorder, attention, AOD abstinence,
human study |
Raúl Pastor, Carles Sanchis-Segura, and Carlos M.G.
Aragon. Effect of
selective antagonism of mu(1)-, mu(1/2)-, mu(3)-, and delta-opioid
receptors on the locomotor-stimulating actions of ethanol.
Drug and
Alcohol Dependence 78(3):289-295,
June 2005.
Summary:
Previous
studies have shown that nonspecific opioid
antagonists such as naltrexone or naloxone reduce ethanol-induced
locomotor activity in mice. Because these antagonists have a broad
pharmacological profile, however, it remains unclear through which
opioid
receptor the antagonism is achieved. This study therefore investigated
further the role of the different opioid
receptors in ethanol-induced (2.5 g/kg) locomotion in mice. First, the
effect of naltrexone (0–2 mg/kg) on ethanol-induced
locomotion was compared with that of the selective delta-opioid
receptor antagonist
naltrindole (0–10 mg/kg). Results showed
that naltrexone completely blocked this effect of ethanol at doses
suggested to occupy only mu-opioid receptors, and naltrindole did not
modify ethanol-induced locomotion. Next, the involvement of mu-opioid
receptors in
ethanol-stimulated motor activity was further investigated by assessing
the involvement of
mu(1)-, mu(1/2)-, and mu(3)-opioid receptor subtypes. Results revealed
that mu(1/2)-, and to a lesser extent mu(3)-, but not mu(1)-opioid
receptor subtypes are involved in the psychomotor actions of ethanol.
These findings are discussed together with previous findings that have
emphasized
the critical dependence of ethanol-induced motor behaviors on opioid
receptors, as well as the integrity of beta-endorphin synthesizing
neurons of the hypothalamic arcuate nucleus.
NIAAA
Glossary Terms: antagonists, naltrexone, naloxone, opioids, opiates,
opioid receptors,
locomotion, ethanol, endorphins,
hypothalamus, animal study, laboratory mice |
Tian P.S. Oei, Penelope A. Hasking, and Ross McD. Young. Drinking Refusal Self-Efficacy
Questionnaire-Revised (DRSEQ-R): A new factor
structure with confirmatory factor analysis. Drug and Alcohol Dependence 78(3):297-307, June 2005.
Summary:
The Drinking Refusal Self-Efficacy
Questionnaire (DRSEQ) assesses
people's belief in their ability to resist
alcohol. Exploratory factor analysis indicates that the DRSEQ is a
sound psychometric instrument, but it has not been subjected to
confirmatory
factor analysis. This study sought to confirm the factor structure of
the DRSEQ in 2,773 participants. Initial analyses revealed that the
original structure was not confirmed. Subsequent
analyses resulted in a revised factor structure (DRSEQ-R) that was
confirmed in community, student, and clinical samples. The DRSEQ-R was
also found to have good construct and concurrent validity. The factor
structure of the DRSEQ-R is more stable than the original structure of
the DRSEQ and the revised scale has considerable potential in future
alcohol-related research.
NIAAA
Glossary Terms:
self-efficacy,
resistance skills, questionnaire,
psychological
assessment, evaluation
study, factor analysis, validation study, construct validity,
reliability (research methods), research and evaluation method, human study |
Maree Teessona, Alys Havard, Sandra Fairbairn, Joanne Ross, Michael
Lynskey, and Shane Darke. Depression
among entrants to treatment for heroin dependence in the Australian
Treatment Outcome Study (ATOS): Prevalence, correlates and treatment
seeking. Drug
and Alcohol Dependence 78(3):309-315,
June 2005.
Summary:
A cross-sectional structured interview was used to determine the rate
of current major depressive disorder (MDD) among
entrants to treatment for heroin dependence in three treatment
modalities and a non-treatment comparison group. Factors associated
with depression were also ascertained. The participants were current
heroin
users (N = 615). Of these, 201
were entering methadone/buprenorphine maintenance (MT), 201
were entering detoxification (DTX), 133 were entering drug-free
residential
rehabilitation (RR), and 80 were not in treatment (NT). Current
major depressive episode was reported by 25%. The rates of major
depressive disorder ranged from 26% in the treatment groups (23% MT,
25% DTX, 31% RR) to 16% of those not in treatment. Females were more
likely to have current major depressive episode (31% versus 21%; odds
ratio [OR] =
1.70; 95% confidence interval [CI], 1.16–2.48). Factors associated with
depression in the
treatment groups were post traumatic stress disorder (PTSD), attempted
suicide in the last 12 months and severe physical disability. Among the
non-treatment group those with depression were also more likely to have
PTSD. Women entering treatment were 3 times more likely to meet
criteria for current major depression than women not in treatment.
Among men however, the rates were not significantly different. Thus
depression is a significant concern among entrants to
treatment for heroin dependence. The authors conclude that
consideration of depression and provision of
appropriate treatment where required should be essential components of
treatment.
NIAAA
Glossary Terms:
major depression, prevalence, AOD dependence, addiction, heroin,
methadone, buprenorphine, comorbidity, detoxification, gender
differences, risk analysis, risk factors, relative risk, posttraumatic stress disorder, suicidal
behavior, physical disability, human study |
Euphrosyne Gouzoulis-Mayfrank, Thomas Fischermann, Markus Rezk, Bastian
Thimm, Gernot Hensen, and Joerg Daumann. Memory
performance in polyvalent MDMA (ecstasy) users who continue or
discontinue MDMA use. Drug and Alcohol Dependence 78(3):317-323, June 2005.
Summary:
Animal studies show that the popular dance drug "ecstasy"
(3,4-methylenedioxymethamphetamine;
MDMA) is a serotonergic neurotoxin. Several
cross-sectional investigations have reported low memory and learning
performance in MDMA users, especially those reporting heavy use. Since
serotonin has a recognized role in memory
processes, these findings were mostly interpreted as evidence for
MDMA-related neurotoxicity in humans. However, studies with user
populations and controls suffer from many inherent methodological
problems. Furthermore, longitudinal data on memory performance after
continued or discontinued ecstasy use are scarce. This longitudinal
study examined memory performance in MDMA users (N = 38) over the course of 18
months. Subjects who stopped using MDMA after the baseline examination (n = 17)
did not improve, and subjects who continued MDMA use (n = 21) did not
deteriorate in terms of test performance. These findings do not
support, but also do not rule out, memory decline
following use of MDMA. Given the
popularity of MDMA among young people, further studies are
needed. The authors believe that research strategies should now move to
prospective
designs in order to shed more light on the course of possible adverse
cognitive effects of ecstasy use.
NIAAA
Glossary Terms: MDMA, AOD use, AOD abstinence, AODR
mental disorder, neurotoxins,
neurotoxicity,
serotonin
receptors, learning
ability, memory,
cognitive and memory disorder, psychological performance test,
longitudinal study, human study |
Christy K Scott, Michael L. Dennis, and Mark A. Foss. Utilizing
Recovery Management Checkups to shorten the cycle of relapse, treatment
reentry, and recovery. Drug and Alcohol Dependence 78(3):325-338, June 2005.
Summary:
Growing evidence over the past several decades suggests that a
subset of substance users suffers from what appears to be a more
chronic condition in which they cycle through periods of relapse,
treatment reentry, incarceration, and recovery, often for several
years. This study examined the frequency, type, and predictors of
transitions between points in the relapse-treatment reentry-recovery
cycle. Interviews were conducted quarterly over a 2-year period with
participants (N = 448) who
were randomly assigned to either an assessment-only condition or a
Recovery Management Checkup (RMC) condition. Results indicated that
about one-third of the
participants transitioned from one point in the cycle to another each
quarter; 82% transitioned at least once and 62% transitioned multiple
times. Participants
assigned to RMC were significantly more likely to return to treatment
sooner and receive more treatment. The probability of transitioning to
recovery was related to the severity, problem orientation, desire for
help, self-efficacy, self-help involvement, and recovery environment at
the beginning of the quarter and the amount of treatment received
during the quarter. The findings clearly support the widespread
belief that addiction is a chronic condition and they demonstrate
the necessity and effectiveness of post-discharge monitoring and
checkups.
The methods used in this study also provide a simple and replicable
method
for learning more about the multiple pathways that individuals travel
before achieving a prolonged state of recovery.
NIAAA
Glossary Terms:
AOD dependence, addiction, AODD relapse, imprisonment, AODD recovery,
predictive factor, risk factors, program dropout, disease severity,
help-seeking behavior, self-efficacy, mutual help and support group,
environmental factors, patient monitoring, human study |
Mallie Paschall and Robert I. Lipton. Wine
preference and related health determinants in a U.S. national sample of
young adults. Drug
and Alcohol Dependence 78(3):339-344,
June 2005.
Summary:
Relationships between wine preference and selected
health determinants were examined in a U.S. national sample of young
adults to
improve understanding of the association between light-to-moderate wine
consumption and long-term morbidity and mortality risk. Interview data
collected from young adults (N
= 12,958) who participated in the National
Longitudinal Study of Adolescent Health were analyzed to determine
whether wine preference was related to educational, health, and
lifestyle characteristics that are predictive of long-term morbidity
and mortality. Wine drinkers generally had more formal education,
better dietary and exercise habits, and more favorable health status
indicators (e.g., normal body mass) than other drinkers and
nondrinkers. A larger proportion of wine drinkers were light-moderate
drinkers compared to beer or liquor drinkers, and wine drinkers were
less likely to report smoking or problem drinking than beer or liquor
drinkers. The findings indicate that wine preference in young
adulthood is related to educational, health, and lifestyle
characteristics that may help to explain the association between
light-to-moderate wine consumption and morbidity, and mortality risk in
later adulthood.
NIAAA
Glossary Terms: wine, light AOD use, moderate AOD use,
AOD nonuse, morbidity, mortality, demographic characteristics,
predictive factor,
educational level achieved, health
related behavior, lifestyle,
diet, physical exercise, body mass index, beer, distilled alcoholic
beverage, smoking, nonproblematic AOD use, comparative study, risk
analysis, young adult, human
study |
R. Mojtabai. Use
of specialty substance abuse and mental health services in adults with
substance use disorders in the community. Drug and Alcohol Dependence 78(3):345-354, June 2005.
Summary:
Patterns and correlates of use of specialty substance
abuse and mental health services were examined in adults with alcohol
or
nonalcohol drug abuse or dependence. Analyses focused on participants
with alcohol or nonalcohol drug
abuse or dependence (N =
5,568) drawn from the 2002 National
Survey on Drug
Use and Health (NSDUH), a large representative cross-sectional
survey of the U.S. general population. Results showed that only 9.7% of
adults with substance use disorders used specialty
substance abuse services in the past year; 22.4% used mental health
services. Substance use disorder severity and less education were
associated with using substance abuse services and psychological
distress and impairment in role functioning due to psychological
problems were associated with mental health service use. Male gender,
black race/ethnicity, and lack of health insurance acted as barriers to
using mental health services but not specialty substance abuse
services. Past year use of substance abuse services, but not mental
health services, was associated with lower likelihood of continued
substance use
in the past month. Thus, while people with substance use disorders are
more likely to use mental
health services than specialty substance abuse services, only
people who use specialty substance abuse services have a lower risk of
continued substance use. The findings emphasize the need to
integrate substance abuse treatments in the mental health care
system and to give attention to different barriers to the two types of
services.
NIAAA
Glossary Terms: health care utilization, AODD
treatment unit,
mental health care, AOD dependence, AOD abuse,
physiological stress, disease severity, educational level achieved, cross-sectional study, survey, treatment
barriers, human study |
Drug
and Alcohol Dependence
Volume
78, Number 2, May 2005
(Updated 5/19/2005)
Home Page
Robert L. Balster. Ian
Stolerman service as editor for Drug
and Alcohol Dependence.
(Editorial). Drug and Alcohol
Dependence 78(2):111-112,
May 2005.
Nancy A. Ator, Roland R. Griffiths, and Elise M. Weerts. Self-injection
of flunitrazepam alone and in the context of methadone maintenance in
baboons. Drug
and Alcohol Dependence 78(2):113-123,
May 2005.
Summary:
Patients in methadone maintenance use benzodiazepines, notably
flunitrazepam, to enhance the subjective effects of methadone. This
study evaluated intravenous self-administration of flunitrazepam
(0.001–0.32 mg/kg) alone and during daily oral methadone administration
in baboons (N = 3).
Flunitrazepam maintained self-injection as
an inverted U-shaped function of dose at rates higher than those
maintained by most other benzodiazepines under the same procedure. In
the context of demonstrated physical dependence on 3.2 mg/kg/day oral
methadone, flunitrazepam doses on the ascending limb of the dose-effect
curve maintained greater rates of self-injection than before methadone
in two baboons. When the methadone dose decreased to 1.8 mg/kg/day,
self-injection remained higher for those baboons and became higher than
before methadone for the third baboon. Self-injection remained higher
when methadone decreased to 1.0 mg/kg/day, except self-injection of the
lowest flunitrazepam dose returned to or below the pre-methadone rate
for two baboons. After methadone was discontinued, the dose-effect
curve shifted to the right in one baboon but remained to the left in
two. Flunitrazepam thus served as a reinforcer alone and in the context
of methadone maintenance. Lower doses maintained higher self-injection
during and shortly after methadone maintenance. The authors recommend
that further research explore the duration of higher self-injection
rates following methadone
maintenance.
NIAAA Glossary Terms:
methadone, benzodiazepines, flunitrazepam, addiction, intravenous
injection, nonhuman
primate, self administration of drugs, dose-response relationship, AOD
dependence, reinforcement, animal study
|
Steven Shoptaw, Cathy J. Reback, James A. Peck, Xiaowei Yang, Erin
Rotheram-Fuller, Sherry Larkinsa, Rosemary C. Veniegas, Thomas E.
Freese, and Christopher Hucks-Ortiz. Behavioral
treatment approaches for methamphetamine dependence and HIV-related
sexual risk behaviors among urban gay and bisexual men.
Drug and Alcohol
Dependence 78(2):125-134,
May 2005.
Summary:
Gay and bisexual men (GBM) who are dependent on methamphetamine (Meth)
are at high risk for human immunodeficiency virus (HIV) transmission,
largely because of drug-associated sexual risk behaviors. This study
evaluated the efficacy of four behavioral drug abuse treatments for
reducing Meth use and sexual risk behaviors among this
population. Meth-dependent
GBM (N = 162) were randomly
assigned to one
of four treatment conditions for 16 weeks: standard cognitive
behavioral therapy (CBT, n =
40), contingency management (CM, n
= 42),
combined cognitive behavioral therapy and contingency management
(CBT+CM, n = 40), and a
culturally tailored cognitive behavioral therapy
(GCBT, n = 40). Stimulant use
was assessed with urine drug screens three times a week during
treatment. Sexual risk behaviors
were monitored monthly (four measures). Follow-up assessments were
at 6 (80.0%) and 12 months (79.9%). Statistically significant
differences in retention (F(3,158) = 3.78, p
< 0.02), in longest period of consecutive urine samples negative for
Meth metabolites (F(3,158) = 11.80, p
< 0.001), and in the
Treatment Effectiveness Score were observed by condition during
treatment (F(3,158) = 7.35, p
< 0.001) with post hoc
analyses showing
the CM and CBT+CM conditions to perform better than standard CBT.
Results of generalized
estimating equations modeling showed GCBT significantly
reduced unprotected
receptive anal intercourse during the first 4 weeks of treatment
(X² = 6.75, p < 0.01).
During treatment between-group
differences disappeared at follow-up with overall reductions in
outcomes sustained to 1-year. Thus, among high-risk Meth-dependent GBM,
drug abuse treatments
produced significant reductions in Meth use and sexual risk
behaviors. The authors conclude that drug abuse treatments merit
consideration as a primary HIV
prevention strategy for this population.
NIAAA Glossary Terms: AOD abuse, methamphetamine, sexual
behavior, risk-taking behavior, HIV infection, homosexual behavior,
bisexual behavior, gay
male, cognitive therapy,
behavior therapy, CNS stimulant, treatment method, treatment outcome,
urinalysis, comparative study, prevention, human study |
Joshua A. Lile, Jason T. Ross, and Michael A. Nader. A
comparison of the reinforcing efficacy of
3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) with cocaine in
rhesus monkeys. Drug and Alcohol Dependence 78(2):135-140, May 2005.
Summary:
The reinforcing efficacy of
3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") was compared to
that of cocaine in rhesus monkeys. Monkeys (N = 4) responded under a
within-session, exponentially
increasing, progressive-ratio (PR) schedule of cocaine reinforcement.
Breaking point (BP) for the PR schedule was defined as the final
response requirement completed before 2 hours had elapsed without an
injection delivered. Saline and doses of cocaine (0.003–0.3
mg/kg/injection) and MDMA (0.01–0.56 mg/kg/injection) were substituted
for the training dose of cocaine for at least five consecutive
sessions. Both cocaine and MDMA functioned as reinforcers, but
self-administration of MDMA occurred at fewer doses and a significantly
lower peak BP was obtained for MDMA. The results show that MDMA
functions as a reinforcer. However, its reinforcing efficacy appears to
be less than that of cocaine.
NIAAA Glossary Terms:
MDMA, reinforcement, cocaine, comparative study, monkey, nonhuman
primate, intravenous injection, illicit drug, animal study
|
Namtip Srirak, Surinda Kawichai, Tasanai Vongchak, Myat Htoo Razak,
Jaroon Jittiwuttikarn, Sodsai Tovanabutra, Kittipong Rungruengthanakit,
Rassamee Keawvichit, Chris Beyrer, Kanokporn Wiboonatakul, Teerada
Sripaipan, Vinai Suriyanon, and David D. Celentano. HIV
infection among female drug users in Northern Thailand.
Drug and Alcohol
Dependence 78(2):141-145,
May 2005.
Summary:
Reports
on human immunodeficiency virus (HIV) infection and risk behaviors
among female drug users in
developing countries, particularly in Asia, are limited. This study
we investigated HIV prevalence and risk factors for HIV infection among
200 women admitted for 21-day inpatient drug detoxification in Chiang
Mai, Thailand. Volunteers received a
structured interview, HIV pre-test counseling, specimen collection for
HIV and sexually transmitted disease tests, and were provided test
results and HIV post-test
counseling a week later. Two-thirds of participants (68%) were ethnic
minorities with no formal education. Overall, 14 (7%) of the women were
HIV
positive: 25% among 28 heroin injectors and 4.1% among 172 opium or
methamphetamine smokers (p
< 0.001). History of drug injection and
sexual abuse were associated with HIV infection. The authors recommend
that HIV prevention
strategies for drug-using women in Thailand consider both harm
reduction strategies for drug use and promoting safer sex measures in a
culturally appropriate context.
NIAAA Glossary Terms:
female, HIV infection, prevalence, risk factors, Thailand, inpatient
care, detoxification, interview, counseling, sexually transmitted
disease, minority group, heroin, intravenous drug user, opium,
methamphetamine, smoking, sexual abuse,
patient history,
prevention strategy, harm reduction,
culturally sensitive prevention approach, human study |
Jichuan Wang, Robert G. Carlson, Russel S. Falck, Harvey A. Siegal,
Ahmmed Rahman, and Linna Li. Respondent-driven
sampling to recruit MDMA users: A methodological assessment.
Drug and Alcohol
Dependence 78(2):147-157,
May 2005.
Summary:
Recruiting
more representative samples of illicit drug users is a continuing
challenge in substance abuse research. Respondent-driven
sampling (RDS), a new form of chain-referral sampling, is designed to
eliminate the bias caused by the non-random selection of the initial
recruits and reduce other sources of bias, such as bias due to
voluntarism and masking, that are usually associated with regular
chain-referral sampling. This study assessed the application of RDS
among young adult users of 3,4-methylenedioxymethamphetamine
(MDMA, "ecstasy") and found that the sample compositions converged
to equilibrium within a limited number of recruitment waves,
independent of the characteristics of the initial "seed" recruits. The
sample compositions approximated the theoretical
equilibrium compositions, and were not significantly different from the
estimated population compositions, except that white
respondents were over-sampled and black respondents were under-sampled.
The effect of voluntarism and masking on the sampling process was
not significant. Though identifying productive seeds and
improving the referral rate are significant challenges when
implementing RDS, the results show that RDS is a flexible and
robust sampling method with the potential to be widely used in
studies of illicit drug-using populations.
NIAAA Glossary Terms:
illicit drug,
AOD user, sample
selection,
sampling bias,
research issue, MDMA,
racial differences, White, Black, intervention referral, human study |
Francisco Aguilar de Arcos, Antonio Verdejo-García, María
Isabel Peralta-Ramírez, María Sánchez-Barrera, and
Miguel Pérez-García. Experience
of emotions in substance abusers exposed to images containing neutral,
positive, and negative affective stimuli. Drug and Alcohol Dependence 78(2):159-167, May 2005.
Summary:
Emerging evidence suggests that emotional processes may be involved
in the development of addiction, and that emotional alterations may
compromise the effectiveness of substance abuse treatment. Yet few
studies have examined the
experience of emotions in substance abusers, especially with regard to
natural affective stimuli that are motivationally relevant for the
normal population. This study examined
possible differences in the experience of emotions of drug-free
substance abusers exposed to images containing motivationally relevant
stimuli, compared to a normal population, and possible
differences in the experience of emotions of substance abusers
depending on their drug of choice. Twenty-five images from the
International Affective Picture System (IAPS) were used to elicit
different
emotional states. The Self Assessment Manikin (SAM) was used to record
participants’ subjective experience on three emotional dimensions:
valence, arousal, and dominance. Bifactorial multivariate
analysis of variance (MANOVA) was used to examine
subjective emotional ratings as a function of group and as a function
of the kind of image shown. Results showed a different emotional
profile of substance abusers compared to healthy controls; and
different emotional profiles between abusers of a number of substances.
The results suggest the experience of emotions may be significantly
altered in substance abusers, and that these alterations may play an
important role in the course and results of drug abuse treatment.
NIAAA Glossary Terms:
addiction, emotion as an AODC, AOD user, motivation, AOD abstinence,
multivariate analysis, analysis of covariance, controlled study,
comparative study, treatment factors, treatment outcome, human study
|
Judith J. Prochaska, James L. Sorensen, Sharon M. Hall, Joseph S.
Rossi, Colleen A. Redding, Amy B. Rosen, Stuart J. Eisendrath, and Marc
R. Meisner. Predictors
of health functioning in two high-risk groups of smokers.
Drug and Alcohol
Dependence 78(2):169-175,
May 2005.
Summary:
The
authors examined the relative and combined health effects of cigarette
smoking, heroin use,
and depression in clinically depressed smokers (n = 322) and
opioid-dependent smokers (n =
117) participating in two studies of the San
Francisco Treatment Research Center. Opioid-dependent smokers averaged
16 years (SD = 9) of heroin use; 3% of depressed smokers used opiates
in the past 6 months. The two groups were comparable in cigarettes per
day (M = 15, SD = 10) and Beck
Depression Inventory (BDI-II) scores (M = 21, SD = 11). Health
functioning was assessed using the Medical
Outcomes Study Short Form (SF-36). With adjustment for demographic
differences, depressed smokers reported better physical but poorer
emotional health relative to opioid-dependent smokers. Both groups
scored significantly lower than published norms (p < .05). Within
groups, severity of depressive symptoms, tobacco use, and opiate use
were independent predictors of lower health functioning (p <0 .05).
Examining risk-related subgroups based on depression scores
(BDI-II ≥
20), cigarettes per day (≥ 1 pack), and opiate use, number of risk
factors was monotonically related to health functioning in both
samples. Individuals with two or more risk factors scored the lowest (p
<0 .05). Severity of depressive symptoms, tobacco use, and opiate
use
contributed individually and collectively to lower health functioning.
The authors conclude that blended treatments targeting multiple risk
factors are needed to
improve health outcomes.
NIAAA Glossary Terms:
smoking, cigarette, heroin, AOD dependence, emotional and psychiatric
depression, multiple drug use, comorbidity, psychiatric status rating
scales, physical health, mental health, symptom severity, comparative
study, risk analysis, risk factors, treatment factors, treatment
outcome, human study
|
Shane Darke, Anna Williamson, Joanne Ross, and Maree Teesson. Attempted
suicide among heroin users: 12-month outcomes from the Australian
Treatment Outcome Study (ATOS). Drug and Alcohol Dependence 78(2):177-186, May 2005.
Summary:
A
cohort of heroin users (N =
495), recruited for the Australian Treatment
Outcome Study (ATOS), were re-interviewed at 12 months about
suicide attempts over the follow-up period. The proportion who had
attempted suicide in the 12 months since baseline was not significantly
different from that reported in the 12 months preceding ATOS enrolment
(12.2% versus 9.1%), and attempted suicide did not decline
significantly in any of the index treatment groups. Among males there
was no significant reduction in attempted suicide (8.7% versus 8.1%).
Among females, however, the proportion reporting an attempt declined
significantly from 19.7 to 9.8%. Of those who reported suicidal
ideation at baseline, 22.8% made an attempt over the follow-up period,
as did 19.0% of those who had major depression. Large and significant
declines in suicidal ideation (23.1% versus 6.9%) and major depression
(25.5% versus 10.9%) occurred over the study period. Independent
predictors of a suicide attempt over the follow-up period were social
isolation, having made an attempt in the preceding 12 months, suicidal
ideation at baseline, a greater number of treatment episodes, and
higher
levels of multiple drug use at baseline.
NIAAA Glossary Terms:
heroin, AOD user, cohort study, suicidal behavior, suicidal ideation,
treatment factors, treatment outcome, follow-up study, gender
differences,
major depression, predictive factor, multiple drug use, social isolation, human study |
Christian J. Hopfer, David Timberlake, Brett Haberstick, Jeffrey M.
Lessem, Marissa A. Ehringer, Andrew Smolen, and John K. Hewitt. Genetic
influences on quantity of alcohol consumed by adolescents and young
adults. Drug
and Alcohol Dependence 78(2):187-193,
May 2005.
Summary:
Genetic and environmental influences on drinking were examined in a
nationally representative study of genetically informative adolescents
followed into young adulthood. The average quantity of alcohol used per
drinking episode during the
past year was analyzed in 4,432 participants assessed during
adolescence (mean
age 16 years) and then 1 and 6 years later. The variance of quantity of
alcohol consumed was decomposed into three components: additive genetic
(a2), shared environmental (c2), non-shared environmental (e2). Four
candidate genes were tested for association. Wave (1) a2 − 0.52e2 −
0.48, Wave (2) a2 − 0.28e2 − 0.72, Wave (3) a2 −
0.30e2 − 0.70. Genetic correlations between Waves 1 and 2 were 0.85,
Waves 1 and 3 were 0.34. The DAT1 440 allele was associated at Wave 1
(p = 0.007). DRD2 TaqI A1/A2
was associated at Wave 3 (p =
0.007). DRD4
and 5HTT were not associated. The DAT1 polymorphism accounted for 3.1%
of the variation and the DRD2 polymorphism accounted
2.0% of the variation. In conclusion, genetic influence on drinking
behavior was common in adolescents
longitudinally assessed 1 year apart, but was less correlated between
these adolescents and their assessment as young adults later on.
Polymorphisms in genes of the dopaminergic system appear to
influence variation in drinking behavior.
NIAAA Glossary Terms:
alcoholic beverage, AOD use pattern, AOD use behavior, AOD consumption,
AOD intake per occasion, hereditary vs environmental factors,
adolescence, adulthood, follow-up study, genetic correlation analysis,
genetic polymorphism, gene, allele,
dopaminergic neuron, dopaminergic receptors, human study |
Douglas Wright, Georgiy V. Bobashev, and Scott P. Novak. Decomposing
the total variation in a nested random effects model of neighborhood,
household, and individual components when the dependent variable is
dichotomous: Implications for adolescent marijuana use.
Drug and
Alcohol Dependence 78(2):195-204,
May 2005.
Summary:
Multilevel
modeling techniques allow substance
abuse researchers to identify more accurately the contribution of
multiple levels of influence on drug-related attitudes and behaviors.
However, it is difficult to determine the relative importance of the
different hierarchical levels. In the case of dichotomous
outcomes, this is because the variance components estimation involves
calculations
using a log-odds metric at the lowest level of estimation. This article
present
methods introduced by Goldstein and Rasbash (Goldstein, H. and Rasbash,
J. Improved approximations for multilevel models with binary
responses. Journal of the Royal
Statistical Society A159:505–513, 1966) to convert the variance
components from the log-odds to the probability metric. This method
provides a more logical and interpretable way to examine variation for
nonlinear outcomes, which tend to be used heavily in substance use
research. Using data from the National Household Survey on Drug Abuse
(available
at http://www.samhsa.gov/oas/nhsda/1999/Collect/toc.htm).
the authors partitioned variation among individual, household, and
neighborhood levels for the binary outcome of past year marijuana use
to illustrate this approach. They also conducted a stability analysis
to
examine the robustness across different estimation procedures commonly
available in commercial multilevel software packages. Finally, they
partitioned the variance components using a conventional continuously
distributed outcome and compared the relative magnitudes across binary
and continuous outcomes.
NIAAA Glossary Terms:
AODR behavioral markers, attitude and behavior,
quantitative data analysis, marijuana in any form, treatment outcome,
statistical modeling, research and evaluation method, multivariate
analysis |
Ryan Vandrey, Alan J. Budney, Jody L. Kamon, and Catherine
Stanger. Cannabis
withdrawal in adolescent treatment seekers. Drug and Alcohol Dependence 78(2):205-210, May 2005.
Summary:
Controlled studies with adult cannabis users have demonstrated a
valid cannabis withdrawal syndrome, but few published reports have
examined cannabis withdrawal among adolescents. In this study,
adolescents whose primary substance of
abuse was cannabis and were presenting
for outpatient substance abuse treatment completed a questionnaire
reporting the presence
and severity of withdrawal symptoms during past periods of cannabis
abstinence. Nearly two-thirds of the sample indicated that they had
experienced four or more symptoms, and over one-third reported four or
more symptoms that occurred at a moderate or greater severity. The
magnitude of withdrawal severity was positively correlated with current
emotional and behavioral symptoms and self-reported problems with
cannabis use. The findings are consistent with previous studies,
although the prevalence and magnitude of withdrawal symptoms were lower
than in a similar study with adult treatment seekers (Budney, A.J.,
Novy, P., and Hughes, J.R. Marijuana withdrawal among
adults seeking treatment for marijuana dependence. Addiction 94,
1311–1322, 1999). The authors concluded that further research is needed
to elucidate associations
between cannabis withdrawal effects, the initiation of cessation
attempts, and relapse.
NIAAA Glossary Terms:
marijuana in any form, AOD dependence, AOD abstinence, AOD withdrawal
syndrome, adolescent, outpatient care, questionnaire, self report,
symptom severity, emotional stability and instability, behavior,
relapse prevention, human study
|
Damaris J. Rohsenow, Rosemarie A. Martin, and Peter M. Monti. Urge-specific
and lifestyle coping strategies of cocaine abusers: Relationships to
treatment outcomes. Drug and Alcohol Dependence 78(2):211-219, May 2005.
Summary:
Specific coping techniques were investigated for effectiveness in
reducing cocaine use after treatment. The Urge-Specific
Strategies-Cocaine (USS-C) questionnaire was used to assess frequency
of use of 21
strategies for coping with urges. The General Change Strategies-Cocaine
(GCS-C) questionnaire was used to assess frequency of use of 21
lifestyle
change strategies designed to maintain abstinence. Cocaine-dependent
patients were assessed at follow-up after residential treatment for
USS-C (n = 59 at 3 months, 84
at 6 months), GCS-C (n = 89 at
3 months,
120 at 6 months) and substance use. Less cocaine use was associated
with urge coping by thinking about negative or positive consequences,
alternative behaviors, distraction, relaxation/meditation, escape,
offer refusal, spiritual methods, behavior chains, mastery messages,
problem-solving, meeting or sponsor, or seeking social support. The
lifestyle change strategies of thinking about consequences, working
toward goals, thinking of oneself as sober, clean recreation, regular
relaxation, avoiding temptations, not carrying much money, living with
clean people, seeking social support, spiritual involvement, keeping
busy, and health activities were also associated with less cocaine use.
The results suggest that coping skills training should focus on these
potentially
effective strategies.
NIAAA Glossary Terms:
cocaine, AOD use, AOD use frequency, coping skills, questionnaire,
treatment outcome, residential facility, social support, relapse
prevention, human study
|
Angelo M. Del Re and John J. Woodward. Inhibition
of gap junction currents by the abused solvent toluene.
Drug and
Alcohol Dependence 78(2):221-224,
May 2005.
Summary:
Because of their widespread commercial use and availability,
inhalants are often among the first drugs that children encounter. Use
of these compounds for their intoxicating and mood altering effects is
often associated with adverse acute and chronic consequences. The
cellular and molecular sites of action for
abused inhalants is not well known, although recent studies report that
toluene and other organic solvents alter the activity of specific
ligand- and voltage-gated ion channels that regulate cellular
excitability. As part of an ongoing effort to define molecular sites of
action for abused inhalants, this study examined the effect of toluene
on the function of gap junction proteins endogenously expressed in
human embryonic kidney (HEK 293) cells. Gap junctions allow
cell-to-cell electrical communication as well as passage of small
molecular weight substances and are critical for synchronizing cellular
activity in certain tissues. Gap junction currents in HEK 293 cells
were measured during brief voltage steps using patch-clamp
electrophysiology and were blocked by known gap junction blockers,
confirming expression of connexin proteins in these cells. Toluene
dose-dependently inhibited these conductances with threshold effects
appearing at approximately 0.4 mM and near complete inhibition
occurring at concentrations of 1 mM and higher. The estimated EC50
value for toluene inhibition of gap junction currents in HEK 293 cells
was 0.57 mM. The results suggest that volatile
solvents including toluene may produce some of their effects by
disrupting intercellular communication mediated by gap junction
proteins.
NIAAA Glossary Terms:
inhaled substance,
solvents, acute AODE,
chronic AODE,
voltage gated channel, receptor ligand binding, toluene, receptor proteins, electrical life processes,
neurotransmission, dose-response relationship, |
Miriam Z. Mintzer, Marc L. Copersino, and Maxine L. Stitzer. Opioid
abuse and cognitive performance. Drug and Alcohol Dependence 78(2):225-230, May 2005.
Summary:
A
few recent studies provide evidence for performance impairment in
dependent opioid abusers enrolled in methadone maintenance programs.
However, it is difficult to differentiate the effects of a history of
long-term opioid (or multiple drug) abuse from the effects of methadone
maintenance itself. This study addressed
the issue by comparing the performance of a newly recruited group of
20 currently abstinent former opioid abusers retrospectively to two
groups (18 methadone maintenance patients (MMP); 21 matched non-drug
abusing controls), who were the subjects of a previous report from the
authors' laboratory (Mintzer,
M.Z. and Stitzer, M.L. Cognitive impairment in methadone
maintenance patients. Drug and
Alcohol Dependence 67, 41–51, 2002), using the same
performance testing battery. The abstinent abusers were demographically
similar to the MMP and matched controls, and reported histories of drug
use similar to those of the MMP. Although conclusions are somewhat
limited by the small sample size, performance of the abstinent abusers
fell between that of the MMP and controls on a number of measures,
suggesting
that methadone maintenance may be associated with additional impairment
over and above that associated with long-term abuse, and that recovery
of functioning may occur during abstinence. The authors recommend
further research to explore the factors underlying performance
impairment in
MMP and to determine the clinical significance of the observed
impairments for daily performance in the natural environment.
NIAAA Glossary Terms:
opioids, opiates, AOD dependence, methadone, multiple drug use, drug
interaction, retrospective study, controlled study, patient AODU
history, AOD abstinence, human study
|
Drug
and Alcohol Dependence
Volume
78, Number 1, April 2005
(Updated 3/16/2005)
Home Page
Marta Torrens, Francina Fonseca, Gerard Mateu, and Magí
Farré. Efficacy of
antidepressants in substance use disorders with and without comorbid
depression: A systematic review and meta-analysis. Drug and Alcohol Dependence 78(1):1-22, April 2005.
Summary:
The literature of the
efficacy of antidepressant drugs in patients with drug abuse disorders,
including alcohol, cocaine, nicotine and opioid, with and without
comorbid depression was systematically reviewed. Only randomized,
double-blind,
controlled trials were evaluated. Studies that used common evaluation
procedures in alcohol,
cocaine, and opioid dependence were used in a meta-analysis.
Prescription of antidepressants for drug abuse seems clear only for
nicotine dependence with or without previous comorbid depression
(bupropion and nortryptiline). Without comorbid
depression, the use of any antidepressant in alcohol dependence seems
unjustified. The usefulness of antidepressants in
cocaine dependence is unclear. Further studies of the use of
antidepressants in
alcohol, cocaine, or opioid dependence with comorbid depression are
needed. To be conclusive, the studies should use well-defined samples,
adequate doses, and duration of
treatment. Interestingly, selective serotonin reuptake inhibitors
(SSRI) seem to have no significant advantages over tricyclic drugs in
substance
abuse disorders. Differences both related to individual characteristics
and specific antidepressant drugs need to be clarified in future
studies.
NIAAA glossary terms:
antidepressants, AOD dependence, ethanol, cocaine, nicotine, opioids,
emotional and psychiatric depression, comorbidity, drug therapy,
evaluation, meta-analysis, literature review,
clinical trial,
randomized controlled trial, double-blind study,
research quality, recommendations or guidelines
|
Li-Tzy Wu, Daniel J. Pilowsky, and William E. Schlenger. High
prevalence of substance use disorders among adolescents who use
marijuana and inhalants. Drug and Alcohol Dependence 78(1):23-32, April 2005.
Summary:
The association between the use of inhalants, marijuana,
and other drugs and recent DSM-IV substance use disorders was examined
in
adolescents, using data from the 2000 and 2001 National Household
Survey on Drug
Abuse. Adolescents aged 12–17 years who reported having ever used an
illicit drug were categorized into four mutually
exclusive groups: inhalant users (16%), marijuana users (53%), inhalant
and marijuana users (16%), and other drug users (15%). Logistic
regression models were used to estimate associations with recent
substance use diagnoses among lifetime adolescent drug users (N =
10,180). Thirty-one percent of lifetime drug users reported having
never used
marijuana; half of these atypical drug users were predominantly
nonmedical users of pain relievers. Adolescents who used inhalants or
other drugs but not marijuana were least likely to report multiple drug
use. Adolescents who reported using both inhalants and marijuana were
most likely to use three or more classes of drugs (73%) and to receive
a diagnosis of past year alcohol (35%) and drug (39%) abuse or
dependence. These
findings suggest that among lifetime adolescent drug users,
those who use both inhalants and marijuana are at very high risk for
alcohol and drug use disorders.
NIAAA glossary terms:
multiple drug use, adolescent, underage AOD use, AOD abuse, underage
drinking, illicit drug, prevalence, survey, marijuana in any form,
inhaled substance, analgesics,
multiple drug use, regression analysis, risk-taking behavior, human
study |
Hendree E. Jones, Rolley E. Johnson, Donald R. Jasinski, and Lorraine
Milio. Randomized
controlled study transitioning opioid-dependent pregnant women from
short-acting morphine to buprenorphine or methadone.
Drug and Alcohol
Dependence 78(1):33-38,
April 2005.
Summary:
The safety and withdrawal discomfort associated with
transitioning pregnant opioid-dependent women from short-acting
morphine onto buprenorphine or methadone was evaluated in a
double-blind study. The participants (n
= 18) were patients in a
comprehensive treatment setting and were part of a larger randomized
controlled trial comparing the neonatal abstinence syndrome in mothers
treated with individualized doses of sublingual buprenorphine or oral
methadone. All patients were given methadone within 24 hours of
admission to treatment. Three to 5 days later, with written informed
consent, methadone was discontinued and immediate release morphine
(IRM) was given four times a day for an initial total daily IRM dose
that was six times the last daily methadone dose. Induction onto
double-blind, double-dummy
(i.e., two medications were administered with only one being active)
methadone or buprenorphine was accomplished over 3 days. Withdrawal
scores during the IRM and induction onto
randomized medication were judged mild and not statistically different
for both methadone (mean dose 53.5 mg) and buprenorphine (mean dose
10.9 mg). There were no significant differences between medication
groups when individual withdrawal items were examined. No observed
differences in safety measures including fetal movement, maternal
physiological parameters of body temperature, heart rate and blood
pressure were observed between groups. It was concluded that
opioid-dependent
pregnant women in the second trimester can be transitioned from IRM to
methadone or buprenorphine with similar comfort and safety.
NIAAA glossary terms:
pregnancy, second trimester, AOD dependence, AOD withdrawal syndrome,
opioids, drug therapy, morphine,
buprenorphine, methadone, fetal
monitoring, randomized
controlled trial, double-blind study, clinical trial, human study
|
Sherry Lipsky, Raul Caetano, Craig A. Field, and Gregory L.
Larkin. Psychosocial
and substance-use risk factors for intimate partner violence. Drug and Alcohol Dependence 78(1):39-47, April 2005.
Summary:
Family history and substance-use factors associated
with intimate partner violence (IPV) were assessed in a case-control
study of women presenting to an urban emergency department. The cases (n = 182) were women identified as
having IPV concerns and an IPV history. The controls (n = 147) were women without IPV who
were frequency-matched by age group and race or ethnicity. Adjusted
odds ratios (AOR) for any IPV,
physical IPV, and sexual IPV were determined by logistic regression.
Living with a partner
(not married) and witnessing parental violence were independent risk
factors for any IPV (AOR = 2.55 and AOR = 2.21 respectively). Partner's
alcohol use (AOR = 1.22 for every five drinks consumed per week) and
heavier drinking (AOR = 5.07) were also significant risk factors, but
not
subject's own substance use. The pattern of risk factors varied only
slightly for physical IPV and sexual IPV. Thse findings suggest a
substantial relationship between partner alcohol
use and IPV among women, beyond the woman's own substance use, and
confirms
previous reports regarding the cycle of violence in women's lives.
NIAAA glossary terms:
violence,
sexual abuse, spouse or significant other,
cohabitation of unmarried partners, spouse abuse,
marital conflict, heavy AOD use, alcoholic
beverage, risk analysis, regression analysis, risk factors,
relative risk, case-control study, human study, epidemiology
|
Wim J.M.J. Gorgels, Richard C. Oude Voshaar, Audrey J.J. Mol, Eloy H.
van de Lisdonk, Anton J.L.M. van Balkom, Henk J.M. van den Hoogen, Jan
Mulder, Marinus H.M. Breteler, and Frans G. Zitman. Discontinuation
of long-term benzodiazepine use by sending a letter to users in family
practice: A prospective controlled intervention study.
Drug and
Alcohol Dependence 78(1):49-56,
April 2005.
Summary:
This study assessed the effects of a letter advising long-term
benzodiazepine users in family practice on discontinuing the drug and
offering an evaluation consultation. The subjects were 2,425 long-term
benzodiazepine users divided into two groups, one group that was sent
the letter (n = 1,707) and a
control group that was not (n =
1,821). Primary
endpoints were the number of prescribed daily dosages (PDD) and the
percentage of subjects without prescription (quitters). At 21 months a
26% reduction in benzodiazepine prescription was observed in the
experimental group, versus 9% in the control group (PDD difference =
12.5; 95% confidence interval [CI], 8.2–16.8). Of the study completers,
13% in the experimental group and 9% in the control group were
benzodiazepine
prescription-free through the full follow-up period (risk ratio [RR] =
2.6; 95% CI,
2.0–3.4). The percentage of quitters at short-term (6 months) was 24%
in the experimental group versus 12% in the control group (RR = 2.1;
95% CI, 1.8–2.4). It was concluded that this intervention strategy
steadily reduces long-term benzodiazepine use in family practice.
NIAAA glossary terms:
benzodiazepines, drug therapy, prescription drug, drug prescription
practices, AOD use duration, patient care management, case management,
treatment outcome, controlled study, human study |
Sandrine Pirard, Estee Sharon, Shimi K. Kang, Gustavo A. Angarita, and
David R. Gastfriend.
Prevalence of physical and sexual abuse among substance abuse patients
and impact on treatment outcomes. Drug and Alcohol Dependence 78(1):57-64, April 2005.
Summary:
More
than half of substance abusers entering addiction treatment report a
history of physical or sexual abuse. To clarify whether such a history
impacts treatment outcomes, the relationship between lifetime
physical and/or sexual abuse and addiction treatment outcome was
examined in a one-year follow-up study of substance abusers (N = 700). Baseline characteristics,
no-show for treatment status, post-treatment
clinical outcomes, and treatment history were studied in subjects with
(47.3%) and without lifetime history of abuse. Abused subjects,
predominantly women, were significantly more impaired at baseline on
clinical dimensions including family/social severity and psychiatric
severity as measured by the Addiction Severity Index (ASI), and general
level of functioning. Different drugs were reported as primary by the
two groups, with the abused group less frequently endorsing heroin and
cocaine in favor of alcohol and multiple drug use. Abused subjects
reported
more prior medical and psychiatric treatments. Abuse history did not
predict no-show for treatment. Over the one-year follow-up, lifetime
physical and/or sexual abuse was significantly associated with worse
psychiatric status and more psychiatric hospitalizations and outpatient
treatment despite receiving similar intensive addiction treatment.
NIAAA glossary terms:
victim of abuse, violence, sexual abuse, treatment
factors, treatment outcome, addiction,
study subject history, patient
history, patient AODU
history, case history,
medical history,
psychiatric care, patient
compliance, psychiatric status rating scales, disease severity, heroin,
cocaine, ethanol, multiple drug use, gender differences, follow-up
study, hospital, outpatient care, comparative study, human study
|
Jumi Hayaki, Michael D. Stein, Joanna A. Lassor, Debra S. Herman, and
Bradley J. Anderson. Adversity
among drug users: Relationship to impulsivity. Drug and Alcohol Dependence 78(1):65-71, April 2005.
Summary:
This study examined whether there is a link between the negative life
experiences of illicit drug users and impulsivity and, if so, whether
the association remains after accounting for potential confounders.
Participants were heroin and cocaine users (N = 330) recruited from the
community. they completed a
structured interview that assessed topics including drug and alcohol
use, impulsivity, and negative life events. High rates of adverse life
events in the previous 6 months were reported by this group. No
specific substance abuse/dependence diagnosis or
combination of diagnoses was associated with negative life experiences.
The number of
substance-related diagnoses was associated with adverse life events,
but not after adjustment for impulsivity. Experience of these events
was
significantly associated with impulsivity (p < 0.001), above and
beyond the shared relation with demographic variables, substance abuse
and dependence, and number of substance-related diagnoses. These
findings document the high frequencies of recent adverse life events
among illicit drug users and indicate that trait impulsivity is
associated with increased risk of these life events.
NIAAA glossary terms:
illicit drug, AOD abuser,
AOD abuse, AOD dependence, heroin, cocaine, impulsive behavior, life
circumstances, life events,
prevalence, diagnosis, interview, human study |
Jane Carlisle Maxwell, Thomas W. Pullum, and Karen Tannert. Deaths of
clients in methadone treatment in Texas: 1994–2002. Drug and Alcohol Dependence 78(1):73-81, April 2005.
Summary:
Causes of death were analyzed in patients (N = 766) who died while in
methadone treatment in Texas between 1994 and 2002. Compared with
deaths in the general Texas population, deaths of patients in
methadone treatment were 4.6 times more likely to be from a drug
overdose, 3.4 times more likely to be from liver disease, 1.7 times
more likely to be from a respiratory disease, 1.5 times more likely to
be from a homicide, and 1.4 times more likely to be from AIDS, but less
likely to be from suicide, motor vehicle accidents, cardiovascular
diseases, or cancer. Twenty percent of the clients died of liver
disease, 18% of
cardiovascular disease, and 14% of drug overdose. An older cohort had
been in treatment longer, had more take-homes, were on higher doses,
and
tended to die of chronic diseases. A younger cohort tended to die from
traumas, including drug overdose. Time in treatment was 43.3 months;
mean daily dose of methadone was 77.3 mg; number of days/month dosed in
the clinic
was 13.9. The authors recommend that the scope of services for patients
on methadone include
on-site treatment for other medical conditions and that staff be
educated about and counsel new patients about the risk of death.
NIAAA glossary terms:
methadone, drug therapy, AOD
overdose mortality, liver disorder, respiratory disorder, homicide,
acquired immunodeficiency syndrome, suicide, accident mortality,
traffic accident, cardiovascular disorder, cancer, age differences,
trauma, counseling, risk factors, human study |
David S. Leland and Martin P. Paulus. Increased
risk-taking decision-making but not altered response to punishment in
stimulant-using young adults. Drug and Alcohol Dependence 78(1):83-90, April 2005.
Summary:
Stimulant-using
and stimulant-naive young adults were administered the “risky gains”
decision-making task, in which increased activation in the right
insula during risk-taking decision-making is related to harm avoidance
and neuroticism (Paulus, M.P. et al. Neuroimage 19(4):1439-1448, 2003).
On each trial, the
numbers 20, 40, and 80 are presented individually in ascending order.
Subjects press a button to receive the points corresponding to the
displayed number. The
20 is the safe response, because it is always associated with a gain of
20 points. There
is a chance that waiting to select a 40 or 80 will result in a loss
of 40 or 80 points respectively (risky response). All subjects made
fewer risky responses immediately following punished trials (p <
0.001). Stimulant-users made more risky responses than never-users
overall (p < 0.02) but
showed the same inhibition effect of
punishment on next-trial risky responding. Risk-taking in the task
correlated with measures of sensation-seeking and impulsivity, but not
other personality measures, anxiety, or tendency toward alcohol use
disorders. These results are consistent with the hypothesis that
stimulant-users show increased risk-taking but are not less sensitive
to punishments than controls. By requiring selection from a sequence of
individual options presented according to a fixed schedule, rather than
allowing deliberation between simultaneously available options, the
risky gains task may model a different sort of risk-taking than other
tasks.
NIAAA glossary terms:
risk-taking behavior, impulsive behavior, sensation-seeking behavior,
decision-making skills,
choice-making behavior, AOD user,
AOD nonuse, CNS stimulant, correlation analysis,
controlled study, comparative study, psychological performance test,
anxiety, alcohol use disorder classification,
human study |
Lawrence P. Carter, Weibin Chen, Huifang Wu, Ashok K. Mehta, R. Jason
Hernandez, Maharaj K. Ticku, Andrew Coop, Wouter Koek, and Charles P.
France. Comparison
of the behavioral effects of gamma-hydroxybutyric acid (GHB) and its
4-methyl-substituted analog, gamma-hydroxyvaleric acid (GHV).
Drug and
Alcohol Dependence 78(1):91-99,
April 2005.
Summary:
Gamma-hydroxybutyrate
(GHB), a metabolite of gamma-aminobutyric acid (GABA), is a therapeutic
drug and also a drug of abuse. The
illicit use of GHB precursors and analogs is reported to have increased
worldwide. Gamma-hydroxyvaleric (GHV) is a 4-methyl-substituted analog
of GHB that reportedly is abused and is marketed as a dietary
supplement and replacement for GHB. This study compared the
pharmacological and behavioral profiles of GHV and GHB. In
radioligand binding studies, GHV completely displaced tritium-labeled
NCS-382
with approximately twofold lower affinity than GHB and did not markedly
displace tritium-labeled GABA from GABAB receptors at a
20-fold larger
concentration. In drug discrimination procedures, GHV did not share
discriminative stimulus effects with GHB or baclofen. GHV shared other
behavioral effects with GHB, such as sedation, catalepsy, and ataxia,
although larger doses of GHV were needed to produce these effects.
Lethality (50%) was observed after the largest dose of GHV (5.6 g/kg),
a dose that produced less-than-maximal catalepsy and ataxia. To
the extent that large doses of GHV might be taken in an attempt to
produce GHB-like effects (e.g., hypnosis) GHV toxicity may pose a
greater public health concern than GHB.
NIAAA glossary terms:
gamma-hydroxybutyric acid, neurotransmitter metabolism, GABA, AOD
abuse, pharmacology and toxicology, AOD use behavior, ligand-binding
domain, ligand, tritium,
radioactive chemical elements, baclofen,
sedative-hypnotics, ataxia,
drug
toxicity
potential, public health |
Cédric Galéra, Eric Fombonne, Jean-François
Chastang, and Manuel Bouvard. Childhood
hyperactivity-inattention symptoms and smoking in adolescence.
Drug and
Alcohol Dependence 78(1):101-108,
April 2005.
Summary:
The link
between childhood hyperactivity-inattention symptoms and smoking
in adolescence was examined with control for psychopathology,
temperament, and
environmental risk factors. The subjects (421 males and
495 females; aged 7 to 18 years) were recruited in the
GAZEL cohort representative of the general population and surveyed in
1991 and 1999. Child psychopathology and smoking patterns were assessed
from parent and adolescent self-report measures. The effects of
childhood hyperactivity-inattention
symptoms and other predictors on adolescent smoking were assessed by
logistic regression. Hyperactivity-inattention symptoms
in females contributed
independently to subsequent daily smoking (odds ratio [OR] = 1.98, p = 0.04). In
males, hyperactivity-inattention symptoms alone did not increase the
risk for smoking. Conduct disorder symptoms were an important predictor
in males (OR = 2.95, p <
0.01) and females (OR = 1.75, p
= 0.09).
The risk of adolescent smoking was significantly increased in boys with
high activity level (OR = 1.70, p
= 0.03) and decreased in shy girls
(OR = 0.60, p = 0.02).
Parental smoking increased the liability to
smoking in their offspring (males: OR = 1.96, p < 0.01; females: OR
= 1.63, p = 0.02). These
findings suggest a role for smoking prevention in
girls with hyperactivity-inattention symptoms and in boys with high
activity level.
NIAAA glossary terms:
hyperactive behavior, childhood, predictive factor, adolescence,
smoking, underage AOD use, AOD use frequency, AOD use pattern,
environmental factors, self report, regression analysis, risk factors,
risk analysis, relative risk, gender differences,
conduct disorder, comparative study, human study |
Drug
and Alcohol Dependence
Volume
77, Number 3, March 2005
(Updated 3/1/2005)
Home Page
Xiaowei
Yang and Steven Shoptaw.
Assessing missing data assumptions in longitudinal studies: an example
using a smoking cessation trial. Drug and Alcohol Dependence 77(3): 213-225, March 2005.
Summary:
Longitudinal data
analysis in substance abuse research is plagued by missing values
because of the chaotic nature of substance use disorders. Different
longitudinal modeling strategies require various assumptions on the
patterns and mechanisms of missing data to obtain an unbiased
estimation of intervention effects. The authors of this article define
missingness as occasional omission and dropout to demonstrate
statistical ways to assess
assumptions about missing data using evidence from a clinical trial.
Within a multiple imputation framework, intermittent missing data are
imputed first so dropouts can be isolated and treated
specifically. A computational tool called pattern reduction
resampling is proposed to simplify missing data methods when the
number of intra-subject repeated measures is large. To test whether
missingness patterns are nondifferential across treatment conditions, a
formal testing approach treats indicators of missingness as a special
type of repeated measures (e.g., 0 = intermittent missing, 1 =
observed,
and 2 = dropout missing). After reviewing the idea of ignorability for
missing data and of classifying missingness mechanisms into
subcategories, the authors provide an example for assessing common
assumptions on missingness mechanisms and how these assumptions affect
model selection for significance testing. A carbon monoxide
longitudinal data set in a smoking cessation study is used for
illustration.
NIAAA Glossary Terms: AOD
abuse, longitudinal study, statistical modeling, statistical
estimation,
statistical data,
data analysis method, treatment model, treatment outcome, patient
compliance, program dropout, clinical trial, quantitative data
analysis, carbon monoxide, theoretical study
|
Scott S. Santibanez, Richard S. Garfein, Andrea Swartzendruber,
Peter
R. Kerndt, Edward Morse, Danielle Ompad, Steffanie Strathdee, Ian T.
Williams, Samuel R. Friedman, and Lawrence J. Ouellet.
Prevalence and correlates of crack-cocaine injection among young
injection drug users in the United States, 1997–1999. Drug and Alcohol Dependence 77(3): 227-233,
March 2005.
|
Summary:
Prevalence of crack-cocaine injection was estimated among young
injection drug users in the United States, and its correlates were
identified by analyzing data from the
second Collaborative Injection Drug Users Study (CIDUS II), a 1997–1999
cohort study of 18–30-year-old, street-recruited injection drug users
(N = 2,198) from six US
cities. Crack-cocaine injection was
reported by 329 (15%) of the participants. Prevalence varied
considerably by site, ranging from 1.5% to 28.0%. No participants
reported injecting only
crack-cocaine. At four sites where crack-cocaine injection prevalence
was greater than 10%, crack-cocaine injection
in the past 6 months was correlated with recent daily injection and
sharing of syringes,
equipment, and drug solution. Lifetime crack-cocaine injection was
correlated with using shooting galleries, initiating others into drug
injection, and having serologic evidence of hepatitis B virus and
hepatitis C virus infection. The findings suggest that crack-cocaine
injection may be a marker for high-risk behaviors that can be used to
direct efforts to prevent HIV and other blood-borne viral infections.
NIAAA Glossary Terms:
crack cocaine, intravenous drug user, young adult, prevalence,
correlation analysis, needle sharing, hepatitis B virus, hepatitis C
virus, infection, viral disease, liver disorder, risk-taking behavior,
behavioral marker, HIV infection, prevention, human study |
Duncan B. Clark, D.Scott Wood, Christopher S. Martin, Jack R.
Cornelius, Kevin G. Lynch, and Saul Shiffman. Multidimensional
assessment of nicotine dependence in adolescents.
Drug and Alcohol
Dependence 77(3): 235-242,
March 2005.
Summary:
Relatively little research has been done on the assessment
of nicotine dependence during adolescence. In this study, adolescents
(N = 301; 140 females and 161
males; ages 12 through 18 years) reporting daily smoking were recruited
from clinical sources (n =
251) or community sources (n =
50) for a
project on alcohol use disorders (AUDs), which were identified in 176
subjects at baseline assessment.
The subjects were evaluated with the Nicotine Dependence Syndrome Scale
(NDSS), the Fagerstrom Test for Nicotine Dependence (FTND), and
determination of average number of cigarettes per day.
A varimax factor analysis of 27 NDSS items revealed four factors: (1)
Drive/Tolerance (13 items; Cronbach α = 0.91); (2) Continuity
(five items; Cronbach α = 0.67); (3) Priority (three items;
Cronbach α = 0.64); (4) Stereotypy (five items; Cronbach α
= 0.66). The NDSS total score, refined by removing four items,
was also examined (23 items; Cronbach α
= 0.90). Initial smoking rate
was the best predictor of cigarettes/day at follow-up. Significant and
similar predictive validity was shown by the FTND and NDSS Total score.
The NDSS Total showed
incremental validity in predicting smoking progression in a
model including demographic characteristics, initial smoking rate, and
FTND. The results suggest that the NDSS has acceptable psychometric
properties when applied to adolescents, complementing smoking rate and
FTND in a multidimensional smoking assessment.
NIAAA Glossary Terms: AOD
dependence, AOD intake per occasion, nicotine, smoking, cigarette, adolescence, diagnosis, AOD
tolerance,
factor analysis, predictive factor, validation study,
predictive validity, demographic
characteristics, human study |
Katherine L. Mills, Michael Lynskey, Maree Teesson, Joanne Ross, and
Shane Darke. Post-traumatic
stress disorder among people with heroin dependence in the Australian
treatment outcome study (ATOS): Prevalence and correlates. Drug and Alcohol Dependence 77(3): 243-249,
March 2005.
Summary:
The prevalence and correlates of post-traumatic stress disorder (PTSD)
were determined among Australians with heroin dependence. Data were
obtained from a cohort of heroin-dependent individuals (N = 615), 535
of whom were entering treatment for heroin dependence and 80 of whom
were not in treatment. The prevalences of trauma exposure and lifetime
PTSD were high (92% and 41% respectively). PTSD was prevalent across
all treatment modalities, most commonly residential rehabilitation
(52%), followed by maintenance therapies (42%) and detoxification
(37%). Prevalence was lowest among those not in treatment (30%).
Although men and women were equally likely to have experienced trauma
(93% and 89% respectively), women were more likely to develop lifetime
PTSD (61% versus 37%). PTSD was chronic in the large majority (84%) of
those who had the disorder, with symptoms continuing for an average of
9.5 years. Those with PTSD had more extensive histories of multiple
drug use, poorer general physical and mental health, and more extensive
use of health services. It was concluded that PTSD is highly prevalent
among heroin-dependent individuals, presenting a significant challenge
to treatment providers.
NIAAA Glossary Terms:
posttraumatic stress disorder, prevalence, correlation analysis, AOD
dependence, heroin, trauma, gender differences, multiple drug use,
physical health, mental health, health care utilization, treatment
factors, treatment complications, comorbidity, human study
|
Martina Reynolds, Gillian Mezey, Murray Chapman, Mike Wheeler, Colin
Drummond, and Alex Baldacchino. Co-morbid
post-traumatic stress disorder in a substance misusing clinical
population. Drug
and Alcohol Dependence 77(3): 251-258,
March 2005.
Summary:
Studies in the United States have reported high rates of comorbid
posttraumatic stress disorder (PTSD) and drug and alcohol
dependence/abuse. Use of drugs and alcohol may help individuals with
substance dependence/abuse avoid trauma reminders and associated
distress. Alternatively, a substance abusing lifestyle might predispose
to experiencing traumatic events. No British studies have examined the
extent of traumatic life events and posttraumatic stress disorder among
substance abusers, although high rates of reported sexual and physical
abuse have been reported in two recent UK studies with drug- and
alcohol-dependent patients in clinical settings. The aims of this
cross-sectional study were to investigate the prevalence of comorbid
PTSD in a UK substance use disorder (SUD) inpatient clinical
population; to identify the characteristics, severity, and types of
trauma experienced; and to compare SUD patients with and without
co-morbid PTSD on substance use and history, psychological/psychiatric,
and social variables. The study involved interviews with patients about
traumatic experiences, PTSD, and addiction, and review of case notes.
Experience of one or more PTSD criterion A traumatic experiences was
reported by 94%; 38.5% met criteria for current PTSD and 51.9% for
lifetime PTSD. Significant differences were found between the PTSD and
non-PTSD groups in PTSD and trauma-related variables, notably social
variables and distress associated with traumatic experiences, but few
differences were found in addiction severity (medical and psychiatric
composite scores of the Addiction Severity Index) and psychiatric
symptoms. In addition to the importance of assessing trauma and PTSD
among substance abusers, this study highlights the need to assess
substance abuse among victims of PTSD. Because comorbid psychopathology
is common, trauma histories and PTSD symptoms may become embedded in
other comorbid psychopathology.
NIAAA Glossary Terms:
posttraumatic stress disorder, AOD dependence, AOD abuse, comorbidity,
cross-sectional study, inpatient care, study subject history,
comparative study, trauma, addiction, human study
|
Jean-François Etter. A
comparison of the content-, construct- and predictive validity of the
cigarette dependence scale and the Fagerström test for nicotine
dependence. Drug
and Alcohol Dependence 77(3): 259-268,
March 2005.
Summary:
It has been shown that the widely used Fagerström test for
nicotine dependence (FTND) does not cover important aspects of
dependence. This study compared the psychometrics of a
new test, the
Cigarette Dependence Scale (CDS-12) and the FTND, as well as the CDS-5
and the Heaviness of Smoking Index
(HSI),
which are short versions of CDS-12 and FTND respectively. The
CDS-12) covers
the main elements in definitions of dependence found in the Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV) and the International Classification of Diseases,
Version 10 (ICD-10). Data from an
Internet survey in 2002-2003 were analyzed. One month after answering
the survey the participants were invited
to answer a second survey on
smoking status and withdrawal symptoms. Both surveys were accepted by
802 smokers. Cronbach's α
coefficients were higher for the CDS-12 (0.91) and CDS-5 (0.77) than
for the FTND (0.68) and HSI (0.63). Among 231 smokers who quit smoking
at follow-up, higher baseline CDS-12 scores predicted higher ratings at
follow-up for all withdrawal symptoms except appetite. The FTND and HSI
predicted higher craving in quitters, but did not predict the intensity
of other withdrawal symptoms. Neither the CDS-5 nor the FTND or HSI
predicted smoking cessation, but higher CDS-12 scores marginally
predicted smoking cessation at follow-up (area under the receiver
operating characteristic [ROC] curve = 0.55; 95% confidence interval,
0.51–0.59). The content validity and internal
consistency of the CDS-12 were better than FTND and it was a slightly
better predictor of withdrawal
symptoms. Unexpectedly, higher (not lower) CDS-12 scores predicted
subsequent smoking cessation, perhaps because endorsement of some
CDS-12 items implies accepting that one is dependent, which in turn
could reflect motivation to quit; the CDS-12 may represent an
alternative to FTND for measuring cigarette dependence.
NIAAA Glossary Terms:
AOD dependence, nicotine, smoking, cigarette, screening and
diagnostic method for AODD,
diagnostic problem, AOD craving, predictive factor, AOD withdrawal
syndrome, AOD abstinence, survey, validation study, follow-up study,
comparative study, human study
|
Steven Belenkoa and Jordon Peugh. Estimating
drug treatment needs among state prison inmates.
Drug and Alcohol
Dependence 77(3): 269-281,
March 2005.
Summary:
Although growing prison populations in the U.S. are largely due to
drug-related crime and drug abuse, relatively few inmates receive
treatment, and existing interventions tend to be short-term or
non-clinical. Better methods are needed to match drug-involved inmates
to level of care. This study used data from the 1997 Survey of Inmates
in State Correctional Facilities, a nationally representative sample of
14,285 inmates from 275 state prisons, to develop a framework for
estimating inmates' levels of treatment need. The framework is drawn
partly from the American Society of Addiction Medicine Patient
Placement Criteria and other client matching protocols, incorporating
drug use severity, drug-related behavioral consequences, and other
social and health problems. The results indicate high levels of drug
involvement, but considerable variation in severity and recency of use
as well as in health and social consequences. It was estimated that
one-third of male and half of female inmates need residential
treatment, but that half of male and one-third of female inmates may
need no treatment or only short-term interventions. Treatment capacity
in state prisons is inadequate relative to need, and improvements in
assessment, treatment matching, and inmate incentives are needed to
conserve scarce treatment resources and facilitate inmate access to
different levels of care.
NIAAA Glossary Terms:
jail inmate, AOD abuse, crime committed in AODR state, treatment issue,
imprisonment,
prison-based health service, gender differences, patient-treatment
matching, patient assessment, health care availability and access,
survey, human study |
K.J. Neufeld, D.H. Peters, M. Rani, S. Bonu, and R.K. Brooner. Regular use
of alcohol and tobacco in India and its association with age, gender,
and poverty. Drug
and Alcohol Dependence 77(3): 283-291,
March 2005.
Summary:
National estimates of regular tobacco and alcohol use in India and
their associations with gender, age, and economic group were determined
using data from the 1995-1996 National Sample Survey, a representative
survey of 471,143 people over the age of 10 years. The national
prevalence of regular use of smoking tobacco was estimated to be 16.2%,
chewing tobacco 14.0%, and alcohol 4.5%. Men were 25.5 times more
likely than women to report smoking regularly, 3.7 times more likely to
chew tobacco regularly, and 9.7 times more likely to use alcohol
regularly. Respondents belonging to scheduled castes and tribes
(recognized disadvantaged groups) were significantly more likely to
report regular alcohol use as well as regularly smoking and chewing
tobacco. People from rural areas had higher rates compared to urban
dwellers, as did those with no formal education. Individuals with
incomes below the poverty line were more likely to use chewing tobacco
and consume alcohol than those above the poverty line. The regular use
of both tobacco and alcohol also increased significantly with each
diminishing income quintile. Comparisons are made between these results
and those found in the United States and elsewhere.
NIAAA Glossary Terms:
tobacco in any form, alcoholic beverage, AOD use, AOD use pattern,
India, prevalence, gender differences, age differences, socioeconomic
status, survey, smoking, smokeless tobacco, economically disadvantaged,
urban area, rural area, educational level achieved, poverty, income,
|
Roberto I. Melendez, Zachary A. Rodd, William J. McBride, and James M.
Murphy. Dopamine
receptor regulation of ethanol intake and extracellular dopamine levels
in the ventral pallidum of alcohol preferring (P) rats.
Drug and
Alcohol Dependence 77(3): 293-301,
March 2005.
Summary:
Sufficient evidence exists for including the ventral pallidum (VP) in
the category of a dopaminoceptive brain region. This study investigated
the effects of inhibiting dopamine D1- or D2-like receptors in the VP
on ethanol intake and extracellular levels of dopamine in
alcohol-preferring (P) rats. SCH-23390 (a D1-like antagonist) and
sulpiride (a D2-like antagonist) were bilaterally injected into
the VP (0.25–2 μg/0.5 μl), and ethanol
(15%, v/v) intake was assessed in a 1-hour limited access paradigm.
Microinjections of sulpiride significantly increased ethanol
consumption (65% increase at the 2.0 μg dose). The D1 antagonist
SCH-23390 tended to decrease ethanol intake, but the effect was not
statistically significant. Reverse microdialysis studies of sulpiride
and SCH-23390 (10–200 μM) were conducted in the VP of a separate group
P rats. Local perfusion of only the 200 μM sulpiride dose significantly
increased extracellular dopamine levels (up to 250% of baseline). On
the other hand, local perfusion of SCH-23390 (10–200 μM)
dose-dependently increased the extracellular dopamine levels (180%–640%
of baseline). The results of this study suggest that (1) tonic
activation of D2 postsynaptic receptors in VP imposes a limit on
ethanol intake in the P rat; (2) there are few D2 autoreceptors
functioning in the VP; and (3) there is tonic D1-like receptor mediated
inhibitory feedback regulation of VP-dopamine release.
NIAAA Glossary Terms:
brain, dopamine, dopaminergic neuron, dopaminergic receptors, ethanol,
animal selectively bred for AOD preference, antagonists, AOD
consumption, microdialysis, dose-response relationship, laboratory rat,
animal study
|
Laura A. Novelli, Susan G. Sherman, Jennifer R. Havens, Steffanie A.
Strathdee, and Marcella Sapun. Circumstances
surrounding the first injection experience and their association with
future syringe sharing behaviors in young urban injection drug users.
Drug and Alcohol
Dependence 77(3): 303-309,
March 2005.
Summary:
Young injection drug users are at risk of blood-borne infections
because of their high rates of unsafe injection behaviors. Yet there
has been little research on the circumstances of injection drug users’
first injection experience ("hit"). This study examined the
relationship between factors associated with young drug users’ first
hit and their subsequent syringe-sharing behaviors. The participants
were 420 initiates to injection drug use (< 5 years) in Baltimore,
Maryland. They were primarily male (58.8%) and white
(71.2%), and their median age was 24 years (interquartile range, 21–27
years). The association between circumstances
surrounding the first hit and recent receptive syringe sharing was
determined by contingency table analysis and logistic regression. With
adjustment for race, gender, and homelessness, the following variables
were independently associated with recent receptive syringe sharing: age at first hit (adjusted
odds ratio [AOR] = 0.92 per year increase; 95% confidence interval
[CI], 0.87–0.98), self-injection
at initiation (AOR = 0.55; 95% CI, 0.32–0.97), and using a syringe that had
previously been used by someone else at first hit (AOR = 2.81;
95% CI, 1.70–4.64). These data suggest that injection-related risk
behaviors may be established as early as injection initiation.
NIAAA Glossary Terms:
intravenous drug user, infection, needle sharing, risk-taking behavior,
health related behavior, regression analysis, age of AODU onset, young
adult, risk analysis, risk factors, relative risk, human study
|
Saul Shiffman. Nicotine
lozenge efficacy in light smokers. Drug and Alcohol Dependence 77(3): 311-314,
March 2005.
Summary:
While nicotine replacement therapy (NRT) has proved effective in
heterogeneous groups of smokers, its efficacy among light smokers (≤15
cigarettes a day) has not been specifically examined. This study
assessed the efficacy of a nicotine lozenge for light smokers in a
secondary analysis of a randomized, placebo-controlled clinical trial
contrasting active 2 mg nicotine lozenge with placebo, and contrasting
light smokers (≤15 cigarettes a day) with moderate–heavy smokers
(>15 cigarettes a day). The participants were 917 light smokers who
smoked their first cigarette >30 minutes after waking, and were
randomized to active (n = 459)
or placebo (n = 458) lozenge.
Biochemically verified continuous abstinence was measured at 6 weeks
and 1 year. Nicotine lozenge significantly increased quit rates
relative to placebo at 6 weeks (45.7% versus 31.1%; odds ratio [OR] =
1.9; confidence interval [CI], 1.3–2.8) and at 1 year (19.2% versus
10.0%; OR = 2.3; CI, 1.3–4.0) among light smokers. There was no
significant difference in lozenge efficacy among light smokers and
heavier smokers (p values
>0.50).
NIAAA Glossary Terms:
nicotine, smoking, light AOD use, moderate AOD use, heavy AOD use,
treatment method, drug therapy, clinical trial, randomized controlled
trial, controlled study, AOD abstinence, treatment outcome, human study
|
Home Page
Drug
and Alcohol Dependence
Volume
77, Number 2, February 2005
(Updated 1/23/2005)
Home Page
Shane
Darke, Sharlene Kaye, and Johan Duflou. Cocaine-related
fatalities in New South Wales, Australia 1993–2002. Drug and Alcohol Dependence 77(2):107-114, February 2005.
Summary:
The demographic characteristics, circumstances of death,
toxicological results, and major autopsy findings of cocaine-related
fatalities were ascertained in a study of recorded cocaine-related
deaths (N = 146) that occurred
in New South
Wales, Australia between January 1, 1993 and December 31, 2002. Cocaine
was implicated as the
direct cause of death in 86% of cases, an antecedent cause in 8%, and a
significant condition contributing to death in 7%. The mean age of
decedents was 34.1 years, and 84% were male. Half were employed, and
26%
were in professional employment. The most common route of
administration was injection (86%), although nasal (8%), oral (3%),
smoking (1%), and anal (1%) administration were all recorded. A private
home was the most common location of death (53%). There was no
intervention
prior to death in 82% of cases. The median blood
benzoylecgonine concentration was 0.40 mg/L (range 0.00–20.00 mg/L).
Cases had a mean of 3.5 drugs, with morphine (79%) the most common
co-occurring drug. Cocaine was the only drug detected in 5% of cases.
Cardiac pathology was noted in 57% of cases, most commonly coronary
artery atherosclerosis (39%) and cardiac hypertrophy (14%). Moderate to
severe arterial occlusion was noted in 15% of cases. Cerebrovascular
pathology was noted in 22% of cases, usually cerebrovascular
atherosclerosis (10%). It was concluded that cocaine-related deaths are
a significant clinical problem
in New South Wales.
NIAAA glossary terms:
cocaine, AODR mortality, Australia, demographic characteristics, causal
pathways, age, gender differences, employment status, professional,
route of administration, intravenous injection, nasal administration,
oral administration, smoking, rectum, drug metabolism, multiple drug
use, morphine, heart disorder, coronary artery disorder,
atherosclerosis, pathology report, human study
|
W. Rees Davis, Bruce D. Johnson, Doris Randolph, and Hilary James
Liberty. Gender
differences in the distribution of cocaine and heroin in Central Harlem.
Drug and Alcohol
Dependence 77(2):115-127,
February 2005.
Summary:
The authors investigated the extent to which users of crack, powder
cocaine, and heroin in Central Harlem participate in various roles
involved in distributing these drugs and examined gender differences in
distribution roles. Several strategies were combined to acquire a
sample (N = 655) of hard drug
users and sellers who self-reported demographics, drug use, and other
factors in an interview. Chi-square analyses were used to
examine factors associated with having drug distribution roles. More
than 40% (N = 269) of all
respondents self-reported
participation in at least one current distribution role. The most
common roles were acting as a middleman, steering buyers, holding drugs
or money, and transporting drugs. Distributors were more likely to have
human immunodeficiency virus (HIV) infection, previous drug treatments,
and less education, employment, or
housing, but had higher incomes than users. A higher proportion of
women reported drug distribution roles, but among distributors, men
were twice as likely women to be direct sellers and transporters of
drugs, and to perform more distribution roles. The findings support
previous research indicating male dominance of
drug distribution roles. Previous studies may underestimate women's
participation in distribution roles. Drug treatment programs are
encouraged to augment existing relapse prevention activities with
distribution prevention efforts.
NIAAA glossary terms:
crack cocaine, cocaine, heroin, drug dealing, drug trafficking, gender
differences, AOD user, AOD use, interview, self-report, demographic
characteristics, statistical estimation, HIV infection, educational
level achieved, employment status, housing, income, treatment program,
relapse prevention, human study
|
Marguerita Lightfoot, Tyson Rogers, Risë Goldstein, Mary Jane
Rotheram-Borus, Susanne May, Sheri Kirshenbaum, Lance Weinhardt, Cathy
Zadoretzky, Lauren Kittel, Mallory Johnson, et al. Predictors
of substance use frequency and reductions in seriousness of use among
persons living with HIV. Drug and Alcohol Dependence 77(2):129-138, February 2005.
Summary:
A cross-sectional survey was carried out in four major metropolitan
areas of the United States to examine predictors of the current level
of substance use and
reductions in seriousness of substance use were examined among adults (N = 3,806) living with human
immunodeficiency virus (HIV). Self-reported substance use, depression,
and quality of
life were obtained using audio computer assisted self-interviewing and
computer
assisted personal interviewing structured assessments. Recent substance
use of persons living with HIV was
classified as frequent (40%), occasional (32%), or abstinent (28%).
Participants using drugs at a frequent level identified as
heterosexual, had public insurance, and had higher levels of
depression. Participants who reduced from a lifetime high seriousness
in substance use were female, older, and knew their HIV status for a
longer period of time. The authors concluded that screening and
identification of substance use should be
included in all treatment settings and community-based organizations
serving adults living with HIV.
NIAAA glossary terms: HIV
infection, AOD use, AOD user, AOD use frequency, AOD use pattern, AOD
abstinence, adult, interview, self-report, emotional and psychiatric
depression, quality of life, heterosexual, insurance, age differences,
gender differences, identification and screening for AOD use, treatment
factors, community-based treatment, human study
|
Deborah A. Dawson, Bridget F. Grant, Frederick S. Stinson, and Patricia
S. Chou. Psychopathology
associated with drinking and alcohol use disorders in the college and
general adult populations. Drug and Alcohol Dependence 77(2):139-150, February 2005.
Summary:
The associations between past-year drinking status and
the prevalence of 15 different past-year anxiety, mood and personality
disorders were examined in a large (N
= 43,093) nationally representative sample
of the U.S. population. The prevalence of these disorders and their
associations with drinking were compared for college students 18–29
years of age, other young people in the same age group, and adults 30
years of
age and older. After adjusting for sociodemographic characteristics and
past-year tobacco and illicit drug use, only drinkers with alcohol
dependence experienced an excess risk of a mood or anxiety disorder
among the college students odds ratio (OR) = 2.4. In contrast, the
excess risk of any mood or anxiety disorder associated with drinking
status among non-college youth varied from OR =1.8 for non-binge
drinkers to OR = 4.7 for drinkers with alcohol dependence. Among
persons 30
years of age and older, the degree of excess risk was slightly lower
but still higher than those for college students, OR = 1.5–3.8.
Likewise, the excess odds ratios for any personality disorder
associated with
drinking varied from 1.6 to 5.0 for the younger, non-college group and
from 1.5 to 3.8 for the older adults, with no significant effect
observed among college students. Factors that may help explain the
weaker association of psychopathology and drinking in the college
population include selectivity and greater availability of social and
treatment resources that serve as alternatives to self-medicating the
symptoms of psychological distress with alcohol.
NIAAA glossary terms:
anxiety, mood and effect disturbance, personality disorder, prevalence,
alcoholic beverage, AOD use, AOD use pattern, undergraduate student,
young adult, age differences, social class, demographic
characteristics, risk analysis, relative risk, health care availability
and access, social support, social class, self-medication, survey,
questionnaire, human study
|
Mark T. Fillmore, Thomas H. Kelly, and Catherine A. Martin. Effects of
d-amphetamine in human models of information processing and inhibitory
control. Drug and
Alcohol Dependence 77(2):151-159,
February 2005.
Summary:
Reports of stimulant effects on behavioral functions that
rely on inhibitory processes have been inconsistent. This study tested
the joint effects of d-amphetamine on information
processing and inhibitory control in healthy adults (N = 22) with no
reported history of illicit stimulant use or drug dependence.
Information processing was measured by a rapid information processing
(RIP) task and inhibitory control was measured using a stop-signal
task. Performance was measured in response to 15 mg/70 kg, 7.5 mg/70
kg, and 0 mg/70 mg (placebo) doses of d-amphetamine, administered
double-blind in a randomized, within-subjects design. Results showed
that d-amphetamine improved information processing in a dose-dependent
manner. By contrast, no enhancement of response inhibition was
observed. Stimulant effects were also observed in physiological and
subjective effects measures. These results indicate that a stimulant
drug can enhance aspects of cognitive functioning without
simultaneously improving inhibitory control of behavior. The findings
highlight the complex nature of stimulant effects on human behavior and
the usefulness of performance tasks to model complex behavioral and
cognitive functions.
NIAAA glossary terms: CNS
stimulants, amphetamines, illicit drug, inhibition, controlled study,
double-blind study, dose-response relationship, psychophysiology,
subjective variables, cognitive ability, human study
|
W.E. Fantegrossi, G. Winger, J.H. Woods, W.L. Woolverton, and A.
Coop. Reinforcing
and discriminative stimulus effects of 1-benzylpiperazine and
trifluoromethylphenylpiperazine in rhesus monkeys. Drug and Alcohol Dependence 77(2):161-168, February 2005.
Summary:
The designer drugs 1-benzylpiperazine
(BZP) and 1-(3-trifluoromethylphenyl)piperazine (TFMPP) are often sold
in combination tablets on the Internet. The discriminative stimulus
properties and reinforcing
effects of these drugs have not previously been assessed in
laboratory primates. This study assessed the reinforcing effects of BZP
and
TFMPP (alone and in combination) through intravenous
self-administration in rhesus monkeys previously trained to
self-administer cocaine, and determined the discriminative stimulus
effects of
these compounds in rhesus monkeys trained to
discriminate amphetamine from saline. BZP was an effective
reinforcer in self-administration tests and appeared to induce
long-lasting direct effects on behavior following sessions where BZP
intakes were large. BZP also produced amphetamine-appropriate
responding dose-dependently, and produced full generalization
in all monkeys tested. TFMPP was not self-administered by
any of the animals and produced essentially no amphetamine-appropriate
responding
at any dose tested. Non-contingent TFMPP administration directly
affected behavior and abolished subsequent cocaine-maintained
responding. Likewise, self-administration of various ratios of
BZP:TFMPP combinations produced less responding than BZP alone.
The results suggest that BZP, but not TFMPP, has abuse liability of the
amphetamine type.
NIAAA glossary terms:
designer drug, amphetamines, piperazines, cocaine, reinforcement, drug
discrimination, discriminative learning, self administration of drugs,
dose-response relationship, monkey, animal study
|
C.W. Lejuez, Marina A. Bornovalova, Stacey B. Daughters, and John J.
Curtin. Differences
in impulsivity and sexual risk behavior among inner-city crack/cocaine
users and heroin users. Drug and Alcohol Dependence 77(2):169-175, February 2005.
Summary:
Sexual risk behavior was compared among
primary users of (a) heroin and not crack/cocaine, (b) crack/cocaine
and not heroin, and (c) both heroin and crack/cocaine. Additional
analyses examined impulsivity as a mediator of drug choice and
sexual risk behavior. The participants were a sample of inner-city drug
users (N = 23) in residential
treatment. Results indicated that sexual risk behavior was higher in
primary crack/cocaine
users than in primary heroin users, while those using both drugs showed
intermediate levels of sexual risk behavior. A
similar pattern across drugs was found for impulsivity. Finally,
impulsivity mediated the relationship between drug choice and sexual
risk behavior.
Although further research is needed to establish causal
relationships, the results support a relationship between sexual risk
behavior and
crack/cocaine, and suggest that disinhibition processes including
impulsivity may underlie this relationship.
NIAAA glossary terms:
sexual behavior, risk-taking behavior, impulsive behavior, heroin,
cocaine, crack cocaine, multiple drug use, residential facility, inner
city, AODD treatment unit, comparative study, disinhibition, human study
|
Roger D. Weiss, Margaret L. Griffin, Robert J. Gallop, Lisa M.
Najavits, Arlene Frank, Paul Crits-Christoph, Michael E. Thase, Jack
Blaine, David R. Gastfriend, Dennis Daley, and Lester Luborsky. The effect
of 12-step self-help group attendance and participation on drug use
outcomes among cocaine-dependent patients. Drug and Alcohol Dependence 77(2):177-184, February 2005.
Summary:
Llittle research has assessed the benefits of 12-step
group attendance by cocaine-dependent patients, who are frequently
referred to such groups, nor has there been much examination of the
distinction between
attending meetings and actively participating in 12-step activities. In
this study, cocaine-dependent outpatients (N = 487) were recruited at five
sites
for a randomized controlled trial of 24-week behavioral treatments.
Study data were examined to see whether self-help attendance or active
participation were related to subsequent drug use. It was found that
12-step group attendance did not predict subsequent drug use.
However, active 12-step participation in a given month predicted less
cocaine use in the following month. Furthermore, patients who increased
their
12-step participation during the first 3 months of treatment had
significantly less cocaine use and lower Addiction Severity Index─Drug Use Composite
scores
in the subsequent 3 months. Finally, individual drug counseling, based
on a 12-step model, and increasing levels of 12-step participation each
offered discrete benefits. These results suggest that active 12-step
participation by cocaine-dependent
patients is more important than attendance at meetings, and that a
combination of individual drug counseling and active 12-step
participation is effective for these patients.
NIAAA glossary terms:
twelve step program, mutual help and support group, individual
counseling, outpatient care, cocaine, AOD dependence, patient
compliance, treatment outcome, predictive factor, combined modality
therapy, behavior therapy, randomized controlled trial, human study
|
Alex Gamma, Lisa Jerome, Matthias E. Liechti, and Harry R.
Sumnall. Is ecstasy
perceived to be safe? A critical survey. Drug and Alcohol Dependence 77(2):185-193, February 2005.
Summary:
Although recent
publications claim that "ecstasy" (3,4-methylenedioxymethamphetamine;
MDMA) is
considered safe by many or most users, or by young people or the
general public, the claim is not supported by any references. Previous
studies of various populations,
including drug users and adolescents in several nations, also failed to
support claims of the perceived safety of ecstasy. Epidemiological
surveys in the United States and the United Kingdom consistently report
high proportions of
young people who perceive great risk in using ecstasy. Studies of
ecstasy users show they are aware of a number of short- and
long-term risks of ecstasy use, although, in the absence of actual
problems, they evaluate the personal significance of these risks as
low. This study investigated the perceived harmfulness of
ecstasy further in an online survey of over 900 drug users. Little
support for the claim was found. Of the
survey participants, 73% viewed ecstasy as carrying at least "some
risk." The claim of ecstasy's perceived safety is plausibly based
on researchers’ assumptions that the continued widespread use of the
drug indicates that users are unaware of the associated risks, and that
informing them about these risks would lead to a reduction in drug use.
The authors of this article argue that these assumptions are inadequate
and that drug
information and harm reduction strategies should focus on more
affective and personally significant aspects of risk perception.
NIAAA glossary terms:
MDMA, public opinion on AOD, safety, risk assessment, survey, Internet,
AOD user, prevention through information dissemination, harm reduction,
affective education, individual-focused prevention, human study
|
Lisa A. Marsch, Warren K. Bickel, Gary J. Badger, and Eric A.
Jacobs. Buprenorphine
treatment for opioid dependence: The relative efficacy of daily, twice
and thrice weekly dosing. Drug and Alcohol Dependence 77(2):195-204, February 2005.
Summary:
The relative efficacy of three
buprenorphine dosing schedules was evaluated in a randomized clinical
trial. Opioid-dependent adults were randomly
assigned to receive buprenorphine 7, 3, or 2 days a week for 24
weeks. Daily maintenance doses were 4, 8, 10, or 12 mg of the
sublingual buprenorphine solution. Participants who attended the clinic
daily received a maintenance dose of buprenorphine daily. Participants
who attended the clinic three times a week received double their
maintenance
dose on Monday and Wednesday, and a triple dose on Friday.
Participants who attended the clinic twice a week received quadruple
their maintenance dose of buprenorphine on Monday and triple their
maintenance dose on Friday. All dosing
regimens were found to have comparable efficacy in promoting treatment
retention,
opioid and cocaine abstinence, and reductions in human immunodeficiency
virus (HIV) risk behavior
(especially as related to drug use) and severity of life problems.
Predictor analyses identified sub-populations of opioid-dependent
individuals who may have a more positive treatment outcome under each
buprenorphine dosing condition. Dosing schedules less than daily may
allow treatment programs to serve a greater
number of opioid-dependent patients and reduce the risk of medication
diversion, which in turn may have a positive impact on community
support of science-based treatment for opioid-dependence.
NIAAA glossary terms: buprenorphine,
drug therapy, opiates, AOD dependent, treatment method, drug
evaluation, drug dose, drug efficacy, treatment factors, treatment
outcome, predictive factor, AOD abstinence, treatment completion,
human immunodeficiency virus, risk-taking behavior, randomized
controlled trial, clinical trial, human study
|
Sean Williams, Adrian Brown, Robert Patton, Michael J. Crawford, and
Robin Touquet. The
half-life of the ‘teachable moment’ for alcohol misusing patients in
the emergency department. Drug and Alcohol Dependence 77(2):205-208, February 2005.
Summary:
This study investigated whether the length of time between
alcohol-related
attendance in the emergency department (ED) and follow-up appointment
with an alcohol health worker alters attendance rate at the alcohol
clinic. Paper and computerized records made by alcohol health workers
over a 4-year
period were used to collect data on the length of time between
identification of
alcohol misuse and the appointment with the alcohol health worker, and
whether the
appointment was kept. An inverse relationship was found between the
length of time between
identification of alcohol misuse and alcohol health worker appointment
and the subsequent
likelihood of keeping that appointment. It was concluded that the time
between identification and intervention for alcohol abusing patients
must be kept to a minimum to maximize attendance rates at alcohol
clinics. Preferably, an appointment with an alcohol health worker
should be made on the same day as
the attendance in the ED.
NIAAA glossary terms: AOD
abuser, AODR injury, ethanol, emergency care, intervention referral,
patient compliance, treatment factors, patient records, human study
|
G. Addolorato, F. Caputo, L. Leggio, T. Vignoli, L. Abenavoli, F.
Lorenzini, M. Bernardi, and G. Gasbarrini. Gamma
hydroxybutyrric acid (GHB) withdrawal does not occur at therapeutic
dosage. Drug and
Alcohol Dependence 77(2):209,
February 2005.
Home Page
Drug
and Alcohol Dependence
Volume
77, Number 1, January 2005
(Updated 12/17/2004)
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Don
C. Des Jarlais, Theresa E. Perlis, and Joy M. Settembrino. The use of
electronic debit cards in longitudinal data collection with
geographically mobile drug users. Drug & Alcohol Dependence 77(1):1-5, January 2005.
Summary:
The use of electronic debit (ATM) cards in conducting
longitudinal research with geographically mobile drug
users was assessed. Young illicit drug users (N = 139) with recent travel history
were
street-recruited from the Lower East Side area of New York City during
2001-2002.
Multiple efforts were made to develop positive relationships between
participants and the study. Honoraria were paid through electronic
debit cards usable at ATMs nationwide. Participants were encouraged to
complete follow-up interviews in person if they were in New York, or by
telephone if elsewhere. Follow-up rates were compared with those from
two other recent cohort
studies of young drug users in New York. They had traveled
extensively, averaging 31 trips per participant to different cities
during the previous 3 years. Telephone follow-up interviews were
obtained from participants in over 200 different cities and towns.
Follow-up interview rates were 81% at 6 months and 71% at 12 months –
substantially higher than corresponding rates in the comparison
studies. In conclusion, the use of electronic debit cards, combined
with
other efforts to develop positive relationships with participants, led
to high rates of continued study participation. Debit cards may be very
useful in conducting longitudinal research with geographically mobile
populations.
NIAAA Glossary Terms:
follow-up study, longitudinal study, illicit drug, AOD user, New York,
patient compliance, interview, comparative study, human study
|
Adam Bisaga, Efrat Aharonovich, Fatima Garawi, Frances R. Levin, Eric
Rubin, Wilfrid N. Raby, Suzanne K. Vosburg, and Edward V. Nunes. Utility of
lead-in period in cocaine dependence pharmacotherapy trials.
Drug & Alcohol
Dependence 77(1):7-11,
January 2005.
Summary:
The objective was to determine whether drug use behaviors during a
2-week lead-in for a
pharmacotherapy trial predicted retention in treatment and of
the level of cocaine use during the subsequent 12 weeks of treatment.
Cocaine dependent patients (N
= 50) were grouped according to (1) principal
route of cocaine administration: intranasal versus smoking, and (2)
level of cocaine use during the 2-week lead-in: high versus low.
Results indicate that level of cocaine use during the 2-week lead-in
was a significant predictor of cocaine use during the subsequent 12
weeks of treatment. Patients with reported higher level of use during
the lead-in period were more likely to continue using cocaine during
the treatment. Patients who used smoking as their primary route of
cocaine use were more likely to drop out early in the treatment.
Findings of this study suggest that route and level of cocaine use
during lead-in be used as a covariate in models testing treatment
effect.
NIAAA Glossary Terms:
cocaine, AOD dependence, AOD use behavior, heavy AOD use, light AOD
use, treatment completion, patient retention, predictive factor, route
of administration, drug therapy, treatment outcome, human study
|
Duncan B. Clark, Jack R. Cornelius, Levent Kirisci, and Ralph E.
Tarter. Childhood
risk categories for adolescent substance involvement: A general
liability typology. Drug
& Alcohol Dependence 77(1):13-21,
January 2005.
Summary:
The objective was to identify childhood
risk categories predicting accelerated adolescent substance involvement
across drug types and stages. The index subjects were 560 children
recruited from high risk (n =
266) or low risk (n = 294)
families based on fathers’ substance use disorders (SUDs). Assessments
were conducted at
approximately ages 11 (baseline), 13, 16, and 19 years. Childhood
predictors included parent SUDs, early tobacco or alcohol use (i.e.,
substance use), and neurobehavior disinhibition (ND) as determined by
indicators of cognitive, affective, and behavioral disinhibition. Five
risk categories were defined by cluster analysis of baseline
characteristics as follows: (1) High (n
= 31; 100% had both parents with SUDs, 100% had early substance use,
and the mean ND score = 58.9); (2) Intermediate-High (n = 76; 45% had one parent with
SUD, 100% early substance use, and ND = 51.9); (3) Intermediate (n = 76; 100% both parents with
SUDs, 0% early substance use, and ND = 51.4); (4) Intermediate-Low (n = 161; 100% with one SUD parent;
0% early substance use, and ND = 49.9) and; (5) Low (n = 216; no parental SUD, no early
substance use, and ND = 47.5). Compared with all other groups, children
in the High risk group had significantly accelerated substance
involvement across all substance types and stages. The ordering of risk
categories from low to high was also consistent for all substance
involvement outcomes. The findings indicate that these five risk
categories constitute general liability classes for adolescent
substance involvement, and may identify homogeneous groups of children
requiring distinct preventive interventions.
NIAAA Glossary Terms:
predictive factor, risk factors, adolescent, underage AOD use, early
AODU onset, underage drinking, smoking, tobacco in any form, cluster
analysis, neurobehavioral theory of AODU, disinhibition, parent, family
AODU history, familial alcoholism, high-risk youth, prevention effort
directed at people at risk, human study
|
John A. Matochik, Dana A. Eldreth, Jean-Lud Cadet, and Karen I.
Bolla. Altered
brain tissue composition in heavy marijuana users. Drug & Alcohol Dependence 77(1):23-30, January 2005.
Summary:
Voxel-based
morphometry was used to investigate possible differences in brain
tissue composition in a group of heavy marijuana users (n = 11 males) and a group
of marijuana non-users (n = 8
males). Statistical comparisons
were made at the voxel level on T1-weighted magnetic resonance images
to determine differences in gray matter and white matter tissue
density. Compared to non-users, marijuana users had lower gray matter
density in a cluster of voxels in the right parahippocampal gyrus (p =
0.0001), and greater density bilaterally near the precentral gyrus and
the right thalamus (p <
0.04). Marijuana users also had lower white
matter density in the left parietal lobe (p = 0.03), and higher density
around the parahippocampal and fusiform gyri on the left side compared
to non-users (p < 0.002).
Longer duration of marijuana use (in
years) was significantly correlated with higher white matter tissue
density in the left precentral gyrus (p
= 0.045). These preliminary
results suggest evidence of possible structural differences in the
brains of heavy marijuana users, and localize regions for further
investigation of the effects of marijuana in the brain.
NIAAA Glossary Terms:
marijuana in any form, heavy AOD use, chronic AODE, AOD nonuse,
comparative study, brain, morphometric analysis, magnetic resonance
imaging, statistical estimation, hippocampus, thalamus, cerebrum, human
study
|
Stefan Langenfeld, Larissa Birkenfeld, Peter Herkenrath, Carsten
Müller, Martin Hellmich, and Martin Theisohn. Therapy of
the neonatal abstinence syndrome with tincture of opium or morphine
drops. Drug &
Alcohol Dependence 77(1):31-36,
January 2005.
Summary:
Treating opioid-addicted women with methadone in pregnancy increased
the number of newborns suffering from neonatal abstinence syndrome
(NAS). High-pitch crying, insomnia, tremor, myoclonic jerks, vomiting,
diarrhea, and poor weight gain were reported symptoms, which were
evaluated using the Finnegan (F)-score. Earlier phenobarbital or
paregoric had been used to suppress symptoms. This study surveyed the
administration of pure μ-agonist morphine in comparison to the
alcoholic opioid mixture in tincture of opium. Thirty-three
newborns were included in the survey with informed consent by their
parents. NAS started 3-5 days after delivery and lasted an average of
27 days in the tincture of opium group and an average of 30 days in the
morphine group. In either of
the tested parameters, no significant differences were found between
the
two groups (2p < 0.05). The
maximum F-score was similar in both
groups, but the dose to suppress NAS was higher in the morphine group
(0.6 versys 0.5 mg/day; total dose 61.6 versus 42.7 mg . The duration
of
the therapy was longer in the morphine group than in the tincture of
opium group (37.5 versus 32.4 days).
On the other hand, weight gain was better in the mrophine group than in
the tincture of opium group (25 versus 19 g/day), but was reduced in
both groups compared
with healthy newborns. In conclusion, morphine is suitable to treat NAS
in a similar manner as tincture of opium, but avoids unwanted effects
of the alcoholic extracts with various alkaloids in the tincture of
opium and allows better weight gain of the newborns.
NIAAA Glossary Terms:
AODR neonatal disorder, AOD withdrawal syndrome, opioids, addiction,
drug therapy, morphine, opium, agonists, comparative study, alkaloids,
human study
|
Sean Esteban McCabe, Christian J. Teter, and Carol J. Boyd. Illicit use
of prescription pain medication among college students.
Drug & Alcohol
Dependence 77(1):37-47,
January 2005.
Summary:
A cross-sectional web-based survey was carried out to determine the
prevalence, correlates, and sources associated
with the illicit use of prescription pain medication among
undergraduate college students. The survey was self-administered by a
large random sample of undergraduate
students (n = 9,161) attending
a large Midwestern university in the United States.
Although undergraduate women were more likely to be prescribed pain
medication, men were more likely to be approached to divert their
prescription pain medication and to report illicit use of prescription
pain medication. Multivariate analyses indicated past year illicit use
of prescription pain medication was higher among undergraduate students
who were previously prescribed pain medication, living in a house or
apartment, and earning lower grade point averages. The majority of
students obtained prescription pain medication for illicit use from
peers; the second leading source was family members. There were
several gender differences in the risk factors and sources of illicit
use of prescription pain medication. Based on qualitative data, illicit
use included recreational use for the purposes of intoxication and
self-medication for pain episodes. Illicit users, who obtained
prescription pain medication from peers, reported significantly higher
rates of other substance use while those who obtained prescription
medications from family members did not. These findings suggest that
the illicit use of prescription pain medications may represent a
problem among undergraduate students and effective prevention efforts
are needed that account for gender differences.
NIAAA Glossary Terms: AOD
abuse, prescription drug, analgesics, prevalence, correlation analysis,
undergraduate student, survey, self-report, random sample, gender
differences, multivariate analysis, AODE on academic performance, risk
factors, AOD intoxication, self medication, human study
|
Judith Bernstein, Edward Bernstein, Katherine Tassiopoulos, Timothy
Heeren, Suzette Levenson, and Ralph Hingson. Brief
motivational intervention at a clinic visit reduces cocaine and heroin
use. Drug &
Alcohol Dependence 77(1):49-59,
January 2005.
Summary:
Brief intervention is effective for alcohol abuse, but has not been
adequately
tested in the clinical setting with drug using patients. This
randomized controlled trial tested the impact of a single, structured
encounter targeting cessation
of drug use, conducted between peer educators and out-of-treatment
cocaine and heroin users screened in the context of a routine medical
visit. The trial was conducted in
inner-city teaching hospital outpatient clinics with 3 and 6 months
follow-up by blinded observers. Drug abstinence was documented by hair
testing. Analysis was limited to enrollees with drug-positive hair
at baseline. Among 23,669 patients screened, 1,232
(5%) were eligible, and 1,175 enrolled. Enrollees (mean age 38 years)
were 29% female, 62% non-Hispanic black, 23% Hispanic, 46% homeless.
Among those with positive hair at entry, the follow-up rate was 82%.
The intervention group was more likely to be abstinent than the control
group for cocaine alone (22.3% versus 16.9%), heroin alone (40.2%
versus 30.6%), and both drugs (17.4% versus 12.8%), with adjusted odds
ratio [OR] of
1.51–1.57. Cocaine levels in hair were reduced by 29% for the
intervention group and only 4% for the control group. Reductions in
opiate levels were similar (29% versus 25%). In conclusion, brief
motivational intervention may help patients achieve abstinence from
heroin and cocaine.
NIAAA Glossary Terms:
brief intervention, motivational interviewing, AOD abuse, illicit drug,
clinical trial, randomized controlled trial, hair analysis,
single-blind study, follow-up study, heroin, cocaine, AOD abstinence,
human study
|
Sarah A. Burgard, Susan D. Cochran, and Vickie M. Mays. Alcohol and
tobacco use patterns among heterosexually and homosexually experienced
California women. Drug
& Alcohol Dependence 77(1):61-70,
January 2005.
Summary:
There is growing evidence suggesting that lesbian and bisexual women
may be at
especially elevated risk for the harmful health effects of alcohol and
tobacco use. This article reports findings from the California Women's
Health Survey (1998–2000), a large, annual statewide health
surveillance survey of California women that in 1998 began to include
questions assessing same-gender sexual behavior. Homosexually
experienced women were more likely than exclusively
heterosexually experienced women to be current smokers and to consume
alcohol more frequently and in greater quantity. The greatest sexual
orientation disparity in
alcohol use patterns was among women in the
26–35-year-old group. Recently bisexually active
women also reported higher and riskier alcohol use than women who are
exclusively heterosexually active. By contrast, among homosexually
experienced women, those who were recently exclusively homosexually
active did not show consistent evidence of risky alcohol
consumption patterns. These findings highlight the importance of
considering within-group differences among homosexually experienced
women in risk for tobacco and dysfunctional alcohol use.
NIAAA Glossary Terms:
lesbian, bisexual, heterosexual, female, tobacco in any form, smoking,
alcoholic beverage, AOD abuse, AOD use pattern, AOD consumption, AOD
intake per occasion, AOD use frequency, survey, California, high-risk
group, risk-taking behavior, age differences, comparative study, human
study
|
Michael R. Oreskovich, Andrew J. Saxon, Mei Ling K. Ellis, Carol A.
Malte, Joseph P. Reoux, and Patricia C. Knox. A
double-blind, double-dummy, randomized, prospective pilot study of the
partial Mu opiate agonist, buprenorphine, for acute detoxification from
heroin. Drug &
Alcohol Dependence 77(1):71-79,
January 2005.
Summary:
Two buprenorphine sublingual tablet dosing
schedules were compared to oral clonidine in a randomized,
double-blind, double-dummy pilot study. Heroin users (N = 30) who met Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV)
criteria for opioid dependence and achieved a Clinical Opiate
Withdrawal Scale (COWS) score of 13 (moderate withdrawal), were
randomized to receive higher dose buprenorphine (HD: 8, 8, 8, 4, 2
mg/day
on days 1–5), lower dose buprenorphine (LD: 2, 4, 8, 4, 2 mg/day on
days
1–5), or clonidine (C: 0.2, 0.3, 0.3, 0.2, 0.1 mg four times a day on
days 1–5). COWS
scores were obtained four times a day. Twenty-four hours after
randomization, the
percentages of subjects who achieved suppression of withdrawal, as
defined by four consecutive COWS scores <12, were: C = 11%, LD =
40%, and HD = 60%. Generalized estimating equation regression models,
controlling for baseline COWS and time, indicated that COWS scores over
the course of 5 days were lower in both LD and HD compared to C (χ2 =
13.28, p = 0.001). Similar
analyses examining scores over time on the
Adjective Rating Scale for Withdrawal (ARSW) and on a Visual Analog
Scale of Opiate Craving (VAS) indicated an overall treatment effect on
the VAS accounted for by a significant difference between HD and C, but
no overall treatment effect on the ARSW. There were no discontinuations
for treatment-related adverse events. Both HD and LD regimens are
safe and efficacious treatment for opioid detoxification, but HD
demonstrated superiority to C on a greater number of measures.
NIAAA Glossary Terms:
drug therapy, buprenorphine, clonidine, opioids, addiction, AOD
dependence, double-blind study, randomized controlled trial, clinical
trial, pilot study, regression analysis, AOD withdrawal syndrome, AOD
withdrawal agents, drug dose, drug efficacy, drug evaluation,
comparative study, human study
|
M.A. Stoové, S.M. Gifford, and G.J. Dore. The impact
of injecting drug use status on hepatitis C-related referral and
treatment. Drug
& Alcohol Dependence 77(1):81-86,
January 2005.
Summary:
Uptake and predictors of
hepatitis C virus (HCV)-related health care services were examined
among a community-based sample of
people with HCV in the state of Victoria, Australia. A
self-administered questionnaire was completed by a
largely non-clinical sample of 362 women and 308 men with HCV. Analyses
were performed according to injection
drug use (IDU) status: no history of injecting (non-IDU), previous
history of injecting (past-IDU), and current (within the last 12
months) history of injecting (current IDU). Bivariate and multivariate
predictors of referral to a specialist liver clinic were also assessed.
Fifty-one percent of participants were current IDUs, 33% past-IDUs, and
16% non-IDUs. Fifty-two percent of women and 37% of men reported ever
being referred to a specialist liver clinic and 18% of women and 20% of
men reported previous HCV antiviral therapy. Although there were many
factors related to an increased likelihood of referral (e.g. being
female, longer time since diagnosis, longer consultation time at
diagnosis, experiencing HCV-related symptoms), multivariate analysis
revealed that the most important independent predictors of referral
were not being a current IDU and seeing a general practitioner
specifically for
HCV. For
those who had been referred to a liver clinic, a history of IDU was
associated with a lower chance of receiving antiviral therapy. IDU
status is associated with both referral and treatment. The extension of
HCV treatment services to involve general practitioners and drug and
alcohol
practitioners should be explored as models to improve access to
antiviral therapy.
NIAAA Glossary Terms:
hepatitis C, hepatitis C virus, help-seeking behavior, treatment
barriers, predictive factor, intravenous drug user, patient AODU
history, Australia, questionnaire, survey, self-report, general
practitioner, gender differences, diagnosis, human study
|
Giancarlo Colombo, Salvatore Serra, Giovanni Vacca, Mauro A.M. Carai,
and Gian Luigi Gessa. Effect of
the combination of naltrexone and baclofen, on acquisition of alcohol
drinking behavior in alcohol-preferring rats. Drug & Alcohol Dependence 77(1):87-91, January 2005.
Summary:
Recent
surveys suggest that drug combinations may produce positive outcomes in
the pharmacotherapy of
alcoholism. This study
evaluated the effect of the combination of the opioid receptor
antagonist naltrexone with the GABAB
receptor agonist baclofen on the acquisition of alcohol drinking
behavior in Sardinian alcohol-preferring (sP) rats. Rats were treated
with either saline, 0.5 mg/kg naltrexone, 1 mg/kg baclofen, or 0.5
mg/kg naltrexone plus 1 mg/kg baclofen once a day for 10 days. Alcohol
was offered immediately after the first drug injection under the
2-bottle regimen. Alcohol intake in saline-treated rats rose to 5–6
g/kg/day within a few days, indicative of a rapid acquisition of
alcohol drinking behavior. Neither naltrexone nor baclofen, when given
alone, affected alcohol drinking behavior. In contrast, the drug
combination resulted in a significant reduction in daily alcohol intake
and retardation in the acquisition of alcohol drinking behavior. These
results suggest that combination of naltrexone plus baclofen may result
in a synergistic reduction in alcohol intake in sP rats. These results
are discussed in terms of naltrexone and baclofen exerting a
concomitant and reciprocally potentiating inhibitory action on
alcohol-induced activation of mesolimbic dopamine transmission.
NIAAA Glossary Terms:
naltrexone, baclofen, combination drug therapy, ethanol, AOD
dependence, animal selectively bred for AOD preference, animal model,
laboratory rat, mu-opioid receptors, GABA receptors, agonists,
antagonists, AOD consumption, AOD intake per occasion, AOD use
behavior, mesolimbic system, dopamine, neurotransmission
|
F.A. Wagner, H.E. Velasco-Mondragón, M. Herrera-Vázquez,
G. Borges, and E. Lazcano-Ponce. Early
alcohol or tobacco onset and transition to other drug use among
students in the State of Morelos, Mexico. Drug & Alcohol Dependence 77(1):93-96, January 2005.
Summary:
This study examined whether patterns in the transition from
alcohol and tobacco to other drug use in the Mexican State of Morelos
are similar to
those observed in other countries. The data were from a
representative sample of youth age 11–21 years (N = 13,105), who
participated in a paper-and-pencil survey in middle schools, high
schools, and colleges in the State of Morelos. Drug use was
assessed with the standardized instrument used in most Mexican student
surveys. Cox's models for discrete time-survival analyses, stratified
by school and age group were used to estimate the risk of drug use in
relation to age of alcohol and tobacco use initiation by gender, while
accommodating the complex survey design. About 5% of the
students were estimated to have used drugs in their life. Male early
users of alcohol or tobacco were more likely to use other drugs,
compared to students who did not have an early alcohol or tobacco
onset. Further studies on social mechanisms might help to
account for observed similarities in patterns of drug involvement in
different countries, even in the context of important differences in
rates of drug use.
NIAAA Glossary Terms:
early AODU onset, age of AODU onset, alcoholic beverage, tobacco in any
form, Mexico, adolescent, young adult, elementary student, high school
student, undergraduate student, survey, questionnaire, gateway drug,
statistical estimation, gender differences, international differences,
human study
|
Home Page
Drug
and Alcohol Dependence
Volume
76, Number 3, December 2004
(Updated 12/11/2004)
Home Page
Helene R.
White, Daniel Nagin,
Elaine Replogle, and Magda Stouthamer-Loeber. Racial
differences in trajectories of cigarette use. Drug & Alcohol Dependence 76(3):219-227, December 2004.
Summary:
Racial
differences in
developmental trajectories of
cigarette smoking from age 10 through age 25 were examined using data
from the Pittsburgh Youth Study, a prospective, longitudinal study of
high-risk males. Preliminary
analyses indicated that there were significant racial differences in
onset, levels, and patterns of cigarette use. Models therefore were
estimated separately for African-Americans (N = 562) and White Americans (N = 421). Three trajectory groups
emerged for both races: nonsmokers, light/occasional smokers, and
heavy/regular smokers. Significantly more Whites were in the
heavy/regular smoker group and more African-Americans were in the
nonsmoker group. Among heavy/regular smokers, White Americans began
smoking earlier than African-Americans and reached higher mean
quantities of
cigarettes per day. There were also racial differences in the
timing and rapidity of the development of regular smoking over time.
Race remained a significant predictor of cigarette use even after
controls for socioeconomic status. Overall, the results indicate that
developmental trends in smoking differ by race and that cigarette
smoking remains more prevalent and more frequent for White males than
African-American males, at least through young adulthood.
NIAAA Glossary: smoking, cigarette, child,
young adult, male, prevalence, AOD use pattern, underage AOD use, AOD
nonuse, light AOD use, heavy AOD use, age of AODU onset, AODU
development, African American, White American, racial differences,
predictive factor, risk factors, statistical modeling, controlled
study, human study
|
Tomás D. Matos, Rafaela R. Robles, Hardeo Sahai, Hector M.
Colón, Juan C. Reyes, C. Amalia Marrero, José M.
Calderón, and Elizabeth W. Shepard. HIV risk
behaviors and alcohol intoxication among injection drug users in Puerto
Rico. Drug &
Alcohol Dependence 76(3):229-234,
December 2004.
Summary:
The
association between alcohol
intoxication and injection and sexual human immunodeficiency virus
(HIV) risk behaviors was investigated in
Hispanic heroin and cocaine injectors (N = 557) not in treatment, who were
recruited in poor communities in Puerto Rico. The participants were
part of a
longitudinal prevention-intervention study aimed at reducing drug use
and HIV risk behaviors. A high prevalence of
co-occurring conditions was reported by participants, particularly
symptoms of severe depression
(52%, measured by Beck's Depression Index) and severe anxiety (37%,
measured by Beck’s Anxiety Index). Nearly one-fifth (18%) of
participants reported alcohol intoxication during the
last 30 days. Associations were
found between alcohol intoxication and both injection and sexual risk
behaviors. In bivariate analysis, subjects reporting alcohol
intoxication were more likely to inject three or more times a day,
pool money to buy drugs, share needles, and share cotton. They were
also significantly more likely to have a casual or paying sex partner
and to have unprotected sex with these partners. After adjustment,
sharing needles and cotton, having sex with a paying or casual
partner, and exchanging sex for money or drugs were significantly
related to alcohol intoxication. It was concluded that HIV prevention
programs, to be
effective, must address alcohol intoxication and its relation to
injection and sexual risk behaviors as a central issue in HIV
prevention among drug injectors.
NIAAA Glossary: sexual behavior, risk-taking
behavior, intravenous drug user, Hispanic, Puerto Rico, human
immunodeficiency virus, HIV infection, sexually transmitted disease,
alcoholic beverage, AOD intoxication, intravenous injection, heroin, cocaine, AOD use frequency, needle
sharing, prevention program, HIV prevention, prevention effort directed
at people at risk, prevention approach, human study
|
Andrew Golub and Bruce D. Johnson. How much do Manhattan-arrestees spend on
drugs? Drug &
Alcohol Dependence 76(3):235-246,
December 2004.
Summary:I
Information about individuals’ drug expenses can indicate much about
the size of drug markets, the financial burden of drug use,
drug-related
crime, and potential challenges for treatment. Drug expenses
usually have been estimated simply by asking respondents how
much they spent. In 2000, the Arrestee Drug Abuse Monitoring (ADAM)
program introduced an advanced questionnaire with highly
specific questions like, "how much cash did you pay for crack that last
time you bought it?" This article describes a procedure for
estimating arrestees’ drug expenses with the new ADAM questionnaire,
discusses problems in interpretation, presents findings for 2,979
ADAM-Manhattan respondents interviewed in 2000–2002, examines
covariates
of drug expense, and compares the 2000–2002 findings with those
obtained from 2,256 respondents interviewed in 1998–1999 with the
previous
questionnaire. Among the 2000–2002 arrestees, median drug expense
in the past 30 days varied widely with frequency of use and drug-user
type. Infrequent marijuana-only users spent as little as $5, daily
marijuana-only users spent about $600. Arrestees that used both heroin
and cocaine spent over $1,000. Estimates based on the 1998–1999 data
were
about half as large. The new questions used in the ADAM program may
greatly advance the quality of estimates of drug expenses, but
additional research is needed to confirm accuracy.
NIAAA Glossary: AOD use,
illicit drug, economic cost of AODU, AOD abuse, arrest, questionnaire,
individual AOD consumption, AOD use frequency, New York, analysis of
covariance, comparative study, marijuana in any form, heroin, cocaine,
multiple drug use, human study
|
R. J. Lamb, Andrew R. Morral, Kimberly C. Kirby, M. Y. Iguchi, and G.
Galbicka. Shaping
smoking cessation using percentile schedules. Drug & Alcohol Dependence 76(3):247-259, December 2004.
Summary:
Behavioral
interventions that provide abstinence-contingent incentives are
effective addiction treatments, but they often
fail for individuals whose recent behaviors are very different from
those reinforced. These hard-to-treat individuals may require shaping
to achieve abstinence. In this study percentile schedules were used to
shape smokers’
delivery of breath samples indicative of recent smoking abstinence
(breath carbon monoxide [CO] < 4 ppm). Percentile schedules deliver
incentives to current behaviors proximal to the target. Participants (N
= 102) were assigned to treatments delivering incentives for breath COs
at or below the 10th, 30th, 50th, or 70th percentile of recent breath
COs. Each condition effectively ensured contact with available
contingencies, and resulted in breath CO < 4 ppm in >90% of the
30th,
50th and 70th percentile groups versus 63% in the 10th percentile
group. The
30th, 50th and 70th percentiles were especially effective in a
subsample of hard-to-treat participants who did not deliver a breath
CO < 4 ppm during an initial abstinence test or during a nine-visit
baseline period, suggesting the value of shaping for this important
subsample.
NIAAA Glossary: smoking,
AOD abstinence,carbon monoxide, treatment goal, treatment
method, behavioral change, reinforcement, patient monitoring, breath
analyzer, clinical psychology, clinical study, human study
|
Srinivasan S. Pillay, Jadwiga Rogowska, Gen Kanayama, Duk-In Jon, Staci
Gruber, Norah Simpson, Monisha Cherayil, Harrison G. Pope, and Deborah
A. Yurgelun-Todd. Neurophysiology
of motor function following cannabis discontinuation in chronic
cannabis smokers: An fMRI study. Drug & Alcohol Dependence 76(3):261-271, December 2004.
Summary:
The
objective was to identify the differences in cerebral
activation between a group of chronic cannabis smokers (N = 9) and controls (N = 16) in response to
finger sequencing. It was hypothesized that attentional areas related
to
motor function as well as primary and supplementary motor cortices
would show diminished activation in chronic cannabis smokers. Echo
planar images and
high-resolution magnetic resonance (MR) images were acquired. The
challenge paradigm
included left and right finger sequencing. Group differences in
cerebral activation were examined for Brodmann areas (BA) 4, 6, 24, and
32 using region-of-interest (ROI) analyses in scanning probe microscopy
(SPM). Cannabis users, tested within 4–36 hours of
discontinuation, showed significantly less activation than controls
in BA 24 and 32 bilaterally during right- and left-sided sequencing and
for BA 6 in all tasks except for left-sided sequencing in the left
hemisphere. There were no statistically significant differences for BA
4. None of these regional activations correlated with urinary cannabis
concentration and verbal IQ for smokers. These results suggest that
recently abstinent chronic cannabis smokers produce reduced activation
in motor cortical areas in response to finger sequencing compared to
controls.
NIAAA Glossary: cerebral
cortex, marijuana in any form, smoking, AOD use, AOD abstinence,
chronic AODE, motor coordination, motor skills disorder, attention,
magnetic resonance imaging, controlled study, human study
|
Elie G. Karam, Wadih E. Maalouf, and Lilian A. Ghandour. Alcohol use
among university students in Lebanon: Prevalence, trends and covariates.
Drug & Alcohol
Dependence 76(3):273-286,
December 2004.
Summary:
Results of a substance use monitoring study among university students
in Lebanon are reported. Two phases of the study (1991 and 1999)
assessed the prevalence,
patterns, trends, and factors associated with the use and abuse of
alcohol (and other substances). In both phases, the sample was a
stratified cluster, representing 25% (N
= 1,850) of the student
population of two major Lebanese universities. The rates of lifetime
alcohol use and problem use increased from 1991 to 1999, especially in
younger cohorts and among females. Belief in God
and practice of that belief, irrespective of the students’ religion,
were associated with less frequent experimentation with alcohol.
Although more Christians ever drank alcohol, once users, university
students (irrespective of their religion) had the same rates of alcohol
problem use and dependence. Several other covariates concordant with
the international literature were also delineated such as students’
antisocial behavior, and family and peer environment.
NIAAA Glossary: Lebanon,
undergraduate student, AOD use, AOD abuse, AOD use pattern, AOD
dependence, problematic AOD use, AOD consumption, AOD
use frequency, prevalence, trend, risk factors,
religious affiliation, Christianity, age differences, gender
differences, religious differences, spiritual and religious regulation
of behavior, covariate analysis, antisocial behavior, family
environment, peer group, human study
|
Ulrich John, Christian Meyer, Hans-Jürgen Rumpf, and Ulfert
Hapke. Smoking,
nicotine dependence and psychiatric comorbidity — a population-based
study including smoking cessation after three years. Drug & Alcohol Dependence 76(3):287-295, December 2004.
Summary:
A cohort study was carried out to analyze relationships of smoking and
nicotine
dependence with psychiatric disease and to determine whether
psychiatric disease
predicts the sustaining of smoking after 3 years. The participants were
a random adult population sample (N
= 4,075) in northern Germany. Measurements included a baseline
measurement of ever daily smokers aged
18–64 years (n = 2,458), a
first follow-up of the current smokers at baseline
(n = 1,552) after 30 months,
and a second follow-up after 36 months.
Measures included Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)
diagnoses by the Composite International
Diagnostic Interview, the Fagerström Test for Nicotine Dependence
(FTND), and smoking cessation (by interview). Current daily smokers
showed higher odds of a substance use disorder
other than nicotine dependence compared with never smokers (odds ratio
[OR] = 4.6; confidence interval [CI], 2.9–7.2), affective (OR = 1.8;
CI,
1.4–2.5), anxiety (OR = 1.6; CI, 1.2–2.0) or somatoform disorder (OR =
1.4;
CI, 1.0–1.8). DSM-IV nicotine dependence and the FTND were positively
related with the number of psychiatric diagnoses. Psychiatric
comorbidity did not predict the maintenance of smoking or quitting.
This study supports findings of increased rates of mental disorders
among
smokers and nicotine-dependent smokers in the adult general population.
The number of nicotine dependence and
withdrawal symptoms are related to mental disorders. In addition,
somatoform disorders show relationships with smoking similar to
relationships with depressive or anxiety disorders. The authors
recommend proactive support of intention to
stop smoking among these comorbid
patients.
NIAAA Glossary: smoking,
tobacco in any form, nicotine, comorbidity, AOD dependence, mentally
ill, AOD abstinence, AOD withdrawal syndrome, symptom, predictive
factor, random sample, cohort study, Germany, diagnostic criteria,
interview, self-report, risk analysis, relative risk, human study
|
Rosa Hoshi, Jatinder Bisla, and H. Valerie Curran. The acute
and sub-acute effects of "ecstasy" (MDMA) on processing of facial
expressions: Preliminary findings. Drug & Alcohol Dependence 76(3):297-304, December 2004.
Summary:
There is evidence that serotonergic processes may modulate the
processing of fearful facial expressions. This raises the possibility
that
the recreational drug "ecstasy" (3-4 methylenedioxymethamphetamine,
MDMA), which has marked serotonergic
effects, may affect people's ability to recognize human facial
expressions portraying fear. This study therefore investigated whether
ecstasy users differed from controls in fear recognition at two
different times: shortly after taking the drug and a few days later.
Ecstasy users (n = 16) and
controls (n = 21) were
compared on a
facial expression recognition task involving the six basic emotions
(happiness, surprise, sadness, anger, fear, and disgust) and on
self-ratings of mood on the night of drug use (day 0) and 4 days later
(day 4). On day 0, ecstasy users were more accurate than controls in
recognising fearful facial expressions, but less accurate than controls
on day
4 when compared with their overall ability to recognize other basic
emotions. Accuracy of fear recognition on day 4 was negatively
correlated with both years of ecstasy use and number of ecstasy tablets
taken on a typical session. On self-rated aggression scales, ecstasy
users scored lower than controls on day 0 and higher on day 4. These
results support the hypothesis that serotonin has a role in
modulating the recognition of fearful facial expressions. Increased
accuracy of fear recognition may relate to serotonin release following
ecstasy use on day 0, and decreased accuracy may reflect subsequent
depletion of serotonin a few days later.
NIAAA Glossary: face,
expression of emotion, serotonin, MDMA, time series analysis,
correlation analysis, controlled study, comparative study, hypothesis
testing, human study
|
Jennifer Bearn, Andrew Evans, Michael Kelleher, Kirsten Turner, and
Andrew Lees. Recognition
of a dopamine replacement therapy dependence syndrome in Parkinson's
disease: A pilot study. Drug & Alcohol Dependence 76(3):305-310, December 2004.
Summary:
This study investigated whether a group of patients with Parkinson's
disease (n = 10), provisionally diagnosed with
“hedonistic homeostatic dysregulation” because of their excessive use
of dopamine replacement therapy (DRT), met established operational
psychiatric criteria for substance
dependence. The noncompliant patients were compared with Parkinson's
disease
patients who were compliant with prescribed DRT (n = 10). Use of a
semi-structured questionnaire
designed to distinguish between adaptive therapeutic dependence on DRT
and a maladaptive pathological pattern of DRT use, in conjunction with
the SCID-1, revealed that seven of the patients deemed by their
treating physicians to be misusing DRT met operational criteria
for maladaptive dependence in contrast to none of the compliant group.
The majority meeting criteria for maladaptive dependence experienced
dysphoric “withdrawal” symptoms in the “off”
state and increased their dose of DRT in an effort to control their
mood. They also continued to use high doses of DRT despite disabling
dyskinesias and social difficulties. This study provides preliminary
evidence that some patients with Parkinson's disease may become
maladaptively dependent on DRT. This finding has both clinical
relevance for the treatment of Parkinson's disease and further
implicates dopaminergic
pathways in the genesis of substance dependence.
NIAAA Glossary:
Parkinson's disease, dopamine, therapeutic agents, patient compliance,
AOD dependence, AOD withdrawal syndrome, symptom, motor skills
disorder, social behavior, homeostasis, comparative study, dopaminergic
neuron, human study
|
Michael T. Compton, Andrew C. Furman, and Nadine J. Kaslow. Preliminary
evidence of an association between childhood abuse and cannabis
dependence among African American first-episode schizophrenia-spectrum
disorder patients. Drug
& Alcohol Dependence 76(3):311-316,
December 2004.
Summary:
Comorbid cannabis dependence is prevalent among patients early in the
course of a schizophrenia-spectrum disorder.
Because determining risk factors for substance abuse may be helpful in
designing interventions to reduce the psychosocial morbidity associated
with substance abuse among this population, this pilot study
investigated whether African American, socially disadvantaged,
first-episode schizophrenia-spectrum patients with cannabis dependence
experienced greater levels of childhood abuse and neglect compared to
similar patients without comorbid cannabis dependence. Among 29
eligible patients, 18 participated in the study. First-episode
patients with comorbid cannabis dependence (n = 8) reported
significantly greater childhood physical and sexual abuse compared to
those without comorbid cannabis dependence (n = 10). This represents
preliminary evidence of an association between childhood maltreatment
and cannabis dependence among this especially vulnerable population.
Childhood physical and sexual abuse may be a risk factor for the
initiation of cannabis dependence and other substance use disorders in
the early course of schizophrenia.
NIAAA Glossary:
comorbidity, schizophrenia, marijuana in any form, AOD dependence,
psychosocial environment, risk factors, abused as child, child abuse,
child neglect, sexual abuse, violence, pilot study, controlled study,
comparative study, human study
|
Drug
and Alcohol Dependence
Volume
76, Supplement 1, December 2004
(Updated 11/20/2004)
Home Page
Lynda Erinoff, Wilson M. Compton, and Nora D. Volkow. Drug abuse and suicidal behavior
(editorial). Drug and Alcohol
Dependence 76(Suppl.
1):S1-S2,
December 2004.
Lynda Erinoffa, James C. Anthony, Gregory K. Brown, Eric D. Caine,
Kenneth R. Conner, Donald M. Dougherty, Anne L. Glowinski, David B.
Goldston, Marsha M. Linehan, J. John Mann, Klaus A. Miczek, Rumi K.
Price, Richard K. Ries, Alec Roy, Kenneth J. Sher, Ralph E. Tarter,
Elaine A. Thompson, Holly D. Wilcox, James D. Wines, and Shirley
Yen. Overview of
workshop on drug abuse and suicidal behavior (editorial) . Drug and Alcohol Dependence 76(Suppl. 1):S3-S9, December 2004.
Anne L. Glowinski, Theodore Jacob, Kathleen K. Bucholz, Jeffrey F.
Scherrer, William Trueb, and Andrew C. Heath. Paternal
alcohol dependence and offspring suicidal behaviors in a
children-of-twins study. Drug and Alcohol Dependence 76(Suppl. 1):S69-S77, December 2004.
Summary:
In
substance abusing families, sources of familial comorbidity are
potentially confounded by genetic-environmental interplays. This study
used the
children-of-twins (COT) design to investigate the association
of parental alcohol dependence and offspring suicidality in a sample of
adolescent and young adult offspring of "Vietnam Era Twins." The
participants completed an interview including
a comprehensive assessment of lifetime suicidal behaviors. The sample
was stratified into four groups based on paternal
zygosity (monozygotic vs. dizygotic) and lifetime paternal alcohol
dependence
history (positive vs. negative) to examine whether the
relationship of paternal alcoholism and offspring suicidality was best
explained by genetic predispositions common to alcoholism and
suicidality or by genetic-environmental interplay. The results
suggested a main effect of paternal alcoholism on offspring
suicide attempt, but a purely genetic
explanation for the association was not supported by COT analyses.
Suicide attempts probably result from genetic-environmental interplays
and must be studied
in genetically informative samples of offspring of substance abusing
parents.
NIAAA Glossary Terms:
family AODU history, AOD abuse, AOD dependence, familial alcoholism,
paternal alcoholism, twin study, family study, family background,
comorbidity, suicidal behavior, children of alcoholics, adult children
of alcoholics, adolescent, young adult, hereditary vs environmental
factors, family environment, interview,
correlation analysis, genetic correlation analysis, human study
|
R.E. Tarter, Levent Kirisci, Maureen Reynolds, and Ada Mezzich. Neurobehavior
disinhibition in childhood predicts suicide potential and substance use
disorder by young adulthood. Drug and Alcohol Dependence 76(Suppl. 1):S45-S52, December 2004.
Summary:
A prospective study was carried out to examine whether two factors that
are established components of the risk for substance use disorder (SUD)
also influence the risk for suicide, and whether substance use disorder
appearing by early adulthood predicts propensity to suicide.
Neurobehavior
disinhibition in boys (N =
227) at ages 10–12 and 16 and parental
history of substance use disorder were prospectively evaluated to
determine their
association with the risk for substance use disorder and suicide
propensity between ages
16 and 19. The results indicated that neurobehavior disinhibition at
age 16 predicts suicide propensity between ages 16 and 19 (p = 0.04). A
trend was observed (p = 0.08)
for substance use disorder between ages 16 and 19 to
predict suicide propensity during the same period. Maternal substance
use disorder was
directly associated with risk of substance use disorder, but not with
suicide propensity, in sons.
Paternal substance use disorder predicted son's neurobehavior
disinhibition, which in turn
predisposes to substance use disorder. A direct relation between
paternal substance use disorder and suicide propensity in sons was not
observed. These findings suggest that
neurobehavior disinhibition, a component of the liability of substance
use disorder, is
also associated with suicide risk. The results are discussed within a
neurobehavioral framework in which prefrontal cortex dysfunction is
hypothesized to underlie the risk for these two outcomes.
NIAAA Glossary Terms:
disinhibition theory of AODU, neurobehavioral theory of AODU, AOD
abuse, AOD dependence, family AODU history, age of AODU onset, suicidal
behavior, suicide, prospective study, risk analysis, risk factors,
predictive factor, adolescent, young adult, mother, father, son, trend,
human study, family study
|
Holly C. Wilcox and James C. Anthony. The
development of suicide ideation and attempts: An epidemiologic study of
first graders followed into young adulthood. Drug and Alcohol Dependence 76(Suppl. 1):S53-S67, December 2004.
Summary:
Risk
of suicidal ideation and suicide attempts from first grade to young
adulthood was estimated in a community sample, with focus on comparing
youths who used drugs before age 16 to those who used
drugs later in development or not at all. Standardized interview
assessments were completed
in 1989–1994 with 2,311 youths 8–15 years old. Roughly 15 years
after recruitment, roughly 75% of the original sample (n = 1,695; mean age, 21) were
reassessed. Of these, 155 had made suicide attempts and 218 experienced
onset of depression-related suicide ideation. Survival analysis and
logistic
regression models were used to estimate relative risk (RR) for early
use of tobacco, alcohol, cannabis,
and inhalants, with covariate adjustments for age, sex, race-ethnicity,
and other pertinent covariates. Early-onset of cannabis use and
inhalant use for females, but not for males, was associated with modest
excess
risk of suicide attempt (cannabis-associated RR = 1.9; p = 0.04;
inhalant-associated RR = 2.2; p
= 0.05). Early-onset of cannabis use by
females (but not by males) was associated with excess risk for suicide
ideation
(RR = 2.9; p = 0.006).
Early-onset alcohol and tobacco use were not
associated with later risk of suicide attempt or suicidal ideation.
Considering the relatively
modest strength of association, the evidence may well reflect an
underlying common diathesis or unmeasured prior confounding influences
that link early-onset illegal drug use with later risk of these
suicide-related events, rather than an influence of early-onset drug
use itself.
NIAAA Glossary Terms:
sucidal behavior, suicidal ideation, age of AODU onset, early AODU
onset, longitudinal study, child, adolescent, young adult,
psychological assessment, risk analysis, relative risk, regression
analysis, alcoholic beverage, tobacco in any form, marijuana in any
form, inhaled substance, gender differences, confounding variables,
human study
|
Holly C. Wilcox, Kenneth R. Conner, and Eric D. Caine. Association
of alcohol and drug use disorders and completed suicide: An empirical
review of cohort studies. Drug and Alcohol Dependence 76(Suppl. 1):S11-S19, December 2004.
Summary:
This literature review updates and expands upon Harris and
Barraclough's empirical
review of
retrospective and prospective studies of alcohol and drug use
disorders and suicide (Harris, E.C., Barraclough,
B. Br. J. Psychiatry
170, 205-228, 1997). The studies used include
those
originally identified by Harris and Barraclough, English language
reports on MEDLINE (1994–2002) identified with the search terms
"substance-disorders" with "mortality" and "follow-up," read-throughs
of four prominent alcohol and drug specialty
journals from 1966 through 2002, and the reference sections of articles
that met criteria; 42 new studies met eligibility criteria. The
estimated standardized mortality ratios (SMRs) for suicide were as
follows: alcohol use disorder (SMR = 979; 95%
confidence interval [CI], 898–1065; p
<0.001), opioid use disorder (SMR = 1351; 95% CI,
1047–1715; p <0.001),
intravenous drug use (SMR = 1373; 95% CI, 1029–1796; p <0.001), mixed drug
use (1685; 95% CI, 1473–1920; p
<0.001),
heavy drinking (351; 95% CI, 251–478; p
<0.001). SMR estimates
stratified by sex were also calculated. These additional studies on the
association of suicide and mixed drug use,
heavy drinking, and alcohol use disorders in women augment the
findings of Harris and Barraclough, along with a novel estimate for
intravenous drug use, a byproduct of the past decade's intensive
research on human immunodeficiency virus (HIV). There is a large
empirical literature on alcohol use
disorders and suicide and a moderate literature on suicide and opioid
use disorders and intravenous drug use. Prospective data
on the association of suicide and other drug use disorders (e.g.,
cocaine, cannabis) remains limited.
NIAAA Glossary Terms:
literature review, suicide, AODR mortality, AOD use, AOD abuse, heavy
AOD use, AOD dependence, AODR disorder, alcohol use disorder
classification, retrospective study, prospective study, database, data
collection from documents, meta-analysis, risk analysis, opioids,
intravenous drug user, multiple drug use, human immunodeficiency virus,
cocaine, marijuana in any form, human study
|
Rumi Kato Price, Nathan K. Risk, Ashley H. Haden, Collins E. Lewis, and
Edward L. Spitznagel. Post-traumatic
stress disorder, drug dependence, and suicidality among male Vietnam
veterans with a history of heavy drug use. Drug and Alcohol Dependence 76(Suppl. 1):S31-S43, December 2004.
Summary:
The roles of post-traumatic stress disorder (PTSD) and
drug dependence in non-fatal suicidality (suicidal ideation and
suicide attempt) were investigated among Vietnam veterans in their
middle-age years. The
sample included male veterans deployed to Vietnam, with oversampling of
those who tested positive for opiates at their return (N
= 642). PTSD, substance abuse, suicidality, and other psychopathology
were analyzed using three waves of survey and military data covering
the
period from early adolescence to middle adulthood. Measures
included the onset and recency of each of the lifetime Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV) PTSD
symptom criteria, and yearly symptom measures of DSM-IV dependence for
alcohol and eight classes of psychoactive substances. Survival and
hazard models were used to assess the effects of drug dependence,
PTSD, and other psychopathology on the duration of suicidality.
Longitudinal models were used to estimate the casual relationships
among PTSD, drug
dependence, and suicidality over a 25-year period. The results showed
evidence of strong continuity of PTSD, drug dependence, and suicidality
over time. The causal role of drug dependence on PTSD and suicidality
is limited to young adulthood. Evidence was stronger for
self-medication
in later adulthood. The results indicate that a life course perspective
is needed for the combined treatment of PTSD and drug dependence for
severely traumatized populations.
NIAAA Glossary Terms:
posttraumatic stress disorder, suicidal behavior, suicidal ideation,
AOD dependence, middle-aged adult, Vietnam veteran, opiates, diagnostic
criteria, symptom, statistical modeling, survey, time series analysis,
longitudinal study, causal path analysis, age differences, disease
severity, human study
|
James D. Wines, Jr., Richard Saitz, Nicholas J. Horton,
Christine Lloyd-Travaglini, and Jeffrey H. Samet. Suicidal
behavior, drug use and depressive symptoms after detoxification: A
2-year prospective study. Drug and Alcohol Dependence 76(Suppl. 1):S21-S29, December 2004.
Summary:
Factors associated with drug-related suicidal behavior
(suicidal ideation, suicide attempt) were examined using multivariable
regression analyses in a 2-year prospective study
of inpatients (N = 470)
enrolled from an open detoxification unit. Lifetime prevalences were
28.5% for suicidal ideation and 21.9% for suicide attempt. During the
2-year follow up, suicidal ideation was reported by 19.9% of the sample
and
a suicide attempt by 6.9%. Correlates of lifetime suicidal
behavior included younger age, female, Hispanic, greater depressive
symptoms, past sexual abuse, and problem sedative or alcohol use.
Factors associated with suicidal behavior at follow up included past
suicidal behavior, more depressive symptoms, and more frequent
benzodiazepine and alcohol use. Cocaine and heroin use did not reach
statistical significance. Suicidal behavior is common among individuals
with substance-related
disorders. Differences in “suicide potential” may exist between drug
categories with central nervous system (CNS) depressants increasing the
risk. These findings emphasize the importance of addressing the
recurrent suicide risk of
patients with substance-related disorders and regularly monitoring for
changes in depressive symptoms and drug use. Because of the prevalence
and severity of this problem, greater attention to the role of
universal suicide screening
of individuals with substance-related disorders is merited.
NIAAA Glossary Terms:
suicidal ideation, suicidal behavior, AODR disorder, prospective study,
regression analysis, prevalence, correlation analysis, age differences,
gender differences, ethnic differences, Hispanic, individual
differences, emotional and psychiatric depression, patient history,
sexual abuse, problematic AOD use, sedative-hypnotics, alcoholic
beverage, benzodiazepines, cocaine, heroin, central nervous system, CNS
depressants, risk factors, patient monitoring, identification and
screening, human study
|
David B. Goldston. Conceptual
issues in understanding the relationship between suicidal behavior and
substance use during adolescence. Drug and Alcohol Dependence 76(Suppl. 1):S79-S91, December 2004.
Summary:
The author reviews conceptual issues regarding the relation between
suicidal behavior and substance use in adolescence. Alcohol
and drug use are risk factors for suicidal behaviors
in adolescence, but the precise nature of the relationship between
suicidality and substance abuse, and the implications of this
relationship for prevention and treatment are unclear.
Several conceptual issues that need to be addressed are identified:
What are the
most appropriate ways of defining suicidal behaviors? What are the best
ways of assessing suicidal behavior and characterizing its course over
time? Should suicidal adolescents be considered a single
homogeneous population? In what possible ways are the course
of substance abuse and suicidality over time related? What factors
might affect the trajectories of both substance abuse and
suicidality? Does the substance abuse-suicidality relationship change
over time? To what extent can knowledge of
factors precipitating and maintaining the joint outcomes of suicidal
and substance abuse behaviors be incorporated into interventions that
target both? Careful consideration and exploration of these issues
should improve understanding of the substance
abuse-suicidality relationship, and ultimately lead to the development
of
more effective prevention efforts and treatments for adolescents with
both
problems.
NIAAA Glossary Terms:
adolescent, suicidal behavior, early AODU onset, underage AOD use, AOD
abuse, underage drinker, risk factors, prevention, treatment factors,
suicide prevention, prevention effort directed at people at risk,
research issue, research agenda, treatment research, literature review
|
Donald M. Dougherty, Charles W. Mathias, Dawn M. Marsh, F. Gerard
Moeller, and Alan C. Swann. Suicidal
behaviors and drug abuse: Impulsivity and its assessment. Drug and Alcohol Dependence 76(Suppl. 1):S93-S105, December 2004.
Summary:
Assessment of the role of impulsivity in sucidal behaviors and drug
abuse is reviewed. Impulsivity
appears to play an important role in suicidal behaviors and drug abuse,
which are two psychiatric problems that may interact with one another.
Interpretation of the literature on impulsivity in these behaviors may
be complicated by the variety of measurement techniques for the
assessment of impulsivity. There are three general types of impulsivity
assessment: self-report, biological, and laboratory-behavioral. Because
laboratory behavioral measures meet an operational definition of
impulsivity and are sensitive to state-dependent changes in
impulsivity, the review focuses on laboratory
behavioral performance among samples exhibiting suicidal behaviors or
substance abuse. Better accounting for influence of impulsivity in
these psychiatric disturbances requires that, no single source of
measurement be used without considering other types of instruments.
NIAAA Glossary Terms:
impulsive behavior, suicidal behavior, suicidal ideation, AOD abuse,
comorbidity, laboratory measurement, self-report, biological markers,
behavioral and mental disorder, measurement in general, literature
review
|
Home Page
Drug
and Alcohol Dependence
Volume
76, Number 2, November 2004
(Updated 10/20/2004)
Home Page
J.
Estelles, M. Rodríguez-Arias, M. A. Aguilar, and J.
Miñarro. Social behavioural profile of cocaine in
isolated and grouped male mice. Drug and Alcohol Dependence 76(2):115-123, November 2004.
|
Summary:
Studies of the relationship between cocaine and
aggression
in humans and animals have found increases,
decreases, or no changes in aggression after single or chronic
cocaine administration. To help clarify cocaine's complex behavioral
actions, this study evaluated
cocaine effects on social behaviors of mice exposed to different
situations (isolated or housed in groups) using confrontations between
two
male mice in a neutral area. Cocaine (6, 25, or
50 mg/kg) was administered as a single dose or in a binge pattern
(three
doses
in 24 hours). The behavioral test was performed 20 minutes
after
the last
injection. No increases in aggression were observed in any situation
tested. Instead, cocaine at the two higher doses (either as
a single dose or in the binge pattern), decreased aggressive behaviors
in
isolated mice and produced no changes in grouped animals. In
both types of animals, cocaine increased defensive behaviors
(avoidance/fleeing) and abolished social contacts. It was concluded
that cocaine has an anti-aggressive action and may be interpreted as
having an
anxiogenic-like effect.
NIAAA Glossary Terms: cocaine,
aggressive behavior, harm-avoidance behavior, social
behavior, anxiety, animal study, animal behavior, laboratory mice,
binge AOD use, psychobehavioral AODE
|
Levent Kirisci, Ralph E. Tarter, Michael Vanyukov, Maureen Reynolds,
and Miguel Habeych. Relation
between cognitive distortions and neurobehavior disinhibition on the
development of substance use during adolescence and substance use
disorder by young adulthood: A prospective study. Drug and Alcohol Dependence 76(2): 125-133, November
2004.
|
Summary:
Neurobehavior disinhibition has been shown in previous studies to
increase the risk for a diagnosis of
substance use disorder. This study tested the hypothesis
that deficient capacity to appraise the effects of alcohol
and drugs and interpret social interactions mediates the relation
between neurobehavior disinhibition in childhood and substance use
disorder by early
adulthood. Boys with fathers having lifetime substance use disorder (n
= 88) and boys whose fathers had no substance use disorder or other
psychiatric disorder (n
= 127) were prospectively tracked from ages 10–12 to 19 years.
Neurobehavior disinhibition was evaluated at baseline followed by
assessments of cognitive distortions and substance use involvement in
early and mid-adolescence. Substance use disorder outcome was evaluated
up to age 19
years. Cognitive
distortions at ages 12–14 years
were found to mediate the association between neurobehavior
disinhibition at ages 10–12
years and marijuana use at age 16, which, in turn, predicted substance
use disorder
by age 19. Cognitive distortions in early adolescence did not
directly predict substance use disorder by young adulthood.Thus
inaccurate
social cognition, significantly predicted by childhood neurobehavior
disinhibition, biases development toward marijuana use prodromal to
substance use disorder. The findings indicate that cognitive processes,
in conjunction
with psychological self-regulation, comprise important components of
the individual liability to substance use disorder.
NIAAA Glossary Terms: cognition,
cognitive development, marijuana in any form, child, adolescent, young
adult, neurobehavioral theory of AODU, disinhibition theory of AODU,
prospective study, longitudinal study, hypothesis testing
|
Sandra C.
Lapham, Janet C’de Baca, Garnett McMillan, and William C. Hunt. Accuracy of
alcohol diagnosis among DWI offenders referred for screening.
Drug and Alcohol
Dependence 76(2):135-141,
November 2004.
|
Summary:
Screening
programs are used by most U.S. courts to evaluate
substance-abuse problems of offenders convicted of driving while
impaired (DWI). The need for treatment is typically based on
self-reported information, although little is known about the accuracy
of such information. This study assessed the accuracy of self-reports
of alcohol-use problems in this population. Alcohol abuse and
dependence diagnoses (Diagnostic and
Statistical Manual of Mental Disorders, Third Edition, Revised)
from an initial, court-ordered
screening evaluation of convicted DWI offenders
(583 females, 495 males) were compared with diagnoses and other
self-reported information from a
voluntary interview 5 years after the screening referral. At
initial screening, 16.8% were diagnosed with alcohol
abuse and 20.1% with alcohol dependence. At the 5-year interview, 19.9%
received a retrospective diagnosis of alcohol abuse and 60.1% a
retrospective diagnosis of alcohol
dependence at the age at which they were screened. Significantly fewer
of those with a retrospective alcohol diagnosis reported that their
alcohol use self-reports at screening were "very accurate" compared to
those with no retrospective diagnosis. Thus, while
many DWI offenders undergoing screening have diagnosable
alcohol-related problems, underreporting is common. This leads to
inaccurate diagnoses and missed treatment opportunities. Researchers
and policymakers are urged to review and reform the
current screening system for alcohol-impaired drivers.
NIAAA Glossary Terms:
drinking and driving, impaired driver, psychosocial screening and
diagnostic method, AOD dependence, AOD abuse, diagnostic problem,
diagnostic criteria, self-report, follow-up study, retrospective study,
interview, human study, legal issues, justice system process and
procedures, assessment of variables and methods |
Judith J. Prochaska, Joseph S. Rossi, Colleen A. Redding, Amy B. Rosen,
Janice Y. Tsoh, Gary L. Humfleet, Stuart J. Eisendrath, Marc R.
Meisner, and Sharon M. Hall. Depressed
smokers and stage of change: Implications for treatment interventions.
Drug and Alcohol
Dependence 76(2):143-151,
November 2004.
Summary:
Mental health, addictions, and tobacco control workers have given
insufficient attention to tobacco dependence among smokers with
psychiatric disorders. This study
examined depressed smokers’ readiness to quit and the applicability of
the Stages of Change framework to a psychiatric sample. The
participants were currently
depressed smokers (N = 322) who were recruited from four outpatient
psychiatric clinics. They averaged 16 cigarettes per day (SD
= 10) and 24 years (SD = 13) of smoking. The majority, 79%, reported
intention to quit smoking and 24% said they were ready to take action
in the next 30
days. Individuals in the preparation stage reported more prior attempts
to quit smoking, a greater commitment to abstinence, increased
recognition of
the negatives of smoking, and greater use of the processes of change.
Precontemplators were least likely to identify a goal related to their
smoking behavior. Severity of depressive symptoms and history of
recurrent
depressive episodes were unrelated to readiness to quit. This is
one of the first studies to examine the smoking behaviors of depressed
psychiatric outpatients. The level and duration of their
tobacco use underscore the need for cessation interventions. The
consistency in hypothesized patterns among theoretical constructs of
the Stages of Change model supports the transfer of stage-tailored
interventions to this clinical population.
NIAAA Glossary Terms:
smoking, cigarate, emotional and psychiatric depression, mentally ill,
AOD use pattern, AOD abstinence, stages of change, disease severity,
intervention (persuasion to treatment), human study
|
Xinguang Chen, a, Xiaoming Li, Bonita Stanton, Rong Mao, Zhifeng Sun,
Hongshia Zhang, Mingfeng Qu, Jing Wang, and Ronald Thomas. Patterns of
cigarette smoking among students from 19 colleges and universities in
Jiangsu Province, China: A latent class analysis. Drug and Alcohol Dependence 76(2):153-163, November 2004.
Patterns
and dynamics of cigarette smoking were examined by age and grade among
college students in China. Cross-sectional data from 1,845 students
(44%
females) in 19 colleges and universities in Jiangsu Province were
derived from the Chinese Youth Health Risk Behavior Survey in 2001.
Data were analyzed using latent class analysis. Overall 11
mutually exclusive types (latent classes) of cigarette users were
derived and their proportions estimated from four variables: lifetime
smoking, past 30-day smoking, attempting to quit in the past, and
intention to smoke in the future. Two types (resistant never-smokers,
self-stopped resistant nonsmokers) were observed across age groups and
grades for both males and females while other smoking types varied with
gender, age and grade. Advanced cigarette smoking types appeared in
older age groups and higher grades. The cross-sectional age and grade
trend suggests substantial progression in cigarette smoking among
Chinese college students, underscoring the need for prevention among
these students. Results also suggest that latent class analysis may be
an effective
methodology for analyzing behavioral types and their dynamics with a
limited number of variables.
NIAAA Glossary Terms:
smoking, cigarette, undergraduate student, China, statistical modeling,
cross-sectional study, age differences, gender differences, trend, AOD
nonuse, AOD abstinence, human study
|
Donald A. Calsyn, Andrew J. Saxon, Kristen R. Bush, Donelle N. Howell,
John S. Baer, Kevin L. Sloan, Carol A. Malte, and Daniel R.
Kivlahan. The Addiction Severity Index medical and
psychiatric composite scores measure similar domains as the SF-36 in
substance-dependent veterans: Concurrent and discriminant validity.
Drug and Alcohol
Dependence 76(2):165-171,
November 2004.
Summary:
Attention has recently been given to the assessment of functional
health status in
substance-dependent individuals. The widely used Addiction Severity Index (ASI)
includes scales for
current medical and psychiatric status. This study examined the
concurrent validity of these ASI composite scores in relation to the Short Form 36-Item Health Survey
(SF-36), a well-established measure of
health-related quality of life and functional health status. Veterans (N = 674) were assessed at admission
to substance dependence
treatment. Correlations were performed between ASI composite scores and
SF-36 scales and the physical and mental summary components (PSC and
MSC respectively). Areas under receiver operating characteristic (ROC)
curves determined the discriminative ability of the ASI composites to
ascertain impairment. The ASI medical composite score showed robust
correlations with the four SF-36 scales that relate
to physical health and with the PCS. The ASI psychiatric composite
score had robust correlations with the four SF-36 scales related to
mental health and with the mental component summary (MCS). ROC curves
indicated that the ASI medical (AUC = 0.83) and psychiatric composites
(AUC = 0.90) accurately detected subjects with impairment. In
conclusion,
ASI medical and psychiatric composite scores provide effective initial
screening for patients with impaired functional status as measured by
the corresponding SF-36 component summary scores.
NIAAA Glossary Terms:
physical health, mental health, quality of life, correlation analysis,
AOD dependence, patient assessment, statistical estimation, disease
severity, evaluation study, comparative study, human study, psychiatric
status rating scales
|
Marisa M. Silveri, Carl M. Anderson, Jane F. McNeil, Claudia I. Diaz,
Scott E. Lukas, Jack H. Mendelson, Perry F. Renshaw, and Marc J.
Kaufman. Oral
methylphenidate challenge selectively decreases putaminal T2 in healthy
subjects. Drug and
Alcohol Dependence 76(2):173-180,
November 2004.
Summary:
Few studies have characterized the
time course of brain effects of oral methylphenidate in humans, despite
the recent rise in abuse of this drug. This study assessed the
hemodynamic effects of oral methylphenidate in 11
healthy young adults (6 women, 5 men), by measuring brain transverse
relaxation times (T2). T2 can be interpreted as a surrogate and
inversely correlated marker for steady-state cerebral blood volume
(CBV). Data were acquired from the caudate nucleus, putamen, and
thalamus, using a 1.5 T magnetic resonance imaging scanner at baseline
and serially for 2 hours after oral methylphenidate administration (0.5
mg/kg). Physiological and
subjective measures and plasma methylphenidate levels also were
examined. Methylphenidate
induced a selective T2 decrease (−1.65 ± 0.53 ms) in the putamen
(F(6,54) = 2.68, p <
0.03). Heart rate, blood pressure, and plasma methylphenidate
levels increased significantly after drug administration, as well as
subjective ratings of "feeling drug effect". T2 decreases may reflect
methylphenidate-induced increases in putaminal blood volume. These data
suggest
that T2 relaxometry can be used to study the time course of regional
cerebral blood volume responses to methylphenidate and perhaps to other
stimulant
drugs.
NIAAA Glossary Terms:
methylphenidate, magnetic resonance imaging, cerebrum, caudate nucleus,
putamen, thalamus, cerebral blood flow, blood flow measurement,
physiological AODE, pharmacology and toxicology, subjective variables,
heart rate, blood pressure, correlation analysis, AOD abuse, CNS
stimulants, human study
|
Raul Gonzalez, Julie D. Rippeth, Catherine L. Carey, Robert K. Heaton,
David J. Moore, Brian C. Schweinsburg, Mariana Cherner, and Igor
Grant. Neurocognitive
performance of methamphetamine users discordant for history of
marijuana exposure. Drug
and Alcohol Dependence 76(2):181-190,
November 2004.
Summary:
This study examined whether methamphetamine (METH)-dependent persons
who also meet criteria for marijuana (MJ)
abuse or dependence differ in neuropsychological performance from those
with
METH dependence alone. Three demographically similar groups were
examined: (1) subjects
with a history of METH dependence and history of MJ
abuse or dependence (METH+/MJ+, n
= 27); (2) METH-dependent
subjects with no history of MJ abuse or dependence (METH+/MJ−, n =
26); and (3) a control group with minimal or no drug use (n
= 41). Neuropsychological performance was
quantified for five cognitive ability areas. The METH+/MJ− group
generally demonstrated the greatest neuropsychological impairment, with
statistically
significant differences observed between the METH+/MJ− and control
group in learning, retention/retrieval, and a summary score of global
neuropsychological performance. The METH+/MJ+ group did not differ
significantly from
the control or METH+/MJ− group on any neuropsychological ability.
However, there was a
significant linear trend in the global neuropsychological score
suggesting that the
METH+/MJ+ performed intermediate to the control and METH+/MJ− groups.
It was not possible to conclude from these findings that MJ use has a
protective
effect in METH users. However, MJ
use clearly did not appear to exacerbate METH neurotoxicity.
Further studies are needed to determine if the emerging
literature, suggesting that certain cannabinoids might have
neuroprotective actions, is generalizable to community-dwelling
substance abusers.
NIAAA Glossary Terms:
neuropsychological assessment, methamphetamine, marijuana in any form,
neuroprotective factors, neurotoxicity, controlled study, human study,
cannabinoids, learning ability, memory retention, memory retrieval, AOD
abuse
|
Diana J. Walker, Nancy J. Beckman, and James P. Zacny. Reinforcing
and subjective effects of the volatile anesthetic, sevoflurane.
Drug and Alcohol
Dependence 76(2):191-201,
November 2004.
|
Summary:
This study assessed the reinforcing and subjective
effects of sevoflurane (SVF), a volatile anesthetic that is chemically
similar to volatile substances of abuse and can be safely administered
to humans in laboratory research. Five concentrations of SVF (0, 0.2,
0.4, 0.6, 0.8%
in O2) were studied in 20 non-drug-abusers.
During each of five sessions, subjects sampled a concentration of SVF
and 100% O2
(placebo) for 10 minutes each. Later, within the session, they
chose
nine
times, once every 5 minutes, among SVF (e.g. "Agent A"),
placebo
(e.g. "Agent B"), or neither (they received 100% O2,
identified as "drug-free air"). Although "neither" was selected most
frequently, mean preference ratios [SVF choices / (SVF
choices + placebo choices)] and total SVF choice peaked at the
0.4% concentration. Choice patterns varied across subjects, with some
subjects never choosing SVF and other subjects showing
monotonic increasing or bitonic concentration–choice functions.
Concentration-related increases in subjective effects were observed,
including effects that are putatively associated with abuse liability.
Ratings of drug liking and of wanting to inhale the drug again were
positively correlated with SVF choice. This study shows that
sevoflurane can function as a reinforcer and produce abuse
liability-related subjective effects in some healthy volunteers.
NIAAA Glossary Terms:
choice-making behavior, positive reinforcement, subjective variables,
volatile inhalant, anesthetics, AOD abuse potential, AOD abuse, human
study, controlled study
|
Shirley J. Semple, Thomas L. Patterson, and Igor Grant. A comparison
of injection and non-injection methamphetamine-using HIV positive men
who have sex with men. Drug and Alcohol Dependence 76(2):203-212, November 2004.
|
Summary:
Injection and non-injection users of methamphetamine were compared on
background characteristics, drug use patterns, health and
social problems, sexual risk behavior, and psychosocial factors. The
subjects were human immunodeficiency virus (HIV)-positive homosexual
men (N
= 194) who were
enrolled in a sexual risk reduction intervention for methamphetamine
users. Compared to non-injectors, methamphetamine injectors were
significantly more likely to be Caucasian,
bisexual, homeless, divorced or separated, with lower educational
attainment. Injectors also reported more
years of methamphetamine use, greater frequency and amount of use, more
social and health problems including higher prevalence of sexually
transmitted diseases and hepatitis C, and more sexual risk behaviors.
Methamphetamine injectors scored significantly higher on
measures of impulsivity and experiences of rejection, and lower on a
measure of emotional support. A multivariate logistic regression
revealed that educational attainment and experiences of rejection were
the factors that best discriminated between injectors and
non-injectors. The unique characteristics of injection methamphetamine
users are
discussed in relation to the development of effective HIV prevention
programs for the target population.
NIAAA Glossary Terms: methamphetamine,
gay male, AOD use pattern, AOD use frequency, intravenous drug user,
intravenous injection, HIV infection, homosexual behavior, risk-taking
behavior, health related behavior, sexually transmitted disease,
hepatitis C, impaired health, psychosocial cause of stress, social
adjustment, social problems, social support, bisexual, White, divorce,
homeless,
impulsive behavior, human study
|
Jennifer Sharpe Potter, Grace Hennessy, Jennifer A. Borrow, Shelly F.
Greenfield, and Roger D. Weiss. Substance
use histories in patients seeking treatment for controlled-release
oxycodone dependence. Drug and Alcohol Dependence 76(2):213-215, November 2004.
Summary:
Medical records were reviewed to ascertain the characteristics of
patients currently abusing
controlled-release
(CR) oxycodone and admitted for inpatient detoxification. Inpatients
with CR oxycodone
dependence (N = 48) were
categorized according to how they initially received the drug, i.e.,
illicitly or by prescription for
legitimate medical use. Fifteen of the 48 patients (31%) initially
obtained a CR oxycodone prescription legitimately for a medical
condition. Although none of these 15 patients had a history of prior
opioid misuse, they were more likely than illicit CR oxycodone users to
report prior detoxifications (p < 0.03) as well as a lower
mean age of first alcohol use (mean age 11.7 years versus 14.7 years, p
< 0.05) and lower mean age of first illicit drug use (mean age 12.8
years
versus 15.8 years, p
< 0.05). These findings suggest that a history of substance abuse is
common among patients abusing CR oxycodone, including those for
whom CR oxycodone was initially legitimately prescribed for pain.
NIAAA Glossary Terms: oxycodone,
opiates, prescription drug, medically necessary care, illicit drug, AOD
abuse, AOD dependence, sense of pain, inpatient care, addiction,
detoxification, age of AODU onset, early AODU onset, comparative study,
human study |
Home Page
Drug
and Alcohol Dependence
Volume
76, Number 1, October 2004
(Updated 9/22/2004)
Home Page
William
B. McAllister. History encapsulated: How the controlled
substances act exemplifies the dilemmas of drug control.
Drug and Alcohol
Dependence 76(1):1-2,
October 2004.
William B. McAllister. The global
political economy of scheduling: The international–historical context
of the Controlled Substances Act. Drug and Alcohol Dependence 76(1):3-8, October 2004.
|
Summary:
The international context of regulation to
control addicting substances that gave rise to schedules is explained.
The article discusses
the impact of scheduling decisions on subsequent national drug control
legislation and international drug control negotiations, with emphasis
on how the creation of schedules introduced new incentives and rewards
into calculations about the national and international commerce in
drugs. The schedules affected the development and clinical
application of psychotropic substances, and the 1971 Convention on
Psychotropic Substances receives special focus. The article highlights
the roles of
governmental representatives, pharmaceutical company interests, medical
researchers, physicians, and pharmacists and illustrates how debates
about scheduling in international treaties over
the previous 40 years impacted the creation of the 1970 Controlled
Substances Act in the United States and how the constituencies that
contributed to constructing the Controlled Substances Act viewed their
efforts in a global context.
|
David T. Courtwright. The
Controlled Substances Act: How a "big tent" reform became a punitive
drug law. Drug and
Alcohol Dependence 76(1):9-15,
October 2004.
|
Summary:
The Controlled Substances Act of 1970 was a reform law designed to
rationalize, and in some respects to liberalize,
United States drug policy. The Act provided additional
resources for law enforcement and a systematic means for regulating the
use of most psychoactive drugs, but it also eliminated mandatory
minimum
sentences and provided more support for treatment and research. In
response to public alarm about drug
abuse, however, the US Congress over the next three decades
continuously amended the law to produce a more
punitive system of drug control. The amendments gave the Drug
Enforcement Administration greater control over scheduling and
maintenance, substantially increased penalties for illicit
trafficking, and transformed the law into the legal foundation of
America’s
"drug war," as the stricter criminal approach came to be known. By the
1980s, the flexibility and innovative spirit of the original Controlled
Substances Act (and that of Nixon-era drug strategy generally) had
largely disappeared from American drug policy.
|
Joseph F. Spillane. Debating the
Controlled Substances Act. Drug
and Alcohol Dependence 76(1):17-29,
October 2004.
Summary:
The
Controlled Substances Act
(CSA) of 1970 is the
basis of modern drug regulation in the United States. The Act defined
the authority
of the federal government and provided a framework for regulating all
existing and new substances based on their abuse
potential, safety, and medical utility. The debates over the Act
centered on several critical issues: where to place the authority to
make scheduling designations, the impact of scheduling on drug
research, and defining what constituted drug "abuse" for purposes of
scheduling. Passage of the Controlled Substances Act was aided by broad
language that could accommodate diverse points of
view. A retrospective assessment of the Act shows that it greatly
expanded federal administrative authority over the nation’s drug
supply, much as its authors intended. Other impacts of the Act,
however, are much less certain. The article concludes by highlighting
the issues and questions that should guide future retrospective
research on the efficacy of drug control regimes. |
Cornelis de Wet, Laurence Reed, Anthony
Glasper, Paul Moran, Jennifer
Bearn, and Michael Gossop. Benzodiazepine co-dependence exacerbates
the opiate withdrawal syndrome.
Drug and Alcohol
Dependence 76(1):31-35,
October 2004.
|
Summary:
This study
compared type, severity, and course of opiate withdrawal symptoms
between opiate dependent patients with and without concurrent
benzodiazepine dependence. It is the first study to make these
comparisons. Patients dependent only on opiates (n = 39), and
patients dependent on both opiates and benzodiazepines (n =
22),
were recruited from consecutive admissions to an in-patient drug
treatment unit. The two groups were similar in the quantity and
duration of their prior opiate use. Patients completed daily
self-ratings of opiate
withdrawal for the duration of a standard in-patient
detoxification treatment. Co-dependent patients were detoxified from
both benzodiazepines and opiates concurrently; they reported more
severe withdrawal symptoms than patients withdrawing
from opiates alone. Thus concurrent benzodiazepine withdrawal
exacerbates opiate-specific withdrawal symptoms. Possible psychological
and neurophysiological mechanisms for the observed sensitisation are
discussed.
|
Patricia Obando, Wendy Kliewer, Lenn Murrelle,
and Dace S.
Svikis. The comorbidity of substance abuse and
depressive symptoms in Costa Rican adolescents. Drug and Alcohol Dependence 76(1):37-44, October 2004.
|
Summary:
Patterns of comorbidity between depressive symptoms and substance
use were examined simultaneously in community and clinical-based
samples of Costa Rican adolescents (N
= 5,268; ages 12–20), using a
series
of descriptive, covariance, and logistic regression analyses. Groups
surveyed included high school students, street youths, and youths in
treatment for substance abuse problems. The authors found significant
group differences in substance use and significant correlations between
depressive symptoms and problems with alcohol and drugs. The
association between depressive symptoms and overall substance use
involvement was significant for all youths, but strongest for female
street youths. Logistic regression analyses revealed that depressive
symptoms were associated with increased odds of specific substance use
for all three groups, though in the case of street youths and youths in
treatment, these associations only were observed in males. Analyses of
covariance indicated that problems with drugs and alcohol differed
across group and sex. Youths in treatment had more problems with drugs
and alcohol than other groups. Among street youths, males had more
problems with drugs than females. This study provides a unique
cross-cultural perspective on the comorbidity of depression and
substance use among youth, and allows for comparative analyses between
community and clinical-based participants.
|
Kypros Kypri, Stephen J. Gallagher, and
Martine L.
Cashell-Smith. An
Internet-based survey method for college student drinking research.
Drug and Alcohol
Dependence 76(1):45-53,
October 2004.
|
Summary:
The authors assessed their Internet-based survey method for
characterizing the alcohol
consumption of college students. A
random sample of students (N = 1,910; ages 16–29 years) was invited to
complete
a questionnaire consisting of a series of web-pages linked to a
relational database on a secure web-site. A branch structure allowed
survey items to be tailored by age and gender. The students received
up to nine contacts, including a pre-notice letter with a token gift
and an e-mail invitation (Phase 1), a reminder letter and e-mail
message (Phase 2), and then telephone reminders and replacement access
codes (Phase 3). Students who did not use computers were offered a
pen-and-paper
alternative. The overall response to
the survey was 82% (n = 1,564). The median completion time was
16.7 minutes. Participants’ comments showed high levels of
satisfaction
with the survey. Comparison of web (n = 1,501) versus pen-and-paper completions (n =
63)
revealed no modality effects. Technical problems addressed during the
course of implementation included web-browser-operating system
incompatibilities, and periodic network errors, although these resulted
in little lost participation. It was concluded that Internet-based
surveys are feasible for
college student research and with carefully managed recruitment, can
yield a high response.
|
G. K. L. Butler and A. M. J. Montgomery.
Impulsivity,
risk taking and recreational "ecstasy" (MDMA) use. Drug and Alcohol Dependence 76(1):55-62, October 2004.
|
Summary:
Characteristics of recreational drug
users, especially ‘ecstasy’ (MDMA) users were investigated. The
participants (N = 254 undergraduates) completed a drug history
questionnaire (DHQ), the
impulsiveness venturesomeness and empathy questionnaire, a novel
risk-taking task (Bets16). Some of the participanits (n = 59) also
completed the tri-dimensional
personality questionnaire (TPQ). DHQ responses allocated participants
to five groups: non-drug controls, cannabis users, polydrug (no
ecstasy) users, low (<20 occasions) ecstasy users, and
high (>20
occasions) ecstasy users. Eighteen percent of the sample had used
ecstasy; only one of the ecstasy users had not used other
substances. A larger proportion of high ecstasy users had also used
amphetamines, cocaine, and LSD in comparison to the low ecstasy and
non-ecstasy polydrug users. High ecstasy users typically took
significantly more ecstasy tablets compared with low ecstasy users.
Impulsiveness, venturesomeness, and novelty-seeking behavior increased
from the non-drug users to high ecstasy users. Ecstasy users (low and
high) and polydrug (non-ecstasy) users had higher levels of
impulsivity, venturesomeness, and novelty-seeking behavior compared
with non-drug users. High ecstasy users also scored higher on
the Bets16 risk-taking measure than non-drug users, cannabis users, and
low ecstasy users. The findings are discussed in relation to the
possibility that increased impulsivity preceded drug use and the
possible link between impulsivity and the putative serotonergic
neurotoxicity of ecstasy.
|
David A. L. Newcombe, Felix Bochner, Jason M.
White, and Andrew A.
Somogyi. Evaluation
of levo-alpha-acetylmethdol (LAAM) as an alternative treatment for
methadone maintenance patients who regularly experience withdrawal: A
pharmacokinetic and pharmacodynamic analysis. Drug and Alcohol Dependence 76(1):63-72, October 2004.
Summary:
The objective was to determine whether substitution of daily
methadone with second daily levo-alpha-acetylmethadol (LAAM) would
convert non-holders on methadone into holders on LAAM. Plasma
concentration–time profiles of (R)-methadone
were also compared with those of LAAM and its two metabolites. Sixteen
stable methadone maintenance treatment participants (non-holders, n
= 8)
were randomly allocated to continue methadone for 3 months or switch to
LAAM for 3 months, and then crossed over to the alternative drug for 3
months. At steady state, there were two testing sessions (24 hours
for
methadone and 48 hours for LAAM), during which opioid withdrawal
severity,
respiration rate, and pupil diameter were measured 10–11 times and
venous blood was collected 13–15 times. Ten age- and gender-matched
controls underwent one 48-hour test session. Areas under the withdrawal
severity score versus time curve (AUC0–47 hours for LAAM and
controls; AUC0–24 × 2 for methadone) were similar in
holders on methadone and LAAM (p =
0.62), but were greater in non-holders when they were taking methadone
than LAAM (p < 0.001). Respiratory depression and pupillary
constriction were similar for LAAM and methadone. In comparison to (R)-methadone,
plasma nor- and dinor-LAAM concentrations fluctuated little over the
dosing interval. LAAM converted methadone non-holders into LAAM
holders. LAAM may therefore be useful in selected methadone non-holders
and
improve retention in opioid treatment programs. |
S. Fassino, G. Abbate Daga, N. Delsedime, L.
Rogna, and S.
Boggio. Quality of
life and personality disorders in heroin abusers. Drug and Alcohol Dependence 76(1):73-80, October 2004.
Summary:
The objective was to describe the
personality disorders and personality profile of heroin-abusers
and their quality of life, and to investigate the correlation
between the two. Heroin-abusers
(N = 180) participated in the study during their residential treatment.
Two subgroups of heroin-abusers were identified on the basis of
presence or absence of
a personality disorder as
determined with the Structured Clinical Interview-II (SCID-II).
All patients completed the Temperament and Character Inventory
(TCI), the McGill Quality of Life Questionnaire (MQOL), and an
anamnestic sheet. The controls (N = 63) were non-clinical recruits.
Abusers with a personality disorder differed in their personality
profile from abusers
without personality disorder and scored | | |
