Suchergebnisse

Does quitting cigarette smoking help or hurt the polydrug user in treatment for drug use? Data were obtained from 407 polydrug users in 15 treatment centers in Los Angeles at baseline and one-year follow-up. Measures: Smoking status, reported drug use, urine test results, SF-36 scores, Hopkins SCL, ASI-alcohol use, -drug use, -psychiatric problems, and ad hoc employment-related problems. Results: Most respondents (95%) reported some lifetime smoking. Over one-year follow-up, 29% reported a change in smoking status. At follow-up, stable former smokers reported fewer psychiatric problems than stable current smokers. Change in smoking status was associated with reduced heroin use, but with increased psychiatric problems and employment-related problems. Stable former smokers consistently reported healthier outcomes than either stable regular smokers or status changers, as reflected in somatization, obsessive/compulsive behavior, depression, and anxiety scores. Conclusions: Long-term but not short-term abstinence from tobacco use in polydrug users undergoing treatment is associated with consistently more favorable health outcomes.

A social policy experiment is presented that was conducted from 1997 to 2000 in a setting with a high level of readiness for implementing a randomized experiment of therapeutic community (TC) drug treatment training in Peru. Seventy-six drug abuse treatment organizations were randomly assigned into three groups, and data were collected at multiple assessment periods. Staff and directors in organizations assigned to the training groups participated in either 6-week basic training or 8-week basic plus booster training sessions, which were theoretically grounded. Small- to medium-size positive effects were found on increased staff empowerment to use actual tools and principles from the training; medium and large positive effects were found on the implementation of TC methods with fidelity after the training. A follow-up with the funding and training organizations 1 year later showed use of the evaluation results in decision making in both organizations.

Objective: The development of the Chinese Drug Involvement Scale for use in Chinese communities. Method: A battery of scales, including the Chinese Drug Involvement Scale and three mental health measures, were administered to 152 students of 13 to 18 years of age. Reliability and validity analyses were performed. The refined version was then cross-validated on a group of identified drug abusers (N = 77). Results: The final version of the Chinese Drug Involvement Scale is a 22-item scale. Validation results demonstrate that the Chinese Drug Involvement Scale has high reliability and a satisfactory level of validity. Conclusion: The Chinese Drug Involvement Scale is a global assessment of an individual's beliefs and values relating to drug use, apart from actual drug abuse behavior. The scale will be particularly useful for periodic assessments or outcome evaluation in treatment programs.

This study examined the association between child maltreatment and adult violence in a high-risk sample of women with and without a history of cocaine abuse and the contribution of working models of childhood attachment relationships in understanding this association. Results indicated that whereas childhood physical abuse was associated with adult sexual victimization for cocaine-abusing women, sexual abuse was associated with both partner violence victimization and perpetration for comparison women. Insecure working models of attachment were associated with partner violence victimization for comparison women, independent of the effect of sexual abuse. These findings suggest the importance of research focused on understanding the processes by which child maltreatment may lead to later violence and that examines both childhood and adulthood experiences in understanding pathways to adult violence.

The North Wales (United Kingdom) Shared-Care Program for methadone treatment of drug abuse was evaluated. The program involves shared care, inasmuch as general practitioners, pharmacists, and community drug workers are jointly involved in the methadone treatment of persons with drug abuse. Evaluation aimed to determine the program's (a) extent of use, (b) impact on patients, (c) positive and negative consequences for methadone reduction or discontinuation, and (d) advantages and disadvantages. Results suggested that the program is successful but identified targets for future improvement.

A set of variables, identified as "cultural variables," is introduced as important descriptors of the life experiences of people from the major ethnic/racial minority groups in the United States. It is stated that most contemporary models for prevention and treatment of substance abuse are "culturally blind" to the effects of these cultural variables on the risk of substance abuse among racial/ethnic minority people. Accordingly, a viable strategy for culturally relevant research and program design is to integrate these cultural variables into extant models to create culturally rich models for research as well as for the development of prevention and treatment programs. The use of "model programs" is discussed in regard to the competing aims of maintaining program fidelity while also making cultural adaptations to these model programs to make them more culturally relevant. Strategies and recommendations are presented for integrating cultural variables into prevention and treatment programs that purport to serve racial/ethnic minority people.