美国药物滥用人群中HIV/AIDS的预防措施

<正> 艾滋病(AIDS)是由人类免疫缺陷病毒(HIV)引起的一种恶性传染病,对人类的健康造成极大危害。我国自1985年发现首例AIDS患者后,经传入期、扩散期,1995年已进入快速增长期。据估计到2001     

Measuring substance abuse program treatment orientations: The drug and alcohol program treatment inventory

Assessment of therapeutic orientation is a significant problem in substance abuse program evaluation. This study reports the initial results of a new approach to measuring treatment orientation through a self-report survey that focuses on distinctive features of substance abuse treatment orientations. The Drug and Alcohol Program Treatment Inventory (DAPTI) assesses treatment goals and activities specific to eight orientations: AA/12 Step, Therapeutic Community, Cognitive-Behavioral, Insight/Psychodynamic, Rehabilitation, Dual Diagnosis, Medical, and Marital/Family Systems. We present findings from a nationwide assessment of 327 Veterans Administration (VA) Substance Abuse treatment programs that demonstrate promising subscale internal consistency, discriminant validity, and concurrent validity. In addition, the DAPTI distinguishes between programs with independently verified orientations and between inpatient, extended care, outpatient, and methadone maintenance programs. The DAPTI may be helpful in systematically assessing differences in treatment orientations between different types of programs, such as inpatient, community residential, and outpatient care.     

The Community Assessment Inventory--client views of supports to drug abuse treatment

A measure assessing client views of the community supports available to them was developed and tested with entrants to outpatient drug free treatment. Items for a Community Assessment Inventory (CAI) fell into four areas of potential social support for treatment entry and engagement: (1) partner and/or family with whom living; (2) family living outside the home; (3) friends; and (4) the community itself. Based on 241 study participants, it was found that internal consistency alphas for the four scales ranged between .79 and .88. Both total CAI score and individual scales assessing support from friends and from partner/spouse were found capable of predicting treatment readiness as assessed using the TCU Motivation Scale. Evidence of construct validity was suggested by differences in CAI total score between participants reporting and not reporting involvement in discussions with others regarding crime and regarding drugs. Findings are also provided regarding leisure time activities and social relations of treatment entrants.     

Family predictors of parent participation in an adolescent drug abuse prevention program

Low participation rates constitute a serious problem faced by family drug abuse prevention programs. In this study we analyse the factors related to participation in a Life Skills Training program implemented in three schools in Spain. Participants in the study were 485 pupils aged 12 - 14 years and their respective parents. The variables that predicted participation in the program were: number of children and educational level of parents, children's drug use, family conflict, parental rearing style, relationships between parents and children and family communication. The results from Spain are similar to those found in international studies, and indicate that the families most at risk of drug use are those least likely to participate in prevention programs. There is a need for strategies to increase participation in prevention programs of the families most at risk.     

Predictors of relapse during treatment and treatment completion among marijuana-dependent adolescents in an intensive outpatient substance abuse program.

The present study assessed possible predictors of relapse while in treatment and treatment completion among marijuana-dependent adolescents (N = 59) in an intensive outpatient substance abuse treatment program. Comorbid depression was associated with an increased likelihood of relapse and a higher total number of relapses. As expected, relapse while in treatment was associated with a reduced likelihood of successfully completing the treatment program. Comorbid attention deficit hyperactivity disorder (ADHD) was also associated with a lower likelihood of successful program completion. These findings add to a slowly growing literature regarding adolescent substance abuse treatment, and may help clinicians identify marijuana-dependent adolescents at greater risk of relapse or noncompliance.     

Smoking as an issue in alcohol and drug abuse treatment

Little attention has been given to the role of tobacco dependence within alcohol and drug abuse treatment. Yet, smoking behavior appears to be interrelated with the use of alcohol and other drugs. This interrelationship is explored, and the role of smoking cessation within alcohol and drug abuse treatment is considered. Areas for future research on this topic are identified. Addictive disorders are generally thought to include alcohol abuse, drug abuse, smoking, overeating, and, sometimes, gambling and caffeine dependence. While some attention has been paid to the common etiological roots of various addictive disorders, relatively little systematic attention has been paid to commonalities in their treatment and especially to the treatment of multiple disorders in the same individuals. The one significant exception is alcohol abuse and drug abuse. Of the other addictive disorders, tobacco dependence has been most closely interrelated with alcohol and drug abuse. Yet, little attention has been given to tobacco dependence within alcohol and drug abuse treatment. This paper will focus on smoking in relationship with alcohol and drug abuse, and will consider the possible role of smoking cessation treatment within the context of alcohol and drug abuse treatment. First, background regarding the interrelationship of alcohol and drug abuse is explored. Then, the relationship of smoking with other substance use is considered, followed by a review of special concerns related to smoking among alcohol and drug abuse clients. Next, the current status of smoking cessation within alcohol and drug abuse treatment is addressed. Finally, implications are considered.     

Gender differences in outcomes in an HMO-based substance abuse treatment program

This study examined gender differences in treatment outcomes and outcomes predictors among 155 men and 81 women attending a gender-sensitive substance abuse treatment program. Bivariate analyses indicated women improved more than men in social/family and daily functioning domains, but differences disappeared after controlling for baseline characteristics. Multivariate models predicting treatment outcomes revealed that, across Addiction Severity Index domains, outcomes for men were predicted primarily by mental health and medical conditions, severity of the substance abuse problem, and treatment com- pletion. For women, in addition to treatment completion, outcomes were more likely to be predicted by social, socio-demographic, and life-history characteristics. For abstinence outcomes, women who completed treatment were 9 times as likely to be abstinent at 7-month follow-up as other women; men who completed were 3 times more likely to be abstinent than other men. Women with more severe psychiatric status and those who felt their life was out of control were less likely to be abstinent, as were men who lived alone. Clinicians targeting such factors differentially for men and women may enhance the effectiveness of treatment.     

Coping with AIDS: strategies for patients and staff in drug abuse treatment programs

HIV infection creates difficulties for patients and staff in drug abuse treatment programs. This article reviews significant problems and coping strategies, drawing on experience in a drug abuse treatment program where a third of the patients are HIV infected. Patient-related problems include denial, anger, depression, and isolation. The coping strategies that patients use can exacerbate their illness. Effective coping strategies may involve the development of mutual-support groups and public education. Staff-related problems include the fear of infection, protecting confidentiality, the need to develop new treatment goals, and recognizing the limitations of drug abuse treatment. To lessen the fears of infection, programs can exercise clear body substance precautions, conduct frequent inservice training, and hold periodic updates for staff. To adequately protect confidentiality, programs can keep up with rapidly changing laws and guidelines. To modify treatment goals, programs can alter admission standards for HIV-infected patients, change treatment methods to minimize the impact of occasional relapses, develop medical referral networks, and give special consideration to counselors who treat HIV-infected patients. To cope with the limitations of drug abuse treatment, programs can support counseling staff in coping with emotionally stressful clinical problems and to avoid burnout.     

我国药物滥用与艾滋病防治的研究进展——第七届全国药物依赖性学术会议纪要

20 0 3年 9月 8日 - 12日 ,在新疆乌鲁木齐市举行了第七届全国药物依赖性学术会议。会议以“吸毒与艾滋病”为主题 ,对药物滥用与艾滋病的流行病学现状、临床特点、防治措施以及药物依赖形成的机理进行了充分的交流和深入的探讨。来自中国内地、香港、澳门、澳大利亚、美国等海内外 15 0余名代表参加了会议。国家禁毒委员会办公室官员、中英性病艾滋病防治合作项目官员、新疆维吾尔族自治区预防医学会的有关领导出席了会议。中国药物依赖性研究所所长郑继旺教授担任本次会议主席。1药物滥用与艾滋病的流行病学现状北京大学中国药物依赖性研…     

Infectious diseases and drug abuse : Prevention and treatment in the drug abuse treatment system

Several communicable infectious Diseases, including AIDS, hepatitis B infection, gonorrhea, syphilis, and tuberculosis, are increasing among drug abusers. Drug abuse treatment programs may be ideal sites to identify those infections and initiate and maintain appropriate medical management. This paper reviews the epidemiology of those infections among drug abusers in the USA, presents rudimentary aspects of medical management of selected infectious diseases, and discusses the need to integrate infectious diseases, drug abuse treatment, and public health approaches if we are to reverse, or at least stabilize, the trends of those diseases.     

Assessment of an adverse drug reaction monitoring program in nursing homes.

An adverse drug reaction monitoring program was developed in ten geriatric nursing care facilities with a population of 826 patients. Over a two year period, the incidence of moderate to severe adverse reactions was decreased from 27 to 20 percent. Digitalis glycosides, antipsychotics, sedatives and hypnotics, diuretics, and anti-inflammatory agents were responsible for more than three quarters of the reactions. Elderly females receiving large numbers of drugs and patients having a history of a previous reaction were found to be at high risk of experiencing an adverse effect. A substantial reduction in the number of drug-related acute care hospital admissions and a decrease in drug consumption demonstrated the cost effectiveness of the program. The response of other health care professionals to the program was excellent. A Patient Assessment Form was developed to assist in the quarterly review of patient medications. Guidelines for monitoring adverse drug reactions in nursing care facilities are suggested to aid other pharmacists in the implementation of similar clinical services.     

Influences of family and friends on client progress during drug abuse treatment

Relationships with family and friends by 439 heroin addicts during the first 3 months of drug abuse treatment were examined in relation to behavioral improvements of clients. Family conflict and peer deviance were significant predictors of injection frequency and illegal activity during treatment, and reductions in family conflict were associated with lower drug use, injection frequency, and illegal activity during treatment. These results provide support for treatment emphasis on helping clients reduce conflict among family members, improve dysfunctional relationships with peers, and replace deviant friendships with others that encourage treatment participation and conformance to social norms.     

Node-link mapping and psychological problems. Perceptions of a residential drug abuse treatment program for probationers

The current study examined program perceptions of 367 probationers admitted to a 4-month residential drug abuse treatment facility that focuses on group counseling. Prior research has shown that many individuals within the criminal justice system have both psychological and drug abuse problems, and that they often have limited success in drug abuse treatment programs. The current study examined whether the benefits of node-link mapping, a visual representation counseling technique that is especially beneficial in group counseling environments, would extend to individuals with psychological problems. Probationers were randomly assigned to mapping-enhanced or standard counseling. Those residents who had higher levels of psychological problems (based on a global indicator of psychological problems), and who received mapping-enhanced counseling, had more favorable perceptions of their counselors and fellow community members over time than their counterparts who received standard counseling.