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Food insecurity and drug use are closely connected in the context of poverty, and both have been suggested to interfere with HIV medication adherence among people living with HIV/AIDS (PLWH). Yet the potential interaction between the two factors on adherence has not been examined. For this study we collected longitudinal data on HIV medication adherence among PLWH in Atlanta, GA, to assess a possible synergistic effect between the two factors on HIV medication adherence. People informed about the study came to the research site and completed an audio computer-assisted self-interview and instructions for pill counting. Over the next 5 weeks participants received three unscheduled follow-up phone assessments conducted 2 weeks apart to collect pill counts of their HIV medication. The prevalence of food insecurity was 60 % (488) and that of drug use was 33 % (274) in the sample of 809 participants. Among 770 participants who completed follow-up phone assessments, both food insecurity and drug use were associated with HIV medication adherence after adjusting for socio-demographic characteristics. The negative association between drug use and adherence persisted after further adjusting for health-related characteristics. Moreover, drug use appeared to moderate the effect of food insufficiency on adherence, with drug users who were food insufficient being the least likely to achieve 85 % adherence. Results from the current study demonstrate a synergism between food insecurity and drug use that may impede adherence among PLWH. The findings imply that the disruptive effects of food insecurity and drug use on adherence are likely to be intensified with the presence of each other, and encourage interventions to address the problem of HIV medication adherence from a multi-faceted perspective that takes into account detrimental combination of problem factors., Author(s): Yiyun Chen[sup.1] , Seth C. Kalichman[sup.1] Author Affiliations: (1) Department of Psychology, University of Connecticut, 406 Babbidge Road, Unit 1020, 06269, Storrs, CT, USA Introduction Food insecurity, defined as [...]

BACKGROUND: Anger, a component of negative affect, has previously been associated with increased drug use primarily among white high school-aged students. However, Few studies have examined these associations over time, and Fewer have examined them among younger adolescents and students of color. Affective factors may play a greater role in drug use For girls relative to boys; yet, little is known regarding differences in associations between affect and drug use by gender. METHODS: The current study used data From the control condition (N = 2025) of a drug and violence preventive intervention trial to examine the association between self-reported anger levels among multiethnic urban adolescents in the sixth grade and their use of cigarettes, alcohol, and marijuana use 1 year later. Potential gender differences were examined as well. RESULTS: Multivariate generalized estimating equations models Found anger to be significantly associated with increases in smoking, drinking, and marijuana use. There were no significant gender differences found for any of the drug use outcomes. CONCLUSIONS: Results are consistent with studies conducted on primarily white high school youth, where anger had a small but significant effect on drug use over time. The findings also suggest that drug prevention programs should include emotion regulation skills, such as anger management, in addition to drug resistance skills. Keywords: emotional health; alcohol; drugs; smoking and tobacco., Entry into middle school is a challenging time for adolescents. In addition to the pubertal changes that occur during this developmental period, middle school students are exposed to more diverse [...]

Using ethnographic data gathered at a mandated, community-based drug treatment program for women offenders, this article analyzes how gendered notions of the self and of autonomy shape penal governance. This study examines how psychological models of women's deviance, racialized visions of motherhood, and therapeutic techniques of the self come into tension with expectations of responsible, autonomous citizenship. The program prioritized therapeutic ways of governing its clients over those that emphasized economic self-reliance, rational decision making, and normalizing gender. This is because staff attributed criminal and addictive behaviors to women's inadequate self-understanding and lack of emotional autonomy in personal relations. Staff discouraged women's motherhood and paid labor because they saw these external obligations as a threat to women's autonomous selfhood. This research complicates claims that contemporary forms of penal treatment manage offenders through rational incentives and personal responsibility by pointing to the ways that subject formation is a gendered process. Keywords: governance; gender; punishment; alternatives to incarceration; therapeutic programs

In this investigation, 3 adults who met criteria for marijuana dependence were treated using an abbreviated version of acceptance and commitment therapy (ACT). The treatment was delivered in eight weekly 90-min individual sessions. The effects of the intervention were assessed using a nonconcurrent multiple baseline across participants design. Self-reported marijuana use, confirmed through oral swabs, reached zero levels for all participants at posttreatment. At a 3-month follow-up, 1 participant was still abstinent and the other 2 were using but at a lower average level of consumption compared to baseline. Depression, anxiety, withdrawal symptoms, and general levels of experiential avoidance generally improved. This preliminary test suggests that additional development and testing of ACT for marijuana use are warranted. DESCRIPTORS: acceptance and commitment therapy, treatment, marijuana, dependence

A genome wide linkage scan for opioid dependence (OD) and related traits is presented. An attempt is made to identify the chromosomal location of genes that increase risk of OD and related traits identified using data reduction and cluster analytic approaches.

We present a hypothetical neurocomputational model that combines a set of neural circuits at the molecular, cellular, and system levels and accounts for several neurobiological and behavioral processes leading to nicotine addiction. We propose that combining changes in the nicotinic receptor response, expressed by mesolimbic dopaminergic neurons, with dopamine-gated learning in action-selection circuits, suffices to capture the acquisition of nicotine addiction. We show that an opponent process enhanced by persistent nicotine-taking renders self-administration rigid and habitual by inhibiting the learning process, resulting in long-term impairments in the absence of the drug. The model implies distinct thresholds on the dosage and duration for the acquisition and persistence of nicotine addiction. Our hypothesis unites a number of prevalent ideas on nicotine action into a coherent formal network for further understanding of compulsive drug addiction. computational model | reward

I WANT to discuss two periods in English literature when drugs and inspiration seemed to go together. The first was the Romantics' furtive flirtation with opium around the close of […]

Byline: Judith S. Brook (1), Martin Whiteman (2), Stephen J. Finch (3), Neo K. Morojele (4), Patricia Cohen (5) Keywords: marijuana use; unconventionality; latent growth modeling Abstract: The present study was designed to examine the relationship between unconventionality and marijuana use over time. The sample for this paper consisted of 532 male and female participants interviewed during early adolescence, late adolescence, their early twenties, and their late twenties. Latent growth modeling was used. The findings indicated that (1) the influence of initial unconventionality (T2) on initial marijuana use (T2) was stronger for males, (2) unconventionality at T2 was not significantly related to overall rate of growth in marijuana use, and (3) change in unconventionality was related to overall growth rate of marijuana use. The implications of the findings for prevention and treatment are discussed. Author Affiliation: (1) Department of Community Medicine, Mount Sinai School of Medicine, Box 1044A, 1 Gustave L. Levy Place, New York, New York, 10029 (2) Department of Community Medicine, Mount Sinai School of Medicine, USA (3) Department of Applied Mathematics and Statistics, State University of New York, Stony Brook, USA (4) Medical Research Council, USA (5) Columbia University, USA Article History: Registration Date: 06/10/2004

Samuel Taylor Coleridge, who felt he competed for literary recognition with William Wordsworth, referred in several letters and in an essay to how scrofula, a lymphatic disease of the neck, affected his writing. He felt philosophy was a helpful treatment for this condition, although reference to scrofula was code for his addiction to opium.

This book comprises 17 chapters that deal with a variety of topics related to cocaine and its abuse. Several of the chapters are excellent, and the book in its totality contains a wealth of information. These are major strengths. On the down side, some important topics are ignored, the relevance of several chapters to cocaine abuse is not apparent, and the various chapters are not well integrated. We recommend Cocaine Abuse as a reference volume for scientists with specific training in the areas that it covers. But we do not recommend it for cover-to-cover reading as an overview of cocaine abuse. DESCRIPTORS: drug abuse, cocaine

General strain theory (Agnew 1992) departs from traditional strain theories by emphasizing the role of the individual's affective responses to negative life experiences in fostering deviant behavior. In this analysis, we examine the central hypotheses of general strain theory using data from a three-wave panel study of high school youths in the Boston metropolitan area (N = 939). Covariance structure models reveal that anger and hostility in response to negative life events do play a causal role in fostering more aggressive forms of delinquency, but are not significantly related to either nonaggressive delinquency or marijuana use. Furthermore, the conditional effects predicted by general strain theory, in which the impact of strain on delinquency varies by youths' personal and social resources, are inconsistent. Discussion centers on the prospect of increasing the utility of general strain theory by further imbuing it with concepts and perspectives from the sociology of mental illness.

Research indicates that drug-related stimuli can increase the motivation to acquire and abuse drugs. Results are based on studies of heroin self-administration in rats.

The possible function of mechanisms of associative learning in drug abuse and addition was analyzed against psychomotor stimulant drugs. Parallel mechanisms by which stimulant drugs influence the effects of aversive and rewarding stimuli were examined. Critical neuromodulatory influences were then determined. These include the amygdala that mediates the associative procedures by which environmental stimuli come to control drug-seeking behavior.

It is now widely recognized that drug dependence and addiction can be partly seen as gradual adaptations of the brain to chronic drug exposure. These adaptations could be sparked off by a drive to control activity of the various brain systems withing certain specified activity limits. In order to assess how the neurochemical and molecular changes caused by drug exposure are connected with the clinical reality of human drug addiction, it is necessary to know how addiction operates at the cognitive, behavioural and neuropsychological levels. It is clear that there are many complex factors that may influence addiction and its treatment.

Dealing with the problems of substance abuse requires both an appreciation of clinical reality and an understanding of basic psychosocial principles. Each of the conference presentations of theory and research, most of them nonapplied in nature, created a welcome and rare occasion for experimental and clinical psychologists (and hybrids) to reflect together on the applied implications of some basic research and on the research implications of some applied professional activities. Among the issues found especially noteworthy by this discussant were the following: the return of cognition and rational decision making as legitimate and critical foci in behavior therapy, the role of exposure to aversive events in reducing their fearsomeness, the advantages of not working doggedly to achieve goals that are better approached with a nonachievement attitude, the possibility that the difficulty in altering pathological behavior derives from the properties of human language, appreciation of individual differences in psychotherapy outcome research, the importance of considering the meaning that therapeutic ministrations can have for certain patients, and the need to reexamine the utility of patients' expressing their concerns., Several interesting issues were raised by psychologists during discussions held in workshops run by the National Institutes of Health's National Institute on Drug Abuse. Key issues included the suggestion that human language has properties which make it difficult to change pathological behavior, the legitimate use of rational decision making and cognition in behavior therapy, the need for research into the efficacy of allowing patients to express their concerns, the reduction in patients' fear of aversive events through exposure and the adoption of a nonachievement attitude in goal achievement.

A study of middle- and upper-class white women over 30 reveals that the initial use of heroin by these women, who are heroin and methadone addicts, was an act of defiance against restrictive gender and class expectations. Initially they saw the drug culture as providing an alternative to an oppressive social system and heroin was seen as a friend. As their lives begin to revolve around it and they need to demean themselves as women to get their drugs, they question their drug habit. They turn to medical organizations to break their habit. Throughout they refuse to wholly comply with social norms.

Conflicting evidence suggests that marijuana use may be associated with either positive or negative mental health. This study explores the possibility that the association of marijuana use with mental health differs among various subgroups of users. Specifically, we investigate the hypothesis that marijuana use and the personality disposition of introspectiveness interact in their effects on psychological well-being. Results support this hypothesis and show that marijuana use is associated significantly with psychological distress for highly introspective individuals. In contrast, marijuana use has no such association for those low on introspectiveness. Additional evidence shows that marijuana use involves primarily self-oriented cognitive and emotional experiences for highly introspective individuals, whereas for those low on introspectiveness it is characterized more often by perceptual distortions and sensorimotor sensations.

Risk factors for depressive symptoms and disorders have been compared under various conditions in numerous studies. But few studies have been conducted that follow subjects into the future to examine and possibly predict risk factors and variables that contribute to depressive symptoms. This study employed a prospective (ongoing into the future) design to identify possible variables involving personality, drug use, stressful life events and social support as risk factors. The study group consisted of previously arrested marijuana users and friends from the neighborhood who had not been arrested. Two sets of data, obtained one year apart, were collected on 942 individuals. Sixty-two persons (cases) were free of depression at time one but reported substantial symptomatology at time two, as measured by a standard scale. Four hundred ninety persons (controls) were free of symptoms at both times one and two. Analysis of the responses obtained revealed that persons with low self-esteem, negative life event experience or methaqualone drug use are at elevated risk for developing depression symptomatology. (Consumer Summary produced by Reliance Medical Information, Inc.)

AT first glance, little seems to link the three papers in this section by Al Alvarez, Frits Staal, and Irving Kirsch. Alvarez is a literary critic who appreciates the poetry […]

EACH of the papers presented in this section places drug use in an historical and interdisciplinary context, opening the debate over the implications of national and global drug policy. These […]

The study of cognitive processes in animals can be utilized to determine selective effects of certain drugs and how drug manipulations can be utilized to examine cognitive processes. Animal models have already been used to examine the reinforcing and punishing characteristics of drugs, and factors influencing drug addiction, tolerance and withdrawal. In addition, drugs may support a role in evaluating cognitive interpretations of experimental findings.

Memory processes may influence the causal chain in which antecedents of alcohol and drug abuse affect drinking. Results of studies on alcohol expectancies were consistent with a memory framework. The results have advanced knowledge on how consumption may be influenced by memory representations of biological and environmental characteristics. In addition, findings showed that expectancies can be influenced to produce decreases in drinking through the development of challenge procedures.