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Objective: The aim of this research was to study marijuana use, associated risks, and response to brief motivational intervention among young adult drinkers treated in an emergency department. Method: Study participants (N = 215; ages 18-24) were in a randomized controlled trial for alcohol use that compared motivational interviewing with personalized feedback (MI) with personalized feedback only. Past-month marijuana users were compared with nonusers on demographics, readiness, self-efficacy, and behavioral risk variables. Marijuana use was examined as a potential moderator of alcohol outcomes. Whether marijuana use alone or combined marijuana and alcohol use would be reduced as a result of brief intervention for alcohol was examined at 6 and 12 months. Results: Current marijuana users were younger, were more likely to be white, and reported more alcohol use, other illicit drug use, and more alcohol-related consequences than nonmarijuana users. Marijuana use at baseline did not moderate response to brief alcohol treatment. Marijuana use declined from baseline to 6 months for both treatment groups, but only MI participants continued to reduce their use of marijuana from 6- to 12-month follow-up. Reductions in number of days of use of marijuana with alcohol appeared to be primarily a function of decreased alcohol use. Conclusions: Young adult drinkers reporting current marijuana use are at generally higher risk but responded to brief alcohol treatment by reducing alcohol and marijuana use., RATES OF MARIJUANA AND ALCOHOL USE are highest among older adolescents and young adults (Substance Abuse and Mental Health Services Administration, 2007b), and the emergency department (ED) is a medical [...]

Objective: Many adolescents engage in polydrug use: however, little is known about whether alcohol and other drug problems show similar posttreatment trajectories of change. We examined concurrent patterns of change for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, symptoms related to the use of alcohol, marijuana, and other drugs and identified predictors of the most common cross-drug patterns of change. Method: Adolescents (N = 542) recruited from addictions treatment were assessed at baseline and at 1-and 3-year follow-up. Latent class mixture modeling identified trajectories for alcohol, marijuana, and other-drug symptoms. Latent class analysis identified cross-drug patterns of change and was used to examine conduct disorder and depression as predictors of cross-drug patterns of change. Results: For alcohol users, three improving groups (72%), stable-low (19%) and stable-high (6%) groups, and groups with increasing trajectories (3%) were identified. For marijuana users, an asymptomatic class (23%), two improving classes (46%), stable-low (13%) and stable-high (13%) classes, and a class with an increasing trajectory (4%) were found. For users of other drugs, groups with asymptomatic (57%), improving 120%), increasing (12%), and stable-high (11%) trajectories were identified. Latent class analysis of cross-drug patterns of change identified three subtypes representing generally concordant cross-drug patterns of change and one subtype that involved stable-high marijuana problems, decreasing alcohol problems, and increasing other-drug problems. Conduct disorder was associated with greater persistence of substance problems. Conclusions: The majority of treated adolescents had similar cross-drug patterns of change for alcohol, marijuana, and other drugs; however, exceptions exist. Furthermore, adolescents with co-occurring psychopathology may benefit from continuing intervention, because they tend to report more persistent posttreatment substance-related problems., ADOLESCENTS SHOW DIVERSE PATTERNS of change following addictions treatment, typically represented by stable-low, stable-high, improving, or worsening trajectories of substance involvement. Most published studies of treated adolescents have reported short-term [...]

Objective: This study examined 6-month treatment outcomes among 428 cocaine-dependent outpatients with (n = 34) and without (n = 394) posttraumatic stress disorder (PTSD) in a randomized controlled multisite clinical trial of manual-based psychotherapies for substance use disorder (SUD). Method: Assessments were completed at baseline and monthly during the 6-month treatment. With longitudinal mixed-effects models, we compared outcomes between SUD-PTSD and SUD-only patients and also examined rates of within-group change. Results: Results indicated a highly consistent pattern: the SUD-PTSD patients were more impaired to begin with and remained so across time compared with SUD-only patients (with the exception of substance use and addiction-related legal and employment problems, which did not differ between groups). Also, the SUD-PTSD patients improved less than SUD-only patients in alcohol use and the majority of addiction-related psychosocial problems. However, the two groups did not differ significantly in improvement over time on drug use or global psychological severity. Conclusions: The greater impairment and relative lack of improvement of SUD-PTSD patients, compared with those with SUD-only, suggest a need for dual-diagnosis treatments that more directly target their areas of difficulty., AN ASSOCIATION BETWEEN SUBSTANCE USE disorder (SUD) and posttraumatic stress disorder (PTSD) is by now well established. For example, epidemiological data document that, among men who experience PTSD in their [...]

They have been a hard group to win support for, the millions in society with alcohol and drug addictions. As public and private resources flow toward helping people with HIV/AIDS, [...]

Are there different types of addicts? Is the success of treatment dependent on understanding these types? These were among the questions posed at a Social Policy conference in November on [...]

ABSTRACT. Use of heroin by American teenagers is beginning to show disturbing increases in national and statewide surveys. According to data from the 1997 National Institute on Drug Abuse monograph [...]

Studies indicate that African American drug users are significantly less likely than White users to have received treatment for illicit drug use (Jones, Lewis, & Shorty, 1993; Little, 1981; Longshore, [...]

Women with alcohol or other drug (AOD) problems experience a range of barriers to inpatient treatment. Although research in the general population shows that high-intensity referrals are more effective than low-intensity referrals at engaging and retaining individuals in outpatient AOD treatment, the impact of referral intensity has not been assessed for women only. To examine this issue, a secondary analysis was conducted using an existing data set that included a sample of 109 women. Although intensity of referral was not related to entry into or relapse during treatment, high-intensity referral was associated with completion of treatment. In addition, women who relapsed during treatment were less likely to complete it, underscoring the need for relapse prevention training. Key words engagement in treatment referrals retention in treatment substance abuse women, Women with alcohol and other drug (AOD) problems experience a range of difficulties, including health problems, psychological problems, reproductive and sexual problems, and increased risk of abuse and sexually transmitted [...]

If there was an easy answer to drug addiction, everyone would use it. Since the evolution of the 1960s, the nation has been faced with the ever increasing use of [...]

Drug dependence refers to a process in which an increasing proportion of an individual's behavior is controlled by drug use vs. other maintaining events. Stimulus-control research is critical for an understanding of drug dependence because discriminative and conditioned stimuli are recognized as playing an important role in maintenance of drug use. Historically, the idea that stimuli can exert control over drug use has been conceptualized in terms of classical conditioning. Research employing the classical-conditioning model has demonstrated several interesting phenomena, but has not led to the development of effective treatment strategies. Consequently, this paper discusses the need to broaden our understanding of the role that environmental stimuli can play in the genesis, maintenance, and treatment of drug dependence. To do this, two recent experiments are reviewed that may facilitate this broadening. One experiment tested for the transfer of stimulus control over drug taking to stimuli in an equivalence class never paired with drug taking, and the other experiment examined the question of whether interoceptive (drug) stimuli can enter into equivalence relations with exteroceptive (visual) stimuli. Using the results of these two experiments as examples, the remaining discussion focuses on the role of stimulus control in the etiology and treatment of drug dependence and drug relapse. In concluding, a model is presented-based partly on the behavioral treatment of cocaine dependence-that may be more effective in eliminating stimulus control over drug use., Drug dependence can be defined as a syndrome in which drug use is given a much higher priority than other behaviors that once had higher value (Edwards, Arif, & Hodgson, [...]

Authors' Note: This article was supported by a grant from the Robert Wood Johnson Foundation to the University of Illinois at Chicago as part of the foundation's ImpacTeen initiative. The [...]

Like many correctional systems, the Arizona Department of Corrections (ADC) has experienced significant growth in the female inmate population. Of the nearly 29,000 inmates committed to ADC, more than 2,200 [...]

DRUG addiction doesn't just happen. It appears to be the result of a series of neurochemical changes in the activity of neurones of the brain. There are two major aspects [...]

IN the 1980s I became heavily involved in the public health campaign, as head of the national AIDS Task Force, seeking rational and sensible solutions to the AIDS epidemic. Although [...]

The effectiveness of jail and prison substance abuse treatment has been well-established over the years. Among inmate treatment programs, prerelease therapeutic communities (TC) have been the most studied, and have [...]

Drug courts have become a major focus for criminal justice system reform in the United States. They are an important component of the Clinton administration's drug strategy and receive strong [...]

Delaware Department of Correction officials believe substance abuse treatment should begin in prison and continue after release. Offenders with substance abuse problems in Delaware go through a three-phase treatment program [...]

Interest in drug courts is sweeping the nation as a number of innovative drug courts have reported success in reducing the levels of drug abuse, incarceration and criminal recidivism among [...]

Since its introduction in 1898 as a cough suppressant, heroin now accounts for nearly 90 percent of all opioid abuse in the United States. Originally derived from the German word [...]

On the surface, there seem to be competing orthodoxies in the field of addiction treatment: * You are an alcoholic so you must be abstinent. Alcoholics can drink socially. * [...]

'Brief therapy' sounds as though it might be to managed care's liking. Here's how it might be adapted to the specific problems of addictions treatment It's a theme for the [...]

Current restrictions on inpatient care have caused a radical decrease in the length of stay available for most patients. Often, patients are being discharged before they are able to cope [...]

UNDERSTANDING THE TRENDS: A Guide to Cooperation Between Treatment Centers and Managed Care Providers THE PROBLEMS Rapid expansion During the late 1960s and early 1970s, the nation accepted alcoholism as [...]

Who Speaks for the Addictions Field? Who should speak for the addictions field? When basic concepts such as the disease nature of chemical dependency and the value of treatment itself [...]

Private Insurance for Substance Abuse Services: A NATIONAL OVERVIEW Recovery from alcoholism or drug addiction frequently involves either inpatient treatment or long-term enrollment in a partial day or outpatient treatment [...]

Challenging The Systems On Both Sides After 18 years in the health care industry, with the last eleven devoted solely to alcoholism and chemical dependency, I have seen fads come [...]

A new strategy that normalizes neurotransmitter deficits common in withdrawal from long-term cocaine use may reduce cocaine-seeking behaviors. The research, led by Dr Richard Rothman of NIH, was published in [...]

David Ogilvie explains what the pilot schemes achieved The authors of this paper report on two pilot schemes in which naloxone was distributed to drug users. Where does a pilot [...]

'I would like to invite you to come visit my neighborhood. It has a higher concentration of substance abusers and chronically mentally ill people than any other area of the [...]