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There is a noticeable lack of targeted treatment options for marijuana dependence, in particular pharmacologic approaches. This is the first study evaluating a targeted pharmacologic approach for marijuana dependence. The goals of the study were to determine if such patients would seek pharmacologic treatment, whether these patients could be retained in treatment using a design previously developed for cocaine-dependent patients, and especially whether divalproex sodium showed promise as a treatment agent for marijuana dependence. We found that marijuana-dependent patients will seek treatment, and such patients can be adequately maintained in a pharmacologic trial. Regardless of treatment group, patients reported a significant reduction in their frequency and amount of marijuana use as well as a reduction in irritability. Given the lack of proven effective treatments for marijuana dependence, pharmacotherapies should be sought. The design of a preliminary clinical trial should include a psychosocial/behavioral intervention emphasizing motivation and medication compliance and a placebo control group.

This paper describes the Physicians in Residence Program (PIR), a program developed to train medical housestaff, at the Hazelden Fellowship Club, a halfway house in Manhattan. The housestaff (n = 31), who were trained at different times, heard two daily lectures by experienced physicians on diverse topics. They received training and practice in interviewing, assessment, and treatment planning. They participated in halfway house resident support groups and spent informal time interacting with Hazelden residents. Evaluation included (a) pre- and postprogram self-reports, (b) daily significant event sheets, and (c) overall program evaluation. Using paired mean t tests, the housestaff reported improvements (P < 0.001) in their interviewing and referral skills, knowledge, attitudes, and role confidence. All components of the program received ratings of “good” to “excellent” and were viewed as helpful. The highest ratings were those that included observation, practice of skills, and interactions with Hazelden residents.

The authors systematically evaluated the frequency patterns of cocaine use in 85 cocaine-dependent outpatients and found four patterns of use: continuous (27%), intermittent patterned (35%), intermittent nonpatterned (25%), and occasional (1.3%)- Few subjects reported consistent cycling between binges and crashes. There were no significant differences in patterns of use associated with gender, race, educational level, route of administration, or recency of heroin use. Continuous users and occasional users were older than intermittent users. Because different contingencies may control patterned vs. nonpatterned cocaine use, pattern of use may have implications for treatment, even in individuals reporting similar amounts of cocaine use.

There is a belief among methadone patients that triple therapy for HIV reduces methadone potency. This cross-sectional study compared the rate of methadone metabolism (peak-trough blood levels) in two groups of methadone-maintained patients, AIDS patients receiving triple therapy (N = 17), and HIV patients without triple therapy (N = 19). These preliminary findings suggest that triple therapy may increase the rate of methadone metabolism, though further studies are warranted.