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Sample records for alcohol treatment services

  1. Service Quality in Alcohol Treatment: A Qualitative Study

    ERIC Educational Resources Information Center

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2010-01-01

    The objective of the study was to qualitatively evaluate the managerial and organisational issues associated with service quality in a privately funded alcohol treatment centre in the UK. Two different groups of participants at a private treatment clinic were interviewed. The first group comprised 25 of its patients. The second group comprised 15…

  2. Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers

    ERIC Educational Resources Information Center

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2012-01-01

    In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

  3. Navigating the Alcohol Treatment Pathway: A Qualitative Study from the Service Users' Perspective

    PubMed Central

    Gilburt, Helen; Drummond, Colin; Sinclair, Julia

    2015-01-01

    Aims Provision of effective treatment for dependent drinkers has been identified as a priority in England yet evidence suggests that access is problematic and there are low levels of retention. This qualitative study explores how the alcohol treatment system is experienced by service users, identifying barriers and facilitators that influence treatment outcomes. Methods A total of 20 semi-structured face-to-face interviews were conducted with patients from community alcohol treatment services in three London boroughs in 2012. Interviews were undertaken one year after initially entering treatment. A thematic analysis was conducted, with the results further abstracted to relate them to specific aspects of the treatment journey. Results Patients journeys were characterized by a perceived lack of control leading to help-seeking, with treatment outcomes influenced by an individuals' self-efficacy and the capabilities and skills of staff in actively engaging and supporting patients on the journey. A focus of services on the detoxification process and fragmented care pathways impacted negatively on engagement. Conclusions Current alcohol care pathways require significant levels of motivation and self-efficacy to navigate that few patients possess. Pathways need to better reflect the capacity and capabilities of patients to be successful in supporting recovery. PMID:25825267

  4. A Key Informant Survey To Assess Service Adequacy in California's Publicly Funded Alcohol and Other Drug Treatment System.

    ERIC Educational Resources Information Center

    Clapp, John D.; Hohman, Melinda M.

    2002-01-01

    Study examined administrators' perceptions of service adequacy, provision of services, and evaluation of services of publicly funded alcohol and other drug treatment systems in California. Administrators reported that systems adequately serve most populations; however some suggested that adolescents, elderly, and homeless were not as adequately…

  5. Similarity of Outcome Predictors across Opiate, Cocaine, and Alcohol Treatments: Role of Treatment Services.

    ERIC Educational Resources Information Center

    McLellan, A. Thomas; And Others

    1994-01-01

    Outcomes were predicted by similar factors, regardless of drug problem or type of treatment. Greater substance use at follow-up was predicted by greater severity of use at admission, not number of services during treatment. Social adjustment was negatively predicted by more severe psychiatric problems at admission and positively predicted by more…

  6. Advances in Alcoholism Treatment

    PubMed Central

    Huebner, Robert B.; Kantor, Lori Wolfgang

    2011-01-01

    Researchers are working on numerous and varied approaches to improving the accessibility, quality, effectiveness, and cost-effectiveness of treatment for alcohol use disorders (AUDs). This overview article summarizes the approaches reviewed in this issue, including potential future developments for alcoholism treatment, such as medications development, behavioral therapy, advances in technology that are being used to improve treatment, integrated care of patients with AUDs and co-occurring disorders, the role of 12-step programs in the broader realm of treatment, treating patients with recurring and chronic alcohol dependence, strategies to close the gap between treatment need and treatment utilization, and how changes in the health care system may affect the delivery of treatment. This research will not only reveal new medications and behavioral therapies but also will contribute to new ways of approaching current treatment problems. PMID:23580014

  7. State Alcoholism Treatment Centers. Program Audit.

    ERIC Educational Resources Information Center

    Geizer, Bernard P., Ed.

    The report presents the results of an evaluation of New York's 13 Alcoholism Treatment Centers (ATCs). The goals of the evaluation were to review the role of the ATCs in relation to other alcoholism treatment facilities, to assess their effectiveness and efficiency, and to determine how much money is collected for service provided to patients.…

  8. Service delivery and pharmacotherapy for alcohol use disorder in the era of health reform: Data from a national sample of treatment organizations

    PubMed Central

    Knudsen, Hannah K.; Roman, Paul M.

    2015-01-01

    Background Although there is a growing literature examining organizational characteristics and medication adoption, little is known about service delivery differences between specialty treatment organizations that have and have not adopted pharmacotherapy for alcohol use disorder (AUD). This study compares adopters and non-adopters across a range of treatment services, including levels of care, availability of tailored services for specific populations, treatment philosophy and counseling orientations, and adoption of comprehensive wraparound services. Methods In-person interviews were conducted with program leaders from a national sample of 372 organizations that deliver AUD treatment services in the US. Results About 23.6% of organizations had adopted at least one AUD medication. Organizations offering pharmacotherapy were similar to non-adopters across many measures of levels of care, tailored services, treatment philosophy, and social services. The primary area of difference between the two groups was for services related to health problems other than AUD. Pharmacotherapy adopters were more likely to offer primary medical care, medications for smoking cessation, and services to address co-occurring psychiatric conditions. Conclusions Service delivery differences were modest between adopters and non-adopters of AUD pharmacotherapy, with the exception of health-related services. However, the greater adoption of health-related services by organizations offering AUD pharmacotherapy represents greater medicalization of treatment, which may mean these programs are more strongly positioned to respond to opportunities for integration under health reform. PMID:25893539

  9. Alcohol, drug, and mental health specialty treatment services and race/ethnicity: a national study of children and families involved with child welfare.

    PubMed

    Libby, Anne M; Orton, Heather D; Barth, Richard P; Webb, Mary Bruce; Burns, Barbara J; Wood, Patricia; Spicer, Paul

    2006-04-01

    We used data on a national sample of children involved with child welfare systems to compare American Indian caregivers with White, Black, and Hispanic caregivers in their need for, and receipt of, specialty alcohol, drug, and mental health treatment. American Indian caregivers were significantly less likely to receive services than were Hispanic caregivers (P<.05) but not significantly less likely than were White or Black caregivers. Child placement, child age, and caregiver psychiatric comorbidity were significantly associated with service receipt.

  10. Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

    ERIC Educational Resources Information Center

    Zakletskaia, Larissa; Wilson, Ellen; Fleming, Michael Francis

    2010-01-01

    Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students…

  11. Burnout and Alcoholic Treatment Counselors.

    ERIC Educational Resources Information Center

    Niehoff, Marilee S.

    1984-01-01

    Uses a hypothetical case study to examine burnout and drinking problems of alcoholic treatment counselors. Suggests ways of coping with stress and developing goals and strategies for positive change. (JAC)

  12. Recent Developments in Alcohol Services Research on Access to Care

    PubMed Central

    Schmidt, Laura A.

    2016-01-01

    In the United States, only about 10 percent of people with an alcohol or drug use disorder receive care for the condition, pointing to a large treatment gap. Several personal characteristics influence whether a person will receive treatment; additionally, many people with an alcohol use disorder do not perceive the need for treatment. The extent of the treatment gap differs somewhat across different population subgroups, such as those based on gender, age, or race and ethnicity. Recent health care reforms, such as implementation of the Patient Protection and Affordable Care Act of 2010, likely will improve access to substance abuse treatment. In addition, new treatment approaches, service delivery systems, and payment innovations may facilitate access to substance abuse services. Nevertheless, efforts to bridge the treatment gap will continue to be needed to ensure that all people who need alcohol and drug abuse treatment can actually receive it. PMID:27159809

  13. 38 CFR 17.81 - Contracts for residential treatment services for veterans with alcohol or drug dependence or...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... social service. (x) Individual counseling as appropriate. (xi) Opportunities for learning/development of...-free life style). (xiii) Opportunities for learning, testing, and internalizing knowledge of illness... Veterans Affairs staff members involved with the treatment program of the veterans concerned....

  14. Telemedicine-Based Alcohol Services for Rural Offenders

    PubMed Central

    Staton-Tindall, Michele; Wahler, Elizabeth; Webster, J. Matthew; Godlaski, Theodore; Freeman, Rebecca; Leukefeld, Carl

    2016-01-01

    Research has consistently shown that alcohol use is a problem in rural communities and access to substance abuse treatment, particularly evidence-based treatment is limited. Because telemedicine has been shown to be effective in delivering services, this article presents a novel and innovative way of using telemedicine technology in the form of videoconferencing to deliver an evidence-based alcohol intervention (motivational enhancement therapy) with at-risk alcohol users in real-world settings (rural probation and parole offices). This article focuses on: (a) creating a profile of an at-risk group of rural alcohol users; (b) describing the evidence-based intervention; and (c) describing the innovative telemedicine-based service delivery approach. PMID:22867122

  15. Addressing tobacco use disorder in smokers in early remission from alcohol dependence: the case for integrating smoking cessation services in substance use disorder treatment programs

    PubMed Central

    Kalman, David; Kim, Sun; DiGirolamo, Gregory; Smelson, David; Ziedonis, Douglas

    2010-01-01

    Despite the declining overall rate of cigarette smoking in the general population in the United States, the prevalence of smoking is estimated to be as high as 80% among treatment-seeking alcoholics. The serious adverse health effects of tobacco and heavy alcohol use are synergistic and recent evidence suggests that smoking slows the process of cognitive recovery following alcohol abstinence. In addition, substantial evidence shows that treatment for tobacco dependence does not jeopardize alcohol abstinence. In this paper, we focus on the impact and treatment implications of tobacco dependence among treatment-seeking alcoholics through a review of five areas of research. We begin with brief reviews of two areas of research: studies investigating the genetic and neurobiological vulnerability of comorbid tobacco and alcohol dependence and studies investigating the consequences of comorbid dependence on neurobiological and cognitive functioning. We then review literature on the effects of smoking cessation on drinking urges and alcohol use and the effectiveness of smoking cessation interventions with alcoholic smokers. Finally, we offer recommendations for research with an emphasis on clinical research for enhancing smoking cessation outcomes in this population. PMID:19748166

  16. Fetal alcohol exposure: consequences, diagnosis, and treatment.

    PubMed

    Pruett, Dawn; Waterman, Emily Hubbard; Caughey, Aaron B

    2013-01-01

    Maternal alcohol use during pregnancy is prevalent, with as many as 12% of pregnant women consuming alcohol. Alcohol intake may vary from an occasional drink, to weekly binge drinking, to chronic alcohol use throughout pregnancy. Whereas there are certain known consequences from fetal alcohol exposure, such as fetal alcohol syndrome, other effects are less well defined. Craniofacial dysmorphologies, abnormalities of organ systems, behavioral and intellectual deficits, and fetal death have all been attributed to maternal alcohol consumption. This review article considers the theoretical mechanisms of how alcohol affects the fetus, including the variable susceptibility to fetal alcohol exposure and the implications of ethanol dose and timing of exposure. Criteria for diagnosis of fetal alcohol syndrome are discussed, as well as new methods for early detection of maternal alcohol use and fetal alcohol exposure, such as the use of fatty acid ethyl esters. Finally, current and novel treatment strategies, both in utero and post utero, are reviewed.

  17. Integrating Substance Abuse Treatment and Child Welfare Services: Findings from the Illinois Alcohol and Other Drug Abuse Waiver Demonstration

    ERIC Educational Resources Information Center

    Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard

    2006-01-01

    Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…

  18. The Delivery of Alcoholism Services: Meeting Whose Needs?

    ERIC Educational Resources Information Center

    Christmas, June J.

    Of grave concern to all who are involved in the delivery of health and mental health services are two recently-observed trends in the drug and alcohol abusing population: the emergence of formerly hidden individuals in need of treatment (among them women, children and the elderly), and the increasing incidence and severity of emotional problems…

  19. A Guide to Planning Alcoholism Treatment Programs.

    ERIC Educational Resources Information Center

    McGough, Dixie P.; Hindman, Margaret H.

    This guide contains information from the alcoholism literature and from interviews with people in state alcoholism agencies, major professional associations, and public and private service programs. It is designed to help readers plan and develop community alcoholism programs by providing an overview of the many considerations involved in starting…

  20. Twenty-five strategies for improving the design, implementation and analysis of health services research related to alcohol and other drug abuse treatment.

    PubMed

    Dennis, M L; Perl, H I; Huebner, R B; McLellan, A T

    2000-11-01

    While some aspects of addiction can be studied in laboratory or controlled settings, the study of long-term recovery management and the health services that support it requires going out into the community and dealing with populations and systems that are much more diverse and less under our control. This in turn raises many methodological challenges for the health service researchers studying alcohol and other drug abuse treatment. This paper identifies some of these challenges related to the design, measurement, implementation and effectiveness of health services research. It then recommends 25 strategies (and key primers) for addressing them: (1) identifying in advance all stakeholders and issues; (2) developing conceptual models of intervention and context; (3) identifying the population to whom the conclusions will be generalized; (4) matching the research design to the question; (5) conducting randomized experiments only when appropriate and necessary; (6) balancing methodological and treatment concerns; (7) prioritizing analysis plans and increasing design sensitivity, (8) combining qualitative and quantitative methods; (9) identifying the four basic types of measures needed; (10) identifying and using standardized measures; (11) carefully balancing measurement selection and modification; (12) developing and evaluating modified and new measures when necessary; (13) identifying and tracking major clinical subgroups; (14) measuring and analyzing the actual pattern of services received; (15) incorporating implementation checks into the design; (16) incorporating baseline measures into the intervention; (17) monitoring implementation and dosage as a form of quality assurance; (18) developing procedures early to facilitate tracking and follow-up of study participants; (19) using more appropriate representations of the actual experiment; (20) using appropriate and sensitive standard deviation terms; (21) partialing out variance due to design or known sources prior

  1. Alcohol use in the service industry.

    PubMed

    Larsen, S

    1994-06-01

    It is frequently alleged that hotel and restaurant personnel drink more than other groups in the service industry, although only indirect evidence has been presented to substantiate this allegation. This paper reports data from two surveys concerning alcohol use in different segments of the service industry. In the first study 84 students at three different colleges in the Stavanger region were interviewed concerning their alcohol habits using the screening instrument AUDIT (Alcohol Use Disorders Identification Test). The second survey concentrated on service employees in the Rogaland area. One hundred and five respondents answered the AUDIT questionnaire in this study. The results showed that hotel and restaurant affiliated individuals scored significantly higher on the AUDIT than the other respondents. The first survey indicated that students at the Norwegian College of Hotel Management obtained significantly higher AUDIT scores than other groups of students, whereas the second survey indicated that restaurant workers scored significantly higher than employees in other branches of the service industry. Implications of these results, as well as future research demands were indicated.

  2. A Treatment Approach for Children of Alcoholics

    ERIC Educational Resources Information Center

    Kern, Joseph C.; And Others

    1977-01-01

    Treatment agencies that ignore needs of children of alcoholics are inadvertently breeding a second generation of alcoholics. This paper reports on an effort to mount an education/prevention effort with children of alcoholics and their mothers. Each session is described in detail and recommendations for programming offered. (Author)

  3. Health Services and Financing of Treatment

    PubMed Central

    Stewart, Maureen T.; Horgan, Constance M.

    2011-01-01

    Financing, payment, and organization and management of alcohol and other drug (AOD) treatment services are closely intertwined and together determine whether people have access to treatment, how the treatment system is designed, and the quality and cost of treatment services. Since the 1960s, changes in these arrangements have driven changes in the delivery of AOD treatment, and recent developments, including the passage of Federal parity legislation and health reform, as well as increasing use of performance contracting, promise to bring additional changes. This article outlines the current state of the AOD treatment system and highlights implications of these impending changes for access to and quality of AOD treatment services. PMID:23580023

  4. Reluctance to Accept Alcohol Treatment by Alcoholic Liver Disease Transplant Patients: A Qualitative Study

    PubMed Central

    Heyes, Cathy M.; Schofield, Toni; Gribble, Robert; Day, Carolyn A.; Haber, Paul S.

    2016-01-01

    Background Liver transplantation (LT) is the optimum treatment for patients with end-stage alcoholic liver disease (ALD). However, despite a recognized risk of relapse to harmful drinking, ALD transplant patients are reluctant to use speciality alcohol treatment to support their abstinence, even when offered within the LT context. This study aimed to understand and identify factors contributing to alcohol treatment reluctance by ALD patients undergoing transplantation. Methods We conducted an in-depth qualitative study of ALD transplant patients. Minimally structured face-to-face interviews explored participants' alcohol-related experiences and their reasons for not using alcohol treatment during the course of their transplantation. Thematic analysis was used to analyze and interpret interview data to understand treatment reluctance based on participants' experiences. Results Five major themes were identified among 3 subgroups of patients (pretransplant and posttransplant abstainers and posttransplant relapsers): (i) the “contract” of mandatory abstinence, (ii) the “gap in the program” involving the lack of candour between patient and staff about alcohol-related matters and the lack of addiction services, (iii) a preference by participants to self-manage their alcohol use disorder, (iv) social support as a facilitator of abstinence and the risk of relapse when social support is diminished, and (v) the fear of stigmatization. Each of these factors were dynamically interrelated and differed slightly for each subgroup. Conclusions The LT services may benefit from the inclusion of integrated specialist addiction services in their model of care. Such an approach may enhance the acceptability of alcohol treatment and reduce the risk of relapse among ALD transplant participants, especially for those whose social supports have diminished. PMID:27795986

  5. Improving Care for the Treatment of Alcohol and Drug Disorders

    PubMed Central

    McCarty, Dennis; Gustafson, David; Capoccia, Victor A.; Cotter, Frances

    2008-01-01

    The Network for the Improvement of Addiction Treatment (NIATx) teaches alcohol and drug treatment programs to apply process improvement strategies and make organizational changes that improve quality of care. Participating programs reduce days to admission, increase retention in care and spread the application of process improvement within their treatment centers. More generally, NIATx provides a framework for addressing the Institute of Medicine’s six dimensions of quality care (i.e., safe, effective, patient-centered, efficient, timely and equitable) in treatments for alcohol, drug and mental health disorders. NIATx and its extensions illustrate how the behavioral health field can respond to the demand for higher quality treatment services. PMID:18259871

  6. Integrating spirituality into alcohol treatment.

    PubMed

    Delaney, Harold D; Forcehimes, Alyssa A; Campbell, William P; Smith, Bruce W

    2009-02-01

    Spirituality is presumed by millions of Americans to be directly relevant to problems of alcohol abuse. We summarize findings regarding the role of religion and spirituality in the prevention and treatment of substance abuse and present a case illustration. We also consider mechanisms responsible for these effects. We offer advice about why, by whom, and how religion and spirituality should be discussed with clients with substance use disorders. In a recent clinical trial, therapists trained in a client-centered approach to facilitate exploration of spirituality fostered clients' use of spiritual practices. We suggest that the therapist's ability to skillfully engage clients in a discussion of spirituality is largely determined by how the therapist balances the dual roles of authoritative expert and evocative facilitator.

  7. Recent developments in alcoholism: inpatient treatment.

    PubMed

    Nace, E P

    1993-01-01

    The historical role of inpatient treatment for alcoholism is reviewed in terms of its advantages and disadvantages. The factors that have forced a change in the utilization of inpatient treatment include increasing recognition of the heterogeneity of alcoholic patients, negative outcome studies, and cost-containment efforts. The clinical domains that warrant inpatient treatment are outlined, and decisions of treatment placement are necessarily guided by the factors of acuteness, ability, safety, and stabilization.

  8. New treatment options for alcoholic hepatitis.

    PubMed

    Shasthry, Saggere Muralikrishna; Sarin, Shiv Kumar

    2016-04-21

    The burden of alcoholic liver disease has rapidly grown in the past two decades and is expected to increase further in the coming years. Alcoholic hepatitis, the most florid presentation of alcoholic liver disease, continues to have high morbidity and mortality, with significant financial and healthcare burden with limited treatment options. Steroids remain the current standard of care in severe alcoholic hepatitis in carefully selected patients. No specific treatments are available for those patients who are steroid ineligible, intolerant or unresponsive. Liver transplant has shown good short-term outcome; however, feasibility, ethical and economic concerns remain. Modification of gut microbiota composition and their products, such as lipopolysaccharide, nutritional interventions, immune modulation, increasing steroid sensitivity, genetic polymorphism and epigenetic modification of alcohol induced liver damage, augmenting hepatic regeneration using GCSF are potential therapeutic avenues in steroid non-responsive/ineligible patients. With better understanding of the pathophysiology, using "Omics" platforms, newer options for patients with alcoholic hepatitis are expected soon.

  9. The Alcohol Services Reporting System (ASRS) Revision Study.

    ERIC Educational Resources Information Center

    Borkman, Thomasina

    This document reports a revision study of the California Alcohol Services Reporting System (ASRS), a system which consists of a structure of definitions and categories of services, a budget form of planned alcohol services, instructions for the county plan, and the report of expenditures. The study problem is that the ASRS structure of…

  10. Public opinions about alcoholism and its treatment.

    PubMed

    Caetano, R

    1987-03-01

    Survey respondents' views about alcoholism as an illness, support for treatment, treatment recommendation and stigma surrounding alcoholics are examined. Subjects (N = 482) comprise a random sample of the population of Contra Costa County, California. About 91% of the respondents agree with the notion that alcoholism is an illness, but 40% also agree that alcoholics drink because they want to. More women than men support the idea that to recover alcoholics will have to quit drinking forever. The contrary is true of the idea of controlled drinking. Education and income are negatively associated with items on loss of control and controlled drinking. Respondents who have had their lives deeply affected by an alcoholic and those who report a drinking problem of their own do not differ in their opinions about alcoholism from those who do not have these characteristics. Alcoholics Anonymous is the most common form of treatment recommended by the respondents. In general, results show considerable support for treatment as well as ambivalence regarding the disease concept.

  11. [Misuse of alcohol and new drug treatments].

    PubMed

    Paille, François

    2011-12-01

    Three drugs are currently marketed in France in the prevention of relapse in alcohol-dependent patients. Their efficacy though real remains limited and it is useful to develop other molecules. Some products are at present under evaluation, and are already or could be used in the near future in the treatment of alcohol dependence: baclofene, oxybate de sodium (GHB), nalmefene, topiramate, ondansetron and aripiprazole. The available studies on these molecules are still limited and the results sometimes clinically modest. Nevertheless, some of them open interesting future prospects. If there is no big revolution to wait in the short term in the treatment of alcohol dependence, we can consider some interesting orientations: better effectiveness on alcohol consumption, but also change of paradigm concerning the objectives and the methods of this treatment: reduction of consumption versus abstinence, treatment on request, choice of the molecule guided by objective criteria (psychosocial, biological, genetic...).

  12. Senior Alcohol Services Revisited: Elderly Alcoholism--Current State of the Art.

    ERIC Educational Resources Information Center

    Dunlop, Jean D.

    This report notes the growing awareness of alcohol problems among the elderly during the past 5 to 10 years, and reviews the final conclusions of the federal demonstration project, Senior Alcohol Services. Five basic concepts are included: (1) there are a growing number of elderly persons with alcohol problems (10-15% of all persons over age 60);…

  13. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82 Pensions... Agencies § 17.82 Contracts for outpatient services for veterans with alcohol or drug dependence or abuse disabilities. (a) Contracts for treatment services authorized under § 17.80 may be awarded in accordance...

  14. Treatment of alcohol withdrawal with gabapentin.

    PubMed

    Bozikas, Vasilis; Petrikis, Petros; Gamvrula, Katerina; Savvidou, Ioanna; Karavatos, Athanasios

    2002-01-01

    Gabapentin is an anticonvulsant agent, also effective in the treatment of mood disorders and anxiety disorders. Three cases of alcohol withdrawal treated with gabapentin are presented. All patients received gabapentin 400 mg tid for 3 days, 400 mg bid for 1 day, and finally 400 mg for 1 day. Withdrawal symptoms subsided and no adverse effects were observed. The possible effectiveness of gabapentin in the treatment of alcohol withdrawal warrants further investigation by systematic and well-designed studies.

  15. Psychoanalytic Treatment of Psychological Addiction to Alcohol (Alcohol Abuse)

    PubMed Central

    Johnson, Brian

    2011-01-01

    The DSM-V Committee plans to abolish the distinction between Alcohol Abuse and Alcohol Dependence (dsm5.org). The author presents a case report as a proof of concept that this distinction should be retained. The author has asserted that Alcohol Abuse is a purely psychological addiction, while Alcohol Dependence involves capture of the ventral tegmental dopaminergic SEEKING system (Johnson, 2003). In psychological addiction the brain can be assumed to function normally, and ordinary psychoanalytic technique can be followed. For the patient described, transference interpretation was the fundamental key to recovery. Alcoholic drinking functioned to prevent this man from remembering overwhelming childhood events; events that were also lived out in his current relationships. Murders that occurred when he was a child were hidden in a screen memory. The patient had an obsessional style of relating where almost all feeling was left out of his associations. After he stopped drinking compulsively, he continued to work compulsively. The maternal transference had to be enacted and then interpreted in order for overwhelming memories to be allowed into conscious thought. After psychoanalysis, the patient resumed drinking and worked a normal schedule that allowed more fulfilling relationships. He had no further symptoms of distress from drinking over a 9-year followup. This case illustrates that Alcohol Abuse is a purely psychological illness, that it does not have the brain changes typical of Alcohol Dependence. Combining epidemiological, neurobiological, longitudinal, and psychoanalytic observations would allow multiple sources of information to be used in creating diagnostic categories. Losing details of human behavior by relying only on epidemiological studies is likely to cause errors in categorization of disorders. In turn, having faulty categories as the basis of further research is likely to impair identification of specific effective treatments. PMID:22144975

  16. Treatment of alcohol withdrawal syndrome with gabapentin.

    PubMed

    Bonnet, U; Banger, M; Leweke, F M; Maschke, M; Kowalski, T; Gastpar, M

    1999-05-01

    Four in-patients with moderate alcohol-withdrawal syndromes benefited from treatment with gabapentin administered in an add-on fashion to clomethiazole. In comparison with the amount of clomethiazole required as estimated using a specially developed score during previous detoxifications of these patients at our hospital, gabapentin (400 mg q.i.d.) clearly reduced the amount of clomethiazole needed now Gabapentin, an anticonvulsant with favorable pharmacokinetic properties and tolerability, and with no known risk of dependence, may therefore be a useful new drug in the treatment of alcohol withdrawal. We believe that the potential value of gabapentin in alcohol withdrawal deserves further controlled studies.

  17. Relationship Between Service Utilization and Runaway Youths' Alcohol and Other Drug Use.

    PubMed

    Slesnick, Natasha; Meade, Melissa; Tonigan, J Scott

    2001-01-01

    Runaway youths represent a vulnerable, high-risk population that has received little societal attention. Studies show that youths at greatest need are the least likely to access mental health, medical, and other social services. This study evaluated service utilization, including medical visits, psychological, alcohol and drug counseling and 12-step attendance, and substance use. Runaway youths (n = 51) between the ages of 12 and 17 with a diagnosis of alcohol abuse or dependence were recruited from two southwestern runaway shelters. Results showed that psychological counseling and medical visits were associated with less alcohol use while 12-step attendance was associated with more alcohol use at pretreatment. Service utilization was not associated with illicit drug use. The findings suggest that alcohol and other drug use are affected differently by service utilization in this sample of youths. More research is required to evaluate and develop treatments which can effectively intervene with this high-risk group.

  18. Impacts of international trade, services and investment treaties on alcohol regulation.

    PubMed

    Grieshaber-Otto, J; Sinclair, S; Schacter, N

    2000-12-01

    There is an underlying incompatibility between government efforts to minimize the harm associated with alcohol, particularly by regulating its supply, and international commercial treaties that promote the freer flow of goods, services and investment. These treaties have already forced changes to many government measures affecting alcohol availability and control, primarily by constraining the activities of government alcohol monopolies and by altering taxation regimes. The North American Free Trade Agreement and the World Trade Organization agreements open new avenues for challenges against alcohol control measures. Some of these agreements extend beyond trade, border measures and differential taxation and allow challenges that intrude into areas of non-discriminatory domestic regulation affecting market access, intellectual property, investment and services. Effective protection from these agreements for vital public health measures has rarely been obtained, although it is increasingly essential. The WTO "services" agreement, basically unknown to the public, is currently being re-negotiated and poses the gravest new challenge to policies designed to influence patterns of alcohol use and minimize alcohol-related harm. In future, these international agreements will probably affect adversely those alcohol approaches considered to be the most effective or promising. These include: maintaining effective state monopolies, restricting the number and locations of retail outlets, taxing and regulating beverages according to alcohol strength, restricting commercial advertising, and maintaining and enhancing public alcohol education and treatment programs. These effects can, in turn, be expected to increase the availability and access to alcohol, to lower alcohol taxes, and to increase advertising and promotion, resulting in increased alcohol consumption and associated health problems. Until more balanced international rules are developed, the challenge facing alcohol

  19. Nature and Treatment of Comorbid Alcohol Problems and Post-Traumatic Stress Disorder Among American Military Personnel and Veterans

    PubMed Central

    Allen, John P.; Crawford, Eric F.; Kudler, Harold

    2016-01-01

    Many service members and veterans seeking treatment for alcohol problems also have post-traumatic stress disorder (PTSD). This article considers the effectiveness of treating alcohol problems and PTSD simultaneously. The authors begin by summarizing the extent of excessive alcohol use among military service members and veterans. They then explore the relationship between combat exposure and subsequent alcohol use; identify and briefly describe evidence-based treatments for alcohol problems and PTSD, separately; and review research on the effects of single treatments for both PTSD symptoms and alcohol use. PMID:27159820

  20. Indian Juvenile Alcoholism and Drug Abuse Prevention. Hearings on H.R. 1156 To Coordinate and Expand Services for the Prevention, Identification, Treatment, and Follow-Up Care of Alcohol and Drug Abuse among Indian Youth and for Other Purposes and H.R. 2624 To Authorize Programs for the Treatment and Prevention of Drug and Alcohol Abuse among Indian Juveniles, before the Committee on Interior and Insular Affairs. House of Representatives, Ninety-Ninth Congress, First and Second Sessions.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Interior and Insular Affairs.

    Two hearings held on October 24, 1985, and April 29, 1986, produced testimony about two House bills on prevention and treatment of Indian juvenile alcoholism and drug abuse. These bills provide for (1) programs of instruction on alcohol and drug abuse in Indian schools in kindergarten through grade 12; (2) training about alcohol and drug abuse for…

  1. Alcoholics Anonymous and 12-step alcoholism treatment programs.

    PubMed

    Humphreys, Keith

    2003-01-01

    Alcoholics Anonymous (AA) self-help groups are the most commonly accessed component of the de facto system of care for alcohol problems in the United States. Further, AA's concepts and approach have strongly influenced a significant number of professional treatment programs. Nevertheless, only a modest number of longitudinal, comparative outcome studies on AA and on professional 12-step treatment programs have been conducted, which has limited both the certainty and scope of conclusions that can be drawn about these interventions. Research indicates that participation in Alcoholics Anonymous and in 12-step treatment are associated with significant reductions in substance abuse and psychiatric problems. Further, such interventions, it has been found, reduce health care costs over time in naturalistic, quasi-experimental, and experimental studies. Evaluation studies have also begun to illuminate the processes through which self-help groups and 12-step treatment programs exert their effects. To build on this knowledge base, future research should (1) be methodologically flexible and well-matched to its phenomenon of interest, (2) include evaluation of the unique features of self-help organizations, (3) increase representation of African-Americans and women in research samples, and (4) increase statistical power through larger sample sizes and more reliable measurement. Key content areas for future enquiry include further longitudinal evaluation of the outcomes of participation in AA and 12-step treatment (particularly in outpatient samples); better specification of the aspects of AA that influence outcome; and individual-, community-, and health organization-level controlled studies of the health care cost consequences of 12-step interventions.

  2. New treatment options for alcoholic hepatitis

    PubMed Central

    Shasthry, Saggere Muralikrishna; Sarin, Shiv Kumar

    2016-01-01

    The burden of alcoholic liver disease has rapidly grown in the past two decades and is expected to increase further in the coming years. Alcoholic hepatitis, the most florid presentation of alcoholic liver disease, continues to have high morbidity and mortality, with significant financial and healthcare burden with limited treatment options. Steroids remain the current standard of care in severe alcoholic hepatitis in carefully selected patients. No specific treatments are available for those patients who are steroid ineligible, intolerant or unresponsive. Liver transplant has shown good short-term outcome; however, feasibility, ethical and economic concerns remain. Modification of gut microbiota composition and their products, such as lipopolysaccharide, nutritional interventions, immune modulation, increasing steroid sensitivity, genetic polymorphism and epigenetic modification of alcohol induced liver damage, augmenting hepatic regeneration using GCSF are potential therapeutic avenues in steroid non-responsive/ineligible patients. With better understanding of the pathophysiology, using “Omics” platforms, newer options for patients with alcoholic hepatitis are expected soon. PMID:27099434

  3. Fetal Alcohol Spectrum Disorders (FASDs): Treatments

    MedlinePlus

    ... that early intervention treatment services can improve a child's development. Early intervention services help children from birth to ... wait for a formal diagnosis. Learn more about child development, milestones, and delays » Learn more about early intervention ...

  4. Elderly Alcoholism: Implications for Human Service Education

    ERIC Educational Resources Information Center

    Beechem, Michael

    2004-01-01

    Incumbent upon those faculty who teach substance abuse courses is the need to integrate elderly alcoholism-related course content to encourage and adequately prepare university students to serve this "hidden" population. Course content would ideally include theories specific to loss-grief, aging, and alcoholism. In addition, field placement…

  5. Divalproex in the treatment of alcohol withdrawal.

    PubMed

    Myrick, H; Brady, K T; Malcolm, R

    2000-02-01

    The present study represents an open-label clinical trial comparing treatment with a benzodiazepine (lorazepam) to divalproex in 11 inpatients with uncomplicated alcohol withdrawal syndrome. The trial used the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) scale. There were no significant differences in demographics or substance use parameters between the divalproex group (n = 6) or the lorazepam group (n = 5). A significant Group x CIWA-Ar score interaction [F(8,72) = 2.57, p < or = .01] was confirmed and further substantiated by a quadratic trend component for the interaction [F(1,9) = 24.9, p < or = .001]. This preliminary study supports further investigation of divalproex in the treatment of alcohol withdrawal.

  6. Measuring treatment process variables in Alcoholics Anonymous.

    PubMed

    Allen, J P

    2000-04-01

    Alcoholism treatment research has traditionally focused on direct questions of efficacy, such as is a particular intervention better than no treatment or is one treatment more effective than another. Recent projects, however, have also attempted to identify variables explaining why treatments vary in their effects. Many of these variables relate to the process of treatment itself or changes that may occur within the patients. Clinicians also need to continuously monitor progress of patients in engaging in behaviors supportive of long-term sobriety and how well the values and behaviors fostered by the particular treatment regimen are being incorporated into daily life. Measurement of process variables may assist in both regards. In the last decade several psychometric instruments have been developed to elucidate the processes involved in Alcoholic Anonymous (AA), a key adjunct of most formal alcoholism programs in the United States. These instruments measure dimensions such as involvement in AA, completion of steps, and adoption of values encouraged by AA. Six such measures are summarized here and several fruitful topics for future research on the measures are suggested.

  7. Resource Guide to New Jersey Adolescent Substance Abuse Treatment Services.

    ERIC Educational Resources Information Center

    Molinari, Geralyn D.

    This guide was developed to assist treatment providers and school personnel to identify New Jersey drug and alcohol treatment programs providing services to adolescents. Geographical areas served, days and hours of operation, admission requirements, services available for adolescents, payment information, and the name of a contact person are…

  8. MEDICATION TREATMENT OF DIFFERENT TYPES OF ALCOHOLISM

    PubMed Central

    Johnson, Bankole A.

    2010-01-01

    Alcoholism remain a serious cause of morbidity and mortality, despite progress through neurobiological research in identifying new pharmacological strategies for its treatment. Drugs that affect neural pathways that modulate the activity of the cortico-mesolimbic dopamine system have been shown to alter drinking behavior, presumably because this dopaminergic system is closely associated with rewarding behavior. Ondansetron, naltrexone, topiramate, and baclofen are examples. Subtyping alcoholism in adults into an early-onset type, with chronic symptoms and a strong biological predisposition to the disease, and a late-onset type, typically brought on by psychosocial triggers and associated with mood symptoms, may help in the selection of optimal therapy. Emerging adults with binge-drinking patterns also might be aided by selective treatments. Although preliminary work on the pharmacogenetics of alcoholism and its treatment has been promising, the assignment to treatment still depends on clinical assessment. Brief behavioral interventions that encourage the patient to set goals for a reduction in heavy drinking or abstinence also are part of optimal therapy. PMID:20516163

  9. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Alcohol and drug... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or...

  10. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Alcohol and drug... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or...

  11. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Alcohol and drug... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or...

  12. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Alcohol and drug... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or...

  13. Alcohols as hydrogen-donor solvents for treatment of coal

    DOEpatents

    Ross, David S.; Blessing, James E.

    1981-01-01

    A method for the hydroconversion of coal by solvent treatment at elevated temperatures and pressure wherein an alcohol having an .alpha.-hydrogen atom, particularly a secondary alcohol such as isopropanol, is utilized as a hydrogen donor solvent. In a particular embodiment, a base capable of providing a catalytically effective amount of the corresponding alcoholate anion under the solvent treatment conditions is added to catalyze the alcohol-coal reaction.

  14. Establishing a drug and alcohol service in an Australian rural area.

    PubMed

    Helliwell, D; Reilly, D; Rippingale, C

    1992-01-01

    The response to drug and alcohol problems in a small Australian rural community is described. The town of Nimbin, the centre of this community, is characterized by alternative life-styles. The area has received considerable publicity over illicit drug use, particularly marijuana-growing and a recent increase in injecting drug usage. The town has one medical practice with two general practitioners and this centre has been actively involved in the development of drug and alcohol services. This paper describes the development of a drug and alcohol service from the perspective of a local general practitioner. Reference is made to problems of community resistance, hospital issues and the steps taken to acquire knowledge and skills in the management of patients presenting to the practice. The importance of a multidisciplinary team approach in the development of services which included a needle and syringe exchange and a methadone treatment programme is emphasized.

  15. [Treatment processes of pre-alcoholism and alcohol dependence targeted towards drinking reduction].

    PubMed

    Yoshimura, Atsushi; Maesato, Hitoshi; Hisatomi, Nobuko; Higuchi, Susumu

    2013-02-01

    Since the 1990s, we have suggested the concept of pre-alcoholism which encompasses patients who have drunk a great deal of alcohol leading to alcohol related problems such as health issues, domestic violence, drunken driving and black-outs. Pre-alcoholism excludes alcohol-dependent patients who have experienced continuous drinking or withdrawal symptoms. We have treated many outpatients with pre-alcoholism for several years. Our regimen demands that the patients must be abstinent for half a year at the beginning of their treatment. After half a year they can choose whether they will continue to be abstinent or they will resume drinking with the aim of reducing their total alcohol consumption. The study clarified the character of pre-alcoholism by investigation of the patients' background and re-diagnosis of the patients based on the International Classification of Diseases, 10th Revision (ICD-10). A remarkable ratio of pre-alcoholic patients was diagnosed with alcohol dependence under ICD-10. We classified pre-alcoholic patients into two groups, one diagnosed as having ICD-10-classed alcohol dependence and the other which did not fulfill the ICD-10 diagnostic criteria of alcohol dependence, and examined the therapeutic processes of the two groups. It was shown that most pre-alcoholic patients could finally take required courses of treatment by themselves without regard to diagnosis under ICD-10, even if they chose any treatment and made alcohol related mistakes on the way. Our findings suggested that pre-alcoholic patients, a portion of whom may have exhibited mild alcohol dependence, could select drinking reduction as a primary goal of treatment after a certain period of abstinence.

  16. Treatment Services Received in the CASAWORKS for Families Program

    ERIC Educational Resources Information Center

    Mckay, James R.; Gutman, Marjorie; Mclellan, A. Thomas; Lynch, Kevin G.; Ketterlinus, Robert

    2003-01-01

    This article presents information on treatment services received by women participating in an initial multistate evaluation of CASAWORKS families. Results indicated most women received services to address medical, employment, basic needs, alcohol and drug, family, and psychiatric problems during the first six months of the program. The clients…

  17. The current situation of treatment systems for alcoholism in Korea.

    PubMed

    Kim, Jee Wook; Lee, Boung Chul; Kang, Tae-Cheon; Choi, Ihn-Geun

    2013-02-01

    Alcoholism is becoming one of the most serious issues in Korea. The purpose of this review article was to understand the present status of the treatment system for alcoholism in Korea compared to the United States and to suggest its developmental direction in Korea. Current modalities of alcoholism treatment in Korea including withdrawal treatment, pharmacotherapy, and psychosocial treatment are available according to Korean evidence-based treatment guidelines. Benzodiazepines and supportive care including vitamin and nutritional support are mainly used to treat alcohol withdrawal in Korea. Naltrexone and acamprosate are the drugs of first choice to treat chronic alcoholism. Psychosocial treatment methods such as individual psychotherapy, group psychotherapy, family therapy, cognitive behavior therapy, cue exposure therapy, 12-step facilitation therapy, self-help group therapy, and community-based treatment have been carried out to treat chronic alcoholism in Korea. However, current alcohol treatment system in Korea is not integrative compared to that in the United States. To establish the treatment system, it is important to set up an independent governmental administration on alcohol abuse, to secure experts on alcoholism, and to conduct outpatient alcoholism treatment programs and facilities in an open system including some form of continuing care.

  18. A Qualitative Study of Service Provision for Alcohol Related Health Issues in Mid to Later Life

    PubMed Central

    Haighton, Catherine; Wilson, Graeme; Ling, Jonathan; McCabe, Karen; Crosland, Ann; Kaner, Eileen

    2016-01-01

    Aims Epidemiological surveys over the last 20 years show a steady increase in the amount of alcohol consumed by older age groups. Physiological changes and an increased likelihood of health problems and medication use make older people more likely than younger age groups to suffer negative consequences of alcohol consumption, often at lower levels. However, health services targeting excessive drinking tend to be aimed at younger age groups. The aim of this study was to gain an in-depth understanding of experiences of, and attitudes towards, support for alcohol related health issues in people aged 50 and over. Methods Qualitative interviews (n = 24, 12 male/12 female, ages 51–90 years) and focus groups (n = 27, 6 male/21 female, ages 50–95 years) were carried out with a purposive sample of participants who consumed alcohol or had been dependent. Findings Participants’ alcohol misuse was often covert, isolated and carefully regulated. Participants tended to look first to their General Practitioner for help with alcohol. Detoxification courses had been found effective for dependent participants but only in the short term; rehabilitation facilities were appreciated but seen as difficult to access. Activities, informal groups and drop-in centres were endorsed. It was seen as difficult to secure treatment for alcohol and mental health problems together. Barriers to seeking help included functioning at a high level, concern about losing positive aspects of drinking, perceived stigma, service orientation to younger people, and fatalistic attitudes to help-seeking. Facilitators included concern about risk of fatal illness or pressure from significant people. Conclusion Primary care professionals need training on improving the detection and treatment of alcohol problems among older people. There is also a compelling need to ensure that aftercare is in place to prevent relapse. Strong preferences were expressed for support to be provided by those who had experienced

  19. Thai men’s experiences of alcohol addiction and treatment

    PubMed Central

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsompon, Jureerat; Östlund, Gunnel

    2014-01-01

    Background Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men’s experiences with addiction and alcohol treatment programs in Thailand. Objective The aim of this study was to explore men’s experiences in terms of the ‘pros and cons of alcohol consumption’ in order to identify the barriers that exist for Thai men with regard to alcohol addiction and the decision to stop drinking. Design Purposive sampling was applied in the process of recruiting participants at an alcohol clinic in a hospital in Thailand. Thirteen men with alcohol addiction (aged 32–49 years) were willing to participate and were interviewed in thematic interviews. The analysis of the data was done with descriptive phenomenology. Results Through men’s descriptions, three clusters of experiences were found that were ‘mending the body’, ‘drinking as payoff and doping related to work’, and ‘alcohol becoming a best friend’ as ways of describing the development of addiction. Conclusions The results highlight the importance of addressing concepts of masculinity and related hegemonic ideas in order to decrease the influence of the barriers that exist for Thai men with alcohol addiction with regard to entering treatment and to stop drinking. PMID:24845212

  20. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or...

  1. Rural Issues in Alcohol and Other Drug Abuse Treatment: Award for Excellence Papers. Technical Assistance Publication Series No. 10.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Prevention.

    This document consists of papers that received recognition in a competition sponsored by the Center for Substance Abuse Treatment and the National Rural Institute on Alcohol and Drug Abuse. The competition sought to focus attention on problems in providing treatment and prevention services for drug and alcohol problems in rural areas. The papers…

  2. Using Couples Therapy in Treatment of Alcoholism.

    ERIC Educational Resources Information Center

    O'Farrell, Timothy J.

    Couples therapy interventions can be used with alcohol abusers and alcoholics during three broadly defined states of recovery: (1) initial commitment to change; (2) change itself; and (3) long-term maintenance of change. Intervening with the alcoholic's spouse (and/or other nonalcoholic family members) can motivate and reinforce commitment to…

  3. Alcohol in Head-Injured Aircrew Evaluated by the Aeromedical Consult Service, 1982-2002

    DTIC Science & Technology

    2012-02-23

    Intoxication 15 Frequency of Alcohol Use Screening 16 Alcohol Treatment Program Referrals 16 Screening Recommendations 17 HEAD IN JURIES 18 Traumatic...46 xi BASELINE ALCOHOL CONSUMPTION 47 ALCOHOL USE AT THE TIME OF INJURY 48 Frequency of Alcohol Assessment by Date of Evaluation 49 BLOOD ALCOHOL... frequency /amount survey had a sensitivity of 80%, and a specificity of 82% for identifying individuals with alcohol dependence. In the same study, the

  4. Mobile Delivery of Treatment for Alcohol Use Disorders

    PubMed Central

    Quanbeck, Andrew; Chih, Ming-Yuan; Isham, Andrew; Johnson, Roberta; Gustafson, David

    2014-01-01

    Several systems for treating alcohol-use disorders (AUDs) exist that operate on mobile phones. These systems are categorized into four groups: text-messaging monitoring and reminder systems, text-messaging intervention systems, comprehensive recovery management systems, and game-based systems. Text-messaging monitoring and reminder systems deliver reminders and prompt reporting of alcohol consumption, enabling continuous monitoring of alcohol use. Text-messaging intervention systems additionally deliver text messages designed to promote abstinence and recovery. Comprehensive recovery management systems use the capabilities of smart-phones to provide a variety of tools and services that can be tailored to individuals, including in-the-moment assessments and access to peer discussion groups. Game-based systems engage the user using video games. Although many commercial applications for treatment of AUDs exist, few (if any) have empirical evidence of effectiveness. The available evidence suggests that although texting-based applications may have beneficial effects, they are probably insufficient as interventions for AUDs. Comprehensive recovery management systems have the strongest theoretical base and have yielded the strongest and longest-lasting effects, but challenges remain, including cost, understanding which features account for effects, and keeping up with technological advances. PMID:26259005

  5. Acamprosate: A prototypic neuromodulator in the treatment of alcohol dependence

    PubMed Central

    Heyser, Charles J.

    2010-01-01

    Alcoholism is one of the most prevalent substance dependence disorders in the world. Advances in research in the neurobiological mechanisms underlying alcohol dependence have identified specific neurotransmitter targets for the development of pharmacological treatments. Acamprosate, marketed under the brand name Campral, is an orally administered drug available by prescription in the U.S. and throughout much of the world for treating alcohol dependence. Its safety and efficacy have been demonstrated in numerous clinical trials worldwide. Here we provide an overview of acamprosate in the context of the neurobiological underpinnings of alcohol dependence. We propose that unlike previously available pharmacotherapies, acamprosate represents a prototype of a neuromodulatory approach in the treatment of alcohol dependence. A neuromodulatory approach seeks to restore the disrupted changes in neurobiology resulting from chronic alcohol intake. It is our opinion that a neuromodulatory approach will provide a heuristic framework for developing more effective pharmacotherapies for alcohol dependence. PMID:20201812

  6. [Treatment of alcohol dependence: rational and arguable approaches].

    PubMed

    Sivolap, Iu P

    2014-01-01

    Treatment of alcohol dependence consist of alcohol detoxification with withdrawal alleviation and relapse prevention or maintenance therapy. Drugs of choice for alcohol withdrawal cure are benzodiazepines and anticonvulsants are an alternative for them. Relapse prevention and alcohol abuse alleviation are carried out using disulfiram, acamprosate, naltrexone and nalmefene. Moreover, therapeutic possibilities of memantine, gabapentine, pregabalin, baclofen, modafinil, ondansetron D-cycloserine and aripiprazole are studying nowadays. Use of selective serotonin reuptake inhibitors including fluvoxamine for alcohol patients is of great importance due to frequent comorbidity of alcoholism, depression and anxiety. There are some doubtful methods of alcoholism treatment accepted in Russian addictive medicine such as clearance detoxification and use of antipsychotics for craving elimination.

  7. Alcohol problem resources and services in State supported programs, FY 1987.

    PubMed Central

    Butynski, W; Canova, D M

    1988-01-01

    During fiscal year 1987, expenditures for alcohol and drug abuse services in facilities receiving at least some funds from State alcohol and drug agencies totaled $1,809,749,013. Of this total, approximately 51.1 percent was contributed by State governments, 17.9 percent by the Federal Government, 9.1 percent by county or local agencies, and 21.9 percent by other sources (for example, private health insurance). Approximately 76.5 percent of the funds was expended for treatment services, 12.6 percent for prevention services, and 10.9 percent for other services (for example, administration, research, training). Between fiscal years 1985 and 1987, total expenditures increased 31.2 percent, although great variability existed among States, with some undergoing significant cuts. The total number of alcohol and drug treatment units that received State funds was 6,632. During fiscal year 1987, admissions for alcoholism treatment in these State-supported facilities totaled 1,317,473. Most admissions were to a nonhospital environment (84.6 percent) and were for outpatient care (44.9 percent). Of the total number of admissions, 76.2 percent were men and 19.8 percent women; the sex of 4.0 percent was not reported. With regard to age, 27.4 percent were 25-34, 21.7 percent were 35-44, 10.7 percent were 21-24, and 4.1 percent were under 18. In terms of race or ethnicity, 69.7 percent of those admitted were white, 15.6 percent black, 5.5 percent Hispanic, 3.6 percent Native American, 0.2 percent Asian or Pacific Islander, 0.3 percent others, and 5.2 percent not reported. Compared with the 1,317,473 admissions for alcoholism, the combined total of all other drug admissions was only 450,553.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3141955

  8. Fetal Alcohol Syndrome: Characteristics, Prevention, Treatment and Long Term Outlook.

    ERIC Educational Resources Information Center

    Seward, Cynthia A.; Barber, William H.

    1991-01-01

    This article discusses fetal alcohol syndrome (FAS) including causes, common characteristics, secondary characteristics, prevention, and treatment. Economic implications are noted which suggest that treatment costs are 100 times the cost of prevention programs. (DB)

  9. Indian Juvenile Alcoholism and Drug Abuse Prevention. Hearings before the Committee on Interior and Insular Affairs. House of Representatives, Ninety-Ninth Congress, First Session on H.R. 1156 to Coordinate and Expand Services for the Prevention, Identification, Treatment, and Follow-Up Care of Alcohol and Drug Abuse among Indian Youth, and for Other Purposes and H.R. 2624 to Authorize Programs for the Treatment and Prevention of Drug and Alcohol Abuse among Indian Juveniles.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Interior and Insular Affairs.

    Three hearings held in Arizona, New Mexico, and South Dakota provide individual statements and panel presentations on problems, programs, and proposals for prevention, identification, treatment, and follow-up care of alcohol and drug abuse among American Indian juveniles. The majority of witnesses are members of Indian tribes in the three…

  10. 49 CFR 40.341 - Must service agents comply with DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Roles and Responsibilities of Service Agents § 40.341 Must service agents comply with DOT drug and alcohol testing... requirements of this part and the DOT agency drug and alcohol testing regulations. (b) If you do not...

  11. 49 CFR 40.341 - Must service agents comply with DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Roles and Responsibilities of Service Agents § 40.341 Must service agents comply with DOT drug and alcohol testing... requirements of this part and the DOT agency drug and alcohol testing regulations. (b) If you do not...

  12. 49 CFR 40.341 - Must service agents comply with DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Roles and Responsibilities of Service Agents § 40.341 Must service agents comply with DOT drug and alcohol testing... requirements of this part and the DOT agency drug and alcohol testing regulations. (b) If you do not...

  13. 49 CFR 40.341 - Must service agents comply with DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Roles and Responsibilities of Service Agents § 40.341 Must service agents comply with DOT drug and alcohol testing... requirements of this part and the DOT agency drug and alcohol testing regulations. (b) If you do not...

  14. 49 CFR 40.341 - Must service agents comply with DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Roles and Responsibilities of Service Agents § 40.341 Must service agents comply with DOT drug and alcohol testing... requirements of this part and the DOT agency drug and alcohol testing regulations. (b) If you do not...

  15. A Case of Psychosis in Disulfiram Treatment for Alcoholism

    PubMed Central

    de Melo, Raquel Calvão; Lopes, Rui; Alves, José Carlos

    2014-01-01

    Background. Disulfiram, a drug used in the treatment of alcohol dependence, is an inhibitor of dopamine-β-hydroxylase causing an increase in the concentration of dopamine in the mesolimbic system. In addition to the physical symptoms associated with concomitant use of alcohol, disulfiram may lead to adverse events, when used alone, including psychosis. Aims. To report a case of a rare complication when using disulfiram for alcoholism treatment in a patient in alcoholic abstinence. Case Report. We describe the case of a 42-year-old male patient, who developed psychotic symptoms 3 weeks after initiating treatment with disulfiram for alcohol dependency. The patient had a history of chronic alcoholism for 12 years and was under disulfiram treatment (250 mg/day) for 1 month, with no other past history of psychiatric illness. The symptoms worsened after he initiated alcohol consumption, while taking disulfiram. The patient was hospitalized and disulfiram was suspended. After 4 days he was asymptomatic and at 6-week follow-up remained asymptomatic. Conclusion. Treatment with disulfiram can lead to the appearance of psychosis in patients with increased vulnerability. In clinical practice, psychosis in the context of alcoholism with disulfiram therapy is often neglected and should be taken into account. PMID:24818034

  16. Increased alcohol consumption in rats after subchronic antidepressant treatment.

    PubMed

    Alén, Francisco; Orio, Laura; Gorriti, Miguel Á; de Heras, Raquel Gómez; Ramírez-López, María Teresa; Pozo, Miguel Ángel; de Fonseca, Fernando Rodríguez

    2013-09-01

    The use of antidepressants for alcoholism in humans has been a matter of controversy in recent years. Despite the existence of an important co-morbidity for depression and alcoholism, some studies suggest that the use of antidepressants could worsen the prognosis of alcoholism. However, there is a lack of studies in animal models exploring this phenomenon. In the present study, we show how the 15-d treatment with fluoxetine (10 mg/kg) or venlafaxine (50 mg/kg) affected alcohol deprivation effect (ADE) and subsequent alcohol consumption. Initially, fluoxetine reduced ADE and venlafaxine did not affect it. However, in the following days, both antidepressants increased alcohol consumption, an effect that was found to last at least 5 wk. Fluoxetine treatment was shown to cause a locomotor sensitized response to a challenge dose of amphetamine (0.5 mg/kg), indicating the presence of a supersensitive dopaminergic transmission. In summary, antidepressant treatment may increase alcohol consumption in rats after a period of alcohol deprivation and this could be related to alterations in the reward circuitry. This finding confirms in an animal model previous reports in humans that may limit the use of antidepressants for alcoholism.

  17. Alcohol consumption, alcohol dependence and related harms in Spain, and the effect of treatment-based interventions on alcohol dependence.

    PubMed

    Rehm, Jürgen; Rehm, Maximilien X; Shield, Kevin D; Gmel, Gerrit; Gual, Antoni

    2013-01-01

    Alcohol consumption in Spain has traditionally followed the Mediterranean drinking pattern, featuring daily drinking with meals, beer as the preferred beverage, and comparatively little drinking to intoxication. Alcohol dependence (AD), one of the most detrimental disorders caused by alcohol, was prevalent in 0.2% of women and 1.2% of men, corresponding to 31,200 women and 186,000 men in Spain with AD in 2005 in the age group of 15 to 64 year. These prevalence estimates of alcohol dependence are likely underestimated due to limitations in the World Mental Health Survey which cannot be fully corrected for; however, the estimates of AD for Spain represent the most accurate and up to date estimates available. Alcohol creates a significant health burden in Spain with 11.3 premature deaths in women per 100,000 aged 15 to 64 years, and 40.9 premature deaths in men per 100,000 in the same age group were due to alcohol consumption (data for 2004). This amounts to 8.4% of all female deaths and 12.3% of all the male deaths in this age group being attributable to alcohol consumption. A large percentage of these harms were due to heavy alcohol consumption and AD. AD is undertreated in Spain, with less than 10% of all people with AD treated. For those who are treated, psychotherapy is the most utilized form of treatment to avoid relapse. If 40% of AD patients in Spain were treated with pharmacological treatment (the most effective treatment method), 2.2% of female and 6.2% of male deaths due to AD would be prevented within one year. Thus by increasing treatment rates is an important means of reducing the alcohol-attributable mortality and health burden in Spain.

  18. Hypnosis in the Treatment of Alcoholism: A Theoretical Perspective.

    ERIC Educational Resources Information Center

    Steffenhagen, R. A.

    1983-01-01

    Reviews the history and theory of alcoholism and hypnosis and proposes a theoretical model of alcholism based on self-esteem. Suggets that hypnosis may be an effective tool in the treatment of alcoholism with cure as the goal, and calls for more consistency in theory and practice. (JAC)

  19. The Role of the Spouse in the Treatment of Alcoholism.

    ERIC Educational Resources Information Center

    McCrady, Barbara S.; Hay, William

    The role of the spouse in both the etiology and the maintenance of alcoholism has been focussed on by theoreticians of various persuasions, including psychoanalytic, behavioral, sociological and family systems. These models, focussing on individual and interactional components of alcoholism, have generated a variety of treatment interventions…

  20. Automatic Avoidance Tendencies for Alcohol Cues Predict Drinking After Detoxification Treatment in Alcohol Dependence

    PubMed Central

    2016-01-01

    Alcohol dependence is characterized by conflict between approach and avoidance motivational orientations for alcohol that operate in automatic and controlled processes. This article describes the first study to investigate the predictive validity of these motivational orientations for relapse to drinking after discharge from alcohol detoxification treatment in alcohol-dependent patients. One hundred twenty alcohol-dependent patients who were nearing the end of inpatient detoxification treatment completed measures of self-reported (Approach and Avoidance of Alcohol Questionnaire; AAAQ) and automatic (modified Stimulus-Response Compatibility task) approach and avoidance motivational orientations for alcohol. Their drinking behavior was assessed via telephone follow-ups at 2, 4, and 6 months after discharge from treatment. Results indicated that, after controlling for the severity of alcohol dependence, strong automatic avoidance tendencies for alcohol cues were predictive of higher percentage of heavy drinking days (PHDD) at 4-month (β = 0.22, 95% CI [0.07, 0.43]) and 6-month (β = 0.22, 95% CI [0.01, 0.42]) follow-ups. We failed to replicate previous demonstrations of the predictive validity of approach subscales of the AAAQ for relapse to drinking, and there were no significant predictors of PHDD at 2-month follow-up. In conclusion, strong automatic avoidance tendencies predicted relapse to drinking after inpatient detoxification treatment, but automatic approach tendencies and self-reported approach and avoidance tendencies were not predictive in this study. Our results extend previous findings and help to resolve ambiguities with earlier studies that investigated the roles of automatic and controlled cognitive processes in recovery from alcohol dependence. PMID:27935726

  1. Neighborhood alcohol outlet density and rates of child abuse and neglect: moderating effects of access to substance abuse services.

    PubMed

    Morton, Cory M; Simmel, Cassandra; Peterson, N Andrew

    2014-05-01

    This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed.

  2. Comparison of Young Navy Alcohol Abusers and Drug Abusers on Demography, Personality, Performance, and Treatment Outcome.

    DTIC Science & Technology

    1979-07-01

    to alcohol or drug residential treatment programs. N.~ J. ’:’ic. ti~n ,... -or ti L INTRODUCTION Backgroun . The U.S. Navy has been operating separate...this hypothesis would involve administering Comrey Scales to newly inducted recruits and following their progress in the service. Perform- ance criteria

  3. A Profile of Clients Entering Treatment for Alcohol Problems.

    ERIC Educational Resources Information Center

    Finkbiner, Richard

    Large numbers of clients entering publicly-funded substance abuse treatment facilities cite problems with alcohol as one reason for seeking treatment. This report presents the results of a secondary analysis of the National Treatment Improvement Evaluation Study (NTIES) data set. It profiles the treatment experiences of three study groups that…

  4. Effects of Depression on Treatment Motivation in Male Alcohol Dependence

    PubMed Central

    CENGİSİZ, Cengiz; DEVECİ, Artuner; YAPICI, Aslıhan

    2015-01-01

    Introduction Treatment motivation in alcohol dependents is usually viewed as a strong predictor of seeking treatment and treatment success. The conditions affecting motivation in alcohol dependence, however, has not been clarified. In this study, it is aimed to determine the effects of depression on treatment motivation in male alcohol dependence. Methods The present study included 34 male alcohol dependents presenting to outpatient clinics in Manisa Hospital of Mental Disorders and Hospital of Celal Bayar University. The patients underwent evaluation using the socio-demographic and clinical information form, DSM-IV SCID-I Clinical Version, Treatment Motivation Questionnaire (TMQ), and Hamilton Depression Rating Scale (HDRS). Results A significant relationship was found between the total score of TMQ and HDRS (p=.039). Conclusion We believe that the present study, in which we examined the relationship between treatment motivation in male alcohol dependence and depression, would provide a significant contribution to literature. It is also important to investigate other factors that may affect treatment motivation in male alcohol dependence. Studies with larger samples are needed on this topic.

  5. Holism and High Level Wellness in the Treatment of Alcoholism.

    ERIC Educational Resources Information Center

    Bartha, Robert; Davis, Tom

    1982-01-01

    Discusses how a holistic and wellness philosophy is a viable alternative in the treatment of alcoholism. Describes five major dimensions of high-level wellness: nutritional awareness, physical fitness, stress management, environmental sensitivity, and self-responsibility. (RC)

  6. Trazodone and alcohol relapse: a retrospective study following residential treatment.

    PubMed

    Kolla, Bhanu Prakash; Schneekloth, Terry D; Biernacka, Joanna M; Frye, Mark A; Mansukhani, Meghna P; Hall-Flavin, Daniel K; Karpyak, Victor M; Loukianova, Larissa L; Lesnick, Timothy G; Mrazek, David

    2011-01-01

    Trazodone is one of the most commonly prescribed hypnotic medications in patients with sleep disturbances in alcohol recovery. A recent study concluded that treating insomnia with trazodone in patients with alcohol dependence might impede improvements in alcohol consumption and lead to increased drinking when trazodone is stopped. We set out to investigate the relationship between trazodone use during alcoholism treatment and relapse rates in patients who were discharged from a residential alcohol treatment program. We retrospectively reviewed records of patients with a diagnosis of alcohol dependence in a residential addiction treatment center from 2005 to 2008 and analyzed the association of trazodone use at discharge and alcohol relapse at 6 months. We also assessed the association between trazodone use and relapse at 6 months adjusting for sex, drug dependence, nonsubstance use Axis I psychiatric diagnoses, patient self-report of difficulties with sleep, and anti-dipsotropic medication use at discharge and evaluated pair-wise interactions of trazodone use with the adjustment variables. Of 283 patients eligible for inclusion, 85 (30%) were taking trazodone at discharge. Older age, self-reported sleep problems, and having a nonsubstance use Axis I psychiatric diagnosis were associated with trazodone use. After discharge, 170 (60%) subjects responded to follow-up efforts. Neither intent to treat nor responder only analysis revealed any association between trazodone use and relapse. Our retrospective study of a complex patient population discharged from a residential treatment setting did not find an association between trazodone use at discharge and relapse rates at 6 months.

  7. Gender, Acculturation, and Other Barriers to Alcohol Treatment Utilization among Latinos in Three National Alcohol Surveys

    PubMed Central

    Zemore, Sarah E.; Mulia, Nina; Ye, Yu; Borges, Guilherme; Greenfield, Thomas K.

    2009-01-01

    This study, using 3 waves of U.S. National Alcohol Surveys (1995-2005), examines lifetime alcohol treatment utilization and perceived treatment barriers among Latinos. The sample included 4204 Latinos (2178 women, 2024 men); data were weighted. Analyses were linear and logistic regressions. Controlling for survey year, severity, and other covariates, male gender and English language interview predicted higher utilization generally and AA use specifically; English interview was also associated with institutional treatment. (Effects for gender on general utilization were marginal.) Other predictors of utilization included older age, lower education, greater social pressures, greater legal consequences, greater dependence symptoms, and public insurance. Whereas men and women differed little on perceived barriers, analyses showed greater barriers among Spanish (vs. English) interviewees. Latina women's underutilization of alcohol treatment requires further research, but may be partially explained by stigma. Associations between language of interview and treatment utilization imply a need for outreach and culturally sensitive programming. PMID:19004599

  8. Differences between Alcoholics and Cocaine Addicts Seeking Treatment.

    PubMed

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso

    2015-03-03

    This study explored the characteristics of a representative sample of patients who were addicted to either alcohol or cocaine, comparing the profiles of both types of drug users. A sample of 234 addicted patients (109 alcoholics and 125 cocaine addicts) who sought outpatient treatment in a Spanish clinical centre was assessed. Data on socio-demographic, consumption, psychopathological and maladjustment characteristics were collected using the European Addiction Severity Index (EuropASI), the Symptom Checklist-90-Revised (SCL-90-R) and the Millon Clinical Multiaxial Inventory (MCMI-II). Demographically, differences were observed with regard to age (alcoholics were older than cocaine addicts; t = 12.2, p = .001), employment (the alcoholic group had more labor problems; χ 2 = 6.2, p = .045) and family consequences (worse in alcoholics; t = 2.3, p = .025). The EuropASI results showed statistically significant differences in addiction severity, with alcoholics showing a greater severity than cocaine addicts. In terms of psychopathology, alcoholics presented more associated symptomatology than cocaine addicts. According to these results, patients with alcohol dependence have a different profile from patients with cocaine dependence, resulting in different repercussions for important areas of their lives. These differences should be taken into account when standard treatments for addiction are implemented.

  9. The moderating role of social networks in the relationship between alcohol consumption and treatment utilization for alcohol-related problems.

    PubMed

    Mowbray, Orion

    2014-01-01

    Many individuals wait until alcohol use becomes severe before treatment is sought. However, social networks, or the number of social groups an individual belongs to, may play a moderating role in this relationship. Logistic regression examined the interaction of alcohol consumption and social networks as a predictor of treatment utilization while adjusting for sociodemographic and clinical variables among 1,433 lifetime alcohol-dependent respondents from wave 2 of the National Epidemiologic Survey on Alcohol Related Conditions (NESARC). Results showed that social networks moderate the relationship between alcohol consumption and treatment utilization such that for individuals with few network ties, the relationship between alcohol consumption and treatment utilization was diminished, compared to the relationship between alcohol consumption and treatment utilization for individuals with many network ties. Findings offer insight into how social networks, at times, can influence individuals to pursue treatment, while at other times, influence individuals to stay out of treatment, or seek treatment substitutes.

  10. Issues in the Treatment of Native Americans with Alcohol Problems.

    ERIC Educational Resources Information Center

    Thomason, Timothy C.

    2000-01-01

    Reviews the literature on the treatment of Native Americans who abuse alcohol or have dependence disorders and provides an interpretation of the research on this topic. The most common treatment modalities are described and critiqued. Recommendations are made regarding revising standard treatments to make them more culturally appropriate for this…

  11. Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

    PubMed Central

    Lee, Jinhee; Kresina, Thomas F.; Campopiano, Melinda; Lubran, Robert; Clark, H. Westley

    2015-01-01

    Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence. PMID:25629034

  12. Anticonvulsants for the treatment of alcohol withdrawal syndrome and alcohol use disorders.

    PubMed

    Hammond, Christopher J; Niciu, Mark J; Drew, Shannon; Arias, Albert J

    2015-04-01

    Alcoholic patients suffer from harmful allostatic neuroplastic changes in the brain causing an acute withdrawal syndrome upon cessation of drinking followed by a protracted abstinence syndrome and an increased risk of relapse to heavy drinking. Benzodiazepines have long been the treatment of choice for detoxifying patients and managing alcohol withdrawal syndrome (AWS). Non-benzodiazepine anticonvulsants (NBACs) are increasingly being used both for alcohol withdrawal management and for ongoing outpatient treatment of alcohol dependence, with the goal of either abstinence or harm reduction. This expert narrative review summarizes the scientific basis and clinical evidence supporting the use of NBACs in treating AWS and for reducing harmful drinking patterns. There is less evidence in support of NBAC therapy for AWS, with few placebo-controlled trials. Carbamazepine and gabapentin appear to be the most promising adjunctive treatments for AWS, and they may be useful as monotherapy in select cases, especially in outpatient settings and for the treatment of mild-to-moderate low-risk patients with the AWS. The body of evidence supporting the use of the NBACs for reducing harmful drinking in the outpatient setting is stronger. Topiramate appears to have a robust effect on reducing harmful drinking in alcoholics. Gabapentin is a potentially efficacious treatment for reducing the risk of relapse to harmful drinking patterns in outpatient management of alcoholism. Gabapentin's ease of use, rapid titration, good tolerability, and efficacy in both the withdrawal and chronic phases of treatment make it particularly appealing. In summary, several NBACs appear to be beneficial in treating AWS and alcohol use disorders.

  13. Alcoholism in Athletes: New Directions for Treatment.

    ERIC Educational Resources Information Center

    Samples, Pat

    1989-01-01

    Discusses steps that professional sports organizations are taking to identify athletes with drinking problems and help them reach full recovery. Many teams are taking preventive steps such as offering information about the dangers of alcohol, issuing new policies dealing with players' rights and providing for employee assistance programs. (SM)

  14. Pharmacotherapeutic Treatment of Alcohol Dependence: An Overview

    ERIC Educational Resources Information Center

    Graves, Erin; Goodwin, Lloyd R., Jr.

    2008-01-01

    Pharmacotherapy medications can reduce the likelihood of relapse, decrease craving intensity and severity of withdrawal symptoms, and bolster the likelihood of achieving and maintaining recovery goals for many individuals seeking recovery from alcohol dependence. An overview of the benefits and concerns of integrating pharmacotherapeutic…

  15. Dynamic association between negative affect and alcohol lapses following alcohol treatment.

    PubMed

    Witkiewitz, Katie; Villarroel, Nadia Aracelliz

    2009-08-01

    Clinical research has found a strong association between negative affect and returning to alcohol use after a period of abstinence. Yet little is known about the probability of a lapse given a particular level of negative affect or whether there is a reciprocal relationship between negative affect and alcohol use across time. The goal of the current study was to examine the association between negative affect and drinking behavior in the 1st year following alcohol treatment. The authors applied an associative latent transition analysis to the Project MATCH outpatient data (n = 952) and then replicated the model in the Project MATCH aftercare data (n = 774). Changes in drinking following treatment were significantly associated with current and prior changes in negative affect, and changes in negative affect were related to prior changes in drinking (effect size range = 0.13-0.33). The results supported the hypothesis that negative affect and alcohol lapses are dynamically linked and suggest that targeting the relationship between negative affect and alcohol use could greatly decrease the probability of lapses and improve alcohol treatment outcomes.

  16. Partner Violence before and after Couples-Based Alcoholism Treatment for Female Alcoholic Patients

    ERIC Educational Resources Information Center

    Schumm, Jeremiah A.; O'Farrell, Timothy J.; Murphy, Christopher M.; Fals-Stewart, William

    2009-01-01

    This study examined partner violence before and in the 1st and 2nd year after behavioral couples therapy (BCT) for 103 married or cohabiting women seeking alcohol dependence treatment and their male partners; it used a demographically matched nonalcoholic comparison sample. The treatment sample received M = 16.7 BCT sessions over 5-6 months.…

  17. Pharmacogenetically driven treatments for alcoholism: are we there yet?

    PubMed

    Arias, Albert J; Sewell, R Andrew

    2012-06-01

    Pharmacogenetic analyses of treatments for alcohol dependence attempt to predict treatment response and side-effect risk for specific medications. We review the literature on pharmacogenetics relevant to alcohol dependence treatment, and describe state-of-the-art methods of pharmacogenetic research in this area. Two main pharmacogenetic study designs predominate: challenge studies and treatment-trial analyses. Medications studied include US FDA-approved naltrexone and acamprosate, both indicated for treating alcohol dependence, as well as several investigational (and off-label) treatments such as sertraline, olanzapine and ondansetron. The best-studied functional genetic variant relevant to alcoholism treatment is rs1799971, a single-nucleotide polymorphism in exon 1 of the OPRM1 gene that encodes the μ-opioid receptor. Evidence from clinical trials suggests that the presence of the variant G allele of rs1799971 may predict better treatment response to opioid receptor antagonists such as naltrexone. Evidence from clinical trials also suggests that several medications interact pharmacogenetically with variation in genes that encode proteins involved in dopaminergic and serotonergic neurotransmission. Variation in the DRD4 gene, which encodes the dopamine D(4) receptor, may predict better response to naltrexone and olanzapine. A polymorphism in the serotonin transporter gene SLC6A4 promoter region appears related to differential treatment response to sertraline depending on the subject's age of onset of alcoholism. Genetic variation in SLC6A4 may also be associated with better treatment response to ondansetron. Initial pharmacogenetic efforts in alcohol research have identified functional variants with potential clinical utility, but more research is needed to further elucidate the mechanism of these pharmacogenetic interactions and their moderators in order to translate them into clinical practice.

  18. Predicting Post Treatment-Initiation Alcohol Use Among Patients With Severe Mental Illness and Alcohol Use Disorders

    PubMed Central

    Bradizza, Clara M.; Maisto, Stephen A.; Vincent, Paula C.; Stasiewicz, Paul R.; Connors, Gerard J.; Mercer, Nicole D.

    2010-01-01

    Few studies examining alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of post-treatment alcohol outcomes. The present study uses a multivariate approach based on a theoretical model to study the relationship between psychosocial factors and post treatment-initiation alcohol use. Predictors of alcohol use outcomes were examined in 278 individuals diagnosed with a current DSM-IV schizophrenia-spectrum or bipolar disorder and an alcohol use disorder (AUD). At 6-months follow-up after initiating treatment, 144 of 228 available participants (63%) had good clinical outcomes. The results of structural equation modeling indicated that type of pretreatment residential setting was directly related to treatment with participants living in supervised settings (41%) reporting significantly more days of treatment (β = .34, p < .001). In addition, participants with more psychiatric symptoms, assessed by the Brief Symptom Inventory and Structured Clinical Interview for the Positive and Negative Syndrome Scale, reported significantly fewer treatment days (β = −.20, p < .001). Number of days participants attended treatment was indirectly associated with alcohol use outcomes and was mediated by use of alcohol coping skills, such that more frequent use of alcohol-specific coping skills was associated with less post treatment-initiation alcohol use (β = −.34, p < .001). This study emphasizes the favorable prognosis for alcohol outcomes among treated individuals with a SMI and AUD and the importance of psychosocial interventions, particularly those that result in better alcohol-specific coping skills. PMID:19968390

  19. Role of exercise in the treatment of alcohol use disorders

    PubMed Central

    MANTHOU, EIRINI; GEORGAKOULI, KALLIOPI; FATOUROS, IOANNIS G.; GIANOULAKIS, CHRISTINA; THEODORAKIS, YANNIS; JAMURTAS, ATHANASIOS Z.

    2016-01-01

    Excessive alcohol use can cause harmful effects on the human body, which are associated with serious health problems, and it can also lead to the development of alcohol use disorders (AUDs). There is certain evidence that physical exercise positively affects excessive alcohol use and the associated problems by leading to reduced alcohol intake. A literature search was conducted using the databases PubMed, Medline and Web of Science. The search terms used as keywords were: Addiction, abuse, alcohol use disorders, exercise training, β-endorphin, opioids, brain, ethanol and alcohol. The current study presents the studies that reported on the use of exercise in the treatment of AUDs between 1970 and 2015. The potential psychological and physiological mechanisms that contribute to the action of exercise were also reviewed, highlighting the role of β-endorphin and the hypothalamic-pituitary-adrenal axis in AUDs and the possible association among physical activity, the endogenous opioid system and the desire for alcohol. Only 11 studies were identified that refer to the effect of exercise on alcohol consumption and/or the associated outcomes. Six of those studies concluded that exercise may have a positive impact towards alcohol consumption, abstinence rates or the urge to drink. One of those studies also indicated that a bout of exercise affects the endogenous opioids, which may be associated with the urge to drink. Another 3 studies indicated that responses to acute exercise in individuals with AUDs are different compared to those in healthy ones. Generally, despite limited research data and often contradictory results, there is certain early promising evidence for the role of exercise as an adjunctive tool in the treatment of AUDs. Physiological and biochemical parameters that would confirm that exercise is safe for individuals with AUDs should be examined in future studies. PMID:27123244

  20. Patient-Reported Offers of Alcohol Treatment for Primary Care Patients at High-Risk for an Alcohol Use Disorder

    PubMed Central

    Grant, Sean; Watkins, Katherine E.; Bogart, Andy; Paddock, Susan M.; Hepner, Kimberly A.

    2016-01-01

    Background This study assessed patient-reported alcohol treatment offers by healthcare providers following routine annual screening for alcohol use in primary care. Methods A telephone interview within 30 days of the annual screen assessed demographics, alcohol and other drug use, mental health symptoms, and offers of formal treatment for alcohol by a VA healthcare provider. We included male patients (n = 349) at high-risk for an alcohol use disorder (AUD) who had not received alcohol treatment in the past three months. We assessed self-reported receipt of any offers of formal treatment for alcohol, and associations of offer of formal treatment for alcohol with demographic and clinical variables. Results 145 (41.5%) patients reported an offer of at least one type of formal treatment for alcohol. More severe alcohol misuse (OR 1.07, 95% CI 1.03 to 1.11) and younger age (OR 0.97, 95% CI 0.95 to 0.99) were associated with reporting an offer of formal treatment. Discussion Most primary care patients at high-risk for an AUD were not offered treatment following an annual screening. Our results highlight the importance of training primary care providers in what constitutes appropriate medical treatment for this population and the most effective ways of making a treatment offer. PMID:28076250

  1. College Student Receptiveness to Various Alcohol Treatment Options

    ERIC Educational Resources Information Center

    Epler, Amee J.; Sher, Kenneth J.; Loomis, Tiffany B.; O'Malley, Stephanie S.

    2009-01-01

    Objective: Heavy episodic drinking remains a significant problem on college campuses. Although most interventions for college students are behavioral, pharmacological treatments, such as naltrexone, could provide additional options. Participants: The authors evaluated receptivity to various alcohol treatment options in a general population of…

  2. Alcoholics Anonymous and Relapse Prevention as Maintenance Strategies After Conjoint Behavioral Alcohol Treatment for Men: 18-Month Outcomes

    ERIC Educational Resources Information Center

    McCrady, Barbara S.; Epstein, Elizabeth E.; Kahler, Christopher W.

    2004-01-01

    Ninety men with alcohol problems and their female partners were randomly assigned to 1 of 3 outpatient conjoint treatments: alcohol behavioral couples therapy (ABCT), ABCT with relapse prevention techniques (RP/ABCT), or ABCT with interventions encouraging Alcoholics Anonymous (AA) involvement (AA/ABCT). Couples were followed for 18 months after…

  3. Predicting Post-Treatment-Initiation Alcohol Use among Patients with Severe Mental Illness and Alcohol Use Disorders

    ERIC Educational Resources Information Center

    Bradizza, Clara M.; Maisto, Stephen A.; Vincent, Paula C.; Stasiewicz, Paul R.; Connors, Gerard J.; Mercer, Nicole D.

    2009-01-01

    Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of…

  4. Alcohol use disorder: pathophysiology, effects, and pharmacologic options for treatment

    PubMed Central

    Wackernah, Robin C; Minnick, Matthew J; Clapp, Peter

    2014-01-01

    Alcohol use disorders (AUD) continue to be a concerning health issue worldwide. Harmful alcohol use leads to 2.5 million deaths annually worldwide. Multiple options exist for the management of dependence on alcohol, not all of which are approved by drug-regulating agencies. Current practice in treating AUD does not reflect the diversity of pharmacologic options that have potential to provide benefit, and guidance for clinicians is limited. Few medications are approved for treatment of AUD, and these have exhibited small and/or inconsistent effects in broad patient populations with diverse drinking patterns. The need for continued research into the treatment of this disease is evident in order to provide patients with more specific and effective options. This review describes the neurobiological mechanisms of AUD that are amenable to treatment and drug therapies that target pathophysiological conditions of AUD to reduce drinking. In addition, current literature on pharmacologic (both approved and non-approved) treatment options for AUD offered in the United States and elsewhere are reviewed. The aim is to inform clinicians regarding the options for alcohol abuse treatment, keeping in mind that not all treatments are completely successful in reducing craving or heavy drinking or increasing abstinence. PMID:24648792

  5. Pharmacogenetic approaches to the treatment of alcohol addiction

    PubMed Central

    Heilig, Markus; Goldman, David; Berrettini, Wade; O’Brien, Charles P.

    2012-01-01

    Addictive disorders are partly heritable, chronic, relapsing conditions that account for a tremendous disease burden. Currently available addiction pharmacotherapies are only moderately successful, continue to be viewed with considerable scepticism outside the scientific community and have not become widely adopted as treatments. More effective medical treatments are needed to transform addiction treatment and address currently unmet medical needs. Emerging evidence from alcoholism research suggests that no single advance can be expected to fundamentally change treatment outcomes. Rather, studies of opioid, corticotropin-releasing factor, GABA and serotonin systems suggest that incremental advances in treatment outcomes will result from an improved understanding of the genetic heterogeneity among patients with alcohol addiction, and the development of personalized treatments. PMID:22011682

  6. Assertive Community Treatment For People With Alcohol Dependence: A Pilot Randomized Controlled Trial

    PubMed Central

    Gilburt, Helen; Burns, Tom; Copello, Alex; Crawford, Michael; Day, Ed; Deluca, Paolo; Godfrey, Christine; Parrott, Steve; Rose, Abigail; Sinclair, Julia; Coulton, Simon

    2017-01-01

    Abstract Aims A pilot randomized controlled trial (RCT) to assess the feasibility and potential efficacy of assertive community treatment (ACT) in adults with alcohol dependence. Methods Single blind, individually randomized, pilot RCT of 12 months of ACT plus treatment as usual (TAU) versus TAU alone in adults (age 18+ years) with alcohol dependence and a history of previous unsuccessful alcohol treatment attending specialist community alcohol treatment services. ACT aimed to actively engage participants for 12 months with assertive, regular, minimum weekly contact. ACT was combined with TAU. TAU comprised access to the full range of services provided by the community teams. Primary outcome is mean drinks per drinking day and percent days abstinent at 12 months follow up. Analysis of covariance was conducted using 80% confidence intervals, appropriate in the context of a pilot trial. Results A total of 94 participants were randomized, 45 in ACT and 49 in TAU. Follow-up was achieved with 98 and 88%, respectively at 12 months. Those in ACT had better treatment engagement, and were more often seen in their homes or local community than TAU participants. At 12 months the ACT group had more problems related to drinking and lower quality of life than TAU but no differences in drinking measures. The ACT group had a higher percentage of days abstinent but lower quality of life at 6 months. The ACT group had less unplanned healthcare use than TAU. Conclusions An trial of ACT was feasible to implement in an alcohol dependent treatment population. Trial registration ISRCTN22775534 PMID:27940571

  7. [Burnout in Residential Drug- and Alcohol Treatment

    PubMed

    Härtel, Roland; Limmer, Uwe; Schiller, Martin; Wolfersdorf, Manfred

    2003-05-01

    OBJECTIVE: The study aimed at comparing burnout in staff members at residential drug and alcohol detoxification wards with and without teamsupervision. METHOD: 4 times in a period of 18 month all staff members (n = 44) were assessed for burnout using a german version (Checkliste Burnoutmerkmale) of the Maslach Burnout Inventory (MBI, Maslach u. Jackson 1986) to asses the severity and the CBE (Checkliste Burnoutentstehungsmerkmale) for associated burnout risc-factors. RESULT: There was no statistical differences between the mean scores of the 3 different wards due to extreme SDs. The interpersonal differences among staff on the 4 occasions were remarkably. On repeated measurements the intraindividual changes were high. Higher scores were correlated with high workload (seen as frequent admissions). CONCLUSION: Work-related variables (admissions) turned out to be of more importance than supervision in times of chronic staff-shortage.

  8. In silico Models of Alcohol Dependence and Treatment

    PubMed Central

    Kovatchev, Boris; Breton, Marc; Johnson, Bankole

    2011-01-01

    In this paper we view alcohol dependence and the response to treatment as a recurrent bio-behavioral process developing in time and propose formal models of this process combining behavior and biology in silico. The behavioral components of alcohol dependence and treatment are formally described by a stochastic process of human behavior, which serves as an event generator challenging the metabolic system. The biological component is driven by the biochemistry of alcohol intoxication described by deterministic models of ethanol pharmacodynamics and pharmacokinetics to enable simulation of drinking addiction in humans. Derived from the known physiology of ethanol and the literature of both ethanol intoxication and ethanol absorption, the different models are distilled into a minimal model (as simple as the complexity of the data allows) that can represent any specific patient. We use these modeling and simulation techniques to explain responses to placebo and ondansetron treatment observed in clinical studies. Specifically, the response to placebo was explained by a reduction of the probability of environmental reinforcement, while the effect of ondansetron was explained by a gradual decline in the degree of ethanol-induced neuromodulation. Further, we use in silico experiments to study critical transitions in blood alcohol levels after specific average number of drinks per day, and propose the existence of two critical thresholds in the human – one at 5 and another at 11 drinks/day – at which the system shifts from stable to critical and to super critical state indicating a state of alcohol addiction. The advantages of such a model-based investigation are that (1) the process of instigation of alcohol dependence and its treatment can be deconstructed into meaningful steps, which allow for individualized treatment tailoring, and (2) physiology and behavior can be quantified in different (animal or human) studies and then the results can be integrated in silico

  9. Associations of Personality with Alcohol Use Behaviour and Alcohol Problems in Adolescents Receiving Child Welfare Services

    ERIC Educational Resources Information Center

    Stewart, Sherry Heather; McGonnell, Melissa; Wekerle, Christine; Adlaf, Ed

    2011-01-01

    Four specific personality factors have been theorized to put adolescents at risk for alcohol abuse: hopelessness (HOP), anxiety sensitivity (AS), sensation seeking (SS), and impulsivity (IMP). We examined relations of these personality factors to various alcohol-related indices in a sample at high risk for alcohol problems--specifically, a child…

  10. Does Disease Matter? Incorporating Solution-Focused Brief Therapy in Alcoholism Treatment.

    ERIC Educational Resources Information Center

    Osborn, Cynthia J.

    1997-01-01

    Surveyed alcoholism counselors (N=284) to determine whether the disease concept of alcoholism precludes acceptance and use of Solution-Focused Brief Therapy (SFBT) in alcoholism treatment. Results suggest that SFBT may be feasible for alcoholism treatment and that endorsement of the disease concept is compatible with the principles of SFBT. (EMK)

  11. Alcohol-adapted Anger Management Treatment: A Randomized Controlled Trial of an Innovative Therapy for Alcohol Dependence

    PubMed Central

    Walitzer, Kimberly S.; Deffenbacher, Jerry L.; Shyhalla, Kathleen

    2015-01-01

    A randomized controlled trial for an innovative alcohol-adapted anger management treatment (AM) for outpatient alcohol dependent individuals scoring moderate or above on anger is described. AM treatment outcomes were compared to those of an empirically-supported intervention, Alcoholics Anonymous Facilitation treatment (AAF). Clients in AM, relative to clients in AAF, were hypothesized to have greater improvement in anger and anger-related cognitions and lesser AA involvement during the six-month follow-up. Anger-related variables were hypothesized to be stronger predictors of improved alcohol outcomes in the AM treatment condition and AA involvement was hypothesized to be a stronger predictor of alcohol outcomes in the AAF treatment group. Seventy-six alcohol dependent men and women were randomly assigned to treatment condition and followed for six months after treatment end. Both AM and AAF treatments were followed by significant reductions in heavy drinking days, alcohol consequences, anger, and maladaptive anger-related thoughts and increases in abstinence and self-confidence regarding not drinking to anger-related triggers. Treatment with AAF was associated with greater AA involvement relative to treatment with AM. Changes in anger and AA involvement were predictive of posttreatment alcohol outcomes for both treatments. Change in trait anger was a stronger predictor of posttreatment alcohol consequences for AM than for AAF clients; during-treatment AA meeting attendance was a stronger predictor of posttreatment heavy drinking and alcohol consequences for AAF than for AM clients. Anger-related constructs and drinking triggers should be foci in treatment of alcohol dependence for anger-involved clients. PMID:26387049

  12. The Effects of Drinking Goal on Treatment Outcome for Alcoholism

    ERIC Educational Resources Information Center

    Bujarski, Spencer; O'Malley, Stephanie S.; Lunny, Katy; Ray, Lara A.

    2013-01-01

    Objective: It is well known to clinicians and researchers in the field of alcoholism that patients vary with respect to drinking goal. The objective in this study was to elucidate the contribution of drinking goal to treatment outcome in the context of specific behavioral and pharmacological interventions. Method: Participants were 1,226…

  13. An Examination of Family-Involved Approaches to Alcoholism Treatment.

    ERIC Educational Resources Information Center

    Chan, James G.

    2003-01-01

    Introduces the development and theoretical underpinnings of family-involved treatment for alcoholism. Describes several interventions from the family therapy literature with an emphasis on behavioral techniques. Outlines efficacy research and considers some problems with the family approach. (Contains 42 references.) (GCP)

  14. Subjective response as a consideration in the pharmacogenetics of alcoholism treatment.

    PubMed

    Roche, Daniel Jo; Ray, Lara A

    2015-01-01

    Currently available pharmacological treatments for alcoholism have modest efficacy and high individual variability in treatment outcomes, both of which have been partially attributed to genetic factors. One path to reducing the variability and improving the efficacy associated with these pharmacotherapies may be to identify overlapping genetic contributions to individual differences in both subjective responses to alcohol and alcoholism pharmacotherapy outcomes. As acute subjective response to alcohol is highly predictive of future alcohol related problems, identifying such shared genetic mechanisms may inform the development of personalized treatments that can effectively target converging pathophysiological mechanisms that convey risk for alcoholism. The focus of this review is to revisit the association between subjective response to alcohol and the etiology of alcoholism while also describing genetic contributions to this relationship, discuss potential pharmacogenetic approaches to target subjective response to alcohol in order to improve the treatment of alcoholism and examine conceptual and methodological issues associated with these topics, and outline future approaches to overcome these challenges.

  15. Some Follow-Up Procedures with Alcoholics Who Have Completed an Alcohol Treatment Program in a Veterans Hospital.

    ERIC Educational Resources Information Center

    Cooper, Louis F.; Wilson, Earl D.

    1988-01-01

    Determined effects on sobriety of two follow-up treatments, self-management and letter and telephone, for alcoholics (N=60) who had completed an alcohol treatment program. Results showed significant difference for the letter and telephone group after one month in comparison to the self-management and the control groups, but no significant…

  16. Microbiota-based treatments in alcoholic liver disease

    PubMed Central

    Sung, Hotaik; Kim, Seung Woo; Hong, Meegun; Suk, Ki Tae

    2016-01-01

    Gut microbiota plays a key role in the pathogenesis of alcoholic liver disease (ALD). Consumption of alcohol leads to increased gut permeability, small intestinal bacterial overgrowth, and enteric dysbiosis. These factors contribute to the increased translocation of microbial products to the liver via the portal tract. Subsequently, bacterial endotoxins such as lipopolysaccharide, in association with the Toll-like receptor 4 signaling pathway, induce a gamut of damaging immune responses in the hepatic milieu. Because of the close association between deleterious inflammation and ALD-induced microbiota imbalance, therapeutic approaches that seek to reestablish gut homeostasis should be considered in the treatment of alcoholic patients. To this end, a number of preliminary studies on probiotics have confirmed their effectiveness in suppressing proinflammatory cytokines and improving liver function in the context of ALD. In addition, there have been few studies linking the administration of prebiotics and antibiotics with reduction of alcohol-induced liver damage. Because these preliminary results are promising, large-scale randomized studies are warranted to elucidate the impact of these microbiota-based treatments on the gut flora and associated immune responses, in addition to exploring questions about optimal delivery. Finally, fecal microbiota transplant has been shown to be an effective method of modulating gut microbiota and deserve further investigation as a potential therapeutic option for ALD. PMID:27547010

  17. Alcohol

    MedlinePlus

    ... that's how many accidents occur. continue What Is Alcoholism? What can be confusing about alcohol is that ... develop a problem with it. Sometimes, that's called alcoholism (say: al-kuh-HOL - ism) or being an ...

  18. Alcohol

    MedlinePlus

    If you are like many Americans, you drink alcohol at least occasionally. For many people, moderate drinking ... risky. Heavy drinking can lead to alcoholism and alcohol abuse, as well as injuries, liver disease, heart ...

  19. NCADI's 1995 National Directory of Drug Abuse and Alcoholism Treatment and Prevention Programs That Have a Special Program for American Indians/Alaska Natives.

    ERIC Educational Resources Information Center

    Vanderbilt, Rebecca, Comp.; Schacht, Robert M., Comp.

    This state-by-state directory lists over 500 alcohol and drug abuse treatment and prevention services that target American Indians and Alaska Natives. The directory was compiled from the website of the National Clearinghouse for Alcohol and Drug Information (NCADI). Their home page on the Internet is located at http://www.health.org/index.htm. The…

  20. How to Find HIV Treatment Services

    MedlinePlus

    ... help with mental health or substance abuse and addiction. SAMHSA’s Behavioral Health Treatment Services Locator allows visitors to confidentially search for mental health and substance addiction treatment facilities anywhere in the United States. SAMHSA ...

  1. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82 Pensions... Agencies § 17.82 Contracts for outpatient services for veterans with alcohol or drug dependence or abuse... requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and...

  2. 38 CFR 17.82 - Contracts for outpatient services for veterans with alcohol or drug dependence or abuse...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82 Pensions... Agencies § 17.82 Contracts for outpatient services for veterans with alcohol or drug dependence or abuse... requirements of the “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part 2) and...

  3. Alcohol in Primary Care. Differential characteristics between alcohol-dependent patients who are receiving or not receiving treatment.

    PubMed

    Barrio, Pablo; Miquel, Laia; Moreno-España, Jose; Martínez, Alicia; Ortega, Lluisa; Teixidor, Lidia; Manthey, Jakob; Rehm, Jürgen; Gual, Antoni

    2016-03-02

    primary health care services for other reasons. The aim of the present study is to describe the differential characteristics of AD patients in primary care, distinguishing between those who receive treatment and those who do not, and their reasons for not seeking it. In a cross-sectional study patients were evaluated by their general practitioner (GP) and interviewed by a member of the research team. Sociodemographic, diagnostic and clinical data were collected. From 1,372 patients interviewed in Catalonia, 118 (8.6%) were diagnosed as AD. These patients showed a lower socioeconomic status (48.3% vs 33.3%, odds ratio 2.02), higher unemployment rates (32.2% vs 19.2 %, odds ratio 2.11), and greater psychological distress and disability. Patients with AD receiving treatment (16.9%), were older (44 vs 36 years of age), reported higher unemployment rates (66% vs 25.5%, odds ratio 6.32) and higher daily alcohol consumption (61.5 vs 23.7 grams), suggesting a more advanced disease. Patients with AD in general showed a higher degree of comorbidity compared to other patients, with patients in treatment showing the most elevated level. The main reasons given for not seeking treatment were shame, fear of giving up drinking and barriers to treatment. Taken together, the data suggest the need to implement earlier strategies for the detection and treatment of AD.

  4. Treated and Treatment-Naïve Alcoholics Come From Different Populations

    PubMed Central

    Fein, George; Landman, Bennett

    2007-01-01

    Most research on alcoholism uses convenience samples of individuals who have been in some type of treatment; Berkson’s fallacy results when the associations found in studies of select samples are incorrectly presumed to apply to all alcoholics (i.e. including untreated alcoholics in the general population). This study examines whether treated and untreated alcoholics have similar early alcohol use histories by comparing abstinent alcoholics (treated and sober at least 6 months) to treatment-naïve alcoholics (active drinkers). We studied fourteen pairs of women and twenty-five pairs of men matched on the age at which they first met criteria for heavy alcohol use (80 drinks/month for women and 100 drinks/month for men). The timeline follow-back interview methodology was used to gather retrospective alcohol use information. Alcohol dose and duration was then computed for two intervals: the time between the person’s first drink and the date at which they met criteria for heavy drinking, and the period between meeting criteria for heavy drinking and the current age of the treatment-naïve person from each pair. During the period prior to meeting the matching ‘heavy drinking’ criteria, alcohol dose did not differ between groups. In the period after meeting criteria for heavy alcohol use, the treated alcoholics had higher average and peak alcohol doses than the treatment naïve alcoholics. We rejected the hypothesis that the treatment naïve alcoholics and the treated alcoholics have similar alcohol use trajectories over time, with the treatment naïve sample simply being observed earlier in their alcohol use histories. Instead we concluded that the two groups come from different populations with regard to alcohol use (in fact, the treated alcoholics had alcohol doses over 50% higher than treatment-naïve alcoholics in the years just after they began drinking heavily). This suggests that results from studies of alcoholics in treatment or post-treatment (i

  5. Antidotes for alcohol and glycol toxicity: translating mechanisms into treatments.

    PubMed

    McMartin, K E

    2010-09-01

    Translational toxicology can be defined as the movement of potential antidotes for the treatment of poisonings from basic mechanistic research to the marketplace. Because poisonings are infrequent, the clinical development of antidotes is fraught with trials and tribulations. Academic scientists often conduct basic mechanistic work with antidotes but are infrequently involved in further drug development. This article presents the development of 4-methylpyrazole (4MP) (fomepizole) as an antidote against toxic alcohol poisonings, particularly by methanol and ethylene glycol (EG).

  6. Pharmacological treatment of alcohol dependence: target symptoms and target mechanisms.

    PubMed

    Heilig, Markus; Egli, Mark

    2006-09-01

    Alcoholism is a major public health problem and resembles, in many ways, other chronic relapsing medical conditions. At least 2 separate dimensions of its symptomatology offer targetable pathophysiological mechanisms. Systems that mediate positive reinforcement by alcohol are likely important targets in early stages of the disease, particularly in genetically susceptible individuals. In contrast, long term neuroadaptive changes caused by chronic alcohol use primarily appear to affect systems mediating negative affective states, and gain importance following a prolonged history of dependence. Feasibility of pharmacological treatment in alcoholism has been demonstrated by a first wave of drugs which consists of 3 currently approved medications, the aldehyde dehydrogenase blocker disulfiram, the opioid antagonist naltrexone (NTX) and the functional glutamate antagonist acamprosate (ACM). The treatment toolkit is likely to be expanded in the near future. This will improve overall efficacy and allow individualized treatment, ultimately taking in account the patient's genetic makeup. In a second wave, early human efficacy data are available for the 5HT3 antagonist ondansetron, the GABA-B agonist baclofen and the anticonvulsant topiramate. The third wave is comprised of compounds predicted to be effective based on a battery of animal models. Using such models, a short list of additional targets has accumulated sufficient preclinical validation to merit clinical development. These include the cannabinoid CB1 receptor, receptors modulating glutamatergic transmission (mGluR2, 3 and 5), and receptors for stress-related neuropeptides corticotropin releasing factor (CRF), neuropeptide Y (NPY) and nociceptin. Once novel treatments are developed, the field faces a major challenge to assure their delivery to patients.

  7. Effects on alcohol related fatal crashes of a community based initiative to increase substance abuse treatment and reduce alcohol availability

    PubMed Central

    Hingson, R; Zakocs, R; Heeren, T; Winter, M; Rosenbloom, D; DeJong, W

    2005-01-01

    Objective: This analysis tested whether comprehensive community interventions that focus on reducing alcohol availability and increasing substance abuse treatment can reduce alcohol related fatal traffic crashes. Intervention: Five of 14 communities awarded Fighting Back grants by The Robert Wood Johnson Foundation to reduce substance abuse and related problems attempted to reduce availability of alcohol and expand substance abuse treatment programs (FBAT communities). Program implementation began on 1 January 1992. Design: A quasi-experimental design matched each program community to two or three other communities of similar demographic composition in the same state. Main outcome measures: The ratio of fatal crashes involving a driver or pedestrian with a blood alcohol concentration of 0.01% or higher, 0.08% or higher, or 0.15% or higher were examined relative to fatal crashes where no alcohol was involved for 10 years preceding and 10 years following program initiation. Results: Relative to their comparison communities, the five FBAT communities experienced significant declines of 22% in alcohol related fatal crashes at 0.01% BAC or higher, 20% at 0.08% or higher, and 17% at 0.15% or higher relative to fatal crashes not involving alcohol. Conclusions: Community interventions to reduce alcohol availability and increase substance abuse treatment can reduce alcohol related fatal traffic crashes. PMID:15805436

  8. Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems.

    PubMed

    Orwat, John; Saitz, Richard; Tompkins, Christopher P; Cheng, Debbie M; Dentato, Michael P; Samet, Jeffrey H

    2011-10-01

    This is a prospective cohort study to identify factors associated with receipt of substance abuse treatment (SAT) among adults with alcohol problems and HIV/AIDS. Data from the HIV Longitudinal Interrelationships of Viruses and Ethanol study were analyzed. Generalized estimating equation logistic regression models were fit to identify factors associated with any service utilization. An alcohol dependence diagnosis had a negative association with SAT (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [95% CI] = 0.19-0.67), as did identifying sexual orientation other than heterosexual (AOR = 0.46, CI = 0.29-0.72) and having social supports that use alcohol/drugs (AOR = 0.62, CI = 0.45-0.83). Positive associations with SAT include presence of hepatitis C antibody (AOR = 3.37, CI = 2.24-5.06), physical or sexual abuse (AOR = 2.12, CI = 1.22-3.69), social supports that help with sobriety (AOR = 1.92, CI = 1.28-2.87), homelessness (AOR = 2.40, CI = 1.60-3.62), drug dependence diagnosis (AOR = 2.64, CI = 1.88-3.70), and clinically important depressive symptoms (AOR = 1.52, CI = 1.08-2.15). While reassuring that factors indicating need for SAT among people with HIV and alcohol problems (e.g., drug dependence) are associated with receipt, nonneed factors (e.g., sexual orientation, age) that should not decrease likelihood of receipt of treatment were identified.

  9. Alcohol

    MedlinePlus

    ... de los dientes Video: Getting an X-ray Alcohol KidsHealth > For Kids > Alcohol Print A A A What's in this article? ... What Is Alcoholism? Say No en español El alcohol Getting the Right Message "Hey, who wants a ...

  10. Women's motivators for seeking treatment for alcohol use disorders.

    PubMed

    Grosso, Justine A; Epstein, Elizabeth E; McCrady, Barbara S; Gaba, Ayorkor; Cook, Sharon; Backer-Fulghum, Lindsey M; Graff, Fiona S

    2013-06-01

    This study examined types of internal and external motivations for seeking treatment and the predictive utility of different types of motivation among 180 women with an alcohol use disorder (AUD) participating in a two-armed trial testing different individual and couple therapies for AUDs. Reasons for seeking treatment were coded for type of internal or external motivation. Most women (97%) cited internal reasons for seeking help, including: concern about progression of AUD (61.1%), health (43.3%), mental health (38.9%), and family (38.3%). Occupational concerns, an internal motivator cited by 6% of women, were associated with better drinking outcomes; interpersonal-family concerns were associated with poorer outcomes. Some motivators for seeking treatment may not be related to sustained changes in drinking, suggesting that understanding motivators for treatment may be inadequate to maintain change. Reasons for help-seeking may need to be addressed in treatment to produce long-lasting change.

  11. Factors influencing the implementation of a brief alcohol screening and educational intervention in social settings not specializing in addiction services

    PubMed Central

    Silver Wolf (Adelv unegv Waya), David A. Patterson

    2015-01-01

    Although alcohol use continues to be a major problem, when high-risk users enter social services, they are not provided with empirically supported treatments (ESTs). This study investigates predictors of successful implementation in agencies not specializing in addiction services. Fifty-four frontline workers in six organizations were enrolled in the study. After completing self-administered surveys of organizational culture and climate and attitudes toward ESTs, workers were trained to implement a brief intervention. The results indicate that organizational factors and attitudes may not be related to implementation. Although high implementers had similar traits, further research is needed to characterize successful EST implementers. PMID:25905766

  12. Age at Onset of Alcohol Use and Alcohol Use Disorder: Time-trend Study in Patients Seeking De-addiction Services in Kerala

    PubMed Central

    Nair, Unnikrishnan Reghukumaran; Vidhukumar, K.; Prabhakaran, Anil

    2016-01-01

    Background: Declining age at onset of alcohol consumption over years has been one of the alarming findings in the epidemiology of alcoholism. The study was done to examine whether there was a decline in the age at onset of alcohol use and use disorder in subjects categorized as birth cohorts over the last 60 years seeking de-addiction services from a teaching hospital. Materials and Methods: A time-trend study, based on data collected from records, was done among 700 randomly selected subjects seeking de-addiction services. The study was done in a Government Medical College. Besides birth year, family history of alcohol use disorder and psychiatric comorbidity were the main independent variables studied. Trend was tested by linear regression. Results: There was a significant linear decline in the age at onset of alcohol use and use disorder. The mean age at onset of alcohol use and alcohol use disorder declined from 24 to 17 years and 46 to 21 years, respectively, from the pre-1950 birth cohort to the post-1985 birth cohort. Surprisingly, there was a plateau for mean age at onset of alcohol use during 1960s. The trend was significant even after adjusting for variables related to age at onset of alcohol consumption. Conclusions: The trend of decreasing age at onset of alcohol use and alcohol use disorder over time has policy implications. Further studies are needed for exploring mediating or causal factors for the decline in the age at onset of alcohol use and use disorder. PMID:27570342

  13. Probiotics and Alcoholic Liver Disease: Treatment and Potential Mechanisms

    PubMed Central

    Li, Fengyuan; Duan, Kangmin; Wang, Cuiling; McClain, Craig; Feng, Wenke

    2016-01-01

    Despite extensive research, alcohol remains one of the most common causes of liver disease in the United States. Alcoholic liver disease (ALD) encompasses a broad spectrum of disorders, including steatosis, steatohepatitis, and cirrhosis. Although many agents and approaches have been tested in patients with ALD and in animals with experimental ALD in the past, there is still no FDA (Food and Drug Administration) approved therapy for any stage of ALD. With the increasing recognition of the importance of gut microbiota in the onset and development of a variety of diseases, the potential use of probiotics in ALD is receiving increasing investigative and clinical attention. In this review, we summarize recent studies on probiotic intervention in the prevention and treatment of ALD in experimental animal models and patients. Potential mechanisms underlying the probiotic function are also discussed. PMID:26839540

  14. Barriers to successful treatment of alcohol addiction as perceived by healthcare professionals in Thailand – a Delphi study about obstacles and improvement suggestions

    PubMed Central

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsomporn, Jureerat; Östlund, Gunnel

    2016-01-01

    Background Many Thai people experiencing alcohol addiction do not seek help, and those who do often have inadequate access to treatment. There are few research studies focusing on alcohol addiction treatment in Thailand. Objective The purpose of the current study was to identify barriers to the treatment of alcohol addiction and to collect experts’ suggestions for improving treatment in Thailand. The Delphi technique was used to achieve consensual agreement among an expert panel within the field of alcohol addiction and treatment. Design Three rounds of a Delphi survey were completed by a panel of experts in alcohol addiction, including physicians, nurses, social workers, psychologists, healthcare officers, and an Alcoholics Anonymous member. The open-ended answers provided by 34 experts in the first round resulted in 60 statements, which were later grouped into three themes. After three rounds of questionnaires, 51 statements were accepted as consensus. Results Thirty-two experts participated in all three Delphi rounds. Over 80% of participants were particularly concerned about five obstacles to alcohol addiction treatment. The majority of suggestions from the expert panel were related to patients’ right to treatment and the national policy for reducing the negative effects of alcohol. According to the results of the present study, the experts suggested that the treatment of alcohol addiction should be continuous from primary care to tertiary care, and convenient pathways should be established in healthcare services. The experts would also like to increase the number of healthcare providers and improve their knowledge and skills in working with people experiencing alcohol addiction. Conclusions Equal rights to health and treatment for people experiencing alcohol addiction in Thailand require policy improvements, as well as acceptance and awareness of alcohol addiction from both the public and policymakers. PMID:27491962

  15. The role of topiramate and other anticonvulsants in the treatment of alcohol dependence: a clinical review.

    PubMed

    De Sousa, Avinash

    2010-03-01

    Alcohol dependence is a major health problem worldwide. Various pharmacological agents have been used in the management of alcohol dependence. This review looks at the role of topiramate and other anticonvulsants in the management of alcohol dependence. Topiramate is the most widely used anticonvulsant in the treatment of alcohol dependence. The literature on topiramate is reviewed and critically analyzed, along with its proposed mechanism of action in alcohol dependence. A review of data available on other anticonvulsants like carbamazepine, oxcarbazepine, sodium valproate, gabapentin and levetiracetam are presented and their potential in the treatment of alcohol dependence is considered, together with future research directions.

  16. Alcohol treatment and cognitive-behavioral therapy: enhancing effectiveness by incorporating spirituality and religion.

    PubMed

    Hodge, David R

    2011-01-01

    Cognitive-behavioral therapy (CBT) is an effective modality for the treatment of alcoholism. Given widespread interest in incorporating spirituality into professional treatment, this article orients practitioners to spiritually modified CBT, an approach that may enhance outcomes with some spiritually motivated clients. More specifically, by integrating clients' spiritual beliefs and practices into treatment, this modality may speed recovery, enhance treatment compliance, prevent relapse, and reduce treatment disparities by providing more culturally congruent services. The process of constructing spiritually modified CBT self-statements is described and illustrated, and suggestions are provided for working with client spirituality in an ethical manner. The article concludes by emphasizing the importance of this approach in light of the growing spiritual diversity that characterizes contemporary society.

  17. Medicaid-covered alcohol and drug treatment use among people with intellectual disabilities: evidence of disparities.

    PubMed

    Slayter, Elspeth

    2010-10-01

    For some, community inclusion facilitates access to alcohol and drugs and, therefore, the potential for developing substance abuse disorders. However, little is known about substance abuse treatment use among people with intellectual disabilities. Using standardized performance measures, substance abuse treatment utilization was examined for Medicaid-covered people with intellectual disabilities and substance abuse (N=9,484) versus people without intellectual disabilities (N=915,070). The sociobehavioral model of healthcare use guides multivariate logistic regression analyses of substance abuse treatment utilization patterns, revealing disability-related disparities. Factors associated with utilization included being non-White, living in a nonurban area, having a serious mental illness, and living in a state with a generous Medicaid plan for substance abuse treatment. Implications relate to health policy, service delivery patterns, and the need for cross-system collaboration in the use of integrated treatment approaches.

  18. Alcohol

    MedlinePlus

    ... parents and other adults use alcohol socially — having beer or wine with dinner, for example — alcohol seems ... besides just hanging out in someone's basement drinking beer all night. Plan a trip to the movies, ...

  19. Monitoring Utilization of a Large Scale Addiction Treatment System: The Drug and Alcohol Treatment Information System (DATIS)

    PubMed Central

    Rotondi, Nooshin Khobzi; Rush, Brian

    2012-01-01

    Client-based information systems can yield data to address issues of system accountability and planning, and contribute information related to changing patterns of substance use in treatment and, indirectly, general populations. The Drug and Alcohol Treatment Information System (DATIS) monitors the number/types of clients treated in approximately 170 publicly-funded addiction treatment agencies in Ontario. The purpose of this study was to estimate the caseload of addiction treatment agencies, and describe important characteristics of clients, their patterns of service utilization and trends over-time from 2005 to 2010. In 2009–2010, 47,065 individuals were admitted to treatment. Since 2005–2006, there has been an increase in adolescents/youth in treatment, and a decrease in the male-female gender ratio. Alcohol problems predominated, but an increasing proportion of clients used cannabis and prescription opioids. DATIS is an evolving system and an integral component of Ontario’s performance measurement system. Linkages with healthcare information systems will allow for longitudinal tracking of client health-related outcomes. PMID:22879755

  20. Alcoholism.

    ERIC Educational Resources Information Center

    Caliguri, Joseph P., Ed.

    This extensive annotated bibliography provides a compilation of documents retreived from a computerized search of the ERIC, Social Science Citation Index, and Med-Line databases on the topic of alcoholism. The materials address the following areas of concern: (1) attitudes toward alcohol users and abusers; (2) characteristics of alcoholics and…

  1. Pharmacotherapy for alcohol dependence: status of current treatments.

    PubMed

    Franck, Johan; Jayaram-Lindström, Nitya

    2013-08-01

    The efficacy of medications for alcohol dependence remains modest, and there are no strong clinical predictors of treatment response. Approved medications include acamprosate (an N-methyl-d-aspartate receptor (NMDA) modulator), disulfiram (an acetaldehyde dehydrogenase inhibitor) and naltrexone (an opioid antagonist) while nalmefene (an opioid antagonist) is currently under review for approval in Europe. Clinical trials suggest that baclofen (a GABA-B agonist) and topiramate (an anticonvulsant) may be promising candidates, while several other drug candidates are currently evaluated at early clinical stages.

  2. Clopentixol decanoate in the treatment of chronic alcoholism.

    PubMed

    Hochenegg, L

    1981-01-01

    The treatment of alcoholism still presents great problems because a number of factors have to be taken into consideration. Tranquilizers and chlormethiazol are only justified in the detoxication phase. For the subsequent after-care, depot neuroleptics are recommended because of the uniformly high plasma level. We gave clopentixol decanoate - 100 mg i.m. - in two-weekly intervals. The symptoms caused by ethylism were adequately overcome without side effects. Clopentixol decanoate creates the basis for successful psychotherapy: only when the mood situation is compensated and the internal unrest overcome can verbal therapy be successful.

  3. Prevalence of co-occurring alcohol and other drug use in an Australian older adult mental health service.

    PubMed

    Searby, Adam; Maude, Phil; McGrath, Ian

    2016-04-01

    Co-occurring mental illness and substance use disorder, known as dual diagnosis, is a significant challenge to mental health services. Few older adult specific alcohol and other drug treatment services exist, meaning older adult mental health services may become the default treatment option for many. Evidence suggests that dual diagnosis leads to substandard treatment outcomes, including higher rates of psychiatric relapse, higher costs of care and poorer treatment engagement. This paper explores the prevalence of co-occurring alcohol and other drug (AOD) use in an older adult community mental health service in inner Melbourne, Australia. This aim was accomplished by using a retrospective file audit of clinical intake assessments (n = 593) performed on consumers presenting to the service over a two-year period, June 2012-2014. Of consumers presenting to the service, 15.5% (n = 92) were assessed by clinicians as having co-occurring AOD use. Depression predominated in the dual diagnosis group as the primary mental health disorder. Dual diagnosis consumers in this sample were statistically more likely to be male and younger than their non-dual diagnosis counterparts. A limitation of this audit was the lack of implementation of screening tools, leaving assessment to clinical judgement or the interest of the clinician. This may also explain the discrepancy between the results of this study and previous work. Although appearing to be a relatively small percentage of assessments, the results accounted for 92 individuals with complex mental health, AOD and medical issues. Poor screening procedures in a population that is traditionally difficult to assess need to be rectified to meet the future challenges inherent in the ageing baby boomer generation, changing drug use trends and extended lifespans through harm reduction initiatives and medical advancements.

  4. 49 CFR 40.15 - May an employer use a service agent to meet DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... drug and alcohol testing requirements? 40.15 Section 40.15 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Employer Responsibilities § 40.15 May an employer use a service agent to meet DOT drug and alcohol testing requirements?...

  5. 49 CFR 40.15 - May an employer use a service agent to meet DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... drug and alcohol testing requirements? 40.15 Section 40.15 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Employer Responsibilities § 40.15 May an employer use a service agent to meet DOT drug and alcohol testing requirements?...

  6. 49 CFR 40.15 - May an employer use a service agent to meet DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... drug and alcohol testing requirements? 40.15 Section 40.15 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Employer Responsibilities § 40.15 May an employer use a service agent to meet DOT drug and alcohol testing requirements?...

  7. 49 CFR 40.15 - May an employer use a service agent to meet DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... drug and alcohol testing requirements? 40.15 Section 40.15 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Employer Responsibilities § 40.15 May an employer use a service agent to meet DOT drug and alcohol testing requirements?...

  8. 49 CFR 40.15 - May an employer use a service agent to meet DOT drug and alcohol testing requirements?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... drug and alcohol testing requirements? 40.15 Section 40.15 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Employer Responsibilities § 40.15 May an employer use a service agent to meet DOT drug and alcohol testing requirements?...

  9. [Alcohol consumption in patients with psychiatric disorders: assessment and treatment].

    PubMed

    Lang, J-P; Bonnewitz, M-L; Kusterer, M; Lalanne-Tongio, L

    2014-09-01

    Alcohol consumption in France exceeds the European average (12.7L of pure alcohol/habitant/year in 2009 for an average of 12.5 L). This consumption has a major professional, social and health impact on the individuals and their families. The cost of such, estimated in Europe to be of 155.8 billion Euros in 2010, is the highest among the central nervous system diseases in Europe, far higher than that of depression or dementia. Patients suffering from psychiatric disorders are more frequently affected by problems related to alcohol use than the general population. They are also more vulnerable to the immediate and subsequent consequences of their consumption. The alcohol related disorders that are often accompanied by risk taking and other addictive behaviour require a global assessment of the addiction, with and without substance, and of the complications. These have a strong impact on risk taking, compliance with care, and the morbidity of somatic and psychiatric disorders, as well as access to optimal care and the life span of patients suffering from psychiatric disorders. The development of addictology care, with integrative treatment programs, is recommended in response to these public health issues. Nevertheless, specific addictology practices and partners with addictology care structures are still scarcely developed in psychiatry. Firstly, it would be necessary to set up such integrated treatments through the systematisation of an "addictology" checkup on admission, a global assessment of addictive behaviour and cognitive disorders, using pragmatic tools that are user-friendly for the care teams, maintain the reduction in risk taking, and apply prescriptions for addiction to psychotropic treatments, in liaison with the referring general practitioner. As early as possible, accompanied by specific training in addictology for the psychiatrists and the mental health nursing teams, such care could be enhanced by the development of liaison and advanced psychiatric

  10. Taming systems to create enabling environments for HCV treatment: negotiating trust in the drug and alcohol setting.

    PubMed

    Harris, Magdalena; Rhodes, Tim; Martin, Anthea

    2013-04-01

    HCV (hepatitis C) treatment uptake among the population most affected - people who inject drugs - is suboptimal. Hospital based treatment provision is one evidenced barrier to HCV treatment uptake. In response, HCV treatment is increasingly located in treatment settings seen as more amenable to people who inject drugs, such as drug and alcohol services. We explored the accessibility of HCV treatment provision at two such partnerships. Data collection comprised qualitative interviews collected in 2011 and 2012 with 35 service users and 14 service providers of HCV treatment in London, United Kingdom. We draw here primarily on thematic analyses of service provider accounts, yet narratives relating to trust and environment emerged unsolicited in both user and provider accounts of negotiated HCV treatment access. A key theme in service provider accounts were strategies they deployed to 'tame' the treatment system so as to create an 'enabling environment' of care, in which trust was a critical feature. This 'taming' of the system was enacted through practices of 'negotiated flexibility', including in relation to appointments, eligibility, and phlebotomy. Service user accounts accentuated familiar environments and known health providers as those most trusted, and the potentially stigmatising effects of negotiating treatment in unfamiliar territory, especially hospital settings. Whilst noting the effects of provider strategies to negotiate flexibility on behalf of would-be patients seeking treatment, we conclude by noting the limits of trust relations in settings of constrained choice.

  11. A Randomized Trial of Individual and Couple Behavioral Alcohol Treatment for Women

    ERIC Educational Resources Information Center

    Mccrady, Barbara S.; Epstein, Elizabeth E.; Cook, Sharon; Jensen, Noelle; Hildebrandt, Thomas

    2009-01-01

    Although alcohol use disorders (AUDs) adversely affect women, research on efficacious treatments for women is limited. In this randomized efficacy trial of 102 heterosexual women with AUDs, the authors compared alcohol behavioral couple therapy (ABCT) and alcohol behavioral individual therapy (ABIT) on percentage of days abstinent (PDA) and…

  12. Risk factors for treatment failure in smokers: relationship to alcohol use and to lifetime history of an alcohol use disorder.

    PubMed

    Leeman, Robert F; McKee, Sherry A; Toll, Benjamin A; Krishnan-Sarin, Suchitra; Cooney, Judith L; Makuch, Robert W; O'Malley, Stephanie S

    2008-12-01

    Little is known about the impact of alcohol involvement on smoking cessation relapse or possible mechanisms for these associations. We addressed these issues using data from a randomized clinical trial of two types of framed messages (gain vs. loss) in conjunction with open label sustained-release (SR) bupropion (Toll et al., 2007) (N = 249). Participants were categorized according to whether or not they were diagnosed with a lifetime alcohol use disorder (AUD; i.e., current or past alcohol abuse or past alcohol dependence) and according to three levels of alcohol use: abstinence, moderate, or hazardous use. Alcohol use categories were established for drinking at baseline, during the 6-week treatment period and through 12 weeks post-quit. There were few significant differences by baseline alcohol use level or AUD history for a series of predictors of smoking cessation failure (e.g., depressive symptoms). During treatment and follow-up, the probability of any smoking on heavy drinking days was significantly higher than the probability of smoking on moderate drinking or abstinent days. AUD history did not predict smoking cessation relapse in any analysis, nor were any alcohol usexAUD history interactions significant. Moderate alcohol users and, to a lesser extent, abstainers from alcohol at baseline were less likely than hazardous drinkers to have relapsed at 12 weeks post-quit. Based on these findings, it appears that risk of any smoking and of relapse was associated primarily with heavy drinking days and a hazardous pattern of use respectively, rather than with moderate drinking.

  13. Risk Factors for Treatment Failure in Smokers: Relationship to Alcohol Use and to Lifetime History of an Alcohol Use Disorder

    PubMed Central

    Leeman, Robert F.; McKee, Sherry A.; Toll, Benjamin A.; Krishnan-Sarin, Suchitra; Cooney, Judith L.; Makuch, Robert W.; O’Malley, Stephanie

    2009-01-01

    Little is known about the impact of alcohol involvement on smoking cessation relapse or possible mechanisms for these associations. We addressed these issues using data from a randomized clinical trial of 2 types of framed messages (gain vs. loss) in conjunction with open label sustained-release (SR) bupropion (Toll et al., 2007) (N = 249). Participants were categorized according to whether or not they were diagnosed with a lifetime alcohol use disorder (AUD; i.e., current or past alcohol abuse or past alcohol dependence) and according to 3 levels of alcohol use: abstinence, moderate or hazardous use. Alcohol use categories were established for drinking at baseline, during the 6-week treatment period and through 12 weeks post-quit. There were few significant differences by baseline alcohol use level or AUD history for a series of predictors of smoking cessation failure (e.g., depressive symptoms). During treatment and follow-up, the probability of any smoking on heavy drinking days was significantly higher than the probability of smoking on moderate drinking or abstinent days. AUD history did not predict smoking cessation relapse in any analysis, nor were any alcohol use × AUD history interactions significant. Moderate alcohol users and to a lesser extent, abstainers from alcohol at baseline were less likely than hazardous drinkers to have relapsed at 12 weeks post-quit. Based on these findings, it appears that risk of any smoking and of relapse was associated primarily with heavy drinking days and a hazardous pattern of use respectively, rather than with moderate drinking. PMID:19023831

  14. Filling service gaps: Providing intensive treatment services for offenders.

    PubMed

    Young, Douglas W; Farrell, Jill L; Henderson, Craig E; Taxman, Faye S

    2009-08-01

    Consistent with the few studies that have previously examined treatment prevalence and access in the adult and juvenile justice systems, the recent National Criminal Justice Treatment Practices (NCJTP) survey indicated that there is a particular need to expand intensive treatment modalities for offenders in both institutional and community corrections settings. Applying multilevel modeling techniques to NCJTP survey data, this study explores conditions and factors that may underlie the wide variation among states in the provision of intensive treatment for offenders. Results indicate that states' overall rates of substance abuse and dependence, funding resources, and the state governor's political party affiliation were significantly associated with intensive treatment provision. Numerous factors that have been implicated in recent studies of evidence-based practice adoption, including state agency executives' views regarding rehabilitation, agency culture and climate, and other state-level measures (e.g., household income, crime rates, expenditures on treatment for the general population) were not associated with treatment provision. Future research should examine further variations in offenders' service needs, the role of legislators' political affiliations, and how other factors may interact with administrator characteristics in the adoption and expansion of intensive treatment services for offenders.

  15. The Efficacy of Coerced Treatment for Offenders: An Evaluation of Two Residential Forensic Drug and Alcohol Treatment Programs.

    ERIC Educational Resources Information Center

    Baird, Francis X.; Frankel, Arthur J.

    2001-01-01

    Reviews the history of community-based treatment for offenders with drug and alcohol addiction. Describes the treatment regimen in two residential programs for offenders with drug and alcohol problems, including a description of the components of the residential treatment model utilized in these two programs. Findings support the efficacy of…

  16. Rehabilitation of the Alcoholic. A Training Guide. A Report from the Study Group on Rehabilitation of the Alcoholic and Public Offender. Rehabilitation Services Series Number 69-11.

    ERIC Educational Resources Information Center

    Rehabilitation Services Administration (DHEW), Washington, DC.

    The many difficulties involved in diagnosing, classifying and treating alcoholics comprise the bulk of the report's content. The very specific social and medical needs of the alcoholic, coupled with personal, social and treatment agency barriers, are viewed as the major feasibility (for treatment outcome) factors. The report recommends six major…

  17. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  18. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  19. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  20. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  1. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance...

  2. Engaging primary health care workers in drug and alcohol and mental health interventions: challenges for service delivery in rural and remote Australia.

    PubMed

    Allan, Julaine

    2010-01-01

    Access to drug and alcohol treatment services is a particularly salient issue for Australia. The nation is paying considerable attention to risky drug and alcohol use. Indigenous Australians are particularly concerned about drug and alcohol related harms in their communities. Access to treatment is the most effective way of reducing drug related harm for disadvantaged populations. Primary health care is the optimal site for delivering drug and alcohol treatment. Semi-structured in-depth interviews with 47 primary health care, drug and alcohol and other health and welfare workers in rural and remote locations were conducted. Thematic analysis of interview data identified divergent perspectives according to a participant's work role about drug and alcohol treatment, client needs and problems and service delivery approaches. Primary health care workers were conceptualised as locals. They tended to perceive that drug and alcohol interventions should quickly prevent individuals from on-going problematic use. Drug and alcohol workers were conceptualised as insiders. Most did not have knowledge or experience of the primary health care setting. Therefore they could not assist primary health care workers to integrate drug and alcohol interventions into their interactions with clients. Professional and organisational barriers constrain the primary health care worker role and limit the application of specialist interventions. Drug and alcohol work is only one of many competing demands in the primary health setting. The lack of understanding of the primary health care worker role and responsibilities is the most significant barrier to implementing specialist interventions in this role. Primary health care workers' perceptions of substance misuse are more consistent with the individual moral or personal deficit philosophy of drug and alcohol treatment than harm minimisation approaches. This is a challenge for a specialist agency that is promoting harm minimisation and an

  3. Associations between Responsible Beverage Service Laws and Binge Drinking and Alcohol-Impaired Driving

    ERIC Educational Resources Information Center

    Linde, Ann C.; Toomey, Traci L.; Wolfson, Julian; Lenk, Kathleen M.; Jones-Webb, Rhonda; Erickson, Darin J.

    2016-01-01

    We explored potential associations between the strength of state Responsible Beverage Service (RBS) laws and self-reported binge drinking and alcohol-impaired driving in the U.S. A multi-level logistic mixed-effects model was used, adjusting for potential confounders. Analyses were conducted on the overall BRFSS sample and drinkers only. Seven…

  4. Quality Assurance for Alcohol, Drug Abuse, and Mental Health Services: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Towery, O. B.; And Others

    This is a comprehensive bibliography for all those in the alcohol, drug abuse and mental health fields who are developing and implementing programs for assuring quality in the services they provide. A major problem is the newness of the language and the unfamilarity with procedures required by the government and others seeking accountability from…

  5. Vitamin D and ibandronate prevent cancellous bone loss associated with binge alcohol treatment in male rats.

    PubMed

    Wezeman, Frederick H; Juknelis, Dainius; Himes, Ryan; Callaci, John J

    2007-10-01

    Decreased bone mass and bone strength can result from excess alcohol consumption in humans and alcohol treatment in the rat. Although the specific mechanism is unknown, the damaging effects of alcohol abuse modulate the bone remodeling cycle and increase bone turnover. Chronic alcohol consumption models have shown an inhibition of bone formation. We previously reported that binge alcohol treatment increases bone resorption and that alcohol-induced damage can be prevented by treatments with intermittent parathyroid hormone and bisphosphonates. In this study, we hypothesized that an effective dose of vitamin D (cholecalciferol) or a single dose of ibandronate would prevent bone loss caused by binge alcohol treatment in male rats. Forty-eight adult (450 gram) male Sprague-Dawley rats were randomly assigned to 6 treatment groups (n=8): (a) saline i.p., 3 days/week (C); (b) binge alcohol, 3 g/kg i.p., 3 days/week (A); (c) vitamin D, 5,000 IU/kg daily s.c. (D); (d) binge alcohol and vitamin D (AD); (e) ibandronate (120 microg, given as a single i.p. injection (I)); and (f) alcohol and ibandronate (AI) . After 4 weeks of treatment, proximal tibia and L3 and L4 vertebrae were analyzed for bone mineral density (BMD) by quantitative computerized tomography and compressive strength-to-failure using an Instron materials testing machine. Type I collagen cross-linked c-telopeptide, calcium, and 25-OH vitamin D levels were measured in serum collected at the time of sacrifice. Binge alcohol significantly decreased cancellous BMD by 58% in tibia and 23% in lumbar spine (p<0.05). Binge alcohol treatment decreased L3 and L4 compressive strength-to-failure by 21% (p<.05). Treatment with vitamin D at 5,000 IU/kg/day prevented alcohol-induced bone loss, significantly increasing both tibial and vertebral cancellous BMD values (161% increase in tibia and 40% increase in vertebra, respectively, p<0.05) compared to alcohol alone groups. Pre-treatment with the single dose of 120 microg

  6. Identifying Alcoholism in Families Seeking Mental Health Treatment.

    ERIC Educational Resources Information Center

    Bayer, Gregory A.; Bayer, Marilyn A.

    A family system is intimately affected by the presence of an alcoholic within the system. One symptom of alcoholism is the development of elaborate defenses. In response to the defense of the alcoholic, each family member develops individual well established and unique defenses. The diagnosis of the defenses is essential in determining the nature…

  7. Alcohol Use and Trauma Exposure among Male and Female Veterans Before, During, and After Military Service

    PubMed Central

    Kelley, Michelle L.; Runnals, Jennifer; Pearson, Matthew R.; Miller, Marinell; Fairbank, John A.; Brancu, Mira

    2017-01-01

    The present study examined lifespan and combat-related trauma exposure as predictors of alcohol use among male and female veterans. Posttraumatic stress and depressive symptoms were examined as mediators of the effects of trauma exposure on alcohol use. Data were examined from 1825 (1450 male, 375 female) veterans and active duty service members who took part in a multi-site research study conducted through the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Centers (VISN 6 MIRECC). For both men and women, depressive symptoms significantly mediated the effects of non-combat trauma exposure experienced before, during and after the military, as well as combat- exposure, on alcohol use. With posttraumatic stress symptoms, the models for men and women differed. For men, the effects of non-combat trauma exposure during and after military service, and combat exposure, on alcohol use were mediated by PTSD symptoms; however, for women, PTSD symptoms did not mediate these relationships. Findings are discussed in the context of potential gender differences in response to trauma such as use of alcohol to cope with traumatic events. PMID:24054989

  8. Alcohol and the law.

    PubMed

    Karasov, Ariela O; Ostacher, Michael J

    2014-01-01

    Society has had an interest in controlling the production, distribution, and use of alcohol for millennia. The use of alcohol has always had consequences, be they positive or negative, and the role of government in the regulation of alcohol is now universal. This is accomplished at several levels, first through controls on production, importation, distribution, and use of alcoholic beverages, and second, through criminal laws, the aim of which is to address the behavior of users themselves. A number of interventions and policies reduce alcohol-related consequences to society by regulating alcohol pricing, targeting alcohol-impaired driving, and limiting alcohol availability. The legal system defines criminal responsibility in the context of alcohol use, as an enormous percentage of violent crime and motor death is associated with alcohol intoxication. In recent years, recovery-oriented policies have aimed to expand social supports for recovery and to improve access to treatment for substance use disorders within the criminal justice system. The Affordable Care Act, also know as "ObamaCare," made substantial changes to access to substance abuse treatment by mandating that health insurance include services for substance use disorders comparable to coverage for medical and surgical treatments. Rather than a simplified "war on drugs" approach, there appears to be an increasing emphasis on evidence-based policy development that approaches alcohol use disorders with hope for treatment and prevention. This chapter focuses on alcohol and the law in the United States.

  9. Alcohol Screening among Opioid Agonist Patients in a Primary Care Clinic and an Opioid Treatment Program.

    PubMed

    Klimas, Jan; Muench, John; Wiest, Katharina; Croff, Raina; Rieckman, Traci; McCarty, Dennis

    2015-01-01

    Problem alcohol use is associated with adverse health and economic outcomes, especially among people in opioid agonist treatment. Screening, brief intervention, and referral to treatment (SBIRT) are effective in reducing alcohol use; however, issues involved in SBIRT implementation among opioid agonist patients are unknown. To assess identification and treatment of alcohol use disorders, we reviewed clinical records of opioid agonist patients screened for an alcohol use disorder in a primary care clinic (n = 208) and in an opioid treatment program (n = 204) over a two-year period. In the primary care clinic, 193 (93%) buprenorphine patients completed an annual alcohol screening and six (3%) had elevated AUDIT scores. In the opioid treatment program, an alcohol abuse or dependence diagnosis was recorded for 54 (27%) methadone patients. Practitioner focus groups were completed in the primary care (n = 4 physicians) and the opioid treatment program (n = 11 counselors) to assess experience with and attitudes towards screening opioid agonist patients for alcohol use disorders. Focus groups suggested that organizational, structural, provider, patient, and community variables hindered or fostered alcohol screening. Alcohol screening is feasible among opioid agonist patients. Effective implementation, however, requires physician training and systematic changes in workflow.

  10. Novel Objective Biomarkers of Alcohol Use: Potential Diagnostic and Treatment Management Tools in Dual Diagnosis Care

    PubMed Central

    Kalapatapu, Raj K.; Chambers, R.

    2010-01-01

    Alcohol use disorders are highly prevalent conditions that generate a large fraction of the total public health burden. These disorders are concentrated in mentally ill populations, in which reliability of self-reporting of alcohol consumption may be especially compromised. The application of objective biomarkers for alcohol use may therefore play an important role in these patients. This article provides a description and comparative overview of traditional versus novel biomarkers of alcohol consumption. Greater professional familiarity with and use of novel biomarkers as diagnostic and treatment management tools may enhance clinical standards and research on alcohol use in patients with a dual diagnosis. PMID:20582236

  11. [Natural recovery and treatment recovery from drug and alcohol abuse].

    PubMed

    Pérez Gómez, Augusto; Sierra Acuña, Diana Raquel

    2007-01-01

    This study examines the concept of natural recovery (without formal treatment) from problems associated with alcohol, marijuana, cocaine and heroin abuse, each one alone or in any combination. Two groups of males (40 Ss between 18 and 60 years of age) and two groups of females (19 Ss between 18 and 55 years of age) with at least one year of abstinence were studied. The main issues considered were: reason for attending treatment or ceasing the use of substances, factors related to maintenance of abstinence, and difficulties and threats associated with abstinence. Several significant differences were found between groups with and without treatment, as well as between males and females, particularly regarding factors related to the maintenance of abstinence. In both cases family and affective links appear as the most relevant factors in the decision to stop using substances. On the other hand, commitment to one's goals and life project are the principal motives for maintaining abstinence or moderate consumption. This reflects the progressive transition from cognitive and emotional processes with external referents to processes with internal referents, associated with personal achievement.

  12. New drug treatments for alcohol problems: a critical appraisal.

    PubMed

    Moncrieff, J; Drummond, D C

    1997-08-01

    This review considers the novel drug treatments that have been suggested to help prevent relapse or attenuate drinking in people with alcohol problems. The evidence from randomized controlled trials for the efficacy of some of the main candidates: acamprosate, naltrexone, bromocriptine, selective serotonin re-uptake inhibitors and buspirone, was examined. Important methodological problems which may have introduced bias were detected in many of the trials. These included failure to test the integrity of the double blind, excluding or estimating outcome in early withdrawals and the comparison of groups on multiple outcome measures with selective reporting of results. In addition, the generalizability of some studies was limited by the procedures used for sample selection. In view of the potential adverse effects of drug treatment it is concluded that the evidence is not strong enough to support the introduction of any of these substances into routine clinical practice at present. The review also emphasizes the importance of methodological rigour to maximize objectivity in treatment evaluation research.

  13. Does Individual Treatment for Alcoholic Fathers Benefit Their Children? A Longitudinal Assessment

    ERIC Educational Resources Information Center

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J.; Fals-Stewart, William

    2006-01-01

    Psychosocial adjustment in children of alcoholics (COAs; N = 125) was examined before and at 3 follow-ups in the 15 months after their fathers entered alcoholism treatment. Before their fathers' treatment, COAs exhibited greater overall and clinical-level symptomatology than children from the demographically matched comparison sample, but they…

  14. Comparative Evaluation of Medical vs. Social Treatment of Alcohol Withdrawal Syndrome.

    ERIC Educational Resources Information Center

    McGovern, Mark P.

    1983-01-01

    Compared medical and social setting detoxification treatments of alcohol withdrawal syndrome regarding the degree to which each involved alcoholics (N=200) in ongoing rehabilitative efforts. Results showed highly significant differences between treatment models, with the social setting model showing significantly greater rates of commitment to…

  15. Alcohol

    MedlinePlus

    ... created when grains, fruits, or vegetables are fermented . Fermentation is a process that uses yeast or bacteria ... change the sugars in the food into alcohol. Fermentation is used to produce many necessary items — everything ...

  16. Alcohol.

    ERIC Educational Resources Information Center

    Schibeci, Renato

    1996-01-01

    Describes the manufacturing of ethanol, the effects of ethanol on the body, the composition of alcoholic drinks, and some properties of ethanol. Presents some classroom experiments using ethanol. (JRH)

  17. Saami and Norwegian clients' use of a treatment facility for drug and alcohol problems in northern Norway.

    PubMed

    Larsen, S

    1992-04-01

    Saami people ("Lapps") and Norwegians make different use of primary health care services, and Larsen and Nergård (1) reported an under-representation of Saami clients at a treatment facility for drug and alcohol problems in Northern Norway in the years 1986-1988. However, Saami and Norwegian groups did not differ in number of days in treatment, number of treatment incidents, mean age or self-reported years of problem drinking. Since it is believed that Saami clients are under-represented in Norwegian treatment facilities because of cultural differences, the location of treatment facilities within a Saami municipality was expected to increase the incidence of Saami clients. The present study investigated the incidence of Saami clients at Karasjok treatment facility during 1988 and 1989, 8 and 9 years after the opening of this treatment centre. All clients registered at Finnmark County's treatment facility for drug and alcohol problems during 1988-89 were categorized as either Saami or Norwegian by their language preference. Unfortunately, the Saami group was still under-represented among clients at this treatment facility. In addition, a significant difference in the sex-ratio between the two groups was found, indicating that Saami women do not use the institution at all. Results are discussed in terms of availability of health services for minority groups.

  18. Dose Specific Effects of Olanzapine in the Treatment of Alcohol Dependence

    PubMed Central

    Littlewood, Rae A.; Claus, Eric D.; Arenella, Pamela; Bogenschutz, Michael; Karoly, Hollis; Feldstein Ewing, Sarah W.; Bryan, Angela D.; Hutchison, Kent E.

    2014-01-01

    Rationale It is well-established that the rewarding effects of alcohol are modulated by the mesolimbic dopaminergic system. Olanzapine, a D2 dopamine antagonist, has been shown to reduce alcohol craving and consumption. Objective To clarify whether olanzapine has clinical utility in the treatment of alcohol dependence, a 12-week, double-blind, randomized clinical trial was conducted. Methods One-hundred twenty-nine treatment-seeking alcohol dependent adults were randomly assigned to 12-weeks of olanzapine (5mg vs. 2.5mg) or placebo. Outcomes examined were average drinks per drinking day (DDD), proportion of drinking days to total days in treatment (PDD), alcohol craving, and impaired control over alcohol use. Mixed models were used to examine medication effects during the course of treatment on specified outcomes. Results All of the analyses indicated a main effect for time, such that there were reductions in alcohol use and craving and an increase in control over alcohol use across treatment conditions. Dose-response analyses indicated that, in comparison to placebo, participants in the 5mg group experienced reduced craving for alcohol and participants in the 2.5mg group decreased in PDD and increased in their control over alcohol use. Better control over alcohol use remained significant 6 months post-treatment for the 2.5mg group. Subjective experiences of the medication suggest that 2.5mg and 5mg were equally well-tolerated. Conclusions Results provide some support for the notion that dosage is an important consideration in relation to effectiveness; however, the cost-benefit balance does not support the clinical utility of olanzapine in treating alcohol dependence. PMID:25304864

  19. Dynamic Association between Negative Affect and Alcohol Lapses following Alcohol Treatment

    ERIC Educational Resources Information Center

    Witkiewitz, Katie; Villarroel, Nadia Aracelliz

    2009-01-01

    Clinical research has found a strong association between negative affect and returning to alcohol use after a period of abstinence. Yet little is known about the probability of a lapse given a particular level of negative affect or whether there is a reciprocal relationship between negative affect and alcohol use across time. The goal of the…

  20. Safety and tolerability of gamma-hydroxybutyric acid in the treatment of alcohol-dependent patients.

    PubMed

    Beghè, F; Carpanini, M T

    2000-04-01

    Gamma-hydroxybutyric acid (GHB) has been in clinical use in Italy since 1991 for treatment of alcohol dependence. Results of phase III and phase IV studies have shown that the drug is effective and well tolerated in the treatment of alcohol withdrawal syndrome and in reducing alcohol consumption and alcohol craving. Pharmacosurveillance indicates that abuse of gamma-hydroxybutyric acid is a limited phenomenon in clinical settings when the drug is dispensed under strict medical surveillance and entrusted to a referring familiar member of the patient.

  1. Prazosin for Treatment With PTSD And Comorbid Alcohol Dependence

    DTIC Science & Technology

    2010-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD and alcohol dependence . The objective of this study is to evaluate the efficacy of prazosis (16mg

  2. Gender Comparison in Referrals and Treatment Completion to Residential and Outpatient Alcohol Treatment

    PubMed Central

    Bazargan-Hejazi, Shahrzad; De Lucia, Valory; Pan, Deyu; Mojtahedzadeh, Mona; Rahmani, Elham; Jabori, Sinan; Zahmatkesh, Golara; Bazargan, Mohsen

    2016-01-01

    BACKGROUND Residential treatment for alcoholism is associated with high completion rates for clients, yet there appear to be gender disparities in patient referrals and treatment completion rates. We studied whether (A) gender is associated with differential patient placement to outpatient vs. residential treatment facilities and (B) completion rates differ by gender. METHODS In this cross-sectional study, we analyzed the admission and discharge data from 185 publicly funded substance abuse treatment facilities across Los Angeles County between 2005 and 2010. RESULTS Among the 33,745 studied cases, women were referred to residential treatment facilities less frequently than men (75% vs. 66%). The adjusted results derived from logistic regression models confirmed that females were more likely to be referred to outpatient treatment than to residential treatment facilities (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.05–1.26). In addition, we observed that compared to White/Caucasian patients, all other races were associated with more referral to outpatient facilities (ie, less referral to residential facilities), indicating a racial disparity on the top of the observed gender disparity. However, there was no significant link between gender and treatment completion rates (OR: 0.93, 95% CI: 0.86–1.00). CONCLUSIONS Women seem to have treatment completion rates comparable to men, yet they are less likely to be referred to residential treatment facilities. Hence, there still remains a gender disparity in alcoholic patient referrals. Further studies should delineate which specific therapeutic aspects and programmatic components of women-focused treatments are essential to augment positive treatment outcomes. PMID:28008266

  3. Prazosin for Treatment of Patients with PTSD and Comorbid Alcohol Dependence

    DTIC Science & Technology

    2014-12-01

    Prazosin for Treatment of Patients with PTSD and Comorbid Alcohol Dependence PRINCIPAL INVESTIGATOR...of Patients with PTSD and Comorbid Alcohol Dependence 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-08-2-0075 5c. PROGRAM ELEMENT NUMBER 6...comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of TSD among individuals with AD are at least twice

  4. Stability of the alcohol use disorders identification test in practical service settings

    PubMed Central

    Sahker, Ethan; Lancianese, Donna A; Arndt, Stephan

    2017-01-01

    Objective The purpose of the present study is to explore the stability of the Alcohol Use Disorders Identification Test (AUDIT) in a clinical setting by comparing prescreening heavy drinking questions and AUDIT scores over time. Because instrument stability is equal to test–retest reliability at worst, investigating the stability of the AUDIT would help better understand patient behavior change in context and the appropriateness of the AUDIT in a clinical setting. Methods This was a retrospective exploratory analysis of Visit 1 to Visit 2 AUDIT stability (n=1,099; male [75.4%], female [24.6%]) from all patients with first-time and second-time records in the Iowa Screening, Brief Intervention, and Referral to Treatment project, October 2012 to July 7, 2015 (N=17,699; male [40.6%], female [59.4%]). Results The AUDIT demonstrated moderate stability (intraclass correlation=0.56, 95% confidence interval: 0.52–0.60). In a multiple regression predicting the (absolute) difference between the two AUDIT scores, the participants’ age was highly significant, t(1,092)=6.23, p<0.001. Younger participants clearly showed less stability than their older counterparts. Results are limited/biased by the observational nature of the study design and the use of clinical service data. Conclusion The present findings contribute to the literature by demonstrating that the AUDIT changes are moderately dependable from Visit 1 to Visit 2 while taking into account patient drinking behavior variability. It is important to know the stability of the AUDIT for continued use in Screening, Brief Intervention, and Referral to Treatment programming. PMID:28392719

  5. Treatment for Alcohol Problems: Finding and Getting Help

    MedlinePlus

    ... combination with counseling. Mutual-Support Groups Alcoholics Anonymous (AA) and other 12-step programs provide peer support ... 800–662–HELP Mutual-support groups Alcoholics Anonymous (AA) www.aa.org 212–870–3400 or check ...

  6. Alcohol and Drug Abusers Entering Treatment: How Different Are They?

    ERIC Educational Resources Information Center

    Seraganian, Peter; And Others

    A major shift in drug abuse epidemiology has been witnessed in North America over the past decade. Although alcohol continues to be widely abused, usage of other substances has proliferated. While addicted individuals share some attributes, certain demographic, psychological, and cognitive characteristics may distinguish alcoholics from those who…

  7. Efficacy of a combination of flumazenil and gabapentin in the treatment of alcohol dependence: relationship to alcohol withdrawal symptoms.

    PubMed

    Anton, Raymond F; Myrick, Hugh; Baros, Alicia M; Latham, Patricia K; Randall, Patrick K; Wright, Tara M; Stewart, Scott H; Waid, Randy; Malcolm, Robert

    2009-08-01

    Improved treatment of alcohol dependence is a high priority, including defining subtypes that might respond differently. We evaluated a medication combination of intravenous flumazenil (FMZ) and oral gabapentin (GBP) in alcoholics who did and did not exhibit pretreatment alcohol withdrawal (AW) symptoms. Sixty alcohol-dependent individuals (44 with low AW and 16 with high AW) were randomized to receive FMZ (2 mg of incremental bolus for 20 minutes for 2 consecutive days) and GBP (up to 1200 mg nightly for 39 days) or their inactive placebos. Alcohol withdrawal was measured for the first 2 days, and drinking, sleep parameters, and adverse events were monitored during weekly evaluations, along with behavioral counseling sessions. Percent days abstinent (PDA) during treatment and time to first heavy drinking (TFHD) day were primary outcome variables. There was an interaction between the pretreatment AW status and the medication group on PDA (P = 0.0006) and TFHD (P = 0.06). Those in the high AW group had more PDA and more TFHD if treated with active medications, whereas those in the low AW group had more PDA and more TFHD if treated with placebo. This interaction remained for those totally abstinent (P = 0.03) and was confirmed by percent carbohydrate-deficient transferrin values. In addition, the pattern of response remained up to 8 weeks after treatment. In addition, in those with high AW, greater improvement in AW symptoms was observed in the active medication group compared with the placebo group. These results suggest a differential response to FMZ/GBP treatment, depending on pretreatment AW status that should be taken into account during future treatment trials.

  8. Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcoholic fathers’ treatment involvement and their children’s externalizing problems

    PubMed Central

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J

    2008-01-01

    We investigated longitudinal associations between alcoholic fathers’ 12-step treatment involvement and their children’s internalizing and externalizing problems (N=125, Mage=9.8±3.1), testing the hypotheses that fathers’ greater treatment involvement would benefit later child behavior, and that this effect would be mediated by fathers’ post-treatment behaviors. The initial association was established between fathers’ treatment involvement and children’s externalizing problems only, while structural equation (SEM) results supported mediating hypotheses. Fathers’ greater treatment involvement predicted children’s lower externalizing problems 12 months later, and fathers’ post-treatment behaviors mediated this association: greater treatment involvement predicted greater post-treatment Alcoholics Anonymous (AA) attendance, which in turn predicted greater abstinence. Finally, fathers’ abstinence was associated with lower externalizing problems in children. Theoretical and practical implications of these findings are discussed. PMID:18715745

  9. Alcohol Screening and Brief Intervention in Workplace Settings and Social Services: A Comparison of Literature

    PubMed Central

    Schulte, Bernd; O’Donnell, Amy Jane; Kastner, Sinja; Schmidt, Christiane Sybille; Schäfer, Ingo; Reimer, Jens

    2014-01-01

    Background: The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBIs) in primary health care (PHC) suggests that a widespread expansion of ASBI in non-medical settings could be beneficial. Social service and criminal justice settings work frequently with persons with alcohol use disorders, and workplace settings can be an appropriate setting for the implementation of alcohol prevention programs, as a considerable part of their social interactions takes place in this context. Methods: Update of two systematic reviews on ASBI effectiveness in workplaces, social service, and criminal justice settings. Review to identify implementation barriers and facilitators and future research needs of ASBI in non-medical settings. Results: We found a limited number of randomized controlled trials in non-medical settings with an equivocal evidence of effectiveness of ASBI. In terms of barriers and facilitators to implementation, the heterogeneity of non-medical settings makes it challenging to draw overarching conclusions. In the workplace, employee concerns with regard to the consequences of self-disclosure appear to be key. For social services, the complexity of certain client needs suggest that a stepped and carefully tailored approach is likely to be required. Discussion: Compared to PHC, the reviewed settings are far more heterogeneous in terms of client groups, external conditions, and the focus on substance use disorders. Thus, future research should try to systematize these differences, and consider their implications for the deliverability, acceptance, and potential effectiveness of ASBI for different target groups, organizational frameworks, and professionals. PMID:25339914

  10. Pharmacological treatments in alcohol use disorders: state of art and new perspectives.

    PubMed

    Guglielmo, R; Ioime, L; Solaroli, S; Janiri, L

    2015-01-01

    The main focus of this narrative review is to present and discuss the most relevant clinical data about the pharmacological therapy for alcohol use disorders. By using PubMed we conducted a review of the clinical literature on drugs related to alcohol use disorders. All data are presented following the three phases of treatment: a) from withdrawal to abstinence; b) abstinence and relapse prevention; c) reduction of alcohol consumption. Historical evidence shows that in addition to the drugs already approved for the treatment of alcoholism, there are some off-label medications as effective as the approved ones which deserve therefore further study. The treatment of the alcoholic patient always requires a multidimensional and multidisciplinary approach, directed to the specific needs of each subject in order to achieve a correct care personalization. The study of the cognitive effects of each drug and pharmacogenetics will allow us to increasingly customize therapy for each individual patient.

  11. Gender Differences in Predictors of Treatment Attrition with High Dose Naltrexone in Cocaine and Alcohol Dependence

    PubMed Central

    Suh, Jesse J.; Pettinati, Helen M.; Kampman, Kyle M.; O’Brien, Charles P.

    2008-01-01

    Recently, we reported that naltrexone at 150mg/day significantly decreased cocaine and alcohol use for men, but not women with co-occurring cocaine and alcohol dependence. The present study is an exploratory investigation of predictors that explain the different gender response to naltrexone, with a particular focus on differential predictors of treatment attrition. No significant predictors were associated with treatment discontinuation in men. Women, however, were more likely to discontinue treatment when reporting severe pre-treatment psychiatric problems, or nausea while in treatment. Further research on the impact of pre-treatment and in-treatment gender differences with naltrexone is warranted. PMID:19034737

  12. A Guide for Starting a Specialty Training Clinic: An Alcohol Treatment Program as an Example

    PubMed Central

    Ladd, Benjamin O.; Glynn, Lisa Hagen; Fischer, Daniel J.; Owens, Mandy; Hallgren, Kevin A.; McLouth, Christopher J.; Monnig, Mollie A.; Campbell, William; McCrady, Barbara S.

    2013-01-01

    Since the Boulder conference more than 50 years ago, clinical psychology has been moving towards empirically based techniques and methods. Considerable research has been conducted and a multitude of studies have documented support for empirically supported treatments (ESTs). However, the literature on implementing ESTs in real-world settings is relatively limited. The absence of practical guidance poses a particular problem for students in clinical psychology training programs that emphasize training and competency in ESTs. This article describes the development of an alcohol specialty clinic within a clinical psychology training program from the first conceptualizations to establishment of a referral base and provision of services. At each step, integration of science and clinical practice is discussed. Future directions and suggestions for developing training clinics are provided. PMID:23704805

  13. Change in Psychiatric Symptomatology after Benfotiamine Treatment in Males is a Function of Lifetime Alcoholism Severity

    PubMed Central

    Manzardo, Ann M.; Pendleton, Tiffany; Poje, Albert; Penick, Elizabeth C.; Butler, Merlin G.

    2015-01-01

    Background Severe alcoholism can be associated with significant nutritional and vitamin deficiency, especially vitamin B1 (thiamine) which is associated with serious illness and neurological deficits that influence mood and cognition. We previously reported reduced alcohol consumption among female but not male alcoholics after supplementation with the high potency thiamine analog benfotiamine (BF). As a follow-up, we have examined the relationship between lifetime alcoholism severity and psychiatric symptoms among the alcohol dependent men from this cohort and their response to BF treatment. Methods Eighty-five adult men (mean age = 48 ± 8 yrs) meeting DSM-IV-TR criteria for current alcohol dependence participated in a randomized, double-blind, placebo-controlled trial of 600 mg BF vs placebo (PL) for 6 months. Psychometric testing included a derived Lifetime Alcoholism Severity Score (AS), Symptom Checklist 90R (SCL-90R), and the Barratt Impulsivity Scale (BIS) at baseline and at 6 months with data analyzed using ANOVA and MANOVA modeling. Results Baseline SCL-90-R scale scores for men with high alcoholism severity (AS ≥ 24; N=46 HAS) were significantly greater than for men with low alcoholism severity (AS < 24; N=39 LAS), but BIS scores did not differ. MANOVA modeling identified a significant treatment effect (F=2.5, df=10, p<0.03) and treatment x alcoholism severity level interaction (F=2.5, dfnum=10, dfden=30, p<0.03) with SCL-90-R scores showing a reduction in symptoms among BF treated, high severity males. Conclustion BF appears to reduce psychiatric distress and may facilitate recovery in severely affected males with lifetime alcohol dependence and should be considered for adjuvant therapy in alcohol rehabilitation. PMID:25908323

  14. The Alcohol Use and Associated Mental Health Problems of Student Service Members/Veterans in Higher Education

    ERIC Educational Resources Information Center

    Barry, Adam E.; Whiteman, Shawn; Wadswroth, Shelley Macdermid; Hitt, Stacie

    2012-01-01

    Aims: This study examined: (a) whether student service members/veterans attending college drank more frequently or in greater quantities than non-service peers; and (b) whether links between student service members/veterans' alcohol use and mental health-related outcomes differed from civilian students.Methods: Participants included 145 student…

  15. Alcohol Use, Psychopathology, and Treatment Utilization in a University Mental Health Clinic

    ERIC Educational Resources Information Center

    Seigers, Danielle K. L.; Carey, Kate B.

    2010-01-01

    In the general population, alcohol use disorders and psychiatric disorders co-occur. Despite ample evidence of the adverse effects of alcohol use on treatment outcomes, these relationships have not been examined among college students presenting at counseling centers. The purpose of this study was to assess the prevalence of hazardous drinking…

  16. DUI/DWAI Offenders Compared to Clients Seen in an Outpatient Alcohol-Treatment Facility.

    ERIC Educational Resources Information Center

    Packard, Michele A.

    1987-01-01

    Examined client records to compare 50 subjects admitted to a drinking-driver program and 50 subjects admitted to an outpatient alcohol treatment clinic. Highly significant differences were found between groups on 10 of 12 drinking indices, suggesting that clients referred for alcohol-related traffic offenses represent a population different from…

  17. Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

    ERIC Educational Resources Information Center

    Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

    2010-01-01

    Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

  18. Pomeroy House: A Residential Treatment Program for Recovering Alcoholic Mothers and Their Children.

    ERIC Educational Resources Information Center

    Norwood, Lucille

    Pomeroy House, a long-term residential treatment program in San Francisco, California, was created to help recovering alcoholic mothers and their children. Eight to 10 families stay at Pomeroy House for a minimum period of 6 months with extensions of up to 9 or 12 months, and the alcoholic mothers care for their children while recovering from…

  19. A Controlled Trial of Topiramate Treatment for Alcohol Dependence in Veterans with PTSD

    DTIC Science & Technology

    2015-10-01

    Dieter J. Meyerhoff, Dr.rer.nat., UCSF Rationale and Content: Civilian and military personnel with posttraumatic stress disorder (PTSD) frequently...observed in both Alcohol Use Disorder (AUD) and Posttraumatic Stress Disorder (PTSD) and is associated with worse treatment outcome. Impairment in...CA 94121 Purpose: Cognitive dysfunction is commonly observed among individuals with Alcohol Use Disorder (AUD) and Posttraumatic Stress Disorder

  20. The Development of a Broad Spectrum Treatment for Patients with Alcohol Dependence in Early Recovery

    ERIC Educational Resources Information Center

    Gulliver, Suzy Bird; Longabaugh, Richard; Davidson, Dena; Swift, Robert

    2005-01-01

    Estimates of the prevalence of alcohol dependence among Americans approach 14% (Read, Kahler, & Stevenson, 2001). Alcohol dependence was once considered among the most recalcitrant of problem behaviors, with only 20% to 30% attaining sustained abstinence (Hunt Barnett & Branch 1971). Although current definitions of treatment success now consider…

  1. Longitudinal Risk Factors for Intimate Partner Violence among Men in Treatment for Alcohol Use Disorders

    ERIC Educational Resources Information Center

    Taft, Casey T.; O'Farrell, Timothy J.; Doron-Lamarca, Susan; Panuzio, Jillian; Suvak, Michael K.; Gagnon, David R.; Murphy, Christopher M.

    2010-01-01

    Objective: This study examined static and time-varying risk factors for perpetration of intimate partner violence (IPV) among men in treatment for alcohol use disorders. Method: Participants were 178 men diagnosed with alcohol abuse or dependence and their partners. Most (85%) of the men were European American; their average age was 41.0 years.…

  2. The Use of Gestalt Interventions in the Treatment of the Resistant Alcohol-Dependent Client.

    ERIC Educational Resources Information Center

    Ramey, Luellen

    1998-01-01

    Reviews ethical and practical dilemmas associated with clients who have hidden alcohol dependencies, and proposes an approach rooted in Gestalt counseling theory which confronts these issues and is compatible with a current emerging alcohol-treatment model. Suggests specific activities for addressing client resistance to revealing a hidden alcohol…

  3. [Preliminary study on detox in outpatient care units with 18 alcoholic patients in Directly Observed Treatment].

    PubMed

    Lloréns Martínez, Ramón; Calatayud Francés, María; Morales Gallús, Esperanza; Añó Cervera, Consol; Adriá Caballero, Librada

    2008-01-01

    Directly Observed Treatment (TOD-DOT) has been tested in different conditions. The objective of this work is to check whether a UCA-CAB (Centre for Addictive Behaviour) can achieve detox and reduce the risk of early relapse (up to 12 weeks) in alcoholic patients. All patients had an established organic addiction and serious withdrawal syndrome, and had undergone multiple previous treatments. Furthermore, they had not managed to abstain for a 3-month consecutive period over the previous 2 years. The aim of the Directly Observed Treatment was to attain detox and reduce relapse by following a multi-method approach: medical, psychological and personal care, based on a brief daily consultation and pharmacological supervision. The results were as follows: Of the 18 patients included in the study, after 12 weeks, 13 (72 %) were still abstinent and 4 (22 %) had relapsed. Thus, 17 (94 %) were still following the treatment, with just one drop-out. We analysed the profiles of the patients abstaining, of those who relapsed (4) and of the one who dropped out. The average CIWA-Ar was 27.05 (21-36). Any value over 20 is considered to indicate serious withdrawal syndrome, though there were no negative events leading to hospitalization. Level of adherence to the treatment (94 %) meant that the most seriously affected patients and those with fewest financial resources could benefit, not only from any auxiliary social schemes, but also from basic health services, permitting them to improve the quality of their everyday life.

  4. The Moderating Effect of Substance Abuse Service Accessibility on the Relationship between Child Maltreatment and Neighborhood Alcohol Availability.

    PubMed

    Morton, Cory M

    2013-12-01

    This study investigates how the relationship between dense concentrations of alcohol retailers and high rates of child maltreatment may be moderated by the presence of substance abuse service facilities. Using a cross-sectional design, the study utilized data from Bergen County, New Jersey on child maltreatment reports, alcohol-selling retailers, substance abuse service facilities, and the United States Census. Findings indicate child maltreatment rates were higher in neighborhoods with lower socioeconomic status and those with greater alcohol outlet density. Neighborhoods with easily accessed substance abuse service facilities had lower rates of child maltreatment. Additionally, the relationship between child maltreatment and alcohol outlet density was moderated by the presence of substance abuse service facilities. The study findings highlight the relevance of making primary prevention approaches readily available and using multi-sector collaboration to reduce child maltreatment.

  5. Children’s Exposure to Parental Conflict after Father’s Treatment for Alcoholism

    PubMed Central

    Rounsaville, Daniel; O’Farrell, Timothy J.; Andreas, Jasmina Burdzovic; Murphy, Christopher M.; Murphy, Marie M.

    2014-01-01

    Objective This study investigated children of alcoholics’ (COAs’) exposure to inter-parental conflict before and after their fathers received alcohol treatment and compared exposure levels to a community comparison sample. Method This study included 67 couples with a treatment-seeking male alcoholic partner and children aged 4–16. The alcoholic fathers and their relationship partners provided data at baseline and at six and twelve months follow-up. A community comparison sample of 78 couples with children in the target age range completed similar longitudinal assessments. It was hypothesized that treatment of paternal alcoholism would be associated with a decrease in COAs’ exposure to conflict, and that among remitted patients exposure to conflict would decrease to the level found in the community sample. Results Prior to the father’s alcohol treatment, the children of the treatment sample were exposed to significantly more conflict between their parents than in the community comparison sample. After the fathers received alcohol treatment, COAs’ exposure to conflict significantly decreased at both the six and twelve month follow-ups compared to baseline. Children of remitted alcoholics did not differ significantly in levels of exposure to conflict at six months follow-up compared with the community sample as predicted. However, at twelve months remitted alcoholics reported significantly more exposure to conflict compared to the community sample. Conclusions Decreased child exposure to parental conflict is a benefit associated with the father’s treatment for alcoholism, and it may lead to improvements in COAs’ functioning after parental treatment. PMID:24727114

  6. Alcoholism - A High Priority Health Problem. A Report of the Indian Health Service Task Force on Alcoholism.

    ERIC Educational Resources Information Center

    Bock, George; And Others

    Three separate reports are included in this document on American Indian alcoholism. Section I of the document (December 1969) outlines the history, nature, extent, and significance of Indian alcoholism (reporting that the incidence of alcoholism among Indians is twice that of the national average, low socioeconomic status, rather than a…

  7. How Imaging Glutamate, GABA, and Dopamine Can Inform the Clinical Treatment of Alcohol Dependence and Withdrawal

    PubMed Central

    Hillmer, Ansel T.; Mason, Graeme F.; Fucito, Lisa M.; O’Malley, Stephanie S.; Cosgrove, Kelly P.

    2015-01-01

    Neuroimaging studies have dramatically advanced our understanding of the neurochemical basis of alcohol dependence, a major public health issue. In this paper we review the research generated from neurochemical-specific imaging modalities including magnetic resonance spectrometry (MRS), positron emission tomography (PET), and single photon emission computed tomography (SPECT) in studies of alcohol dependence and withdrawal. We focus on studies interrogating γ-aminobutryic acid (GABA), glutamate, and dopamine, as these are prominent neurotransmitter systems implicated in alcohol dependence. Highlighted findings include diminished dopaminergic functioning and modulation of the GABA system by tobacco smoking during alcohol withdrawal. Then, we consider how these findings impact the clinical treatment of alcohol dependence and discuss directions for future experiments to address existing gaps in the literature, e.g., sex differences and smoking comorbidity. These and other considerations provide opportunities to build upon the current neurochemistry imaging literature of alcohol dependence and withdrawal, which may usher in improved therapeutic and relapse prevention strategies. PMID:26510169

  8. Opioid Receptor Antagonists in the Treatment of Alcoholism.

    PubMed

    Serecigni, Josep Guardia

    2015-09-29

    Objetivos: A partir de los recientes progresos en la farmacoterapia del alcoholismo, hemos efectuado una revisión sobre los fármacos antagonistas de los receptores opioides, que tienen aprobada la indicación para el tratamiento del alcoholismo, como son naltrexona y nalmefeno. Metodología: Hemos revisado más de 100 publicaciones sobre péptidos y receptores opioides, el efecto de los fármacos antagonistas de los receptores opioides sobre el consumo de alcohol, tanto en animales como en humanos, tanto en el laboratorio como para el tratamiento del alcoholismo. También se describen las características farmacológicas de naltrexona y de nalmefeno y su utilidad en la práctica clínica. Resultados: Múltiples evidencias han demostrado la eficacia de naltrexona y nalmefeno para reducir el consumo de alcohol, tanto en animales de laboratorio como también en personas estudiadas en situación de bar experimental, aunque debido al diferente perfil receptorial, nalmefeno ha sido relacionado con una mayor eficacia para la reducción del consumo de alcohol, en ratas que presentan dependencia del alcohol. Además, un gran número de ensayos clínicos controlados han demostrado la eficacia de naltrexona para la prevención de recaídas, en personas que presentan un trastorno por dependencia del alcohol. Ensayos clínicos controlados recientes han demostrado la eficacia de nalmefeno “a demanda” para reducir el consumo de alcohol, en personas que presentan un trastorno por dependencia del alcohol de baja gravedad. Conclusiones: Tanto naltrexona como nalmefeno han demostrado ser fármacos seguros, bien tolerados, de manejo sencillo, y eficaces para el tratamiento del trastorno por dependencia del alcohol, (actualmente llamado trastorno por consumo de alcohol). A partir de recientes ensayos clínicos controlados se ha comprobado que nalmefeno produce una reducción significativa del consumo de alcohol, lo cual supone un nuevo objetivo que amplía las posibilidades de

  9. Opioid antagonists for pharmacological treatment of alcohol dependence - a critical review.

    PubMed

    Soyka, Michael; Rösner, Susanne

    2008-11-01

    Alcohol dependence is a widespread psychiatric disorder. While relapse prevention therapy in alcoholism was exclusively dominated by social and psychological treatments for many years, in the last decades the benefits of pharmacological agents for the rehabilitation treatment in alcoholism have become increasingly evident. Naltrexone, an opiate receptor antagonist, blocks the pleasant and reinforcing effects of alcohol by preventing the stimulation of opioid receptors and the reduction of dopamine release in the ventral tegmental area (VTA). Clinical evidence about the effectiveness of the substance is not always consistent, but meta-analyses confirm naltrexone's effect on the risk of heavy drinking. Evidence about the abstinence-maintaining effects of the substance comes from a relatively small database and needs further investigation. The evaluation of differential effects of naltrexone depending on biological or psychological profiles, which could further enhance the effectiveness of treatments for alcohol dependence, remains a challenge. Nalmefene, another opioid antagonist, as well as naltrexone depot, a sustained release formulation of naltrexone, are further promising strategies for the treatment of alcohol dependence. The review at hand gives on overview of the current evidence on opioid antagonists for the treatment of alcohol dependence regarding the possible mechanism of action, the substances' safety profiles and their effectiveness. The corresponding evidence is critically reviewed taking into consideration the influence of the study design on the magnitude and consistency of effect sizes as well the impact of patient characteristics on the response to the treatment with opioid antagonists. Future studies on the role of different subtypes of alcoholics according to their genetic or psychological profile to explain or even predict the effects of opioid antagonists in the treatment of alcohol dependence are needed.

  10. [Using hepatomaks forte in the treatment of chronic alcoholic hepatitis].

    PubMed

    Linevskiĭ, Iu V; Linevskaia, K Iu; Voronin, K A

    2013-01-01

    Installed significantly more pronounced positive effect on clinical manifestations and laboratory indicators of liver in patients with chronic alcoholic hepatitis who received within 4 weeks of basal therapy in conjunction with Gepatomax Forte in comparison with a group of patients with chronic alcoholic hepatitis who received during the same time only basic therapy. Side adverse effects in the group of patients receiving Gepatomax Forte were not registered.

  11. REVIEW OF OUTCOME RESEARCH ON MARITAL AND FAMILY THERAPY IN TREATMENT OF ALCOHOLISM

    PubMed Central

    O’Farrell, Timothy J.

    2011-01-01

    This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates our earlier review (XXXXXXX). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better; and Community Reinforcement and Family Training (CRAFT) promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics; and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning. PMID:22283384

  12. New Treatment Strategies for Alcohol-Induced Heart Damage

    PubMed Central

    Fernández-Solà, Joaquim; Planavila Porta, Ana

    2016-01-01

    High-dose alcohol misuse induces multiple noxious cardiac effects, including myocyte hypertrophy and necrosis, interstitial fibrosis, decreased ventricular contraction and ventricle enlargement. These effects produce diastolic and systolic ventricular dysfunction leading to congestive heart failure, arrhythmias and an increased death rate. There are multiple, dose-dependent, synchronic and synergistic mechanisms of alcohol-induced cardiac damage. Ethanol alters membrane permeability and composition, interferes with receptors and intracellular transients, induces oxidative, metabolic and energy damage, decreases protein synthesis, excitation-contraction coupling and increases cell apoptosis. In addition, ethanol decreases myocyte protective and repair mechanisms and their regeneration. Although there are diverse different strategies to directly target alcohol-induced heart damage, they are partially effective, and can only be used as support medication in a multidisciplinary approach. Alcohol abstinence is the preferred goal, but control drinking is useful in alcohol-addicted subjects not able to abstain. Correction of nutrition, ionic and vitamin deficiencies and control of alcohol-related systemic organ damage are compulsory. Recently, several growth factors (myostatin, IGF-1, leptin, ghrelin, miRNA, and ROCK inhibitors) and new cardiomyokines such as FGF21 have been described to regulate cardiac plasticity and decrease cardiac damage, improving cardiac repair mechanisms, and they are promising agents in this field. New potential therapeutic targets aim to control oxidative damage, myocyte hypertrophy, interstitial fibrosis and persistent apoptosis In addition, stem-cell therapy may improve myocyte regeneration. However, these strategies are not yet approved for clinical use. PMID:27690014

  13. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder.

    PubMed

    Wang, Fang; Li, Ya; Zhang, Yu-Jie; Zhou, Yue; Li, Sha; Li, Hua-Bin

    2016-01-07

    Alcoholic beverages such as beer, wine and spirits are widely consumed around the world. However, alcohol and its metabolite acetaldehyde are toxic and harmful to human beings. Chronic alcohol use disorder or occasional binge drinking can cause a wide range of health problems, such as hangover, liver damage and cancer. Some natural products such as traditional herbs, fruits, and vegetables might be potential dietary supplements or medicinal products for the prevention and treatment of the problems caused by excessive alcohol consumption. The aim of this review is to provide an overview of effective natural products for the prevention and treatment of hangover and alcohol use disorder, and special emphasis is paid to the possible functional component(s) and related mechanism(s) of action.

  14. Does individual treatment for alcoholic fathers benefit their children? A longitudinal assessment.

    PubMed

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J; Fals-Stewart, William

    2006-02-01

    Psychosocial adjustment in children of alcoholics (COAs; N=125) was examined before and at 3 follow-ups in the 15 months after their fathers entered alcoholism treatment. Before their fathers' treatment, COAs exhibited greater overall and clinical-level symptomatology than children from the demographically matched comparison sample, but they improved significantly following their fathers' treatment. Children of stably remitted fathers were similar to their demographic counterparts from the comparison sample and had fewer adjustment problems than children of relapsed fathers, even after accounting for children's baseline adjustment. Thus, COAs' adjustment improved when their fathers received treatment for alcoholism, and fathers' recovery from alcoholism was associated with clinically significant reductions in child problems.

  15. Feasibility randomized controlled trial of cognitive and behavioral interventions for depression symptoms in patients accessing drug and alcohol treatment.

    PubMed

    Delgadillo, Jaime; Gore, Stuart; Ali, Shehzad; Ekers, David; Gilbody, Simon; Gilchrist, Gail; McMillan, Dean; Hughes, Elizabeth

    2015-08-01

    Depressed mood often co-exists with frequent drug and alcohol use. This trial examined the feasibility of screening, recruitment, randomization and engagement of drug and alcohol users in psychological interventions for depression symptoms. A total of 50 patients involved in community drugs and alcohol treatment (CDAT) were randomly allocated to behavioral activation delivered by psychological therapists (n = 23) or to cognitive behavioral therapy based self-help introduced by CDAT workers (n = 27). We examined recruitment and engagement rates, as well as changes in depression (PHQ-9) symptoms and changes in percent days abstinent (PDA within last month) at 24 weeks follow-up. The ratio of screened to recruited participants was 4 to 1, and the randomization schedule successfully generated 2 groups with comparable characteristics. Follow-up was possible with 78% of participants post-treatment. Overall engagement in psychological interventions was low; only 42% of randomized participants attended at least 1 therapy session. Patients offered therapy appointments co-located in CDAT clinics were more likely to engage with treatment (odds ratio = 7.14, p = .04) compared to those offered appointments in community psychological care clinics. Intention-to-treat analyses indicated no significant between-group differences at follow-up in mean PHQ-9 change scores (p = .59) or in PDA (p = .08). Overall, it was feasible to conduct a pragmatic trial within busy CDAT services, maximizing external validity of study results. Moderate and comparable improvements in depression symptoms over time were observed for participants in both treatment groups.

  16. Understanding Disparities in Service Seeking Following Forcible Versus Drug-or Alcohol-Facilitated/ Incapacitated Rape

    PubMed Central

    Walsh, Kate; Zinzow, Heidi M.; Badour, Christal L.; Ruggiero, Kenneth J.; Kilpatrick, Dean G.; Resnick, Heidi S.

    2015-01-01

    Victims of drug- or alcohol-facilitated/incapacitated rape (DAFR/IR) are substantially less likely to seek medical, rape crisis, or police services compared with victims of forcible rape (FR); however, reasons for these disparities are poorly understood. The current study examined explanatory mechanisms in the pathway from rape type (FR vs. DAFR/IR) to disparities in post-rape service seeking (medical, rape crisis, criminal justice). Participants were 445 adult women from a nationally representative household probability sample who had experienced FR, DAFR/IR, or both since age 14. Personal characteristics (age, race, income, prior rape history), rape characteristics (fear, injury, loss of consciousness), and post-rape acknowledgment, medical concerns, and service seeking were collected. An indirect effects model using bootstrapped standard errors was estimated to examine pathways from rape type to service seeking. DAFR/IR-only victims were less likely to seek services compared with FR victims despite similar post-rape medical concerns. FR victims were more likely to report fear during the rape and a prior rape history, and to acknowledge the incident as rape; each of these characteristics was positively associated with service seeking. However, only prior rape history and acknowledgment served as indirect paths to service seeking; acknowledgment was the strongest predictor of service seeking. Diminished acknowledgment of the incident as rape may be especially important to explaining why DAFR/IR victims are less likely than FR victims to seek services. Public service campaigns designed to increase awareness of rape definitions, particularly around DAFR/IR, are important to reducing disparities in rape-related service seeking. PMID:25846758

  17. Understanding Disparities in Service Seeking Following Forcible Versus Drug- or Alcohol-Facilitated/Incapacitated Rape.

    PubMed

    Walsh, Kate; Zinzow, Heidi M; Badour, Christal L; Ruggiero, Kenneth J; Kilpatrick, Dean G; Resnick, Heidi S

    2016-09-01

    Victims of drug- or alcohol-facilitated/incapacitated rape (DAFR/IR) are substantially less likely to seek medical, rape crisis, or police services compared with victims of forcible rape (FR); however, reasons for these disparities are poorly understood. The current study examined explanatory mechanisms in the pathway from rape type (FR vs. DAFR/IR) to disparities in post-rape service seeking (medical, rape crisis, criminal justice). Participants were 445 adult women from a nationally representative household probability sample who had experienced FR, DAFR/IR, or both since age 14. Personal characteristics (age, race, income, prior rape history), rape characteristics (fear, injury, loss of consciousness), and post-rape acknowledgment, medical concerns, and service seeking were collected. An indirect effects model using bootstrapped standard errors was estimated to examine pathways from rape type to service seeking. DAFR/IR-only victims were less likely to seek services compared with FR victims despite similar post-rape medical concerns. FR victims were more likely to report fear during the rape and a prior rape history, and to acknowledge the incident as rape; each of these characteristics was positively associated with service seeking. However, only prior rape history and acknowledgment served as indirect paths to service seeking; acknowledgment was the strongest predictor of service seeking. Diminished acknowledgment of the incident as rape may be especially important to explaining why DAFR/IR victims are less likely than FR victims to seek services. Public service campaigns designed to increase awareness of rape definitions, particularly around DAFR/IR, are important to reducing disparities in rape-related service seeking.

  18. Prazosin for Treatment of Patients with PTSD and Comorbid Alcohol Dependence

    DTIC Science & Technology

    2011-07-01

    08-2-0075 TITLE: Prazosin for Treatment of Patients With PTSD and Comorbid Alcohol Dependence PRINCIPAL INVESTIGATOR: Ismene...page. Subject terms on next page. 6 Prazosin for Treatment of Patients With PTSD and Comorbid Alcohol Dependence Ismene Petrakis Yale University New...PTSD. There is evidence of common neurobiological mechanisms that underlie both AD and PTSD. Prazosin is an alpha-! adrenergic •ceptor antagonist

  19. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  20. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  1. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  2. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  3. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  4. Patient satisfaction with treatment for alcohol use disorders: comparing patients with and without severe mental health symptoms

    PubMed Central

    McCallum, Stacey L; Andrews, Jane M; Gaughwin, Matthew D; Turnbull, Deborah A; Mikocka-Walus, Antonina A

    2016-01-01

    Background Previous studies suggest patients with co-occurring alcohol use disorders (AUDs) and severe mental health symptoms (SMHS) are less satisfied with standard AUD treatment when compared to patients with an AUD alone. This study compared patient satisfaction with standard AUD treatment among patients with and without SMHS and explored how standard treatment might be improved to better address the needs of these patients. Methods Eighty-nine patients receiving treatment for an AUD either at an inpatient hospital, outpatient clinic, inpatient detoxification, or residential/therapeutic community services were surveyed. Patient satisfaction with treatment was assessed using the Treatment Perception Questionnaire (range: 0–40). Patients were stratified according to their score on the Depression Anxiety Stress Scale. Forty patients scored in the extremely severe range of depression (score >14) and/or anxiety (score >10) (indicating SMHS) and 49 patients did not. An inductive content analysis was also conducted on qualitative data relating to areas of service improvement. Results Patients with SMHS were found to be equally satisfied with treatment (mean =25.10, standard deviation =8.12) as patients with an AUD alone (mean =25.43, standard deviation =6.91). Analysis revealed that being an inpatient in hospital was associated with reduced treatment satisfaction. Patients with SMHS were found to be significantly less satisfied with staffs’ understanding of the type of help they wanted in treatment, when compared to patients with AUDs alone. Five areas for service improvement were identified, including staff qualities, informed care, treatment access and continuity, issues relating to inpatient stay, and addressing patients’ mental health needs. Conclusion While findings suggest that AUD treatment services adequately meet the needs of patients with SMHS in treatment, patients with SMHS do feel that staff lack understanding of their treatment needs. Findings have

  5. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical...

  6. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical...

  7. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical...

  8. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical...

  9. 34 CFR 104.53 - Drug and alcohol addicts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical condition... 34 Education 1 2010-07-01 2010-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which...

  10. ALCOHOL USE DISORDERS IN THE ELDERLY: A BRIEF OVERVIEW FROM EPIDEMIOLOGY TO TREATMENT OPTIONS

    PubMed Central

    Caputo, Fabio; Vignoli, Teo; Leggio, Lorenzo; Addolorato, Giovanni; Zoli, Giorgio; Bernardi, Mauro

    2016-01-01

    Alcohol-use-disorders (AUDs) afflict 1–3% of elderly subjects. The CAGE, SMAST-G, and AUDIT are the most common and validated questionnaires used to identify AUDs in the elderly, and some laboratory markers of alcohol abuse (AST, GGT, MCV, and CDT) may also be helpful. In particular, the sensitivity of MCV or GGT in detecting alcohol misuse is higher in older than in younger populations. The incidence of medical and neurological complications during alcohol withdrawal syndrome in elderly alcoholics is higher than in younger alcoholics. Chronic alcohol abuse is associated with tissue damage to several organs. Namely, an increased level of blood pressure is more frequent in the elderly than in younger adults, and a greater vulnerability to the onset of alcoholic liver disease, and an increasing risk of breast cancer in menopausal women have been described. In addition, the prevalence of dementia in elderly alcoholics is almost 5 times higher than in non-alcoholic elderly individuals, approximately 25% of elderly patients with dementia also present AUDs, and almost 20% of individuals aged 65 and over with a diagnosis of depression have a co-occurring AUD. Moreover, prevention of drinking relapse in older alcoholics is, in some cases, better than in younger patients; indeed, more than 20% of treated elderly alcohol-dependent patients remain abstinent after four years. Considering that the incidence of AUDs in the elderly is fairly high, and AUDs in the elderly are still underestimated, more studies in the fields of epidemiology, prevention and pharmacological and psychotherapeutic treatment of AUDs in the elderly are warranted. PMID:22575256

  11. Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems.

    PubMed

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J

    2009-01-01

    We investigated longitudinal associations between alcohol-dependent fathers' 12-step treatment involvement and their children's internalizing and externalizing problems (N = 125, M(age) = 9.8 +/- 3.1), testing the hypotheses that fathers' greater treatment involvement would benefit later child behavior and that this effect would be mediated by fathers' posttreatment behaviors. The initial association was established between fathers' treatment involvement and children's externalizing problems only, whereas Structural Equation Modeling (SEM) results supported mediating hypotheses. Fathers' greater treatment involvement predicted children's lower externalizing problems 12 months later, and fathers' posttreatment behaviors mediated this association: Greater treatment involvement predicted greater posttreatment Alcoholics Anonymous attendance, which in turn predicted greater abstinence. Finally, fathers' abstinence was associated with lower externalizing problems in children. Theoretical and practical implications of these findings are discussed.

  12. Service engagement: psychopathology, recovery style and treatments.

    PubMed

    Vender, Simone; Poloni, Nicola; Aletti, Francesca; Bonalumi, Cristiano; Callegari, Camilla

    2014-01-01

    The aim of the present study is to evaluate how recovery style, a set of strategies used by patients to interact with services and therapists, and the severity of psychotic symptoms affect the quality/continuity of taking charge of each patient. 156 psychotic patients at different stages of illness were enrolled. Sociodemographic and clinical data were collected and integration/sealing-Over Scale, Recovery Style Questionnaire and Positive and Negative Syndrome Scale were administered. Patients were distinguished into four groups according to the type of treatment received: clinical package, hospital package, day-care package, and residential package. A positive correlation between the cost of psychiatric performance and psychopathological severity (measured with PANSS scores) was identified. No association emerged between ISOS/RSQ total scores and costs. The sanitary expenditure appears to be linked to positive psychotic symptoms while lower performances are given for the treatment of patients with predominant negative symptoms. Recovery style itself has not a direct influence on the quantity/quality of psychiatric services.

  13. Predicting the In-Hospital Responsiveness to Treatment of Alcoholics. Social Factors as Predictors of Outcome. Brain Damage as a Factor in Treatment Outcome of Chronic Alcoholic Patients.

    ERIC Educational Resources Information Center

    Mascia, George V.; And Others

    The authors attempt to locate predictor variables associated with the outcome of alcoholic treatment programs. Muscia's study focuses on the predictive potential of: (1) response to a GSR conditioning procedure; (2) several personality variables; and (3) age and IQ measures. Nine variables, reflecting diverse perspectives, were selected as a basis…

  14. Intervention for individuals with fetal alcohol spectrum disorders: treatment approaches and case management.

    PubMed

    Paley, Blair; O'Connor, Mary J

    2009-01-01

    Exposure to alcohol in utero is considered to be the leading cause of developmental disabilities of known etiology. The most severe consequence of such exposure, fetal alcohol syndrome (FAS), is characterized by a distinct constellation of characteristic facial anomalies, growth retardation, and central nervous system (CNS) dysfunction. Some individuals with prenatal alcohol exposure (PAE) do not meet the full criteria for FAS, but instead are diagnosed with partial FAS, alcohol related neurodevelopmental disorder (ARND), or alcohol related birth defects (ARBD). The entire continuum of effects from PAE is increasingly being referred to under the umbrella term of fetal alcohol spectrum disorders (FASDs). An extensive body of research has documented major cognitive, behavioral, adaptive, social, and emotional impairments among individuals with FASDs. Although FAS was identified in the U.S. over 35 years ago, the development, evaluation, and dissemination of evidence-based interventions for individuals with FASDs have lagged behind significantly. Encouragingly, however, in recent years there has been a marked increase in efforts to design and test interventions to remediate the impairments associated with prenatal alcohol exposure. This article will review treatment needs and considerations for individuals with FASDs and their families, current empirically tested treatment approaches, case management issues, and suggestions for future directions in research on the treatment of FASDs.

  15. Transcranial Magnetic Stimulation and Deep Brain Stimulation in the treatment of alcohol dependence

    PubMed Central

    Alba-Ferrara, L.; Fernandez, F.; Salas, R.; de Erausquin, G. A.

    2013-01-01

    Alcohol dependence is a major social, economic, and public health problem. Alcoholism can lead to damage of the gastrointestinal, nervous, cardiovascular, and respiratory systems and it can be lethal, costing hundreds of billions to the health care system. Despite the existence of cognitive-behavioral therapy, psychosocial interventions, and spiritually integrated treatment to treat it, alcohol dependence has a high relapse rate and poor prognosis, albeit with high interindividual variability. In this review, we discuss the use of two neuromodulation techniques, namely repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation (DBS), and their advantages and disadvantages compared to first-line pharmacological treatment for alcohol dependence. We also discuss rTMS and DBS targets for alcohol dependence treatment, considering experimental animal and human evidence, with careful consideration of methodological issues preventing the identification of feasible targets for neuromodulation treatments, as well as inter-individual variability factors influencing alcoholism prognosis. Lastly, we anticipate future research aiming to tailor the treatment to each individual patient by combining neurofunctional, neuroanatomical and neurodisruptive techniques optimizing the outcome. PMID:25598743

  16. A DOUBLE BLIND TRIAL OF GABAPENTIN VS. LORAZEPAM IN THE TREATMENT OF ALCOHOL WITHDRAWAL

    PubMed Central

    Myrick, Hugh; Malcolm, Robert; Randall, Patrick K.; Boyle, Elizabeth; Anton, Raymond F.; Becker, Howard C.; Randall, Carrie L.

    2009-01-01

    Introduction Some anticonvulsants ameliorate signs and symptoms of alcohol withdrawal, but have an unacceptable side effect burden. Among the advantages of using anticonvulsant agents in this capacity is their purported lack of interaction with alcohol that could increase psychomotor deficits, increase cognitive impairment, or increase intoxication. The aim of the current study was to evaluate alcohol use and symptom reduction of gabapentin as compared to lorazepam in the treatment of alcohol withdrawal in a double-blinded randomized clinical trial. Methods One hundred individuals seeking outpatient treatment of alcohol withdrawal with Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) ratings ≥10 were randomized to double-blind treatment with two doses of gabapentin (900 mg tapering to 600 mg or 1200 tapering to 800 mg) or lorazepam (6 mg tapering to 4 mg) for four days. Severity of alcohol withdrawal was measured by the CIWA-Ar on days 1-4 of treatment and on days 5, 7 and 12 post-treatment and alcohol use monitored by verbal report and breath alcohol levels Results CIWA-Ar scores decreased over time in all groups; high-dose gabapentin was statistically superior but clinically similar to lorazepam (p=0.009). During treatment, lorazepam-treated participants had higher probabilities of drinking on the first day of dose decrease (day 2) and the second day off medication (day 6) as compared to gabapentin-treated participants (p=.0002). Post-treatment, gabapentin-treated participants had less probability of drinking during the follow-up post-treatment period (probability=.2 for 900 mg and probability=.3 for 1200mg) compared to the lorazepam-treated participants (probability=.55). The gabapentin groups also had less craving, anxiety, and sedation compared to lorazepam. Conclusions Gabapentin was well tolerated and effectively diminished the symptoms of alcohol withdrawal in our population especially at the higher target dose (1200mg) used in this

  17. Double-blind clinical trial of sertraline treatment for alcohol dependence.

    PubMed

    Pettinati, H M; Volpicelli, J R; Luck, G; Kranzler, H R; Rukstalis, M R; Cnaan, A

    2001-04-01

    Clinical studies that have evaluated serotonergic medications to reduce alcohol consumption have yielded conflicting results. These studies primarily treated patients with alcohol dependence, excluding those with a current depressive disorder, in an effort to differentiate any medication effects directly on drinking from those on mood. Yet despite the exclusion of current depression, a group of alcohol-dependent patients who are not depressed can be highly heterogeneous. For example, this subgroup can include those with a lifetime depressive disorder. If these patients were more sensitive to serotonergic medications than patients without a lifetime depressive disorder, medication effects in a subgroup of patients who were not depressed could be obscured. Thus, the purpose of this study was to examine the efficacy of sertraline for treating alcohol dependence in patient groups that were differentiated by the presence or absence of lifetime depression. This study examined the effectiveness of sertraline (200 mg/day) or placebo for 14 weeks in 100 alcohol-dependent subjects with (N = 53) or without (N = 47) a lifetime diagnosis of comorbid depression. Sertraline treatment seemed to provide an advantage in reducing drinking in alcohol-dependent patients without lifetime depression, illustrated best with a measure of drinking frequency during treatment. However, sertraline was no better than placebo in patients with a diagnosis of lifetime comorbid depression, and current depression did not change the results. Treatment with selective serotonin reuptake inhibitors may be useful in alcohol-dependent patients who are not depressed. Subtyping those with alcohol dependence on the basis of the absence versus the presence of a lifetime depressive disorder may help to resolve conflicting findings in the literature on the treatment of alcohol dependence with serotonergic medications.

  18. Alcoholic pancreatitis: New insights into the pathogenesis and treatment

    PubMed Central

    Clemens, Dahn L; Schneider, Katrina J; Arkfeld, Christopher K; Grode, Jaclyn R; Wells, Mark A; Singh, Shailender

    2016-01-01

    Acute pancreatitis is a necro-inflammatory disease of the exocrine pancreas that is characterized by inappropriate activation of zymogens, infiltration of the pancreas by inflammatory cells, and destruction of the pancreatic exocrine cells. Acute pancreatitis can progress to a severe life-threatening disease. Currently there is no pharmacotherapy to prevent or treat acute pancreatitis. One of the more common factors associated with acute pancreatitis is alcohol abuse. Although commonly associated with pancreatitis alcohol alone is unable to cause pancreatitis. Instead, it appears that alcohol and its metabolic by-products predispose the pancreas to damage from agents that normally do not cause pancreatitis, or to more severe disease from agents that normally cause mild pancreatic damage. Over the last 10 to 20 years, a tremendous amount of work has defined a number of alcohol-mediated biochemical changes in pancreatic cells. Among these changes are: Sustained levels of intracellular calcium, activation of the mitochondrial permeability transition pore, endoplasmic reticulum stress, impairment in autophagy, alteration in the activity of transcriptional activators, and colocalization of lysosomal and pancreatic digestive enzymes. Elucidation of these changes has led to a deeper understanding of the mechanisms by which ethanol predisposes acinar cells to damage. This greater understanding has revealed a number of promising targets for therapeutic intervention. It is hoped that further investigation of these targets will lead to the development of pharmacotherapy that is effective in treating and preventing the progression of acute pancreatitis. PMID:26909228

  19. Alcohol

    MedlinePlus

    ... Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ... us get closer to curing diabetes and better treatments for those living with diabetes. Other Ways to ...

  20. Can I have a beer, please? A study of alcohol service to young adults on licensed premises in Stockholm.

    PubMed

    Wallin, Eva; Andreásson, Sven

    2004-12-01

    This study evaluated the effects of a community alcohol prevention program on the frequency of alcohol service to young adults at licensed premises in Stockholm, Sweden. We used a pretest (1996)-posttests (1998 and 2001) design with intervention and control areas. The multicomponent intervention combines training of serving staff in responsible beverage service, policy initiatives, and enforcement of existing alcohol regulations. Adolescents 18 years old (the legal drinking age on licensed premises in Sweden), but younger looking according to an expert panel, visited licensed premises in pairs, where each adolescent ordered a beer. At baseline in 1996, the adolescents made 600 attempts to order. At follow-up in 1998, the number of attempts to order was 252, and at the second follow-up in 2001, the adolescents made 238 attempts. We found no statistically significant differences between the intervention and control areas. Overall, the frequency of alcohol service to adolescents on licensed premises in these areas of Stockholm decreased significantly over time, from 45 to 41 and to 32%, in 1996, 1998, and 2001, respectively. The decrease in alcohol service in 2001 was statistically significant compared to the baseline in 1996. One explanation for this improvement could be more effective enforcement of existing alcohol laws in both the intervention and control areas. We also found that licensed premises that used doormen to screen potential customers were less likely to sell to minors.

  1. The influence of physical activity on alcohol consumption among heavy drinkers participating in an alcohol treatment intervention.

    PubMed

    Kendzor, Darla E; Dubbert, Patricia M; Olivier, Jake; Businelle, Michael S; Grothe, Karen B

    2008-10-01

    Researchers have hypothesized that physical activity may be beneficial for individuals attempting to reduce their alcohol consumption, although few studies have actually tested this relationship. The purpose of the present study was to describe the physical activity of 620 male veterans enrolled in a treatment intervention study for heavy drinkers, and to determine whether greater involvement in physical activity was associated with greater reductions in alcohol consumption. Participants endorsed moderate physical activity at the baseline visit (median=1.65 kcal/kg/day expended from physical activity), although physical activity declined during over time, p=.011. The most frequently endorsed activities included walking, gardening/yardwork, calisthenics, biking, swimming, weight lifting, golfing, and dancing. Regression analyses revealed no significant relationships between energy expenditure from physical activity and reductions in alcohol consumption at the six- and 12-month visits. Findings suggest that engaging in physical activity does not enhance treatment outcomes within interventions that do not specifically aim to increase physical activity. However, commonly endorsed activities may be easily incorporated into interventions in which physical activity is a desired component.

  2. An Update on Fetal Alcohol Syndrome-Pathogenesis, Risks, and Treatment.

    PubMed

    Gupta, Keshav K; Gupta, Vinay K; Shirasaka, Tomohiro

    2016-08-01

    Alcohol is a well-established teratogen that can cause variable physical and behavioral effects on the fetus. The most severe condition in this spectrum of diseases is known as fetal alcohol syndrome (FAS). The differences in maternal and fetal enzymes, in terms of abundance and efficiency, in addition to reduced elimination, allow for alcohol to have a prolonged effect on the fetus. This can act as a teratogen through numerous methods including reactive oxygen species (generated as by products of CYP2E1), decreased endogenous antioxidant levels, mitochondrial damage, lipid peroxidation, disrupted neuronal cell-cell adhesion, placental vasoconstriction, and inhibition of cofactors required for fetal growth and development. More recently, alcohol has also been shown to have epigenetic effects. Increased fetal exposure to alcohol and sustained alcohol intake during any trimester of pregnancy is associated with an increased risk of FAS. Other risk factors include genetic influences, maternal characteristics, for example, lower socioeconomic statuses and smoking, and paternal chronic alcohol use. The treatment options for FAS have recently started to be explored although none are currently approved clinically. These include prenatal antioxidant administration food supplements, folic acid, choline, neuroactive peptides, and neurotrophic growth factors. Tackling the wider impacts of FAS, such as comorbidities, and the family system have been shown to improve the quality of life of FAS patients. This review aimed to focus on the pathogenesis, especially mechanisms of alcohol teratogenicity, and risks of developing FAS. Recent developments in potential management strategies, including prenatal interventions, are discussed.

  3. Anterior Cingulate Glutamate Is Reduced by Acamprosate Treatment in Patients With Alcohol Dependence.

    PubMed

    Frye, Mark A; Hinton, David J; Karpyak, Victor M; Biernacka, Joanna M; Gunderson, Lee J; Feeder, Scott E; Choi, Doo-Sup; Port, John D

    2016-12-01

    Although the precise drug mechanism of action of acamprosate remains unclear, its antidipsotropic effect is mediated in part through glutamatergic neurotransmission. We evaluated the effect of 4 weeks of acamprosate treatment in a cohort of 13 subjects with alcohol dependence (confirmed by a structured interview, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) on proton magnetic resonance spectroscopy glutamate levels in the midline anterior cingulate cortex (MACC). We compared levels of metabolites with a group of 16 healthy controls. The Pennsylvania Alcohol Craving Scale was used to assess craving intensity. At baseline, before treatment, the mean cerebrospinal fluid-corrected MACC glutamate (Glu) level was significantly elevated in subjects with alcohol dependence compared with controls (P = 0.004). Four weeks of acamprosate treatment reduced glutamate levels (P = 0.025), an effect that was not observed in subjects who did not take acamprosate. At baseline, there was a significant positive correlation between cravings, measured by the Pennsylvania Alcohol Craving Scale, and MACC (Glu) levels (P = 0.019). Overall, these data would suggest a normalizing effect of acamprosate on a hyperglutamatergic state observed in recently withdrawn patients with alcohol dependence and a positive association between MACC glutamate levels and craving intensity in early abstinence. Further research is needed to evaluate the use of these findings for clinical practice, including monitoring of craving intensity and individualized selection of treatment with antidipsotropic medications in subjects with alcohol dependence.

  4. PERCEIVED BARRIERS TO TREATMENT FOR ALCOHOL PROBLEMS: A LATENT CLASS ANALYSIS

    PubMed Central

    Schuler, Megan S.; Puttaiah, Savitha; Mojtabai, Ramin; Crum, Rosa M.

    2015-01-01

    Objective Low rates of alcohol treatment seeking has been shown to be associated with perceived barriers to treatment, yet heterogeneity in patterns of perceived barriers have not been explored. We used data from a population-based sample of adults with alcohol abuse and dependence to: describe latent classes of perceived barriers to seeking alcohol treatment and identify characteristics associated with class membership. Methods Data are from the National Epidemiologic Survey on Alcohol and Related Conditions (2001-02). Analyses were restricted to treatment-naive adults with alcohol abuse or dependence with a perceived treatment need (N=1,053). Latent class analysis was performed to identify subgroups with respect to barriers to treatment; latent class regression was performed to identify variables associated with each subgroup. Results Two subgroups emerged: the low barriers class (87%), characterized primarily by attitudinal barriers, and the high barriers class (13%), characterized by significant attitudinal, financial, stigma and readiness for change barriers. In both classes, the most frequently endorsed barrier was the attitudinal belief that they should be “strong enough” to handle it on their own. Univariate analyses showed strong associations between membership in the high barriers class and comorbid psychiatric disorders, alcohol dependence (relative to abuse), and family history of alcohol problems; multivariate analyses found significant associations with lifetime anxiety disorder and education level. Conclusions Findings show that attitudinal barriers are most prevalent, and highlight the existence of a notable subgroup with multiple barriers, including financial and stigma-related barriers, who may require additional resources and support in order to enter treatment. PMID:26234326

  5. Medications acting on the dopaminergic system in the treatment of alcoholic patients.

    PubMed

    Swift, Robert

    2010-01-01

    An extensive literature supports the role of dopamine in the development and maintenance of alcohol dependence. Yet the organization of brain dopamine is complex, with multiple dopamine receptor subtypes and distinct effects on reinforcement, craving, motivation and behavior. Several modestly effective pharmacological treatments for alcoholism, including naltrexone, baclofen and ondansetron, affect dopaminergic systems indirectly. Direct dopamine antagonists, including tiapride, quetiapine, ondansetron and clozapine have been shown to be somewhat effective in reducing alcohol consumption in controlled clinical trials. The partial dopamine agonist, aripiprazole has shown mixed efficacy. Dopaminergic medications can have significant side effects. A better understanding of how dopamine affects the various aspects of addictive behavior may lead to more effective medications.

  6. Public spending for illegal drug and alcohol treatment in hospitals: an EU cross-country comparison

    PubMed Central

    2014-01-01

    Background In view of the current economic crisis and the resulting austerity measures being implemented by governments across Europe, public expenditure for substance abuse treatment has increasingly become a subject of discussion. An EU cross-country comparison would allow an estimation of the total amount of public resources spent on substance abuse treatment, compare various substance abuse treatment funding options, and evaluate the division of expenditures between alcohol and illegal drugs. The purpose of this study is to estimate the public spending of EU countries for alcohol and illegal drug abuse treatment in hospitals. Methods Our study uses a uniform methodology in order to enable valid cross-national comparisons. Our data are drawn from the Eurostat database, which provides anno 2010 data on government spending for the treatment of illegal drug and alcohol abuse in 21 EU member states. The cross-country comparison is restricted to hospitals, since data were unavailable for other types of treatment providers. The systematic registration of in- and outpatient data is essential to monitoring public expenditures on substance abuse treatment using international databases. Results Total public spending for hospital-based treatment of illegal drug and alcohol abuse in the 21 EU member states studied is estimated to be 7.6 billion euros. Per capita expenditures for treatment of illegal drug abuse vary, ranging from 0.1 euros in Romania to 13 euros in Sweden. For alcohol abuse, that figure varied from 0.9 euros in Bulgaria to 24 euros in Austria. These results confirm other studies indicating that public expenditures for alcohol treatment exceed that for illegal drug treatment. Conclusions Multiple factors may influence the number of hospital days for alcohol or illegal substance abuse treatment, and expenditures fluctuate accordingly. In this respect, we found a strong correlation between gross domestic product (GDP) per capita and public expenditures per

  7. Treatment-refractory substance use disorder: Focus on alcohol, opioids, and cocaine.

    PubMed

    Soyka, Michael; Mutschler, Jochen

    2016-10-03

    Substance use disorders are common, but only a small minority of patients receive adequate treatment. Although psychosocial therapies are effective, relapse is common. This review focusses on novel pharmacological and other treatments for patients with alcohol, opioid, or cocaine use disorders who do not respond to conventional treatments. Disulfiram, acamprosate, and the opioid antagonist naltrexone have been approved for the treatment of alcoholism. A novel, "as needed" approach is the use of the mu-opioid antagonist and partial kappa agonist nalmefene to reduce alcohol consumption. Other novel pharmacological approaches include the GABA-B receptor agonist baclofen, anticonvulsants such as topiramate and gabapentin, the partial nicotine receptor agonist varenicline, and other drugs. For opioid dependence, opioid agonist therapy with methadone or buprenorphine is the first-line treatment option. Other options include oral or depot naltrexone, morphine sulfate, depot or implant formulations, and heroin (diacetylmorphine) in treatment-refractory patients. To date, no pharmacological treatment has been approved for cocaine addiction; however, 3 potential pharmacological treatments are being studied, disulfiram, methylphenidate, and modafinil. Pharmacogenetic approaches may help to optimize treatment response in otherwise treatment-refractory patients and to identify which patients are more likely to respond to treatment, and neuromodulation techniques such as repeated transcranial magnetic stimulation and deep brain stimulation also may play a role in the treatment of substance use disorders. Although no magic bullet is in sight for treatment-refractory patients, some novel medications and brain stimulation techniques have the potential to enrich treatment options at least for some patients.

  8. A randomized, open-label, controlled trial of gabapentin and phenobarbital in the treatment of alcohol withdrawal.

    PubMed

    Mariani, John J; Rosenthal, Richard N; Tross, Susan; Singh, Prameet; Anand, Om P

    2006-01-01

    Gabapentin was compared with phenobarbital for the treatment of alcohol withdrawal in a randomized, open-label, controlled trial in 27 inpatients. There were no significant differences in the proportion of treatment completers between treatment groups or the proportion of patients in each group requiring rescue medication for breakthrough signs and symptoms of alcohol withdrawal. There were no significant treatment differences in withdrawal symptoms or psychological distress, nor were there serious adverse events. These findings suggest that gabapentin may be as effective as phenobarbital in the treatment of alcohol withdrawal. Given gabapentin's favorable pharmacokinetic profile, further study of its effectiveness in treating alcohol withdrawal is warranted.

  9. Treatment Outcome in Male Gambling Disorder Patients Associated with Alcohol Use

    PubMed Central

    Jiménez-Murcia, Susana; Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando; Granero, Roser; Hakänsson, Anders; Tárrega, Salomé; Valdepérez, Ana; Aymamí, Neus; Gómez-Peña, Mónica; Moragas, Laura; Baño, Marta; Sauvaget, Anne; Romeu, Maria; Steward, Trevor; Menchón, José M.

    2016-01-01

    Aims: The primary objective of this study was to analyze the association between alcohol consumption and short-term response to treatment (post intervention) in male patients with gambling disorder enrolled in a group cognitive behavioral therapy (CBT) program. Methods: The sample consisted of 111 male individuals with a diagnosis of Gambling Disorder, with a mean age of 45 years (SD = 12.2). All participants were evaluated by a comprehensive assessment battery and assigned to CBT groups of 10–14 patients attending 16 weekly outpatient sessions lasting 90 min each. Results: The highest mean pre- and post-therapy differences were recorded for the alcohol risk/dependence group on the obsessive/compulsive and anxiety dimensions of the SCL-90-R. As regards the presence of relapses and dropouts over the course of the CBT sessions, the results show a significant association with moderate effect size: patients with risk consumption or alcohol dependence were more likely to present poor treatment outcomes. Conclusions: Alcohol abuse was frequent in GD, especially in patients with low family income and high accumulated debts. High levels of somatization and high overall psychopathology (measured by the SCL-90-R) were associated with increased risk of alcohol abuse. Alcohol abuse was also associated with poor response to treatment. PMID:27065113

  10. The efficacy and safety of statins for the treatment of non-alcoholic fatty liver disease.

    PubMed

    Pastori, Daniele; Polimeni, Licia; Baratta, Francesco; Pani, Arianna; Del Ben, Maria; Angelico, Francesco

    2015-01-01

    Non-alcoholic fatty liver disease is an emerging liver disease in Western countries and the most frequent cause of incidental elevation of serum liver enzymes. Dyslipidaemia is frequently observed in patients with non-alcoholic fatty liver disease, and treatment of dyslipidaemia plays a critical role in the overall management of these patients. Moreover, coronary artery disease remains the most common cause of death. Statins are effective lipid-lowering agents, associated with a lowering the risk of cardiovascular events in several interventional randomized clinical trials. However, statins are often underused in patients with non-alcoholic fatty liver disease and many physicians are concerned about the prescription of statins to patients with unexplained persistent elevation of liver enzymes or active liver disease. Based on currently available data, statin therapy, at low-to-moderate doses, seems to be safe and has low liver toxicity. Treatment of dyslipidaemia in patients with non-alcoholic fatty liver disease is recommended and may also improve liver function tests. In these patients, the risks of not taking statins could outweigh the risks of taking the drug. Conversely, the usefulness of statins for the treatment of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis is still a matter of debate and randomized clinical trials of adequate size and duration are required.

  11. [Study of a sample of alcoholic patients two years post-treatment].

    PubMed

    Avila Escribano, J J; Pérez Madruga, A; Rodríguez Treceño, M

    1994-01-01

    This survey analyzes the evolution of one sample of alcoholic patients two years after finishing treatment. Its target is to determine the percentage of patients that remain abstinent, their rate of retention, and what factors can have an influence on abstinence. In 1990, 72 alcoholic patients were treated in the Alcoholism Unit, who make up our study sample. The average age was 37.9 +/- 11.47 years old; 77.8% were diagnosed as being Alcohol-dependents and 22.2% as Alcohol-abusers; 19.4% dropped out the treatment early. In 1992 our sample of study was 53 patients (2 died and 17 refused to participate), of whom 77.7% were abstinent and 28.3% continued ingesting alcohol; the average abstinence was 22.92 +/- 8.73 months. An important finding of this study was that the diagnosis, sex, and treatment with aversives had not an influence on abstinence; however the percentage of abstinent patients in those who had attended Therapeutic Discussion Groups was significantly higher than in those who had not.

  12. Alcoholism and its treatment approach from a citizen perspective.

    PubMed

    Gual, Antoni; Arbesú, José Ángel; Zarco, José; López Pelayo, Hugo; Miquel, Laia; Bobes, Julio

    2016-06-14

    Introducción: El objetivo del estudio es describir el consumo de alcohol de la población general española, conocer la opinión que tienen los ciudadanos de su consumo, del alcoholismo y de su abordaje terapéutico.Métodos: Estudio descriptivo transversal mediante encuesta telefónica  que se realizó en mayo de 2015. Se seleccionó una muestra representativa de la población adulta española a quien se le preguntó acerca de su patrón de consumo de alcohol, percepción de riesgo, opinión acerca del alcoholismo,  y consecuencias del consumo, y abordaje terapéutico. Se diseñó un cuestionario ad hoc utilizando el AUDIT-C para determinar el patrón de consumo. Se realizó un análisis descriptivo e inferencial según las características socio-demográficas.Resultados:  El 22,1% presentan un consumo de riesgo, siendo mayor en los hombres y los jóvenes. Mayoritariamente el alcoholismo es considerado una enfermedad y más del 75% de los ciudadanos coinciden que el alcohol tiene consecuencias negativas en la salud  a nivel sociolaboral y familiar. La percepción de riesgo que tienen los ciudadanos de su consumo es mayor de lo esperado (37,6%). El 67,7% considera  al médico de familia capacitado para atender los problemas relacionados con el consumo de alcohol, sobre todo entre las mujeres y los ciudadanos de mayor edad.Conclusiones: El consumo de riesgo es muy prevalente entre los ciudadanos españoles sobre todo entre los  jóvenes (31,8%). Existe una alta autopercepción de riesgo del consumo de alcohol. La mayoría de ciudadanos coinciden que el médico de familia está capacitado para tratar el alcoholismo.

  13. Gait and Balance in Treatment-Naive Active Alcoholics with and without a Lifetime Drug Codependence

    PubMed Central

    Fein, George; Smith, Stan; Greenstein, David

    2012-01-01

    Background Disturbed gait and balance are among the most consistent sequelae of chronic alcoholism. However, although a majority of alcoholics have never sought treatment, most investigations showing ataxia in alcohol dependent individuals have relied on samples drawn from treated populations. In addition, few studies have addressed the associations of codependence on other drugs with alcoholic gait and balance disturbance. Methods The present study employed the Walk-a-line Ataxia Battery (Fregly et al. 1972) to assess gait and balance in treatment-naive, actively drinking alcohol dependent men and women (TNA; n = 69) who were dependent on alcohol only (ALC; n = 43), or who also had a lifetime drug dependence (ALC+DRG; n = 26; i.e., methamphetamine, cocaine, opiates, and/or marijuana), compared with non-substance abusing controls (NSAC; n = 74). We also examined associations between lifetime alcohol use and age with gait and balance measures. Results Our main findings were 1) no evidence of disturbed gait and balance in ALC vs. NSAC and 2) significantly disturbed gait and balance in ALC+DRG, relative to both NSAC and ALC, along with steeper age-associated decline in gait and balance performance in ALC vs. ALC+DRG. Conclusions Our results provide evidence consistent with previous studies that TNA (without a lifetime drug codependence) may represent a population that is different and less impaired (including in gait and balance) than treated alcoholics. Additionally, we provide evidence that ALC+DRG, with greater alcohol use and family drinking density than ALC, have an accelerated effect of age on gait and balance disturbance compared to both NSAC and ALC. The ALC+DRG group likely represents a subset of TNA with different characteristics than ALC. PMID:22390787

  14. Treatment Components and Their Relationships with Drug and Alcohol Abstinence.

    ERIC Educational Resources Information Center

    Orwin, Rob; Ellis, Bruce

    This study evaluates the effect of treatment components through a secondary analysis of data from the National Treatment Improvement Evaluation Study (NTIES). The study examines the relationship between treatment components, client-level factors, and treatment outcomes, and how these relationships vary by treatment modality. It seeks to understand…

  15. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 416.936... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material...

  16. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 404.1536... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to... alcoholism is a contributing factor material to the determination of disability (as described in §...

  17. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 416.936... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material...

  18. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 416.936... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material...

  19. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 416.936... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material...

  20. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 416.936... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material...

  1. Alcohol and Drug Treatment: How It Works, and How It Can Help You

    MedlinePlus

    Alcohol and Drug Treatment How It Works, And How It Can Help You With the Criminal Justice System With the Rest of Your Life U.S. DEPARTMENT OF ... worse sentence. Treatment is more than doing time. It is hard work, but it offers you much ...

  2. Factors Affecting Entry into Substance Abuse Treatment: Gender Differences among Alcohol-Dependent Alaska Natives.

    ERIC Educational Resources Information Center

    Parks, Cheryl A.; Hesselbrock, Michie N.; Hesselbrock, Victor M.; Segal, Bernard

    2003-01-01

    Investigates alcohol treatment among Alaska Natives. Time between age at diagnosis and first treatment was similar for men and women. Women were more likely to be parents and reported more contact with health and mental health providers. Among men, acting as a parent, lifetime depression, and type of professional consulted were significantly…

  3. Alcohol Treatment and Cognitive-Behavioral Therapy: Enhancing Effectiveness by Incorporating Spirituality and Religion

    ERIC Educational Resources Information Center

    Hodge, David R.

    2011-01-01

    Cognitive-behavioral therapy (CBT) is an effective modality for the treatment of alcoholism. Given widespread interest in incorporating spirituality into professional treatment, this article orients practitioners to spiritually modified CBT, an approach that may enhance outcomes with some spiritually motivated clients. More specifically, by…

  4. Medicaid-Covered Alcohol and Drug Treatment Use among People with Intellectual Disabilities: Evidence of Disparities

    ERIC Educational Resources Information Center

    Slayter, Elspeth

    2010-01-01

    For some, community inclusion facilitates access to alcohol and drugs and, therefore, the potential for developing substance abuse disorders. However, little is known about substance abuse treatment use among people with intellectual disabilities. Using standardized performance measures, substance abuse treatment utilization was examined for…

  5. Motivating Treatment Seeking and Behavior Change by Untreated Military Personnel Abusing Alcohol or Drugs

    DTIC Science & Technology

    2010-09-01

    intervention , motivational enhancement therapy 16. SECURITY CLASSIFICATION OF: U 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF...military personnel who are not currently in substance abuse treatment . The intervention is designed to prompt: (a) a willingness to participate voluntarily...Motivating Treatment Seeking and Behavior Change by Untreated Military Personnel Abusing Alcohol or Drugs PRINCIPAL INVESTIGATOR: Denise

  6. Successful treatment of polydipsia, water intoxication, and delusional jealousy in an alcohol dependent patient with clozapine.

    PubMed

    Margetić, Branimir; Aukst-Margetić, Branka; Zarković-Palijan, Tija

    2006-09-30

    The beneficial effect of clozapine on polydipsia and water intoxication in patients with schizophrenia has been demonstrated many times. The authors report a successful clozapine treatment of polydipsia, intermittent water intoxication, and delusional jealousy of an alcoholic. This is a rare case of clozapine treatment of a non-schizophrenic patient affected by polydipsia.

  7. Active Ingredients of Treatment and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later

    PubMed Central

    Magill, M.; Kiluk, B.D.; McCrady, B.; Tonigan, J.S.; Longabaugh, R.

    2015-01-01

    Background The current review revisits the article entitled: Active Ingredients of Behavioral Treatments for Alcohol Use Disorders (AUDs) published in Alcoholism: Clinical and Experimental Research. This work summarized proceedings from a 2004 Symposium of the same name that was held at the Annual Meeting of the Research Society on Alcoholism (RSA). A decade has passed, which provides occasion for an evaluation of progress. In 2014, an RSA symposium titled Active Treatment Ingredients and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later did just that. Overview The current review revisits state-of-the-art research on the three treatments examined 10 years ago: Cognitive Behavioral Therapy (CBT), Alcohol Behavior Couples Therapy (ABCT), and Twelve Step Facilitation (TSF). Because of its empirically-validated effectiveness and robust research agenda on the study of process-outcome, Motivational Interviewing (MI) has been selected as the fourth treatment modality to be discussed. For each of these four treatments, the reviewers provide a critical assessment of current theory and research with a special emphasis on key recommendations for the future. Conclusions Noteworthy progress has been made in identifying AITs and MOBCs in these four behavioral interventions for alcohol and other drug use disorders. Not only have we established some of the mechanisms through which these evidence-based treatments work, but we have also uncovered some of the limitations in our existing frameworks and methods. Further progress in this area will require a broader view with respect to conceptual frameworks, analytic methods, and measurement instrumentation. PMID:26344200

  8. Examining intensity and types of interagency collaboration between child welfare and drug and alcohol service providers.

    PubMed

    He, Amy S

    2015-08-01

    The co-occurrence of child maltreatment and caregiver substance use disorders (SUDs) is a pervasive problem, with an estimated two thirds of child welfare (CW) systems cases involving SUDs. Interagency collaboration between CW and drug and alcohol service (DAS) providers shows promise in improving connections to and delivery of SUD services for CW-involved families. However, interagency collaboration between CW and DAS providers continues to be difficult to achieve and little is known about organizational characteristics and contexts that influence collaboration between these two entities. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, this study examined national trends in interagency collaboration between CW and DAS providers and organizational factors that influence the nature and intensity of interagency collaboration. Results indicated that collaboration intensity was greater for CW agencies that reported increased caseloads and those located in more populated counties. However, collaboration intensity decreased for CW agencies located in counties with higher child poverty. Study findings have implications for policy leaders and directors of CW agencies throughout the United States, especially because collaborating with DAS providers may increase CW agencies' organizational capacity and relieve job stress related to high caseloads. Development of strategies that spur engagement in more intense and multiple types of collaboration between CW agencies and DAS providers has the potential to relieve service burden on CW staffs and expedite service delivery to CW-involved families dealing with SUDs.

  9. UPDATE ON NEUROPHARMACOLOGICAL TREATMENTS FOR ALCOHOLISM: SCIENTIFIC BASIS AND CLINICAL FINDINGS

    PubMed Central

    JOHNSON, BANKOLE A.

    2008-01-01

    The past decade has seen an expansion of research and knowledge on pharmacotherapy for the treatment of alcohol dependence. The Food and Drug Administration (FDA)–approved medications naltrexone and acamprosate have shown mixed results in clinical trials. Oral naltrexone and naltrexone depot formulations have generally demonstrated efficacy at treating alcohol dependence, but their treatment effect size is small, and more research is needed to compare the effects of different doses on drinking outcome. Acamprosate has demonstrated efficacy for treating alcohol dependence in European trials, but with a small effect size. In U.S. trials, acamprosate has not proved to be efficacious. Research continues to explore which types of alcohol-dependent individual would benefit the most from treatment with naltrexone or acamprosate. The combination of the two medications demonstrated efficacy for treating alcohol dependence in one European study but not in a multi-site U.S. study. Another FDA-approved medication, disulfiram, is an aversive agent that does not diminish craving for alcohol. Disulfiram is most effective when given to those who are highly compliant or who are receiving their medication under supervision. Of the non-approved medications, topiramate is among the most promising, with a medium effect size in clinical trials. Another promising medication, baclofen, has shown efficacy in small trials. Serotonergic agents such as selective serotonin reuptake inhibitors and the serotonin-3 receptor antagonist, ondansetron, appear to be efficacious only among certain genetic subtypes of alcoholic. As neuroscientific research progresses, other promising medications, as well as medication combinations, for treating alcohol dependence continue to be explored. PMID:17880925

  10. Age of onset as a discriminator between alcoholic subtypes in a treatment-seeking outpatient population.

    PubMed

    Johnson, B A; Cloninger, C R; Roache, J D; Bordnick, P S; Ruiz, P

    2000-01-01

    Subtyping alcoholics may provide a more accurate guide as to the course and character of the disease. Classifications of different ages of onset of problem drinking have so far resulted in categorical inconsistencies. In the past, hospital-based alcoholics have over-represented those most severely ill, and comprehensive evaluations of psychopathology for discriminating between alcoholic subtypes have been infrequent. In a heterogeneous treatment-seeking, outpatient, alcoholic population, we tested the hypothesis that age of onset represents a continuum of disease, and that greater severity of psychopathology is associated with lower ages of onset. Using a standard questionnaire, 253 male and female treatment-seeking alcoholics were stratified according to specific ages of onset: a) < 20 years; b) 20-25 years, and c) > 25 years. These age of onset groups were compared on alcohol severity and craving, family history, childhood behavior, personality, hostility, overt aggression, mood, and social functioning. Symptom severity and age of onset were negatively correlated, and the 20-25-year onset group usually had intermediate scores. The < 20 year onset group was characterized by greater severity of alcohol-related problems, family history, childhood behavioral problems, craving, hostility, antisocial traits, mood disturbance, and poor social functioning. Alcoholics with an earlier age of onset have relatively greater psychopathology than those of later onset. While the preponderance of psychopathology among those in the < 20-year onset group could be conceptualized as a clinical "subtype," such a characterization would not define an entirely homogeneous category. Yet, this clinical characterization would be clinically important if specific age of onset levels were found to be differentially sensitive to pharmacological and/or psychological treatments.

  11. Posttraumatic stress disorder and use of psychiatric and alcohol related services: the effect of the 2004-2005 Florida hurricane seasons on veterans.

    PubMed

    Frahm, Kathryn A; Barnett, Scott D; Brown, Lisa M; Hickling, Edward J; Olney, Ron; Campbell, Robert R; Lapcevic, William A

    2013-12-01

    The purpose of this study was to document preliminary findings of the association between posttraumatic stress disorder (PTSD), mental health service use, and alcohol related health visits among veterans following 2004-2005 Florida hurricane seasons. A retrospective review of the Veterans Health Administration Medical SAS Outpatient Dataset was conducted to identify veterans residing in Florida during the 2004-2005 hurricane seasons with a history of PTSD and/or PTSD and a substance use disorder. It was found that veterans with PTSD residing in counties affected by hurricanes demonstrated an immediate 28 % increase in use of mental health services following hurricane landfall versus veterans residing in non-hurricane affected counties (+28.0 vs. -6.5 %, p = 0.001). Additionally, veterans residing in affected counties were found to use more group psychotherapy treatment sessions overall (30.3 vs. 27.2 %, p = 0.001). Of note, veterans with PTSD experienced a -0.16 per month (p = 0.114) decrease in alcohol related visits following the 2004 hurricane season. These findings provide insight into the mental health needs of veterans with PTSD following a disaster and can inform delivery of services to veterans with PTSD and alcohol related issues in disaster prone areas.

  12. Substance abuse treatment services for pregnant women: psychosocial and behavioral approaches.

    PubMed

    Haug, Nancy A; Duffy, Megan; McCaul, Mary E

    2014-06-01

    Women who use tobacco, alcohol and drugs during pregnancy are at increased risk of maternal and fetal morbidity. Universal screening using empirically validated approaches can improve identification of substance-using pregnant women and facilitate comprehensive assessment of treatment needs. There is strong evidence for effectiveness of psychosocial and behavioral substance abuse treatments across a range of intensities and levels of care. In addition to addressing substance use, services for co-occurring psychiatric disorders, trauma exposure, and prenatal care are important components of coordinated systems of care. More research on and greater access to evidence-based interventions is needed for this underserved population.

  13. GABAB receptor ligands for the treatment of alcohol use disorder: preclinical and clinical evidence

    PubMed Central

    Agabio, Roberta; Colombo, Giancarlo

    2014-01-01

    The present paper summarizes the preclinical and clinical studies conducted to define the “anti-alcohol” pharmacological profile of the prototypic GABAB receptor agonist, baclofen, and its therapeutic potential for treatment of alcohol use disorder (AUD). Numerous studies have reported baclofen-induced suppression of alcohol drinking (including relapse- and binge-like drinking) and alcohol reinforcing, motivational, stimulating, and rewarding properties in rodents and monkeys. The majority of clinical surveys conducted to date—including case reports, retrospective chart reviews, and randomized placebo-controlled studies—suggest the ability of baclofen to suppress alcohol consumption, craving for alcohol, and alcohol withdrawal symptomatology in alcohol-dependent patients. The recent identification of a positive allosteric modulatory binding site, together with the synthesis of in vivo effective ligands, represents a novel, and likely more favorable, option for pharmacological manipulations of the GABAB receptor. Accordingly, data collected to date suggest that positive allosteric modulators of the GABAB receptor reproduce several “anti-alcohol” effects of baclofen and display a higher therapeutic index (with larger separation—in terms of doses—between “anti-alcohol” effects and sedation). PMID:24936171

  14. Metabotropic and ionotropic glutamate receptors as potential targets for the treatment of alcohol use disorder.

    PubMed

    Goodwani, Sunil; Saternos, Hannah; Alasmari, Fawaz; Sari, Youssef

    2017-02-24

    Emerging evidence indicates that dysfunctional glutamate neurotransmission is critical in the initiation and development of alcohol and drug dependence. Alcohol consumption induced downregulation of glutamate transporter 1 (GLT-1) as reported in previous studies from our laboratory. Glutamate is the major excitatory neurotransmitter in the brain, which acts via interactions with several glutamate receptors. Alcohol consumption interferes with the glutamatergic signal transmission by altering the functions of these receptors. Among the glutamate receptors involved in alcohol-drinking behavior are the metabotropic receptors such as mGluR1/5, mGluR2/3, and mGluR7, as well as the ionotropic receptors, NMDA and AMPA. Preclinical studies using agonists and antagonists implicate these glutamatergic receptors in the development of alcohol use disorder (AUD). Therefore, the purpose of this review is to discuss the neurocircuitry involving glutamate transmission in animals exposed to alcohol and further outline the role of metabotropic and ionotropic receptors in the regulation of alcohol-drinking behavior. This review provides ample information about the potential therapeutic role of glutamatergic receptors for the treatment of AUD.

  15. Normal Performance on a Simulated Gambling Task in Treatment-Naïve Alcohol Dependent Individuals

    PubMed Central

    Fein, George; McGillivray, Shannon; Finn, Peter

    2007-01-01

    Background Research suggests that substance abusers make more disadvantageous decisions on the simulated gambling task (SGT); such decisions are associated with deviance proneness and antisocial symptoms. This study examines decision-making on the SGT in young adults with alcohol dependence that are treatment-naïve (TxN). Methods 116 subjects (58 controls, 58 TxNs) were tested on the SGT, where participants choose cards from 4 different decks that vary in terms of the magnitude of the immediate gain (large/small) and the magnitude of long-term loss (larger/smaller). Participants also were assessed on measures of externalizing symptoms, personality traits reflecting social deviance, neuropsychological function, and the density of the family history of alcoholism. Results TxNs did not differ from controls on measures of SGT decision-making. SGT performance was not associated with externalizing symptoms, social deviance proneness, or a familial density of alcoholism. Although, TxNs had higher levels of externalizing symptoms, social deviance and familial density of alcoholism compared with controls, these variables were only modestly elevated compared with previous samples of long-term abstinent alcohol dependent individuals who showed decision-making deficits on the SGT. Conclusions The results suggest that our sample of young adult TxN adults with alcohol dependence do not have global deficits in decision-making as measured by the SGT, and that their poor decisions regarding their alcohol consumption are more specific to drinking. PMID:16737453

  16. Alcohol-Focused Spouse Involvement and Behavioral Couples Therapy: Evaluation of Enhancements to Drinking Reduction Treatment for Male Problem Drinkers

    ERIC Educational Resources Information Center

    Walitzer, Kimberly S.; Dermen, Kurt H.

    2004-01-01

    This study evaluated the effects of alcohol-focused spouse involvement and behavioral couples therapy (BCT) in group drinking reduction treatment for male problem drinkers. Sixty-four male clients and their female partners were randomly assigned to 1 of 3 conditions: treatment for problem drinkers only (PDO), couples alcohol-focused treatment, or…

  17. Prediction of treatment outcome in a clinical sample of problem drinkers: self-efficacy, alcohol expectancies, and readiness to change.

    PubMed

    Demmel, Ralf; Beck, Beate; Lammers, André

    2003-10-15

    Cognitive processes related to client motivation are important mediators of alcoholism treatment outcome. The present study aimed to expand previous research on client motivation and treatment outcome by establishing the predictive utility of self-efficacy, alcohol expectancies, and readiness to change in a sample of alcohol-dependent inpatients (N = 83). Treatment outcome was assessed three months following discharge. According to self-reported alcohol use, 22 clients were classified as abstainers and 41 clients as relapsers. Twenty participants were lost to follow-up. Readiness to change and anticipated reinforcement from alcohol predicted abstinence at follow-up. Client motivation was unrelated to both frequency and quantity of alcohol use. In accordance with social learning theory, self-efficacy was inversely correlated with alcohol expectancies. The results of the present study suggest that once abstinence has been violated factors other than pretreatment motivation determine drinking behavior.

  18. Distal and proximal factors related to aggression severity among patients in substance abuse treatment: family history, alcohol use and expectancies.

    PubMed

    Chermack, Stephen T; Wryobeck, John M; Walton, Maureen A; Blow, Frederic C

    2006-05-01

    This study examined the relationships among distal (paternal and maternal family history of alcohol problems and violence) and proximal (general alcohol use, acute use associated with conflict incidents, alcohol-aggression expectancies) factors and physical aggression severity among 125 men and 125 women recruited from substance abuse treatment. Paternal alcohol problem history (PA) was related to alcohol-aggression expectancies, but no family history factors were related to general or acute alcohol use. Separate analyses examining predictors of aggression were conducted, one with general alcohol use and one with acute alcohol use. In both analyses, alcohol use and the maternal violence (MV) by PA interaction were significant. Specifically, MV was associated with aggression severity for those with a history of PA. The general alcohol use model also revealed significant alcohol by expectancy and MV by gender interactions. The findings suggest that expectancies are not the primary mediator of the alcohol-aggression relationship, alcohol use measurement issues may impact whether expectancies are observed to moderate the alcohol-aggression relationship, and that both maternal and paternal family history factors appear to impact aggression severity.

  19. EEG Spectral Changes in Treatment Naïve Active Alcoholics

    PubMed Central

    Fein, G.; Allen, J.

    2007-01-01

    Background The present study examines the EEG spectra of actively drinking treatment naïve alcoholics (TxNA). Methods EEGs were gathered on 51 TxNA’s and age and sex-matched controls during eyes-closed conditions. Participants were excluded for lifetime diagnoses of psychiatric or substance abuse disorders. Power for the theta to high beta bands was examined across midline electrodes. Results The TxNA sample exhibited a nexus of disinhibited traits associated with the vulnerability to alcoholism, and had developed alcohol dependence, but no other diagnosable psychiatric or substance abuse disorders. The TxNA subjects evidenced higher power for all EEG bands compared to controls. The magnitude and anterior-posterior extent of the group differences varied across bands. Within the TxNA group, EEG power was negatively correlated with average and peak alcohol drinking duration and average and peak alcohol dose. Conclusions Increased EEG power across the theta to high beta bands distinguishes TxNAs without comorbid diagnoses from controls. These effects varied across bands in their magnitude and spatial extent, suggesting that there are different effects for the different EEG spectral generators. We hypothesize the increased power in these individuals is a trait difference associated with the inherited nexus of disinhibited traits and its manifestation in alcoholism. Based on the strong negative correlations with alcohol use variables, we speculate that decreases in EEG power are a morbid effect of long-term alcohol abuse. We acknowledge that this hypothesized effect of alcohol abuse on EEG power is opposite to the increased EEG power we hypothesize is associated with alcoholism and its inherited nexus of disinhibited traits. An implication of this model is that with continuing alcohol abuse, the increased EEG power in TxNAs will eventually be overpowered by the effects of long-term severe alcohol abuse. This model predicts that in very long-term alcoholics EEG power

  20. Understanding Lay Assessments of Alcohol Use Disorder: Need for Treatment and Associated Stigma

    PubMed Central

    Weine, Erienne R.; Kim, Nancy S.; Lincoln, Alisa K.

    2016-01-01

    Aims Three-quarters of people with an alcohol use disorder in the USA never receive treatment. Our understandings of who receives care are informed by sociological perspectives, theories and models, each of which discuss the role of lay people's understanding of illness. However, comparatively little work has been done to unpack the cognitive processes underlying lay assessment. In the context of the Framework Integrating Normative Influences on Stigma (FINIS), we aim to understand key factors guiding lay people's stigmatizing attitudes, perceptions and assessments of alcohol use disorder behaviors. Methods Lay people read a vignette depicting a male or female adult with a diagnosable alcohol use disorder, along with either a causal life-event explanation for the alcohol use disorder behaviors or no explanation. They then made judgments of the need for treatment, psychological abnormality and the stigma they felt toward the person depicted. Results Causal life-event explanations decreased lay judgments of the need for treatment, psychological abnormality and stigma. Conclusions The results suggest that the availability of a causal life-event explanation may have a complex effect on lay judgments, decreasing the likelihood of recommending treatment for alcohol use disorders, yet simultaneously reducing stigmatizing perceptions (and presumably social distance). PMID:26113491

  1. Effects of heroin-assisted treatment on alcohol consumption: findings of the German randomized controlled trial.

    PubMed

    Haasen, C; Eiroa-Orosa, F J; Verthein, U; Soyka, M; Dilg, C; Schäfer, I; Reimer, J

    2009-06-01

    Alcohol has been suggested to be a risk factor for opioid-dependent patients in methadone maintenance treatment (MMT). Literature shows that MMT has limited effects on alcohol use. Nevertheless, a decrease in alcohol use was detected in the Swiss heroin-assisted treatment (HAT) study. In this article, we carry out an in-depth analysis of the German HAT trial with the aim of determining whether alcohol use was affected among patients undergoing HAT and MMT. Analysis was carried out using self-reported data on consumption units of alcohol used (CU), Addiction Severity Index composite scores (ASI CSs), and carbohydrate-deficient transferrin (CDT) measures. Results suggest significant reduction of CU and CDT in both groups, yet larger effects in the HAT group. ASI CS significantly decreased in the HAT but not in the MMT group. The greater benefit of HAT in reducing alcohol use may be due to the greater daily frequency of dispensing heroin coupled with a requirement of sobriety at each dosing occasion.

  2. Social Support and Treatment Outcome in Alcohol Dependence Syndrome in Armed Forces

    PubMed Central

    Chauhan, Vinay Singh; Azad, Sudip

    2015-01-01

    Introduction Social factors play vital role in unfolding of alcohol use disorders in any given population. Several factors beyond the confines of treatment settings influence treatment outcome in alcohol dependence syndrome. Social support has positive effect in treatment outcome of alcohol dependence syndrome. This has not been much studied in India in past. Therefore we decided to study the perception of social support in cases of alcohol dependence syndrome admitted in a busy hospital in armed forces. Aim The aim was to study the perception of social support across relapsed and abstinent group and see if it reached any statistical proportion and also to see if any socio-demographic variables also affected perception of social support. Materials and Methods Fifty five consecutive male patients of alcohol dependent syndrome without a co-morbid neurological/psychiatric diagnosis were assessed for their perception of social support after taking informed consent. They were explained the procedure and their alcoholic milestones were recorded in specially designed pro-forma. Subjects were then divided in abstinent and relapsed group. Subsequently they were assessed for their perception of social support by administering Social provision scale and Social support questionnaire. Statistical Analysis Data were tabulated and statistically analysed by using chi square test, Mann Whitney U-Test and Rank ANOVA test where applicable p-value <.05 was taken as significant. Results Results indicated that perception of social support across abstinent (n=18) and relapsed (n= 37) group reached significant statistical proportion as measured by social provision scale and social support questionnaire. Duration of use, dependence and family history of alcoholism did not influence perception of social support across patient population. There was inverse relationship between patients with alcohol related problem and their perception of social support. Professional and qualified soldiers

  3. Habilitational treatment of a child with fetal alcohol syndrome: case report.

    PubMed

    Matijević, Valentina; Bartolović, Jelena; Crnković, Maja; Kosicek, Tena; Barisić, Irma

    2014-03-01

    Fetal alcohol syndrome is defined by a triad of symptoms such as facial dysmorphology, prenatal and postnatal growth deficiency, and central nervous system dysfunction. It is the result of teratogenic effects of alcohol consumption in pregnancy. The prevalence of fetal alcohol syndrome is 1 to 3 per 1000 live births. From the neurological point of view, there is a possibility of the central nervous system dysfunction. Structural disjunctions are the consequences of fine and gross motor dysfunction, oculomotor dysfunction, and difficulties in sensorimotor integration. From the functional point view, there are complex cognitive disorders and behavioral disorders, attention disorders and impulse control disorders, learning difficulties, and social communication and perception difficulties. This paper presents a case study of a boy diagnosed with fetal alcohol syndrome at the age of four, monitored by a team of experts including a physiatrist and neuropediatrician. The boy is also included in polyvalent habilitation treatment provided by a speech therapist, rehabilitator and psychologist.

  4. Alcohol consumption and partner violence among women entering substance use disorder treatment.

    PubMed

    Kaufmann, Vyga G; O'Farrell, Timothy J; Murphy, Christopher M; Murphy, Marie M; Muchowski, Patrice

    2014-06-01

    To test the hypothesized role of alcohol consumption as a proximal risk factor for partner violence, a within-subjects analysis compared levels of alcohol consumption in violent versus nonviolent conflict events among substance-abusing women and their male partners. Participants were married or cohabiting women (N = 145) who had recently begun a substance abuse treatment program and reported both a violent and a nonviolent relationship conflict event with their male partner in the prior 6 months. The average age was 38, and 83% were White. Male partners did not participate in the study. The female participant provided information about the male partner. Women were interviewed regarding a violent conflict event in which physical violence occurred and a nonviolent conflict event in which psychological aggression occurred without physical violence. The interview assessed quantity of alcohol consumed and use of other drugs prior to each conflict. Alcohol consumption was significantly greater prior to violent versus nonviolent conflict events for all measures of women's alcohol consumption examined: any drinking, heavy drinking, number of drinks in the 12 hr preceding the conflict event, and estimated blood alcohol concentration at time of the event. Male partners' alcohol consumption showed similar results. Use of other drugs in women, but not men, was significantly more likely prior to physical conflicts. These within-subject comparisons help to rule out individual difference explanations for the alcohol-violence association and indicate that the quantity of alcohol consumption is an important proximal risk factor for partner violence in substance-abusing women and their male partners. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  5. An Assessment of Individual-Level Factors Associated with Alcohol Treatment Utilization among Mexican Americans

    PubMed Central

    Gonzalez, Jennifer M. Reingle; Caetano, Raul; Mills, Britain A.; Vaeth, Patrice A.C.

    2014-01-01

    The purpose of this study is to identify enabling factors for treatment utilization for alcohol-related problems, and to evaluate how enabling factors vary by need for treatment, among two samples of Mexican American adults. These two distinct samples included 2,595 current and former drinkers (one sample included 787 U.S./Mexico border residents; the other sample included 740 Mexican Americans living in U.S. cities not proximal to the border). Need for treatment (alcohol disorder severity) and (male) gender were the primary correlates of treatment utilization; and there was no moderation in the enabling factors by need for treatment as “enablers” of utilization. Further theoretical and empirical research is necessary to determine which mechanisms are driving disparities in treatment utilization across racial/ethnic groups generally, and Hispanic national groups specifically. PMID:25113028

  6. An assessment of individual-level factors associated with alcohol treatment utilization among Mexican Americans.

    PubMed

    Reingle Gonzalez, Jennifer M; Caetano, Raul; Mills, Britain A; Vaeth, Patrice A C

    2014-01-01

    The purpose of this study is to identify enabling factors for treatment utilization for alcohol-related problems, and to evaluate how enabling factors vary by need for treatment, among two samples of Mexican American adults. These two distinct samples included 2,595 current and former drinkers (one sample included 787 U.S./Mexico border residents; the other sample included 740 Mexican Americans living in U.S. cities not proximal to the border). Need for treatment (alcohol disorder severity) and (male) gender were the primary correlates of treatment utilization; and there was no moderation in the enabling factors by need for treatment as "enablers" of utilization. Further theoretical and empirical research is necessary to determine which mechanisms are driving disparities in treatment utilization across racial/ethnic groups generally, and Hispanic national groups specifically.

  7. Critical thoughts on current rodent models for evaluating potential treatments of alcohol addiction and withdrawal

    PubMed Central

    Ripley, Tamzin L; Stephens, David N

    2011-01-01

    Despite years of neurobiological research that have helped to identify potential therapeutic targets, we do not have a reliable pharmacological treatment for alcoholism. There are a range of possible explanations for this failure, including arguments that alcoholism is a spectrum disorder and that different population subtypes may respond to different treatments. This view is supported by categorisations such as early- and late-onset alcoholism, whilst multifactorial genetic factors may also alter responsivity to pharmacological agents. Furthermore, experience of alcohol withdrawal may play a role in future drinking in a way that may distinguish alcoholism from other forms of addiction. Additionally, our neurobiological models, based largely upon results from rodent studies, may not mimic specific aspects of the human condition and may reflect different underlying phenomena and biological processes from the clinical pattern. As a result, potential treatments may be targeting inappropriate aspects of alcohol-related behaviours. Instead, we suggest a more profitable approach is (a) to identify well-defined intermediate behavioural phenotypes in human experimental models that reflect defined aspects of the human clinical disorder and (b) to develop animal models that are homologous with those phenotypes in terms of psychological processes and underlying neurobiological mechanisms. This review describes an array of animal models currently used in the addiction field and what they tell us about alcoholism. We will then examine how established pharmacological agents have been developed using only a limited number of these models, before describing some alternative novel approaches to achieving homology between animal and human experimental measures. LINKED ARTICLES This article is part of a themed issue on Translational Neuropharmacology. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.164.issue-4 PMID:21470204

  8. Treatment with neuropeptides attenuates c-fos expression in a mouse model of fetal alcohol syndrome.

    PubMed

    Incerti, Maddalena; Vink, Joy; Roberson, Robin; Abebe, Daniel; Spong, Catherine Y

    2010-10-01

    Fetal alcohol syndrome (FAS) is the most common nongenetic cause of mental retardation and is characterized by neurodevelopmental anomalies. C-FOS is a cellular marker of transcriptional activity in the stress-signal pathway. Previously, we showed the treatment with NAP (NAPVSIPQ) + SAL (SALLRSIPA) reversed the learning deficit after prenatal alcohol exposure in FAS. Our objective was to evaluate if the mechanism of actions of NAP + SAL involves the stress-signal pathway differentiating C-FOS expression in mouse brains after prenatal alcohol exposure. C57Bl6/J mice were treated with alcohol (0.03 mL/g) or placebo on gestational day 8. On postnatal day 40, in utero alcohol-exposed males were treated via gavage with 40 μg D-NAP and 40 μg D-SAL ( N = 6) or placebo ( N = 4); controls were gavaged with placebo daily ( N = 12). After learning evaluation, hippocampus, cerebellum, and cortex were isolated. Calibrator-normalized relative real-time polymerase chain reaction and Western blot analysis were performed. Statistics included analysis of variance and post hoc Fisher analysis. Adult treatment with NAP + SAL restored the down-regulation of C-FOS in the hippocampus after prenatal alcohol exposure ( P < 0.05), but not in the cerebellum. There was no difference in C-FOS expression in the cortex. Adult treatment with NAP + SAL restored the down-regulation of C-FOS expression in hippocampus attenuating the alcohol-induced alteration of the stress-signal pathway.

  9. Effects of acute alcohol consumption and vitamin E co-treatment on oxidative stress parameters in rats tongue.

    PubMed

    Carrard, V C; Pires, A S; Mendez, M; Mattos, F; Moreira, J C F; Sant'Ana Filho, M

    2009-06-01

    The aim of this study was to evaluate the effects of acute alcohol consumption and vitamin E co-treatment upon oxidative stress parameters in rats tongue. Thirty-eight, Wistar rats were separated into five groups (alcohol, alcohol/vitamin E, control, Tween, vitamin E). Alcohol and alcohol vitamin E groups had the standard diet, and 40% alcohol on drinking water. Other groups were fed with the same standard diet and water ad libitum. Vitamin E was given by gavage to vitamin E and alcohol/vitamin E rats twice a week. Alcohol and control groups were subjected to saline gavage and Tween group to 5% Tween 80 solution, the vitamin E vehicle. At day 14, the animals were anesthetized and specimens were obtained from tongue. Lipid peroxidation (TBARS), protein oxidative damage, catalase (CAT) and superoxide dismutase (SOD) activities were quantified. Alcohol group decreased TBARS in relation to control group and alcohol vitamin-treated animals decreased TBARS when compared to Tween and vitamin E groups. SOD activity was lower and CAT activity was higher in animals treated with both alcohol and vitamin E. These results suggest that short-term alcohol consumption decreases lipid peroxidation levels. Alternatively, alcohol/vitamin E group increased CAT, showing the toxicity of this association.

  10. The Important People Drug and Alcohol Interview: Psychometric Properties, Predictive Validity, and Implications for Treatment

    PubMed Central

    Zywiak, William H.; Neighbors, Charles J.; Martin, Rosemarie A.; Johnson, Jennifer E.; Eaton, Cheryl A.; Rohsenow, Damaris J.

    2009-01-01

    Research with the Important People instrument has demonstrated that social support for abstinence is related to alcohol treatment outcomes but less work has been done on the role of network support in drug treatment outcomes. A drug and alcohol version of the Important People instrument (IPDA) was developed and administered to 141 patients in residential treatment for cocaine dependence. Three components were found, all with acceptable internal consistency: (1) substance involvement of the network, (2) general/treatment support, and (3) support for abstinence. These components and three fundamental network characteristics (size of daily network, size of network, and importance of the most important people) were investigated as correlates of pretreatment and posttreatment alcohol and drug use. The general/treatment support component and network size were inversely related to pretreatment days using drugs while network substance involvement positively correlated with pretreatment drinking frequency. Size of the daily network predicted less drinking, less drug use, and less problem severity during the 6 months after treatment whereas general/treatment support and support for abstinence did not predict outcome. Network substance involvement decreased for patients who stayed abstinent but not for those who later relapsed. Results suggest that increasing the number of people the patient sees daily while replacing substance-involved with abstinent-supportive people may improve treatment outcomes. Treatment programs may use the IPDA to identify clients most likely to benefit from changes in their social networks. PMID:18835677

  11. The Important People Drug and Alcohol interview: psychometric properties, predictive validity, and implications for treatment.

    PubMed

    Zywiak, William H; Neighbors, Charles J; Martin, Rosemarie A; Johnson, Jennifer E; Eaton, Cheryl A; Rohsenow, Damaris J

    2009-04-01

    Research with the Important People instrument has shown that social support for abstinence is related to alcohol treatment outcomes, but less work has been done on the role of network support in drug treatment outcomes. A drug and alcohol version of the Important People instrument (IPDA) was developed and administered to 141 patients in residential treatment for cocaine dependence. Three components were found, all with acceptable internal consistency: (a) substance involvement of the network, (b) general/treatment support, and (c) support for abstinence. These components and three fundamental network characteristics (size of daily network, size of network, and importance of the most important people) were investigated as correlates of pretreatment and posttreatment alcohol and drug use. The general/treatment support component and network size were inversely related to pretreatment days using drugs, whereas network substance involvement positively correlated with pretreatment drinking frequency. Size of the daily network predicted less drinking, less drug use, and less problem severity during the 6 months after treatment, whereas general/treatment support and support for abstinence did not predict outcome. Network substance involvement decreased for patients who stayed abstinent but not for those who later relapsed. Results suggest that increasing the number of people the patient sees daily while replacing substance-involved with abstinent-supportive people may improve treatment outcomes. Treatment programs may use the IPDA to identify clients most likely to benefit from changes in their social networks.

  12. The impact of alcohol use severity on anxiety treatment outcomes in a large effectiveness trial in primary care

    PubMed Central

    Wolitzky-Taylor, Kate; Brown, Lily A.; Roy-Byrne, Peter; Sherbourne, Cathy; Stein, Murray B.; Sullivan, Greer; Bystritsky, Alexander; Craske, Michelle G.

    2014-01-01

    Objective The presence of anxiety disorders is associated with poorer alcohol use disorder treatment outcomes, but little is known about the impact of alcohol use problems on anxiety disorder treatment outcomes despite their high comorbidity. The current study examined the impact of alcohol use symptom severity on anxiety disorder treatment outcomes in a multi-site primary care effectiveness study of anxiety disorder treatment. Method Data came from the Coordinated Anxiety Learning and Management (CALM) effectiveness trial. Participants (N = 1004) were randomized to an evidence-based anxiety intervention (including cognitive behavioral therapy and medications) or usual care in primary care. Participants completed measures of alcohol use, anxiety, and depression a baseline, 6-mo, 12-mo, and 18-mo follow-up periods. Patients with alcohol dependence were excluded. Results There were no significant moderating (Treatment Group x Alcohol Use Severity) interactions. The majority of analyses revealed no predictive effects of alcohol use severity on outcome; however, alcohol problems at baseline were associated with somewhat higher anxiety and depression symptoms at the 18-mo follow-up. Conclusions These data indicate that patients with alcohol problems in primary care can be effectively treated for anxiety disorders. Baseline alcohol problems were associated with some poorer long-term outcomes, but this was evident across CALM and usual care. These findings provide preliminary evidence that there may be no need to postpone treatment of anxiety disorders until alcohol problems are addressed, at least among those who have mild to moderate alcohol problems. Replication with more severe alcohol use disorders is needed. PMID:25615523

  13. On the activation of symbiotic gratification fantasies as an aid in the treatment of alcoholics.

    PubMed

    Schurtman, R; Palmatier, J R; Martin, E S

    1982-10-01

    Seventy-two alcoholics being treated at Veritas Villa were divided into an experimental and a control group. In addition to the regular treatment program both groups received four subliminal exposures of a verbal message in each of six sessions over a 2-week period. The messages were MOMMY AND I ARE ONE (experimental) and PEOPLE ARE WALKING (control), administered under double-blind conditions. In keeping with the main hypothesis, the experimental Ss were rated as significantly more involved in treatment. In addition, among the alcoholics who were more symptomatic to begin with, the MOMMY message, when contrasted with the control, lowered anxiety and depression, enhanced self-concept, and reduced alcohol consumption after a 3-month follow-up.

  14. Alcohol consumption, illicit substances, and intimate partner violence in a sample of batterers in psychological treatment.

    PubMed

    Redondo Rodríguez, Natalia; Graña Gómez, José Luis

    2015-03-01

    The purpose of this study is to analyze the alcohol and illicit substance consumption characteristics in a sample of 572 batterers in treatment by court order. The results indicate that the prevalence of alcohol consumption in the past year was 89.3%, whereas within illicit substances, the prevalences were higher for cannabis (27.8%), followed by cocaine 20.3%). In order to analyze the possible effect of consumption on levels of perpetration and victimization of partner-aggression, the sample was divided into 4 groups: nonconsumers (16.3%), alcohol consumers (58.6%), illicit drug consumers (3.5%), and consumers of alcohol and illicit drugs (21.7%), finding that the groups of nonconsumers and alcohol consumers presented the lowest level of perpetration of psychological, physical, and sexual aggression and of victimization of psychological and physical aggression, whereas the group of consumers of alcohol and illicit drugs presented the highest levels. The results reveal the need to assess substance consumption when designing intervention protocols with batterers.

  15. ADH and ALDH polymorphisms among Alaska Natives entering treatment for alcoholism.

    PubMed

    Segal, B

    1999-01-01

    The alcohol dehydrogenase (ADHs) and aldehyde dehydrogenases (ALDHs) involved in alcohol metabolism are polymorphic. Different alleles encode subunits of the enzymes that are related to differences in alcohol metabolism with different ethnic groups. This study examined the allele frequencies at the ADH1, ADH2, ADH3 and ALDH2 loci in Alaska Natives entering treatment for alcoholism to determine if allele frequencies at these loci differ among five distinct Alaska Native groups: Yupik and Inupiat Eskimos, Athabascan, Tlingit and Aleut. It was found that all persons were homozygous for the ADH1*1, ADH2*1 and ALDH2*1 alleles. Variations, however, were found for the allele distribution of the ADH3 genotype. Comparison with a general population sample found no differences in allele distributions for ADHs and ALDH2*1, but differences were found when comparisons were made with four Asian Groups. The study's findings suggest that the Alaska Natives are not protected from the risk of alcoholism in the same way that Asians who possess the ALDH2*2 genotype are considered to have a negative risk factor. Nor, does there appear to be any generalized differences between Alaska Native alcoholics and members of the general population with respect to the ALDH and ADH polymorphisms studied herein.

  16. Drug treatment program ownership, Medicaid acceptance, and service provision.

    PubMed

    McBride, Duane C; Chriqui, Jamie F; Terry-McElrath, Yvonne M; Mulatu, Mesfin S

    2012-03-01

    The Institute of Medicine noted that effective substance abuse treatment (SAT) programs integrate individual therapeutic approaches with transitional/ancillary services. In addition, research suggests that type of ownership impacts SAT services offered and that Medicaid plays a key role in SAT access. Data from the National Survey of Substance Abuse Treatment Services for the years 2000 and 2002-2006 were used to examine relationships among SAT program Medicaid acceptance, program ownership, and transitional/ancillary service accessibility. Multivariate logistic regression models controlling for state- and program-level contextual factors were used to analyze the data. Nonprofit SAT programs were significantly more likely to offer transitional/ancillary services than for-profit programs. However, programs that accepted Medicaid, regardless of ownership, were significantly more likely to offer most transitional/ancillary services. The data suggest that Medicaid may play a significant role in offering key transitional/ancillary services related to successful treatment outcome, regardless of program ownership type.

  17. Challenges in Engaging Parents in the Drug and Alcohol Treatment: The Professionals' Perspective.

    PubMed

    Misouridou, Evdokia; Papadatou, Danai

    2016-11-02

    Addiction treatment centers often fail to involve families in treatment. The aim of the present study was to explore the challenges that Greek mental health professionals encounter in their work with parents of drug and alcohol abusers. A qualitative study design was adopted, and five focus group discussions were conducted with 27 drug and alcohol professionals. The thematic analysis of their accounts revealed the key difficulties that professionals encounter in their collaboration with parents that included parental lack of involvement or over-engagement in treatment, unrealistic expectations, ambivalence or opposition to change, ethical dilemmas, and alliance issues, as well as collaboration challenges among therapists. Findings highlight the challenges of a family approach in the treatment of addiction, and underscore the value of clinical supervision in addition to specialized training, to help professionals work on their anxiety, anger, guilt, prejudices, and deception, when engaging parents in the treatment of their addicted child.

  18. Alcohol and Drug Defense Program Manual on Comprehensive K-12 School-Based Prevention and Intervention Alcohol and Drug Services.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Instruction, Raleigh. Alcohol and Drug Defense Program.

    This document presents a manual to help program developers plan for a comprehensive school and community-based response to the drug problem as required by the Drug-Free Schools and Communities Act. Part I explains the purpose of the manual and discusses other work being conducted by the North Carolina Alcohol and Drug Defense Program. Part II…

  19. 45 CFR 96.131 - Treatment services for pregnant women.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Substance Abuse Prevention and Treatment Block Grant § 96.131 Treatment services for pregnant women. (a) The... Director for Substance Abuse Services. (f) The State shall develop effective strategies for monitoring.... Programs which serve an injecting drug abuse population and who receive Block Grant funds shall...

  20. 45 CFR 96.131 - Treatment services for pregnant women.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Substance Abuse Prevention and Treatment Block Grant § 96.131 Treatment services for pregnant women. (a) The... Director for Substance Abuse Services. (f) The State shall develop effective strategies for monitoring.... Programs which serve an injecting drug abuse population and who receive Block Grant funds shall...

  1. 45 CFR 96.131 - Treatment services for pregnant women.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Substance Abuse Prevention and Treatment Block Grant § 96.131 Treatment services for pregnant women. (a) The... Director for Substance Abuse Services. (f) The State shall develop effective strategies for monitoring.... Programs which serve an injecting drug abuse population and who receive Block Grant funds shall...

  2. BRAIN MORPHOLOGY AT ENTRY INTO TREATMENT FOR ALCOHOL DEPENDENCE IS RELATED TO RELAPSE PROPENSITY

    PubMed Central

    Cardenas, VA; Durazzo, TC; Gazdzinski, S; Mon, A; Studholme, C; Meyerhoff, DJ

    2011-01-01

    Background We examined whether any differences in brain volumes at entry into alcohol dependence treatment differentiate subsequent Abstainers from Relapsers. Methods Individuals in alcohol dependence treatment (N=75) underwent magnetic resonance imaging approximately 6 ± 4 days after their last alcoholic drink, and 40 age-matched non-smoking light drinkers were studied as controls. At follow-up 7.8 ± 2.6 months later, 23 alcoholics (31%) had abstained from drinking and 52 (69%) had relapsed. Deformation morphometry compared Relapsers, Abstainers, and light drinkers. Results Compared to light drinkers, future Abstainers had smaller brain tissue volumes in the left amygdala, hippocampal head, and entorhinal cortex, and bilaterally in the thalamus and adjacent subcortical white matter (WM), and had larger volume in the left lateral orbitofrontal region. Compared to light drinkers, future Relapsers had smaller brain tissue volumes in the right middle temporal, occipital, and superior frontal WM. Compared to future Abstainers, future Relapsers had smaller tissue volumes primarily in bilateral orbitofrontal cortex and surrounding WM. Results were virtually unaffected after controlling for common comorbidities. Conclusion At entry into alcohol dependence treatment, the brain structure of future Relapsers differs from that of future Abstainers. Future Relapsers have smaller brain volumes in regions of the mesocorticolimbic reward system that are critically involved in impulse control, emotional regulation, craving, and evaluation and anticipation of stimulus salience and hedonics. Structural abnormalities of this circuitry may confer greater risk for resumption of hazardous drinking after treatment and may contribute to the definition of a neurobiological relapse risk profile in alcohol dependence. PMID:21601177

  3. Association between Physical Pain and Alcohol Treatment Outcomes: The Mediating Role of Negative Affect

    PubMed Central

    Witkiewitz, Katie; McCallion, Elizabeth; Vowles, Kevin E.; Kirouac, Megan; Frohe, Tessa; Maisto, Stephen A.; Hodgson, Ray; Heather, Nick

    2015-01-01

    Objective Physical pain and negative affect have been described as risk factors for alcohol use following alcohol treatment. The current study was a secondary analysis of two clinical trials for alcohol use disorder (AUD) to examine the associations between pain, negative affect and AUD treatment outcomes. Method Participants included 1383 individuals from the COMBINE Study (COMBINE Study Group, 2003; 31% female, 23% ethnic minorities, average age=44.4 (SD=10.2)), a multisite combination pharmacotherapy and behavioral intervention study for AUD in the United States, and 742 individuals from the United Kingdom Alcohol Treatment Trial (UKATT Research Team, 2001; 25.9% female, 4.4% ethnic minorities, average age=41.6 (SD=10.1)) a multisite behavioral intervention study for AUD in the United Kingdom. The Form-90 was used to collect alcohol use data, the Short Form Health Survey and Quality of Life measures were used to assess pain, and negative affect was assessed using the Brief Symptom Inventory (COMBINE) and the General Health Questionnaire (UKATT). Results Pain scores were significantly associated with drinking outcomes in both datasets. Greater pain scores were associated with greater negative affect and increases in pain were associated with increases in negative affect. Negative affect significantly mediated the association between pain and drinking outcomes and this effect was moderated by social behavior network therapy (SBNT) in the UKATT study, with SBNT attenuating the association between pain and drinking. Conclusion Findings suggest pain and negative affect are associated among individuals in AUD treatment and that negative affect mediated pain may be a risk factor for alcohol relapse. PMID:26098375

  4. Questioning the Value of Realism: Young Adults' Processing of Messages in Alcohol-Related Public Service Announcements and Advertising.

    ERIC Educational Resources Information Center

    Andsager, Julie L.; Austin, Erica Weintraub; Pinkleton, Bruce E.

    2001-01-01

    Finds that: (1) perceived realism and themes that students could identify with are important factors in increasing the salience and persuasiveness of alcohol-related public service announcements (PSAs) among undergraduate students; (2) realistic but logic-based PSAs were not as effective as unrealistic but enjoyable ads; and (3) low production…

  5. Collegiate-Based Emergency Medical Service: Impact on Alcohol-Related Emergency Department Transports at a Small Liberal Arts College

    ERIC Educational Resources Information Center

    Rosen, Joshua B.; Olson, Mark H.; Kelly, Marianne

    2012-01-01

    Objective: The authors examined the impact of a collegiate-based emergency medical service (CBEMS) on the frequency of emergency department (ED) transports. Participants: Students transported to the ED for acute alcohol intoxication during the Fall 2008 and the Fall 2009 semesters (N = 50). Methods: The frequency of students receiving…

  6. Within treatment therapeutic alliance ratings profiles predict posttreatment frequency of alcohol use

    PubMed Central

    Prince, Mark A.; Connors, Gerard J.; Maisto, Stephen A.; Dearing, Ronda L.

    2016-01-01

    While past research has demonstrated a positive relationship between the therapeutic alliance (TA) and improved drinking outcomes, specific aspects of the alliance have received less attention. In this study, we examined the association between alliance characteristics during treatment and 4-month follow-up drinking reports. 65 treatment-seeking alcohol dependent clients who participated in 12 weeks of individual outpatient treatment provided weekly TA ratings during treatment and reported on pre-treatment, during treatment, and post-treatment alcohol use. Latent profile analysis was conducted to discern distinct profiles of client and therapist ratings of therapeutic alliance with similar alliance characteristics. TA profiles were based on clients’ and therapists’ mean alliance rating, minimum alliance rating, maximum alliance rating, the range of alliance ratings, and the difference in session number between maximum and minimum alliance ratings. 1- through 4- class models were fit to the data. Model fit was judged by comparative fit indices, substantive interpretability, and parsimony. Wald tests of mean equality determined whether classes differed on follow-up percentage of days abstinent (PDA) at 4 months posttreatment. 3-profile solutions provided the best fit for both client and therapist ratings of the therapeutic alliance. Client alliance rating profiles predicted drinking in the follow-up period, but therapist rating profiles did not. These results suggest that distinct profiles of the therapeutic alliance can be identified and that client alliance rating profiles are associated with frequency of alcohol use following outpatient treatment. PMID:26999350

  7. Cost Effectiveness of Alcoholism Treatment in Partial Hospital versus Inpatient Settings After Brief Inpatient Treatment: 12-Month Outcomes.

    ERIC Educational Resources Information Center

    McCrady, Barbara; And Others

    1986-01-01

    Alcoholics (N=174) were randomly assigned to partial hospital treatment (PHT) or extended inpatient (EIP) rehabilitation after inpatient evaluation and/or detoxification. There were few differences in clinical outcomes between the PHT and EIP groups. Subjects showed significant improvements in psychological well-being and social behavior.…

  8. Alcoholism and Minority Populations.

    ERIC Educational Resources Information Center

    Watts, Thomas D.; Wright, Roosevelt, Jr.

    1991-01-01

    Briefly discusses some aspects of the role of the state and the position of minorities in respect to alcoholism policies and services. Includes case study of a Black alcoholic. Refers readers to studies on Black alcoholism, Native American alcoholism, Hispanic alcoholism, and Asian-American alcoholism. (Author/NB)

  9. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  10. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  11. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  12. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  13. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  14. Marital Violence in the Year before and after Spouse-Involved Alcoholism Treatment.

    ERIC Educational Resources Information Center

    O'Farrell, Timothy J.; Choquette, Keith A.

    The Conflict Tactics Scale questionnaire on marital violence was administered to 29 alcoholics and their wives at entry to, and 1 year after, completing a behavioral marital therapy (BMT) treatment program. In the year prior to BMT, prevalence rates of any violent act, of minor to moderate violent acts, and of severe violent acts were five to six…

  15. Marital Therapy and Spouse Involvement in the Treatment of Depression, Agoraphobia, and Alcoholism.

    ERIC Educational Resources Information Center

    Jacobson, Neil S.; And Others

    1989-01-01

    Examines literature on marital therapy and spouse involvement as treatments for major psychopathology, focusing on depression, agoraphobia, and alcoholism. For each disorder, examines relation between marital dynamics and disorder and discusses empirical efforts to evaluate impact of marital therapy or spouse involvement on disorder. Summarizes…

  16. Senior Alcohol and Drug Coalition: Statement of Treatment Philosophy for the Elderly.

    ERIC Educational Resources Information Center

    Dunlop, Jean D.; And Others

    This document recognizes the growing awareness of alcohol problems faced by the elderly during the last 10 to 15 years and cites results of studies conducted to examine the extent of these problems. It then presents a community treatment continuum designed by a coalition of concerned individuals in the northwestern part of the United States. The…

  17. Motivating Treatment Seeking and Behavior Change by Untreated Military Personnel Abusing Alcohol or Drugs

    DTIC Science & Technology

    2012-09-01

    ABSTRACT Conducting the efficacy trial to evaluate the utility of a Motivational Enhancement Therapy intervention to attract untreated active duty...SUBJECT TERMS Alcohol abuse, substance abuse, early intervention , motivational enhancement therapy 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...enhancement intervention (MET) for substance abusing military personnel who are not currently in substance abuse treatment . The intervention is

  18. Does Oxidative Stress Induced by Alcohol Consumption Affect Orthodontic Treatment Outcome?

    PubMed Central

    Barcia, Jorge M.; Portolés, Sandra; Portolés, Laura; Urdaneta, Alba C.; Ausina, Verónica; Pérez-Pastor, Gema M. A.; Romero, Francisco J.; Villar, Vincent M.

    2017-01-01

    HIGHLIGHTS Ethanol, Periodontal ligament, Extracellular matrix, Orthodontic movement. Alcohol is a legal drug present in several drinks commonly used worldwide (chemically known as ethyl alcohol or ethanol). Alcohol consumption is associated with several disease conditions, ranging from mental disorders to organic alterations. One of the most deleterious effects of ethanol metabolism is related to oxidative stress. This promotes cellular alterations associated with inflammatory processes that eventually lead to cell death or cell cycle arrest, among others. Alcohol intake leads to bone destruction and modifies the expression of interleukins, metalloproteinases and other pro-inflammatory signals involving GSKβ, Rho, and ERK pathways. Orthodontic treatment implicates mechanical forces on teeth. Interestingly, the extra- and intra-cellular responses of periodontal cells to mechanical movement show a suggestive similarity with the effects induced by ethanol metabolism on bone and other cell types. Several clinical traits such as age, presence of systemic diseases or pharmacological treatments, are taken into account when planning orthodontic treatments. However, little is known about the potential role of the oxidative conditions induced by ethanol intake as a possible setback for orthodontic treatment in adults. PMID:28179886

  19. Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression

    ERIC Educational Resources Information Center

    Curry, John; Silva, Susan; Rohde, Paul; Ginsburg, Golda; Kennard, Betsy; Kratochvil, Christopher; Simons, Anne; Kirchner, Jerry; May, Diane; Mayes, Taryn; Feeny, Norah; Albano, Anne Marie; Lavanier, Sarah; Reinecke, Mark; Jacobs, Rachel; Becker-Weidman, Emily; Weller, Elizabeth; Emslie, Graham; Walkup, John; Kastelic, Elizabeth; Burns, Barbara; Wells, Karen; March, John

    2012-01-01

    Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in…

  20. The role of promotion in alcoholism treatment marketing.

    PubMed

    Jones, M A; Self, D R; Owens, C A; Kline, T A

    1988-01-01

    This article is an overview of the promotion function as a part of the ATM's marketing mix. It approaches various promotion decision areas from a managerial perspective, focusing upon some key components of promotion planning. Rather than provide specific operational or implementation details (how to write a brochure) it is more conceptual in nature and offers a framework for promotion planners. The article addresses promotion management, promotion objectives, analysis for promotion planning, the promotion mix, and addresses the benefits and limitations of some specific promotion tools available to the ATM manager. It treats ATMs as a service and reveals specific implications for promotion strategy dictated by services. The article also reports promotion tools employed by Alabama ATMs citing data from the Alabama study.

  1. The role of expectation in the therapeutic outcomes of alcohol and drug addiction treatments.

    PubMed

    Spagnolo, Primavera A; Colloca, Luana; Heilig, Markus

    2015-05-01

    Throughout history, patient-physician relationships have been acknowledged as an important component of the therapeutic effects of any pharmacological treatment. Here, we discuss the role of physicians' expectations in influencing the therapeutic outcomes of alcohol and drug addiction pharmacological treatments. As largely demonstrated, such expectations and attitudes may contribute to produce placebo and nocebo effects that in turn affect the course of the disease and the response to the therapy. This article is aimed at discussing the current insights into expectations, placebo and nocebo mechanisms and their impact on the therapeutic outcomes of alcohol and drug addiction treatments; with the goal of informing physicians and other health care providers about the potentially widespread implications for clinical practice and for a successful treatment regimen.

  2. The Role of Expectation in the Therapeutic Outcomes of Alcohol and Drug Addiction Treatments

    PubMed Central

    Spagnolo, Primavera A.; Colloca, Luana; Heilig, Markus

    2015-01-01

    Throughout history, patient–physician relationships have been acknowledged as an important component of the therapeutic effects of any pharmacological treatment. Here, we discuss the role of physicians' expectations in influencing the therapeutic outcomes of alcohol and drug addiction pharmacological treatments. As largely demonstrated, such expectations and attitudes may contribute to produce placebo and nocebo effects that in turn affect the course of the disease and the response to the therapy. This article is aimed at discussing the current insights into expectations, placebo and nocebo mechanisms and their impact on the therapeutic outcomes of alcohol and drug addiction treatments; with the goal of informing physicians and other health care providers about the potentially widespread implications for clinical practice and for a successful treatment regimen. PMID:25761920

  3. A randomized, controlled study of treatment for alcohol dependence in patients awaiting liver transplantation.

    PubMed

    Weinrieb, Robert M; Van Horn, Deborah H A; Lynch, Kevin G; Lucey, Michael R

    2011-05-01

    Alcohol is the second most common cause of cirrhosis necessitating liver transplantation in the United States, yet rates of posttransplant drinking approach 50% and no controlled clinical trials of alcoholism treatment exist in this population. Eligible patients were randomly assigned to receive Motivational Enhancement Therapy (MET), or referral to local treatment sources ("treatment as usual" [TAU]). Addictive behavior, mood states, and general health were compared. Candor concerning alcohol use was encouraged by keeping drinking questionnaires in confidence, except in medical emergencies. Ninety-one subjects were studied; 46 received MET, 45 received TAU, 29 proceeded to transplantation (MET, n = 13; TAU, n = 16). A total of 69 subjects completed 24 weeks of observation, and 25 subjects were assessed at 96 weeks. No difference in study attendance was observed, but significantly more MET subjects attended 1 or more treatment sessions. Twenty-three subjects (25% of sample) drank after randomization but before transplant. Excluding an extreme outlier, MET drinkers had significantly fewer drinks per drinking days than TAU drinkers. Neither treatment plan resulted in significant variances in measures of psychosocial health. In conclusion, although MET afforded no significant benefit over TAU for mood or general health outcomes, this study provides some degree of support for MET to limit the quantity and frequency of pretransplant alcohol consumption among liver transplant candidates with alcohol dependence. However, because of the limited number of study subjects, these data must be interpreted cautiously. Further research to validate our findings or to identify better methods to identify and intervene with patients at risk of pretransplant and posttransplant drinking should continue.

  4. [SEMERGEN positioning for the treatment of alcohol disorders in primary care].

    PubMed

    Arbesú, José Ángel; Gual, Antoni; Casquero, Rafael; Bobes, Julio; Ortega, Patricia

    2015-12-01

    The present manuscript is based on the recommendations of a panel of health care professionals, including several experts in primary health care, psychiatry and addictions. The participants are recognized specialists in the treatment of alcohol use disorder. The panel met in Barcelona on 2015 April 22 with the aims of evaluating the current management of alcohol use disorder in primary health care and developing a strategy to address this problem, basing on the evidence and the recommendations of the scientific societies and national and international organizations.

  5. Assessment and treatment of insomnia in adult patients with alcohol use disorders.

    PubMed

    Brower, Kirk J

    2015-06-01

    Insomnia in patients with alcohol dependence has increasingly become a target of treatment due to its prevalence, persistence, and associations with relapse and suicidal thoughts, as well as randomized controlled studies demonstrating efficacy with behavior therapies and non-addictive medications. This article focuses on assessing and treating insomnia that persists despite 4 or more weeks of sobriety in alcohol-dependent adults. Selecting among the various options for treatment follows a comprehensive assessment of insomnia and its multifactorial causes. In addition to chronic, heavy alcohol consumption and its effects on sleep regulatory systems, contributing factors include premorbid insomnia; co-occurring medical, psychiatric, and other sleep disorders; use of other substances and medications; stress; environmental factors; and inadequate sleep hygiene. The assessment makes use of history, rating scales, and sleep diaries as well as physical, mental status, and laboratory examinations to rule out these factors. Polysomnography is indicated when another sleep disorder is suspected, such as sleep apnea or periodic limb movement disorder, or when insomnia is resistant to treatment. Sobriety remains a necessary, first-line treatment for insomnia, and most patients will have some improvement. If insomnia-specific treatment is needed, then brief behavioral therapies are the treatment of choice, because they have shown long-lasting benefit without worsening of drinking outcomes. Medications work faster, but they generally work only as long as they are taken. Melatonin agonists; sedating antidepressants, anticonvulsants, and antipsychotics; and benzodiazepine receptor agonists each have their benefits and risks, which must be weighed and monitored to optimize outcomes. Some relapse prevention medications may also have sleep-promoting activity. Although it is assumed that treatment for insomnia will help prevent relapse, this has not been firmly established. Therefore

  6. Vital Signs Screening for Alcohol Misuse in a Rural Primary Care Clinic: A Feasibility Study

    ERIC Educational Resources Information Center

    Seale, J. Paul; Guyinn, Monique R.; Matthews, Michael; Okosun, Ike; Dent, M. Marie

    2008-01-01

    Context: Alcohol misuse is more common in rural areas, and rural problem drinkers are less likely to seek alcohol treatment services. Rural clinics face unique challenges to implementing routine alcohol screening and intervention. Purpose: To assess the feasibility of using the single alcohol screening question (SASQ) during routine nursing vital…

  7. Estimates of alcohol use and clinical treatment needs among homosexually active men and women in the U.S. population.

    PubMed

    Cochran, S D; Keenan, C; Schober, C; Mays, V M

    2000-12-01

    Concerns about dysfunctional alcohol use among lesbians and gay men are longstanding. The authors examined alcohol use patterns and treatment utilization among adults interviewed in the 1996 National Household Survey on Drug Abuse. Sexually active respondents were classified into 2 groups: those with at least 1 same-gender sexual partner (n = 194) in the year prior to interview and those with only opposite-gender sexual partners (n = 9,714). The authors compared these 2 groups separately by gender. For men, normative alcohol use patterns or morbidity did not differ significantly between the 2 groups. However, homosexually active women reported using alcohol more frequently and in greater amounts and experienced greater alcohol-related morbidity than exclusively heterosexually active women. Findings suggest higher risk for alcohol-related problems among lesbians as compared with other women, perhaps because of a more common pattern of moderate alcohol consumption.

  8. Within treatment therapeutic alliance ratings profiles predict posttreatment frequency of alcohol use.

    PubMed

    Prince, Mark A; Connors, Gerard J; Maisto, Stephen A; Dearing, Ronda L

    2016-03-01

    Although past research has demonstrated a positive relationship between the therapeutic alliance (TA) and improved drinking outcomes, specific aspects of the alliance have received less attention. In this study, we examined the association between alliance characteristics during treatment and 4-month follow-up drinking reports. Sixty-five treatment-seeking alcohol dependent clients who participated in 12 weeks of individual outpatient treatment provided weekly TA ratings during treatment and reported on pretreatment, during treatment, and posttreatment alcohol use. Latent profile analysis was conducted to discern distinct profiles of client and therapist ratings of therapeutic alliance with similar alliance characteristics. TA profiles were based on clients' and therapists' mean alliance rating, minimum alliance rating, maximum alliance rating, the range of alliance ratings, and the difference in session number between maximum and minimum alliance ratings. One- through 4-class models were fit to the data. Model fit was judged by comparative fit indices, substantive interpretability, and parsimony. Wald tests of mean equality determined whether classes differed on follow-up percentage of days abstinent (PDA) at 4-months posttreatment. Three-profile solutions provided the best fit for both client and therapist ratings of the therapeutic alliance. Client alliance rating profiles predicted drinking in the follow-up period, but therapist rating profiles did not. These results suggest that distinct profiles of the therapeutic alliance can be identified and that client alliance rating profiles are associated with frequency of alcohol use following outpatient treatment.

  9. [Assessment of problematic alcohol use].

    PubMed

    Rumpf, H-J; Bischof, G; Freyer-Adam, J; Coder, B

    2009-11-01

    An overview with respect to the identification of patients with risky drinking, alcohol abuse or alcohol dependence is given. As a first step, a simple screening questionnaire should be used. Self-statements in standardized questionnaires are more valid than standard laboratory markers. A useful instrument is for example BASIC. In screening positive patients, an in-depth diagnosis is necessary and helps to distinguish between different forms of problematic alcohol use. Depending on the severity of the alcohol problem, brochures, internet-programs, counselling or referral to treatment services is helpful.

  10. Feasibility of emergency department bilingual computerized alcohol screening, brief intervention, and referral to treatment.

    PubMed

    Vaca, Federico; Winn, Diane; Anderson, Craig; Kim, Doug; Arcila, Mauricio

    2010-10-01

    The purpose of this study was to assess the feasibility of utilizing a computerized alcohol screening and intervention (CASI) kiosk in an emergency department (ED). An interactive English and Spanish audiographical computer program, developed for used on a mobile computer cart, was administered to 5103 patients. Patients who screened at risk (19%) also received a fully computer-guided brief negotiated interview (BNI) and a printed personal alcohol reduction plan. A higher percentage of younger patients, and males (31% versus 16% females), screened at risk or dependent. Patient surveys indicated CASI was easy to use and over 75% did not prefer a medical professional over the computer. The ED-based bilingual computerized alcohol screening, brief intervention, and referral to treatment required little time to administer, was acceptable to patients, identified at-risk and dependent drinkers, and was able to provide personalized feedback and brief intervention.

  11. [Early detection, negotiation and treatment of alcohol use disorders in primary care].

    PubMed

    Reimer, J; Cimander, K F; Reimer, C

    2014-05-01

    Subjects with alcohol dependence or alcohol-related health problems frequently use the primary care system without receiving the correct diagnosis or specific interventions. Stigma, lack of knowledge and know-how with regards to diagnosis and treatment of alcohol-related disorders on the site of the health care professionals may contribute to the treatment gap. General anamnesis, clinical evaluation, and laboratory parameters can serve as indicators, and validated screening tests can further corroborate the hypothesis. However, a diagnosis should only be made according to ICD-10 criteria. Adequate counselling techniques substantially contribute to successful physician-patient interaction. Motivational Interviewing combines a positive, appreciative attitude with communicative techniques to create a motivation to change. It includes general approaches as open questions, appreciation of the patient, active listening, summarizing results as well as specific approaches such as change and confidence talk and dealing with resistance. Within a positive relationship, the conversation can lead to change. Brief interventions cover four to five sessions with a duration between five and sixty minutes. Brief interventions based on an empathic attitude und reflection of findings, a brief advice leaving the responsibility on the patient's side and supporting self-efficacy can improve alcohol-related disorders. The transtheoretical model of change may help the health care provider to adapt intervention strategies to the patient's state. Primary health care provides an adequate framework for screening, diagnosis and intervention for alcohol-related disorders with the aim of reduction or abstinence. Further institutions in addiction treatment such as self-help and clinical institutions may complement the treatment system.

  12. 78 FR 42529 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review....D., Scientific Review Administrator, National Institutes on Alcohol Abuse & Alcoholism,...

  13. 75 FR 38533 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis... Alcohol Abuse and Alcoholism, Office of Extramural Activities, Extramural Project Officer, 5635...

  14. 78 FR 42530 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review..., Ph.D., Scientific Review Officer, National Institute on Alcohol Abuse & Alcoholism,...

  15. 76 FR 77841 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-14

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review..., Ph.D., Scientific Review Officer, National Institute on Alcohol Abuse & Alcoholism,...

  16. 76 FR 78014 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-15

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review...., Scientific Review Administrator, National Institutes on Alcohol Abuse & Alcoholism, National Institutes...

  17. 75 FR 10808 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-09

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis... Officer, National Institute on Alcohol Abuse & Alcoholism, National Institutes of Health, 5635...

  18. 77 FR 22794 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-17

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review..., Ph.D., Scientific Review Administrator, National Institutes on Alcohol Abuse & Alcoholism...

  19. 77 FR 70171 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review... Review Officer, National Institute ] on Alcohol Abuse & Alcoholism, National Institutes of Health,...

  20. 76 FR 26308 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial Review..., Scientific Review Administrator, National Institutes On Alcohol Abuse & Alcoholism National, Institutes...

  1. 77 FR 22794 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-17

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism, Initial Review..., Ph.D., Scientific Review Officer, National Institute on Alcohol Abuse & Alcoholism,...

  2. 75 FR 57473 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis... Officer, National Institute on Alcohol Abuse and Alcoholism, Office of Extramural Activities,...

  3. Acardiac twin pregnancy: successful intrauterine ablative treatment with alcohol at 14 weeks of gestation.

    PubMed

    Guven, M A; Koc, O; Bodur, H; Erkanli, S; Bagis, T; Usal, D

    2016-01-01

    Twin reversed arterial perfusion (TRAP) sequence is a serious condition of monochorionic twin pregnancy, occurring in approximately one in 35,000 cases. First trimester treatment of TRAP sequence is controversial with higher incidence of procedure related complications. Present case demonstrates a TRAP sequence that was managed by intrauterine treatment with one-ml 100% pure alcohol injection into the abdominal part of the umbilical artery and obliteration of the acardiac twin at 14 weeks of gestation. Antenatal follow-up was uneventful and elective cesarean section was performed at 39 weeks' gestation. Postnatal outcome of the pump twin was excellent at 30 months after birth. Early second trimester elective ablation by alcohol injection can be an inexpensive, alternative, and reasonable minimal invasive treatment option to prevent fetal loss of pump twin before mid and late second trimester in perinatology centers where intrafetal cord occlusive methods are not available.

  4. Social stability on admission and success of in-patient treatment for alcoholism.

    PubMed

    Williams, R J

    1977-03-01

    The pre-treatment social stability score (combined economic-familial-residential scales), indicating whether the patients were comparatively integrated or disintegrated socially, was found to be of greater prognostic value regarding post-treatment drinking than was information about whether they received full, part or "no" treatment. There was a differential treatment effect for the first 3 months of the 12-month period only. Of the overall sample, one-third of the patients could be considered to have improved following treatment, but two-thirds drank as much, if not more, than they did prior to treatment. These two groups were significantly different in terms of social stability and different types of treatment appear necessary to accommodate these differences. Social integration/disintegration is most readily seen in terms of the number of previous treatments (or institutionalisations) the subject has received for alcohol-related problems.

  5. A smartphone application of alcohol resilience treatment for behavioral self-control training.

    PubMed

    Yu, Fei; Albers, Jörg; Gao, Tian; Wang, Minghao; Bilberg, Arne; Stenager, Elsebeth

    2012-01-01

    High relapse rate is one of the most prominent problems in addiction treatment. Alcohol Resilience Treatment (ART), an alcohol addiction therapy, is based on Cue Exposure Treatment, which has shown promising results in preliminary studies. ART aims at optimizing the core area of relapse prevention, and intends to improve patients' capability to withstand craving of alcohol. This method emphasizes the interplay of resilience and resourcefulness. It contains 6 sessions with different topics according to the stage of treatment circuit, and each session consists of 6 steps. Due to the purity and structure of the treatment rationale, it is realistic, reasonable and manageable to transform the method into a smartphone application. An ART app in Android system and an accessory of bilateral tactile stimulation were developed and will be used in a study with behavioral self-control training. This paper presents the design and realization of the smartphone based ART application. The design of a pilot study, which is to examine the benefits of a smartphone application providing behavioral self-control training, is also reported in this paper.

  6. HIV/AIDS Services in Private Substance Abuse Treatment Programs

    PubMed Central

    Abraham, Amanda J.; O’Brien, Lauren A.; Bride, Brian E.; Roman, Paul M.

    2010-01-01

    Background HIV infection among substance abusers is a growing concern in the United States. Little research, however, has examined the provision of HIV/AIDS services in substance abuse treatment programs. Methods This study examines the provision of onsite HIV/AIDS services in a nationally representative sample of 345 privately funded substance abuse treatment programs. Data were collected via face-to-face interviews with administrators and clinical directors of treatment programs in 2007–2008. Results Results show that larger programs and programs with a higher percentage of both African American and injection drug using (IDU) patients were more likely to offer onsite HIV/AIDS support groups and a dedicated HIV/AIDS treatment track. Multinomial logistic regression reveals that the odds of offering onsite HIV testing services were higher for hospital based programs, programs providing medical services onsite, and programs with higher percentages of African American patients, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. The odds of providing onsite testing were lower for outpatient-only treatment programs, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. Conclusions Our findings highlight critical barriers to the adoption of onsite HIV/AIDS services and suggest treatment programs are missing the opportunity to significantly impact HIV-related health outcomes. PMID:21145179

  7. Screening services for alcohol misuse and abuse at four-year colleges in the U.S.

    PubMed

    Lenk, Kathleen M; Erickson, Darin J; Winters, Ken C; Nelson, Toben F; Toomey, Traci L

    2012-10-01

    We examine the prevalence of screening for student alcohol misuse/abuse among 333 U.S. colleges via a survey of campus leaders. We also use latent class modeling to identify classes of colleges based on screening practices. We found that most colleges conduct screening after a student is involved in an alcohol-related incident, and about 50% of colleges screen students at regular health care visits. Legal, health care, and housing staff are trained in screening at nearly all colleges; other key personnel were trained at about one third of colleges. We identified four classes of colleges: 62% of colleges fit in a class that had many screening components in place, 9% in a class with very limited services, and the remainder (29%) fit in 2 middle classes. Although most colleges had many alcohol misuse/abuse screening components in place, more than one third show need for improvement in how, where, and when screening is conducted.

  8. Hitting rock bottom? Resource loss as a predictor of alcoholism treatment completion.

    PubMed

    Gruszczyńska, Ewa; Kaczmarek, Małgorzata; Chodkiewicz, Jan

    2016-07-01

    Background Efforts to better understand the phenomenon of the 'bottom', the beginning of the process of turning away from alcohol, are important for both theoretical and practical goals. The conservation of resources theory by Hobfoll may represent a suitable framework to base these attempts around. Aim The aim of the study was to examine the role of resource loss in completing alcoholism treatment on the basis of Hobfoll's conservation of resources theory. Methods The study included 86 patients undergoing inpatient alcoholism treatment. An assessment of resource loss and gain during the previous year, as well as of the decisional balance regarding the pros and cons of drinking alcohol, took place at the beginning of therapy. Results The results of hierarchical binary logistic regression confirmed that resource loss was the only significant predictor of therapy completion, after adjustment for decisional balance, demographics and basic clinical data. Additionally, gender moderated the relationship between resource gain and therapy completion: while an increase in gain was related to a decreased chance of completing therapy in men, the opposite effect was noted in women. Conclusions Resource loss has more influence than decisional balance in predicting therapy completion, which can be translated into clinically valid recommendations based on gender differences.

  9. Self-regulation, daily drinking, and partner violence in alcohol treatment-seeking men.

    PubMed

    Schumacher, Julie A; Coffey, Scott F; Leonard, Kenneth E; O'Jile, Judith R; Landy, Noah C

    2013-02-01

    This study builds on research identifying deficits in behavioral self-regulation as risk factors for intimate partner violence (IPV). It also builds on alcohol administration research identifying these deficits as moderators of the association between acute alcohol consumption and aggression in laboratory paradigms. Participants analyzed were 97 men seeking residential treatment for alcohol dependence who were involved in a current or recent heterosexual relationship of at least 1 year. Participants completed a self-report measure of impulsivity, neuropsychological tests of executive function, and computerized delay discounting and behavioral inhibition tasks. With the exception of the self-report measure of impulsivity, performance on measures of behavioral self-regulation was not associated with the occurrence or frequency of past year IPV in this sample. Similarly, self-reported impulsivity moderated the association between daily drinking and IPV in multivariate models controlling for daily drug use, but deficits in performance on other measures did not. Performance on a tower task moderated the association between daily drinking and the occurrence of IPV, but contrary to hypotheses, better task performance was associated with greater likelihood of IPV on drinking days. These results suggest that self-perceived impulsivity is a better predictor of IPV in alcohol treatment seeking men than deficits in performance on behavioral measures of delay discounting, behavioral inhibition, and executive function.

  10. The contribution of emotional maltreatment to alcohol dependence in a treatment-seeking sample.

    PubMed

    Potthast, Nadine; Neuner, Frank; Catani, Claudia

    2014-05-01

    Studies reporting a link between child maltreatment and addiction have typically focused on physical and sexual abuse. In contrast, emotional maltreatment has rarely been studied in substance-abusing samples although it is associated with a wide range of dysfunction. The current study aimed to determine the specific impact of different types of maltreatment and peer victimization on alcohol dependence and to examine the potentially mediating role of psychopathology. A sample of treatment seeking adults with alcohol dependence (N=72) underwent an extensive clinical examination including both a standardized interview and self-report measures. Child maltreatment, peer victimization, severity of alcohol dependence, and general psychopathology were assessed. Regression analyses revealed that emotional maltreatment was the strongest predictor of alcohol dependence severity whereas a unique contribution of peer victimization was not found. Our findings suggest that emotional maltreatment might have a major role in the etiology of AD that seems to exceed the contribution of other abuse and victimization experiences. Thereby, the study underscores the need for considering child maltreatment experiences in the prevention and treatment of AD.

  11. Alcohol and Marijuana Use and Treatment Nonadherence Among Medically Vulnerable Youth

    PubMed Central

    Ziemnik, Rosemary E.; Huang, Quian; Levy, Sharon

    2015-01-01

    BACKGROUND AND OBJECTIVE: Adolescents face peak risks for onset and intensification of alcohol and marijuana use. However, we know little about these behaviors and their associations with knowledge or treatment adherence among chronically ill youth, a medically vulnerable group. METHODS: Cross-sectional assessment of consented youth ages 9 to 18 years receiving care for asthma/cystic fibrosis, type 1 diabetes, arthritis, or inflammatory bowel disease (IBD) by using a self-administered online tool. Prevalence and correlates of risk behaviors and associations with knowledge and treatment adherence were estimated using descriptive statistics and logistic regression, controlling for demographics, mental health, and the multiclinic sampling frame. RESULTS: Of 403 consented youth (75.8% response), 51.6% were girls, 75.1% were white, and average age was 15.6 years. Of high school youth, 36.5% and 12.7% reported past-year alcohol use and binge drinking, respectively; 20% reported past-year marijuana use. Among high school youth, 53.1% and 37.2% answered correctly that alcohol can interfere with their medications and laboratory tests; youth answering incorrectly were 8.53 and 4.46 times more likely to drink and binge drink, respectively (P values < .001). Thirty-two percent and 8.3% of high school youth reported regularly forgetting or skipping their medications in the past 30 days; compared with past-year nondrinking youth, drinkers were 1.79 and 1.61 times as likely to report regularly missing or skipping medications (P values < .05). CONCLUSIONS: Alcohol and marijuana use are common among youth with chronic medical conditions. Alcohol use is associated with treatment nonadherence. Education and preventive interventions are warranted to ameliorate risk. PMID:26668849

  12. Neural activation during processing of aversive faces predicts treatment outcome in alcoholism.

    PubMed

    Charlet, Katrin; Schlagenhauf, Florian; Richter, Anne; Naundorf, Karina; Dornhof, Lina; Weinfurtner, Christopher E J; König, Friederike; Walaszek, Bernadeta; Schubert, Florian; Müller, Christian A; Gutwinski, Stefan; Seissinger, Annette; Schmitz, Lioba; Walter, Henrik; Beck, Anne; Gallinat, Jürgen; Kiefer, Falk; Heinz, Andreas

    2014-05-01

    Neuropsychological studies reported decoding deficits of emotional facial expressions in alcohol-dependent patients, and imaging studies revealed reduced prefrontal and limbic activation during emotional face processing. However, it remains unclear whether this reduced neural activation is mediated by alcohol-associated volume reductions and whether it interacts with treatment outcome. We combined analyses of neural activation during an aversive face-cue-comparison task and local gray matter volumes (GM) using Biological Parametric Mapping in 33 detoxified alcohol-dependent patients and 33 matched healthy controls. Alcoholics displayed reduced activation toward aversive faces-neutral shapes in bilateral fusiform gyrus [FG; Brodmann areas (BA) 18/19], right middle frontal gyrus (BA46/47), right inferior parietal gyrus (BA7) and left cerebellum compared with controls, which were explained by GM differences (except for cerebellum). Enhanced functional activation in patients versus controls was found in left rostral anterior cingulate cortex (ACC) and medial frontal gyrus (BA10/11), even after GM reduction control. Increased ACC activation correlated significantly with less (previous) lifetime alcohol intake [Lifetime Drinking History (LDH)], longer abstinence and less subsequent binge drinking in patients. High LDH appear to impair treatment outcome via its neurotoxicity on ACC integrity. Thus, high activation of the rostral ACC elicited by affective faces appears to be a resilience factor predicting better treatment outcome. Although no group differences were found, increased FG activation correlated with patients' higher LDH. Because high LDH correlated with worse task performance for facial stimuli in patients, elevated activation in the fusiform 'face' area may reflect inefficient compensatory activation. Therapeutic interventions (e.g. emotion evaluation training) may enable patients to cope with social stress and to decrease relapses after detoxification.

  13. Effect of variations in treatment regimen and liver cirrhosis on exposure to benzodiazepines during treatment of alcohol withdrawal syndrome

    PubMed Central

    Gershkovich, Pavel; Wasan, Kishor M; Ribeyre, Charles; Ibrahim, Fady; McNeill, John H

    2015-01-01

    Purpose: Benzodiazepines (BDZs) are the drugs of choice to prevent the symptoms of alcohol withdrawal syndrome (AWS). Various treatment protocols are published and have been shown to be effective in both office-managed and facility-managed treatment of AWS. The aim of this scientific commentary is to demonstrate the differences in the expected exposure to BDZs during AWS treatment using different treatment regimens available in the literature, in patients with or without alcoholic liver cirrhosis. Methods: Diazepam and lorazepam AWS protocols were examined and reviewed in the literature, and blood plasma levels were examined and compared, respectively. Results: Considerable variation in the blood levels with the different dosing schedules was found. Because the drugs are metabolized differently, we have also shown that liver disease affects the blood levels of diazepam, but not of lorazepam. Conclusions: Differences in treatment regimens, the choice of BDZ, as well as the presence of liver cirrhosis can substantially alter the exposure of patients to drugs used for AWS treatment. Outpatient treatment of AWS has been shown to be relatively safe and effective for the treatment of AWS but patients should be carefully monitored. PMID:26322116

  14. A comparison of three methods of measuring the type and quantity of services provided during substance abuse treatment.

    PubMed

    Zanis, D A; McLellan, A T; Belding, M A; Moyer, G

    1997-12-01

    This study examined three data collection methods of quantifying and categorizing treatment services provided in a publicly funded methadone program. All three approaches were research technician implemented: (1) bi-weekly patient interview with the Treatment Services Review (TSR); (2) weekly counselor interview by the Counselor Services Interview (CSI); and (3) data abstraction from clinical patient records (REC). Fifty patients were followed over 28 days using each method to assess the services received/provided within the program. Five service domains were assessed: medical, employment, alcohol/drug, family, and psychiatric. Correlations were calculated among the three methods of data collection across each of the five service domains. Overall, low to moderate correlations were found with the highest rates of agreement detected between the TSR and the REC in the employment domain (0.48) and the REC and CSI in the family domain (0.48). Post hoc focus groups with the counselors and patients found that: (1) counseling sessions rarely focused on specific problem domains; (2) counselors and patients disagreed about the quality of treatment services; and (3) counselors 'rounded-up' time spent counseling. These findings suggest that measuring treatment service delivery varies markedly based on who provides the information (e.g. patient or treatment staff) and what procedures are used for data collection (e.g. chart abstraction or self-report).

  15. Southeast Asian Mental Health: Treatment, Prevention, Services, Training and Research.

    ERIC Educational Resources Information Center

    Owan, Tom Choken, Ed.

    This sourcebook contains 19 papers which discuss the mental health service needs of Southeast Asian refugees in the United States. The volume is divided into five sections: Treatment; Prevention; Services; Training; and Research. The papers (and their authors) are: (1) "Psychiatric Care for Southeast Asians: How Different Is Different?"…

  16. Transcranial magnetotherapy in the complex treatment of affective disorders in patients with alcoholism.

    PubMed

    Staroverov, A T; Vil'yanov, V B; Raigorodskii, Yu M; Rogozina, M A

    2009-06-01

    Transcranial magnetotherapy (TMT) was used in 32 patients with alcoholism (study group) on the background of basal treatment (nootropes, hepatoprotectors, vitamin/mineral formulations, etc.). The influence of this treatment was compared with a control group (30 subjects), in which TMT was replaced with an appropriate (placebo) procedure. All patients, who were aged from 35 to 64 years, had second-degree alcoholism with disease durations of 4-12 years. Patients were in a post-abstinence state during the treatment period. Courses of TMT consisted of 10 daily procedures with exposures of 10-20 min. Somatic, neurological, and laboratory studies were performed before and after treatment and included cardiointervalography, electroencephalography, assessments of the state of the autonomic nervous system, and use of psychometric scales to evaluate levels of anxiety and depression. TMT was followed by improvements in wellbeing, mood, and sleep, with increases in physical exercise tolerance and decreases in alcohol craving in 75% of patients in the study group and 30% of patients in the control group. Improvements in patients' status were supported by paraclinical investigations (electrophysiological, measures of the state of the autonomic nervous system, etc.) and psychometric scales.

  17. [Recommendations on classification of German pain treatment services].

    PubMed

    Sabatowski, R; Maier, C; Willweber-Strumpf, A; Thomm, M; Nilges, P; Kayser, H; Casser, R

    2011-08-01

    On behalf of the German chapter of the International Association for the Study of Pain (IASP) recommendations for German pain treatment services have been developed for the first time. The criteria were based on the IASP recommendations but adapted to the specific German situation. According to the structure and process criteria four different levels of pain treatment services can be distinguished. The aim of the recommendations is to serve as a guide for future development and implementation of pain therapy and quality assurance.

  18. Cognitive control network function in alcohol use disorder before and during treatment with lorazepam.

    PubMed

    Wilcox, Claire E; Mayer, Andrew R; Bogenschutz, Michael P; Ling, Josef; Dekonenko, Charlene; Cumbo, Heather

    2015-01-01

    Individuals with alcohol use disorders (AUDs) have deficits in cognitive control, but how they change with treatment is unclear. Seven patients with AUD and anxiety from an open-label trial of disulfiram plus lorazepam performed a multisensory Stroop task during fMRI (both pre and post initiation of treatment), and were compared to nine healthy controls (HCs) (n = 16; Albuquerque, NM; years 2009-2012). Evoked BOLD signal and resting state functional connectivity were compared (HC vs. AUD; Scan 1 vs. Scan 2). AUD demonstrated hyperactivity and altered connectivity in the cognitive control network compared to HC, but treatment did not normalize function.

  19. Cognitive Control Network Function in Alcohol Use Disorder Before and During Treatment With Lorazepam

    PubMed Central

    Wilcox, Claire E.; Mayer, Andrew R.; Bogenschutz, Michael P; Ling, Josef; Dekonenko, Charlene; Cumbo, Heather

    2015-01-01

    Individuals with alcohol use disorders (AUDs) have deficits in cognitive control, but how they change with treatment is unclear. Seven patients with AUD and anxiety from an open-label trial of disulfiram plus lorazepam performed a multisensory Stroop task during fMRI (both pre and post initiation of treatment), and were compared to nine healthy controls (HCs) (n = 16; Albuquerque, NM; years 2009–2012). Evoked BOLD signal and resting state functional connectivity were compared (HC vs. AUD; Scan 1 vs. Scan 2). AUD demonstrated hyperactivity and altered connectivity in the cognitive control network compared to HC, but treatment did not normalize function. PMID:25290463

  20. Investigation of allyphenyline efficacy in the treatment of alcohol withdrawal symptoms.

    PubMed

    Ubaldi, Massimo; Del Bello, Fabio; Domi, Esi; Pigini, Maria; Nasuti, Cinzia

    2015-08-05

    We have recently demonstrated that allyphenyline, behaving as α2C-adrenoceptor/serotonin 5-HT1A receptor agonist and α2A-adrenoceptor antagonist, in mice enhanced morphine analgesia, attenuated morphine withdrawal symptoms, showed significant antidepressant-like activity and was devoid of sedative side effects. Opioid and alcohol withdrawal shares several common neurobiological and molecular mechanisms. Therefore, in this study we expanded our analysis of the pharmacological properties of allyphenyline by investigating its ability to prevent the expression of somatic withdrawal signs, anxiety-like behavior and hyperlocomotion associated with chronic ethanol intoxication. Rats were subjected to induction of ethanol dependence via repeated daily intragastric ethanol (20%) administration for 4 consecutive days. Twelve hours after the last alcohol administration, somatic alcohol withdrawal signs were scored. Results revealed a significant expression of physical withdrawal signs that were not affected by intraperitoneal (i.p.) administration of allyphenyline at the doses of 0.05, 0.275 and 0.5 mg/kg. In contrast, allyphenyline (0.05 and 0.275 mg/kg i.p.) significantly reduced hyperanxiety-like behavior observed 6 days after alcohol intoxication as measured using the defensive burying test. Allyphenyline also reduced open field hyperlocomotor activity associated with alcohol withdrawal. Notably, the anxiolytic effect of the compound, as well as the already reported antidepressant action, was observed at very low doses, suggesting the involvement of its α2C-adrenoceptor/serotonin 5-HT1A receptor agonism. Therefore, the present investigation suggests that allyphenyline might represent an interesting pharmacological tool to investigate the potential of compounds exhibiting α2C-adrenoceptor/serotonin 5-HT1A receptor agonism and α2A-adrenoceptor antagonism in the treatment of hyperanxiety and hyperlocomotion occurring during alcohol withdrawal in dependent subjects.

  1. Internet Therapy versus Internet Self-Help versus No Treatment for Problematic Alcohol Use: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Blankers, Matthijs; Koeter, Maarten W. J.; Schippers, Gerard M.

    2011-01-01

    Objective: Problematic alcohol use is the third leading contributor to the global burden of disease, partly because the majority of problem drinkers are not receiving treatment. Internet-based alcohol interventions attract an otherwise untreated population, but their effectiveness has not yet been established. The current study examined the…

  2. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 404.1536... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction...

  3. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 404.1536... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction...

  4. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 404.1536... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction...

  5. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 404.1536... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction...

  6. Heterogeneous impact of alcohol consumption according to treatment method on survival in head and neck cancer: A prospective study.

    PubMed

    Sawabe, Michi; Ito, Hidemi; Oze, Isao; Hosono, Satoyo; Kawakita, Daisuke; Tanaka, Hideo; Hasegawa, Yasuhisa; Murakami, Shingo; Matsuo, Keitaro

    2017-01-01

    Alcohol consumption is an established risk factor, and also a potential prognostic factor, for squamous cell carcinoma of the head and neck (HNSCC). However, little is known about whether the prognostic impact of alcohol consumption differs by treatment method. We evaluated the association between alcohol drinking and survival by treatment method to the primary site in 427 patients with HNSCC treated between 2005 and 2013 at Aichi Cancer Center Central Hospital (Nagoya, Japan). The impact of alcohol on prognosis was measured by multivariable Cox regression analysis adjusted for established prognostic factors. Among all HNSCC patients, the overall survival rate was significantly poorer with increased levels of alcohol consumption in multivariable analysis (trend P = 0.038). Stratification by treatment method and primary site revealed that the impact of drinking was heterogeneous. Among laryngopharyngeal cancer (laryngeal, oropharyngeal, and hypopharyngeal cancer) patients receiving radiotherapy (n = 141), a significant dose-response relationship was observed (trend P = 0.034). In contrast, among laryngopharyngeal cancer patients treated with surgery (n = 80), no obvious impact of alcohol was observed. This heterogeneity in the impact of alcohol between surgery and radiotherapy was significant (for interaction, P = 0.048). Furthermore, among patients with oral cavity cancer treated by surgery, a significant impact of drinking on survival was seen with tongue cancer, but not with non-tongue oral cancer. We observed a significant inverse association between alcohol drinking and prognosis among HNSCC patients, and its impact was heterogeneous by treatment method and primary site.

  7. Moderating Effects of a Craving Intervention on the Relation between Negative Mood and Heavy Drinking Following Treatment for Alcohol Dependence

    ERIC Educational Resources Information Center

    Witkiewitz, Katie; Bowen, Sarah; Donovan, Dennis M.

    2011-01-01

    Objective: Negative affect is a significant predictor of alcohol relapse, and the relation between negative affect and drinking has been shown to be strongly mediated by alcohol craving. Thus, targeting craving during treatment could potentially attenuate the relation between negative affect and drinking. Method: The current study is a secondary…

  8. Differences in Personality Disorders and Family-of-Origin Characteristics for Male and Female Alcoholics: Implications for Treatment.

    ERIC Educational Resources Information Center

    Lisek, Victor J.; Coll, Kenneth M.

    1997-01-01

    Investigated personality and family-of-origin differences in male and female alcoholics. Results, based on medical records (N=204) of patients admitted to a residential chemical dependency center indicate that, regarding personality disturbances, men were healthier than women. More women had psychiatric treatment, were married to an alcoholic, or…

  9. Cloninger's typology and treatment outcome in alcohol-dependent subjects during pharmacotherapy with naltrexone.

    PubMed

    Kiefer, Falk; Jiménez-Arriero, Miguel Angel; Klein, Oliver; Diehl, Alexander; Rubio, Gabriel

    2008-03-01

    Naltrexone is an opiate receptor antagonist mainly at the micro-receptor that is thought to reduce the positively reinforcing, pleasurable effects of alcohol and to reduce craving. An increase in time to first relapse to heavy drinking has been the most consistent finding obtained with naltrexone, although not all trials including two of the largest have been positive. Inconsistent outcome data suggest that effectiveness varies among different subgroups of patients. This paper re-evaluates recent data on the effectiveness of naltrexone in subjects differentiated according to Cloninger Type I and II. Moreover, it combines and cross-validates results of two recent European studies that found naltrexone treatment more beneficial in alcohol-dependent patients with early age at onset of drinking problems (Cloninger Type II). It is discussed whether especially these subjects should be targeted for pharmacological relapse prevention treatment with naltrexone.

  10. Development of Child-Teen Obesity Treatment Service Platform

    PubMed Central

    Lim, Kahyun; Lee, Byung Mun

    2016-01-01

    Objectives This study aimed to develop an effective and efficient obesity treatment and management service platform for obese children/teenagers. Methods The integrated smart platform was planned and established through cooperation with service providers such as hospitals and public health centers, obese children/teenagers who constitute the service's user base, and IT development and policy institutions and companies focusing on child-teen obesity management and treatment. Results Based on guidelines on intervention strategies to manage child-teen obesity, we developed two patient/parent mobile applications, one web-monitoring service for medical staff, one mobile application for food-craving endurance, and one mobile application for medical examinations. Conclusions The establishment of the integrated service platform was successfully completed; however, this study was restrictively to the hospital where the pilot program took place. The effectiveness of the proposed platform will be verified in the future in tests involving other organizations. PMID:27525166

  11. The role of the working alliance in treatment for alcohol problems.

    PubMed

    Cook, Sarah; Heather, Nick; McCambridge, Jim

    2015-06-01

    Little research has been done on the role of the therapeutic working alliance in treatment for alcohol problems. This longitudinal study's objectives were (a) to identify predictors of working alliance and (b) to investigate whether client and/or therapist reports of the working alliance predicted posttreatment motivation and then later treatment outcome. Client and therapist perceptions of the working alliance were assessed after the first treatment session using a short form of the Working Alliance Inventory (WAI) among 173 clients taking part in the United Kingdom Alcohol Treatment Trial (UKATT) and randomized to motivational enhancement therapy (MET) or social behavior and network therapy (SBNT) with complete data on all measures of interest. Structural equation models were fitted to identify predictors of WAI scores and investigate the relationships between WAI and measures of drinking during treatment, posttreatment motivation, and successful treatment outcome (abstinent or nonproblem drinker), and measures of drinks per drinking day and nondrinking days, assessed 9 months after the conclusion of treatment. Motivation to change drinking when treatment began was a strong predictor of client-adjusted coefficient = 2.21 (95% confidence interval [CI] [0.36, 4.06]-but not therapist WAI. Client WAI predicted successful treatment outcome-adjusted odds ratios (OR) = 1.09 (95% CI [1.02, 1.17])-and had effects on drinking during treatment, and on posttreatment motivation to change. There was evidence for effect modification by treatment, with strong associations between WAI and posttreatment motivation, and evidence of WAI prediction of treatment outcomes in the MET group, but no evidence of associations for SBNT. Therapist WAI was not strongly associated with treatment outcome (adjusted OR = 1.05; 95% CI [0.99, 1.10]). The working alliance is important to treatment outcomes for alcohol problems, with client evaluation of the alliance strongly related to motivation to

  12. Alcohol and Health. Fifth Special Report to the U.S. Congress from the Secretary of Health and Human Services.

    ERIC Educational Resources Information Center

    National Inst. on Alcohol Abuse and Alcoholism (DHHS), Rockville, MD.

    This report is divided into an overview of alcohol and health, and eight chapters which deal with various aspects of alcohol use and abuse. The epidemiology of alcohol abuse and alcoholism is discussed. Data are presented on self-reported consumption of alcohol among youths and adults; alcohol consumption during pregnancy; alcohol-related…

  13. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and six months

    PubMed Central

    Madras, Bertha K.; Compton, Wilson M.; Avula, Deepa; Stegbauer, Tom; Stein, Jack B.; Clark, H. Westley

    2009-01-01

    Objectives Alcohol screening and brief interventions in medical settings can significantly reduce alcohol use. Corresponding data for illicit drug use is sparse. A Federally funded Screening, Brief Intervention, Referral to Treatment (SBIRT) service program, the largest of its kind to date, was initiated by the Substance Abuse and Mental Health Services Administration (SAMHSA) in a wide variety of medical settings. We compared illicit drug use at intake and six months after drug screening and interventions were administered. Design SBIRT services were implemented in a range of medical settings across six states. A diverse patient population (Alaska Natives, American Indians, African-Americans, Caucasians, Hispanics), was screened and offered score-based progressive levels of intervention (brief intervention, brief treatment, referral to specialty treatment). In this secondary analysis of the SBIRT service program, drug use data was compared at intake and at a six month follow-up, in a sample of a randomly selected population (10%) that screened positive at baseline. Results Of 459,599 patients screened, 22.7% screened positive for a spectrum of use (risky/problematic, abuse/addiction). The majority were recommended for a brief intervention (15.9%), with a smaller percentage recommended for brief treatment (3.2%) or referral to specialty treatment (3.7%). Among those reporting baseline illicit drug use, rates of drug use at 6 month follow-up (4 of 6 sites), were 67.7% lower (p < 0.001) and heavy alcohol use was 38.6% lower (p < 0.001), with comparable findings across sites, gender, race/ethnic, age subgroups. Among persons recommended for brief treatment or referral to specialty treatment, self-reported improvements in general health (p < 0.001), mental health (p < 0.001), employment (p < 0.001), housing status (p < 0.001), and criminal behavior (p < 0.001) were found. Conclusions SBIRT was feasible to implement and the self-reported patient status at six months

  14. Alcohol use and treatment among Former Soviet Union immigrants in Israel: review of publications July 2009-December 2011.

    PubMed

    Weiss, Shoshana

    2012-01-01

    This article examines the current state of alcohol use among immigrants from the Former Soviet Union (FSU) in Israel, as an update to the 2 previous publications that reviewed studies published in the professional literature (mainly in Hebrew) and referred to earlier periods (from the early 1990s until 2006 and from 2007 through June 2009). This article reviews studies published primarily in Hebrew from mid-2009 throughout December 2011 and describes alcohol use patterns and treatment among FSU immigrants. As the third in the sequence of reviews aimed at English readers, it confirms the findings of the previous 2 reviews. Alcohol use among FSU immigrants continues to be more prevalent than among Israeli-born residents, and FSU immigrants continue to be overrepresented in treatment programs. Moreover, the review describes a severe worsening in alcohol use among FSU detached youth and no differences in alcohol use among early and recent immigrants between the ages of 18 and 40 years.

  15. Alcohol use in Polish 9/11 responders: implications for cross-cultural treatment.

    PubMed

    Katz, Craig L; Jutras-Aswad, Didier; Kiliman, Marta; Pilatowicz, Iwona; Akerele, Evaristo; Marrone, Kathryn; Ozbay, Fatih

    2012-01-01

    More than 35,000 individuals are estimated to have responded to the World Trade Center (WTC) site following the terrorist attacks of September 11, 2001. The federally funded WTC Medical Monitoring and Treatment Program (WTCMMTP) provides medical monitoring and occupational medicine treatment as well as counseling regarding entitlements and benefits to the workers and volunteers who participated in the WTC response. A major component of the WTCMMTP is the WTC Mental Health Program (WTCMHP), which offers annual mental health assessments and ongoing treatment for those found to have 9/11 associated mental health problems. In the program's 9.5 years of evaluating and treating mental health problems in thousands of Ground Zero responders, diversity in multiple domains (e.g., gender, family, profession and employment status, state of physical health, cultural identity, and immigration status) has been a hallmark of the population served by the program. To illustrate the types of issues that arise in treating this diverse patient population, the authors first present a representative case involving a Polish asbestos worker with an alcohol use disorder. They then discuss how accepted alcohol treatment modalities can and often must be modified in providing psychiatric treatment to Polish responders, in particular, and to foreign-born patients in general. Treatment modalities discussed include cognitive and behavioral therapy, relapse prevention strategies, psychodynamic therapy, motivational approaches, family therapy, group peer support, and pharmacotherapy. Implications for the practice of addiction psychiatry, cultural psychiatry, and disaster psychiatry are discussed.

  16. Treatment of acute alcohol withdrawal with gabapentin: results from a controlled two-center trial.

    PubMed

    Bonnet, Udo; Banger, Markus; Leweke, F Markus; Specka, Michael; Müller, Bernhard W; Hashemi, Thilo; Nyhuis, Peter W; Kutscher, Sven; Burtscheidt, Wilhelm; Gastpar, Markus

    2003-10-01

    A few case reports and data from animal experiments point to a possible efficacy of gabapentin (GP) in the treatment of alcohol withdrawal syndrome (AWS). Because of ethical considerations, the efficacy of GP in acute AWS was tested in an add-on fashion to clomethiazole (CLO). Given that the symptom-triggered amount of CLO required to limit AWS within the first 24 hours is related to the severity of AWS, we tested this amount of CLO during placebo (P) or GP (400 mg qid) under double blind, randomized conditions. Sixty-one patients (P = 29/GP = 32) suffering from alcohol dependence (ICD-10) and without any other psychiatric condition or psychotropic medication were included. The groups were not significantly different in baseline characteristics (eg, demographic data, severity of AWS). Both ITT and completer analyses revealed no significant differences between the groups considering the primary effectiveness measure: amount of CLO required in the first 24 hours (P = 6.1 +/- 5.4/GP = 6.2 +/- 4.7 capsules). In addition, premature discontinuations (P = 3/GP = 2) and decreases in Mainz Alcohol Withdrawal Scores were not significantly different in the first 48 hours of AWS (secondary effectiveness measures). Tolerability of combined CLO/GP was studied throughout the whole treatment comprising a 5-day lasting reduction part subsequent to the first 48 hours. Throughout the whole 7-day treatment a total of 5 and 2 patients dropped out and 6 and 5 patients reported adverse clinical events in the P and GP groups, respectively. All together, GP (400 mg qid) was no better than P in saving initial consumption of CLO or decreasing initial Mainz Alcohol Withdrawal Scores suggesting that GP was ineffective in the management of acute AWS in this model. The combination of GP and CLO was safe.

  17. Phobic anxiety and depression as predictor variables for treatment outcome. A LISREL analysis on treated female alcoholics.

    PubMed

    Haver, Brit; Gjestad, Rolf

    2005-01-01

    The study focuses on the relationship between phobic anxiety and depression, alcohol abuse, treatment and drinking outcome in female alcoholics. A structural equation analysis (LISREL) was used to test the strength and direction of predictor variables, enabling the development of models for the process of change taking place following treatment. Participants were patients attending a specific treatment programme for women with alcohol problems at Karolinska Hospital, Stockholm, Sweden. One hundred and twenty female alcoholics consecutively admitted during 1991-1993 were followed up 2 years after treatment. The Alcohol Use Inventory (AUI) and Symptom Check List-90 were used at intake and follow-up. Duration of problem drinking and depression at follow-up affected drinking outcome directly and negatively, whereas duration of treatment affected drinking outcome directly and positively in all our models. Phobic anxiety on the other hand affected drinking outcome negatively and indirectly, via shorter treatment duration and higher depression at follow-up. Using different outcome variables as an end product resulted in only minor changes. Thus, the model presented is viewed as robust and clinically meaningful. The results underscore the importance of phobic anxiety and recurrent or sustained depression--in addition to the pre-treatment duration of problem drinking--for the drinking outcome among female alcoholics.

  18. Women’s Motivators for Seeking Treatment for Alcohol Use Disorders

    PubMed Central

    Grosso, Justine A.; Epstein, Elizabeth E.; McCrady, Barbara S.; Gaba, Ayorkor; Cook, Sharon; Backer-Fulghum, Lindsey M.; Graff, Fiona S.

    2013-01-01

    This study examined types of internal and external motivation for seeking treatment and the predictive utility of different types of motivation among 180 women with an alcohol use disorder (AUD) participating in a two-armed trial testing different individual and couple therapies for AUDs. Reasons for seeking treatment were coded for type of internal or external motivation. Most women (97%) cited internal reasons for seeking help, including: concern about progression of AUD (61.1%), health (43.3%), mental health (38.9%), and family (38.3%). Occupational concerns, an internal motivator cited by 6% of women, were associated with better drinking outcomes; interpersonal-family concerns were associated with poorer outcomes. Some motivators for seeking treatment may not be related to sustained changes in drinking, suggesting that understanding motivators for treatment may be inadequate to maintain change. Reasons for help-seeking may need to be addressed in treatment to produce long-lasting change. PMID:23501141

  19. Efficacy of transcranial magnetotherapy in the complex treatment of alcohol withdrawal syndrome.

    PubMed

    Staroverov, A T; Zhukov, O B; Raigorodskii, Yu M

    2009-11-01

    A total of 54 patients with alcoholism were studied during abstinence. Of these, 29 patients in the experimental group received basal therapy supplemented with physical treatment consisting of transcranial dynamic magnetotherapy (TcDMT), while the control group of 25 patients received only basal therapy. Comparison of the status of patients in the experimental and control groups during treatment demonstrated advantages of TcDMT in relation to improving the functional state of the CNS, memory, and attention, the autonomic nervous system, and the psychoemotional status of the patients (with decreases in the severity of anxiety and depression).

  20. Spirituality, Religiousness, and Alcoholism Treatment Outcomes: A Comparison between Black and White Participants

    PubMed Central

    Krentzman, Amy R.; Farkas, Kathleen J.; Townsend, Aloen L.

    2012-01-01

    This study addresses an unexplained finding in the alcoholism treatment field: despite the health and socioeconomic disparities that exist between blacks and whites at intake, blacks and whites achieve equivalent treatment outcomes. Using Project MATCH data, this study explores religiousness and spirituality as strengths in the African American community that may account in part for equivalent outcomes. Using binary logistic regression, this study found that as purpose in life increased, blacks were more likely to achieve sobriety than whites. This study provides evidence that purpose in life is a cultural strength and an advantage among blacks in achieving sobriety. PMID:22707846

  1. Study Protocol: Screening and Treatment of Alcohol-Related Trauma (START) – a randomised controlled trial

    PubMed Central

    2012-01-01

    Background The incidence of mandibular fractures in the Northern Territory of Australia is very high, especially among Indigenous people. Alcohol intoxication is implicated in the majority of facial injuries, and substance use is therefore an important target for secondary prevention. The current study tests the efficacy of a brief therapy, Motivational Care Planning, in improving wellbeing and substance misuse in youth and adults hospitalised with alcohol-related facial trauma. Methods and design The study is a randomised controlled trial with 6 months of follow-up, to examine the effectiveness of a brief and culturally adapted intervention in improving outcomes for trauma patients with at-risk drinking admitted to the Royal Darwin Hospital maxillofacial surgery unit. Potential participants are identified using AUDIT-C questionnaire. Eligible participants are randomised to either Motivational Care Planning (MCP) or Treatment as Usual (TAU). The outcome measures will include quantity and frequency of alcohol and other substance use by Timeline Followback. The recruitment target is 154 participants, which with 20% dropout, is hoped to provide 124 people receiving treatment and follow-up. Discussion This project introduces screening and brief interventions for high-risk drinkers admitted to the hospital with facial trauma. It introduces a practical approach to integrating brief interventions in the hospital setting, and has potential to demonstrate significant benefits for at-risk drinkers with facial trauma. Trial Registration The trial has been registered in Australian New Zealand Clinical Trials Registry (ANZCTR) and Trial Registration: ACTRN12611000135910. PMID:23106916

  2. Alcoholism and Alcohol Abuse

    MedlinePlus

    ... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... groups. NIH: National Institute on Alcohol Abuse and Alcoholism

  3. [Pharmacological treatment in alcohol-, drug- and benzodiazepine-dependent patients - the significance of trazodone].

    PubMed

    Funk, Sándor

    2013-06-01

    Currently detoxification of drug and alcohol dependent patients is pharmacologically unresolved, and long-term treatment following the acute phase is also not very successful including a high number of relapses. We would need medications that on the short term cease: the severe vegetative symptoms, the pain, the extremely distressing psychosyndrome characterised by restlessness, anxiety or acute depressive symptoms, and the craving. The optimal would be if there was one medication capable of simultaneously alleviating or diminishing all the above symptoms without causing dependency and preventing relapse in the long-term. Dependency is almost all cases accompanied by primary and/or secondary mood disorder or sleep disorder which should also be treated. It should be considered, however, that following withdrawal of the agent benzodiazepine dependency often develops. The serotonin antagonist and reuptake inhibitor (SARI) trazodone is effective in the treatment of depression accompanied by sleeping disorder and it has also shown efficacy in alcohol and benzodiazepine-dependency. Its administration may improve the efficacy of detoxification and treatment of following conditions, may decrease medication load and the risk of the development of benzodiazepine dependency. In our clinical practice we frequently use this agent to treat our patients simultaneously suffering from depression and addiction problems, gaining experience comparing it to other pharmacotherapies (benzodiazepines or other antidepressants). The medication is not approved for alcohol and drug dependence, however, treatment t of comorbid conditions is not against to the official recommendations. Our aim was, in addition to reviewing the literature, to share our experience which, although cannot be considered an evidence based study, we deemed worthy of publishing. We cannot, at this point, put forward a protocol addressing all related scientific problems and problems of off-label treatment, and we could

  4. Evaluating the validity and utility of scaling alcohol consumption indices alongside AUD symptoms in treatment-seeking adolescents

    PubMed Central

    Hoeppner, Bettina B.; Kahler, Christopher W.; Jackson, Kristina M.

    2010-01-01

    Background Current initiatives to update diagnostic criteria for alcohol use disorders (AUDs) have stimulated dialogue about the usefulness of indicators of alcohol consumption in the diagnosis of AUDs. Methods This study used Rasch model analyses to examine the properties of alcohol consumption descriptors and AUD symptoms among 3,382 treatment-seeking adolescents, aged 12–18 years, in the DATOS-A (USDHHS, 1993–1995) baseline assessment, and evaluated the predictive validity of different scoring methods (with and without alcohol consumption) for 12-month alcohol involvement. Results Rasch model analyses supported the unidimensionality of indices of alcohol consumption and AUD symptoms. Test information functions showed that adding consumption items provides further information at all points of the alcohol involvement severity spectrum. Combining AUD symptoms with indices of alcohol consumption provided better prediction of alcohol involvement after treatment than either AUD symptoms counts or DSM-IV dependence diagnosis alone. Differential item functioning (DIF), however, was observed for select items. Generally, indices of drinking “too much too fast” were more severe for females, African Americans and Hispanics, while the opposite was true for items measuring “too much too often”. For age, “too much too often” items were more severe for the younger (12–14yrs) age group, and AUD symptoms were more severe for the older (15–18yrs) age group. Conclusions Indices of alcohol consumption can be validly scaled along with AUD symptoms in this population, and their inclusion provides statistical measurement advantages. Nevertheless, caution is necessary in using consumption items in measuring alcohol involvement due to DIF observed across sex, race and age. PMID:21146941

  5. Concurrent Treatment for Posttraumatic Stress Disorder and Alcohol Dependence: Predictors and Moderators of Outcome

    PubMed Central

    Zandberg, Laurie J.; Rosenfield, David; McLean, Carmen P.; Powers, Mark B.; Asnaani, Anu; Foa, Edna B.

    2015-01-01

    Objective The present study examined predictors and moderators of treatment response among 165 adults meeting DSM-IV criteria for comorbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD) who were randomized to 24 weeks of naltrexone (NAL), NAL and prolonged exposure (PE), pill placebo, or pill placebo and PE. All participants received supportive counseling for alcohol use. Method Six domains of predictors/moderators (23 variables) were evaluated using measures of PTSD (Posttraumatic Stress Symptom Scale Interview; PSS-I) and AD (percent days drinking from the Timeline Follow-Back Interview) collected every four weeks throughout treatment. Multi-level modeling using the Fournier approach was employed to evaluate predictors and moderators of rates of symptom improvement and post-treatment outcomes. Results Combat trauma, sexual assault trauma, and higher baseline anxiety sensitivity predicted slower improvement and poorer PTSD outcome. Combat trauma, white race, and higher baseline drinking severity predicted poorer drinking outcome. PTSD severity moderated the efficacy of PE on PTSD outcomes, such that the benefit of PE over no-PE was greater for participants with higher baseline PTSD severity. Baseline depressive severity moderated the efficacy of PE on drinking outcomes, whereby the benefit of PE over no-PE was greater for participants with higher depressive symptoms. NAL effects were most beneficial for those with the longest duration of alcohol dependence. Conclusions These results suggest that concurrent, trauma-focused treatment should be recommended for PTSD-AD patients who present with moderate or severe baseline PTSD and depressive symptoms. Future research should examine the mechanisms underlying poorer outcome among identified sub-groups of PTSD-AD patients. PMID:26460570

  6. The Use of a Modified Marathon in Conjunction with Group Counseling in Short-term Treatment of Alcoholics

    ERIC Educational Resources Information Center

    Gazda, G. M.; And Others

    1971-01-01

    Two conclusions drawn from the application of the modified marathon to a short term treatment center were that the modified marathon had the advantages of holding" alcoholics for treatment once they were sober and it enhanced the quality of typical group counseling and therapy treatment. (Author)

  7. Risk Factors and Neuropsychological Recovery in Clients with Alcohol Use Disorders Who Were Exposed to Different Treatments

    ERIC Educational Resources Information Center

    Bates, Marsha E.; Barry, Danielle; Labouvie, Erich W.; Fals-Stewart, William; Voelbel, Gerald; Buckman, Jennifer F.

    2004-01-01

    Risk covariates of neuropsychological ability (NA) at treatment entry and neuropsychological recovery (NR) across 15 months were examined and replicated in 2 samples (Ns = 952 and 774) from Project MATCH, a multisite study of alcoholism treatments. NA at treatment entry was associated with age, education, and other covariates. Statistically…

  8. Q&A with Dr. Koob about Treatment for Alcohol Problems

    MedlinePlus

    ... norm for people who need them. Is the historical stigma of addiction diminishing as alcohol research teaches ... the United States. In 2006, alcohol misuse problems cost the United States $223.5 billion. Alcohol contributes ...

  9. Troubled families and individualised solutions: an institutional discourse analysis of alcohol and drug treatment practices involving affected others.

    PubMed

    Selbekk, Anne Schanche; Sagvaag, Hildegunn

    2016-09-01

    Research shows that members of the families with patients suffering from alcohol and other drug-related issues (AOD) experience stress and strain. An important question is, what options do AOD treatment have for them when it comes to support? To answer this, we interviewed directors and clinicians from three AOD treatment institutions in Norway. The study revealed that family-oriented practices are gaining ground as a 'going concern'. However, the relative position of family-orientation in the services, is constrained and shaped by three other going concerns related to: (i) discourse on health and illness, emphasising that addiction is an individual medical and psychological phenomenon, rather than a relational one; (ii) discourse on rights and involvement, emphasising the autonomy of the individual patient and their right to define the format of their own treatment; and (iii) discourse on management, emphasising the relationship between cost and benefit, where family-oriented practices are defined as not being cost-effective. All three discourses are connected to underpin the weight placed on individualised practices. Thus, the findings point to a paradox: there is a growing focus on the needs of children and affected family members, while the possibility of performing integrated work on families is limited.

  10. [Parenteral S-adenosylmethionine compared to placebos in the treatment of alcoholic liver diseases].

    PubMed

    Diaz Belmont, A; Dominguez Henkel, R; Uribe Ancira, F

    1996-01-01

    The improvements in the knowledge of the action of ethanol over the hepatic cell, its direct action over the cell, and the intracytoplasmatic structures membranes, point out the possibilities of use of sulfo-adenosil-L-metionina (SAMe); as an util drug inn the treatment of the altered metilation reactions, that take place in those membranes, facilitating their physiological functions. The primary end point in this study was to demonstrate the therapeutic worth os SAMe, by parenteral route in 45 patients with alcoholic liver disease, which were determined by clinical laboratory and hepatic function test, label qith 32 points or more of the discriminatory function index. Divided into two groups, placebo-SAMe, randomized, double blind. As well as total plasmatic and reduced glutation and lipoperoxidation index, indirect form as malondehaldehyde. Were determined at the first visit anf after 8 and 15 days of treatment. Comparing the results of both groups there were a significative favorable results for the group treatment with SAMe and this confirms the utility of this drug in the treatment of patients with alcoholic liver disease with a discriminatory function index (Maddrey index), of 32 points or more.

  11. Pregabalin for the Treatment of Drug and Alcohol Withdrawal Symptoms: A Comprehensive Review.

    PubMed

    Freynhagen, Rainer; Backonja, Miroslav; Schug, Stephan; Lyndon, Gavin; Parsons, Bruce; Watt, Stephen; Behar, Regina

    2016-12-01

    Treatments for physical dependence and associated withdrawal symptoms following the abrupt discontinuation of prescription drugs (such as opioids and benzodiazepines), nicotine, alcohol, and cannabinoids are available, but there is still a need for new and more effective therapies. This review examines evidence supporting the potential use of pregabalin, an α2δ voltage-gated calcium channel subunit ligand, for the treatment of physical dependence and associated withdrawal symptoms. A literature search of the MEDLINE and Cochrane Library databases up to and including 11 December 2015 was conducted. The search term used was '(dependence OR withdrawal) AND pregabalin'. No other date limits were set and no language restrictions were applied. Works cited in identified articles were cross-referenced and personal archives of references also searched. Articles were included based on the expert opinions of the authors. There is limited evidence supporting the role of pregabalin for the treatment of physical dependence and accompanying withdrawal symptoms associated with opioids, benzodiazepines, nicotine, cannabinoids, and alcohol, although data from randomized controlled studies are sparse. However, the current evidence is promising and provides a platform for future studies, including appropriate randomized, placebo- and/or comparator-controlled studies, to further explore the efficacy and safety of pregabalin for the treatment of withdrawal symptoms. Given the potential for pregabalin misuse or abuse, particularly in individuals with a previous history of substance abuse, clinicians should exercise caution when using pregabalin in this patient population.

  12. Smaller Feedback ERN Amplitudes During the BART are Associated with a Greater Family History Density of Alcohol Problems in Treatment-Naïve Alcoholics

    PubMed Central

    Fein, George; Chang, Maria

    2008-01-01

    BACKGROUND Alcoholism is characterized by impaired decision-making (i.e., choosing intoxication in the face of mounting negative consequences). This impairment may involve a reduced brain response to the negative consequences of behavior, which supports an inclination to engage in risky behaviors. The feedback error-related negativity (F-ERN) is hypothesized to reflect the valence attached to the negative consequences of behavior. Performance on the Balloon Analogue Risk Task (BART) measures risk-taking propensity. We recorded F-ERNs during the BART and during a BART simulation, where individuals observed the rewards and consequences of (someone else’s) BART performance. METHODS EEGs were recorded on 22 actively drinking, treatment-naïve alcoholics during the BART and BART simulation. F-ERNs were measured and their association with psychological and alcohol use measures was examined. RESULTS F-ERNs over fronto-central electrode sites were observed to balloon pops in the BART and BART simulation. F-ERNs during the BART were more than twice the amplitude of F-ERNs during the BART simulation. Smaller F-ERN amplitudes from the BART (but not the BART simulation) were associated with a greater family history density of alcohol problems. CONCLUSION The results suggest a possible link between the genetic vulnerability toward developing alcoholism and the brain’s response to the negative consequences of behavior. PMID:17869027

  13. Proximal vs. distal predictors of alcohol use disorders and treatment utilization in at-risk men in early middle age

    PubMed Central

    Feingold, Alan; Capaldi, Deborah M.; Owen, Lee D.

    2015-01-01

    Understanding factors that predict both development and treatment of alcohol misuse and its consequences can inform prevention and treatment efforts. This study used measures of both proximal (e.g., behaviors) and distal (e.g., traits) risk factors that were predicted to relate to both an alcohol use disorder (AUD) and to treatment utilization among AUD-diagnosed men to test the hypothesis that both type of factors predict AUDs but only proximal factors influence treatment-seeking. Analyses of variance with contrasts were used to compare the means for risk factors between men with an AUD and AUD-free men and—given an AUD diagnosis—between men who were treated for an AUD and untreated men (n = 181). As predicted, men with AUDs differed on a broad range of proximal and distal factors, including number of alcohol problems, alcohol-related influences of peers and partners, alcohol expectancies, familial factors, and psychopathology. As hypothesized, only proximal risk factors predicted treatment-seeking among the AUD men, particularly alcohol problems and related consequences. PMID:26072267

  14. Proximal vs. distal predictors of alcohol use disorders and treatment utilization in at-risk men in early middle age.

    PubMed

    Feingold, Alan; Capaldi, Deborah M; Owen, Lee D

    2015-08-01

    Understanding factors that predict both development and treatment of alcohol misuse and its consequences can inform prevention and treatment efforts. This study used measures of both proximal (e.g., behaviors) and distal (e.g., traits) risk factors that were predicted to relate to both an alcohol use disorder (AUD) and to treatment utilization among AUD-diagnosed men to test the hypothesis that both type of factors predict AUDs but only proximal factors influence treatment-seeking. Analyses of variance with contrasts were used to compare the means for risk factors between men with an AUD and AUD-free men and-given an AUD diagnosis-between men who were treated for an AUD and untreated men (n=181). As predicted, men with AUDs differed on a broad range of proximal and distal factors, including number of alcohol problems, alcohol-related influences of peers and partners, alcohol expectancies, familial factors, and psychopathology. As hypothesized, only proximal risk factors predicted treatment-seeking among the AUD men, particularly alcohol problems and related consequences.

  15. Long-term γ-hydroxybutyric acid (GHB) and disulfiram combination therapy in GHB treatment-resistant chronic alcoholics.

    PubMed

    Maremmani, Angelo Giovanni Icro; Pani, Pier Paolo; Rovai, Luca; Pacini, Matteo; Dell'Osso, Liliana; Maremmani, Icro

    2011-07-01

    Leading Italian studies support the use of γ-hydroxybutyric acid (GHB), not only in the treatment of the alcohol withdrawal syndrome, but also in maintaining alcohol abstinence. GHB gives a better result than naltrexone and disulfiram in maintaining abstinence, and it has a better effect on craving than placebo or disulfiram. The problem is that about 30-40% of alcoholics are non-responders to GHB therapy. In our clinical practice, we speculate that by combining disulfiram with GHB treatment we may be able to achieve a kind of 'antagonist' effect by using the 'psychological threat' of disulfiram (adversative effect) while taking advantage of the anticraving effect of GHB, despite the limitation of its 'non-blockade' effect on alcohol. In this context, to improve the outcome in GHB long-term treated alcoholics, we added disulfiram to GHB in the management of GHB treatment-resistant alcoholics. In this study we compared retention in treatment of 52 patients who were treated with the GHB-disulfiram combination for up to six months, with retention for the same subjects considering their most recent unsuccessful outpatient long-term treatment with GHB only. An additional comparison was carried out on the days of complete abstention from alcohol. Thirty four patients (65.4%) successfully completed the protocol and were considered to be responders; 18 (34.6%) left the programme, and were considered to be non-responders. Considering the days of complete abstinence from alcohol, 36 patients stayed in treatment longer with the GHB-Disulfiram combination, 12 stayed for a shorter time and four for the same time. The results of this study seem to indicate a higher efficacy of the GHB-disulfiram association compared with GHB alone. Randomized controlled trials are now needed to verify this hypothesis.

  16. Long-Term γ-Hydroxybutyric Acid (GHB) and Disulfiram Combination Therapy in GHB Treatment-Resistant Chronic Alcoholics

    PubMed Central

    Maremmani, Angelo Giovanni Icro; Pani, Pier Paolo; Rovai, Luca; Pacini, Matteo; Dell’Osso, Liliana; Maremmani, Icro

    2011-01-01

    Leading Italian studies support the use of γ-hydroxybutyric acid (GHB), not only in the treatment of the alcohol withdrawal syndrome, but also in maintaining alcohol abstinence. GHB gives a better result than naltrexone and disulfiram in maintaining abstinence, and it has a better effect on craving than placebo or disulfiram. The problem is that about 30–40% of alcoholics are non-responders to GHB therapy. In our clinical practice, we speculate that by combining disulfiram with GHB treatment we may be able to achieve a kind of ‘antagonist’ effect by using the ‘psychological threat’ of disulfiram (adversative effect) while taking advantage of the anticraving effect of GHB, despite the limitation of its ‘non-blockade’ effect on alcohol. In this context, to improve the outcome in GHB long-term treated alcoholics, we added disulfiram to GHB in the management of GHB treatment-resistant alcoholics. In this study we compared retention in treatment of 52 patients who were treated with the GHB-disulfiram combination for up to six months, with retention for the same subjects considering their most recent unsuccessful outpatient long-term treatment with GHB only. An additional comparison was carried out on the days of complete abstention from alcohol. Thirty four patients (65.4%) successfully completed the protocol and were considered to be responders; 18 (34.6%) left the programme, and were considered to be non-responders. Considering the days of complete abstinence from alcohol, 36 patients stayed in treatment longer with the GHB-Disulfiram combination, 12 stayed for a shorter time and four for the same time. The results of this study seem to indicate a higher efficacy of the GHB-disulfiram association compared with GHB alone. Randomized controlled trials are now needed to verify this hypothesis. PMID:21845160

  17. A qualitative study of patients' knowledge and views of about oral health and acceptability of related intervention in an Australian inpatient alcohol and drug treatment facility.

    PubMed

    Cheah, Alison Li Sun; Pandey, Ram; Daglish, Mark; Ford, Pauline J; Patterson, Sue

    2017-01-20

    Social factors, health behaviours and the direct effects of substances contribute to the poor oral health and restricted access to dental services experienced by people who are dependent on drugs and/or alcohol. Admission for inpatient withdrawal management provides an opportunity for intervention to promote oral health but to be effective it must be acceptable to patients. To support intervention design, we examined patients' views about oral health, practices and treatment access, and appropriateness of health-promoting intervention in this context. Given paucity of knowledge in the area we employed a qualitative approach, data were collected in semi-structured interviews with inpatients of a public specialist alcohol and drug unit in Australia in September 2014. Analysis employed the framework approach. All 14 participants wanted 'good teeth' but few diligently attended to oral healthcare; most sought assistance only in emergencies. Participants' knowledge of services was limited and practical and affective barriers hindered access. With none recalling attention to oral health during admission, support was strong for incorporation of oral health in inpatient assessments. Participants wanted information about the impact of substances on oral health and oral hygiene practices provided in various formats, and facilitated referral to non-judgemental, affordable treatment. Patients regarded promotion of oral health in the inpatient context as important, relevant and acceptable. Support should respect the different knowledge, practices and motivations for oral health and recovery, of patients. Addressing practical and affective barriers to dental services will require collaboration between drug and alcohol and dental services, and this should be the focus of further research.

  18. Alcohol-control public service announcements (PSAs) and drunk-driving fatal accidents in the United States, 1996-2010.

    PubMed

    Niederdeppe, Jeff; Avery, Rosemary; Miller, Emily N

    2017-03-18

    Widespread concern regarding the detrimental effects of excessive alcohol consumption (especially by minors) and associated social problems (particularly drunk driving) continues to exist among policymakers, law enforcement officers, and the general public. Alcohol consumption is a leading contributor to death from injuries, which itself is one of the main causes of death for people under 21years of age in the United States. This study examines the relationship between the volume and timing of alcohol-control public service announcements (PSAs) and rates of drunk-driving fatal accidents in the U.S. We estimate ordinary least squares (OLS) regression models to predict rates of drunk-driving fatal accidents by state and month as a function of the volume of alcohol-control PSAs aired during the previous 8months. Models include controls for state anti-drunk-driving laws and regulations, state demographic characteristics, state taxes on alcohol, calendar year, and seasonality. Results indicate that higher volumes of anti-drunk driving PSAs airing in the preceding 2 to 3months are associated, albeit modest in magnitude, with reduced rates of drunk-driving fatal accidents. The regression coefficients are largest for adults (relative to underage drunk drivers) and when the PSAs air during prime time (relative to daytime or nighttime). We conclude that PSAs could play an important contributing role in reducing drunk-driving fatal accidents, although levels of exposure and potential effects likely remain modest due to reliance on donated air time. Well-funded anti-drunk driving campaigns could achieve higher levels of exposure and have a larger impact.

  19. Typology of Couples Entering Alcohol Behavioral Couple Therapy: An Empirical Approach and Test of Predictive Validity on Treatment Response

    PubMed Central

    Ladd, Benjamin O.; McCrady, Barbara S.

    2016-01-01

    The current study aimed to examine whether classification of couples in which one partner has an alcohol problem is similar to that reported in the general couples literature. Typologies of couples seeking Alcohol Behavioral Couple Therapy (ABCT) were developed via hierarchical cluster analysis using behavioral codes of couple interactions during their first ABCT session. Four couples types based on in-session behavior were established reliably, labeled Avoider, Validator, Hostile, and Ambivalent-Detached. These couple types resembled couples types found in previous research. Couple type was associated with baseline relationship satisfaction, but not alcohol use. Results suggest heterogeneity in couples with alcohol problems presenting to treatment; further study is needed to investigate the function of alcohol within these different types. PMID:25808432

  20. Alcohol Facts

    MedlinePlus

    ... Families? Why Is It So Hard to Quit Drugs? Effects of Drugs Drug Use Hurts Other People Drug Use Hurts ... This Section Signs of Alcohol Abuse and Addiction Effects of Alcohol on Brains and Bodies Previous ... Treatment Work? Treatment and Rehab Resources About the ...

  1. Alcohol Can Be a Risky Guest At Holiday Parties

    MedlinePlus

    ... Services. More Health News on: Alcohol Alcoholism and Alcohol Abuse Recent Health News Related MedlinePlus Health Topics Alcohol Alcoholism and Alcohol Abuse About MedlinePlus Site Map FAQs Customer Support Get ...

  2. Varenicline effects on drinking, craving and neural reward processing among non-treatment-seeking alcohol-dependent individuals

    PubMed Central

    Schacht, Joseph P.; Anton, Raymond F.; Randall, Patrick K.; Li, Xingbao; Henderson, Scott; Myrick, Hugh

    2014-01-01

    Rationale The α4β2 nicotinic acetylcholine receptor partial agonist varenicline has been reported to reduce drinking among both heavy-drinking smokers and primary alcoholics, and this effect may be related to varenicline-mediated reduction of alcohol craving. Among smokers, varenicline has been reported to modulate cigarette cue-elicited brain activation in several reward-related areas. Objectives This pilot study tested varenicline’s effects on drinking, alcohol craving, and alcohol cue-elicited activation of reward-related brain areas among non-treatment-seeking alcohol-dependent individuals. Methods Thirty-five such individuals (mean age = 30, 57% male, 76% heavy drinking days in the past month, 15 smokers) were randomized to either varenicline (titrated to 2 mg) or placebo for 14 days, and were administered an alcohol cue reactivity fMRI task on day 14. A priori regions of interest (ROIs) were bilateral and medial orbitofrontal cortex (OFC), right ventral striatum (VS), and medial prefrontal cortex (mPFC). Results Despite good medication adherence, varenicline did not reduce heavy drinking days or other drinking parameters. It did, however, increase self-reported control over alcohol-related thoughts and reduced cue-elicited activation bilaterally in the OFC, but not in other brain areas. Conclusions These data indicate that varenicline reduces alcohol craving and some of the neural substrates of alcohol cue reactivity. However, varenicline effects on drinking mediated by cue-elicited brain activation and craving might be best observed among treatment-seekers motivated to reduce their alcohol consumption. PMID:24647921

  3. 78 FR 66023 - National Institute on Alcohol Abuse and Alcoholism; Amended Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the Clinical, Treatment and...

  4. Treatment of Essential Tremor with Long-Chain Alcohols: Still Experimental or Ready for Prime Time?

    PubMed Central

    Haubenberger, Dietrich; Nahab, Fatta B.; Voller, Bernhard; Hallett, Mark

    2014-01-01

    Aim To review current literature on long-chain alcohols and their derivatives as novel pharmacotherapy for the treatment of essential tremor (ET). Background Currently available and recommended pharmacotherapies for ET are often limited by suboptimal treatment effects, frequent adverse effects, and drug interactions. While ethanol is reported to profoundly decrease tremor severity in the majority of patients with ET, preclinical experience suggests that long-chain alcohols such as 1-octanol might lead to a comparable tremor reduction without ethanol’s typical side effects of sedation and intoxication. Here, we review the literature on the first clinical trials on 1-octanol and its metabolite octanoic acid (OA) for the treatment of ET. Methods The literature on preclinical and clinical trials on long-chain alcohols as well as OA was reviewed and summarized, and an outlook given on next phases of development. Discussion 1-octanol was demonstrated to be safe and effective in a double-blind, placebo-controlled low-dose trial, and open-label data showed excellent tolerability and dose-dependent efficacy up to 128 mg/kg. Despite 1-octanol’s efficacy, its future viability as an effective therapy is limited by its pharmacological properties that require large volumes to be orally administered. Pharmacokinetic data indicate that OA is the active metabolite of 1-octanol. Preclinical efficacy data for OA are positive, and human pilot data demonstrated excellent safety as well as efficacy in secondary outcome measures of tremor amplitudes. OA also has more favorable pharmacological properties for drug delivery; hence, OA may be worth developing as a pharmaceutical. PMID:24587968

  5. Relationship between Women's Alcohol Problems and Experiences of Childhood Violence.

    ERIC Educational Resources Information Center

    Miller, Brenda A.; And Others

    The effects of childhood physical and sexual abuse on the development of alcoholism in women was examined by comparing 127 alcoholic women in treatment with two comparison groups. One comparison group was comprised of 83 nonalcoholic women in mental health treatment or receiving services for battering. The second comparison group consisted of 92…

  6. Prospective Analysis of Early Lapse to Drinking and Smoking Among Individuals in Concurrent Alcohol and Tobacco Treatment

    PubMed Central

    Holt, Laura J.; Litt, Mark D.; Cooney, Ned L.

    2012-01-01

    The aims of the current study were to examine, prospectively, 1) dynamic changes in affective state, self-efficacy, and urge in the hours before initial smoking and drinking lapses among individuals in concurrent alcohol and smoking treatment, and 2) the extent to which self-efficacy, urge to use, and/or the use of one substance predicted lapse to the other substance. Ninety-six men and women recruited for a clinical trial of concurrent alcohol and tobacco treatment were eligible for inclusion. Only data from those who experienced an initial lapse to drinking (n=29), or smoking (n=32) were included. Two outpatient substance abuse clinics provided concurrent alcohol and smoking treatment on a weekly basis for three months. Ecological Momentary Assessment (EMA) methods were employed over a 28-day monitoring period to assess antecedents to first drink and a 14-day monitoring period was examined for initial smoking lapses. Baseline and EMA measures of positive and negative affect, alcohol/smoking urge, alcohol/smoking abstinence self-efficacy, nicotine withdrawal, and quantity/frequency of alcohol and tobacco use were examined as lapse predictors. Analyses of EMA ratings controlled for the corresponding baseline measure. Smoking lapse among individuals in concurrent alcohol and tobacco treatment was foreshadowed by higher urges to smoke, lower positive mood, and lower confidence to resist smoking. Drinking lapse was preceded by lower confidence to resist smoking, but only among individuals who reported recent smoking. Concurrent alcohol and smoking treatment should focus on the enhancement of abstinence self-efficacy, positive mood, and the curbing of urges in order to offset lapse risk. PMID:22023022

  7. [Diagnostics and treatment of Wernicke-Korsakoff syndrome patients with an alcohol abuse].

    PubMed

    Nilsson, Maria; Sonne, Charlotte

    2013-04-01

    Wernicke-Korsakoff syndrome is a condition with high morbidity and mortality and occurs as a consequence of thiamine deficiency. Clinical symptoms are often ambiguous and post-mortem examinations show that the syndrome is underdiagnosed and probably undertreated. There is sparse clinical evidence concerning optimal dosage and duration of treatment. This article reviews the current literature and concludes that all patients with a history of alcohol abuse should be treated with high dosage IV thiamine for an extended period of time, albeit further research is needed.

  8. Current State of Treatment for Alcohol and Other Drug Use Disorders in Adolescents

    PubMed Central

    Deas, Deborah; Clark, Andrew

    2009-01-01

    Over the past he decade, treatment programs have been developed specifically for adolescents with alcohol and other drug (AOD) use disorders. The vast majority of these programs use psychosocial approaches, which can be further classified into family-based interventions and multisystemic therapy, motivational enhancement therapy, behavioral therapy, and cognitive–behavioral therapy. Outcome studies have evaluated the effectiveness of the different approaches. The results indicate that all of these strategies can improve an adolescent’s outcome on a variety of measures. Pharmacotherapy rarely is used in the treatment of adolescents with AOD use disorders, and existing studies only have assessed the effectiveness of agents aimed at treating coexisting psychiatric conditions. Future studies should use more consistent, state-of-the-art assessment instruments developed specifically for adolescents and also pay greater attention to an adolescent’s developmental status and its impact on treatment outcome. PMID:23104449

  9. Older Adults and Alcohol

    MedlinePlus

    ... Alcohol Exposure Support & Treatment Alcohol Policy Special Populations & Co-occurring Disorders Publications & Multimedia Brochures & Fact Sheets NIAAA ... are here Home » Alcohol & Your Health » Special Populations & Co-occurring Disorders » Older Adults In this Section Underage ...

  10. Fetal Alcohol Spectrum Disorders (FASDs): Alcohol Use Quiz

    MedlinePlus

    ... this page: About CDC.gov . FASD Homepage Facts Secondary Conditions Videos Alcohol Use in Pregnancy Questions & Answers Quiz Alcohol Screening & Brief Intervention Diagnosis Treatments Data & Statistics Alcohol Consumption Rates Research & Tracking Monitoring Alcohol ...

  11. Using administrative data to assess the process of treatment services for adolescents with substance use disorders.

    PubMed

    Cavanaugh, Doreen A; Doucette, Ann

    2004-12-01

    In 1998, the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA) convened an expert panel comprised of a multidisciplinary group of providers, researchers, managed care representatives and public policymakers known as the Washington Circle (WC) to improve the quality and effectiveness of treatment for substance use disorders through the use of performance measures. The initial goals of the panel included developing, testing and implementing performance measures in health plans and encouraging collaboration with key stakeholders to ensure widespread adoption of the measures. The WC focused its initial efforts on the prevention, recognition and treatment of adults with alcohol and other drug (AOD) disorders who receive health care through private and/or public sector health plans (McCorry et al. 2000). In 2002, CSAT, aware of the need to improve access and quality of treatment for adolescents, supported the Washington Circle in the establishment of a special subcommittee focused specifically on adolescent treatment issues. This article introduces the work of the Washington Circle and describes the Adolescent Subcommittee's progress in developing performance measures for the treatment of adolescents with substance use disorders.

  12. 78 FR 65347 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis... Abuse and Alcoholism, 5635 Fishers Lane (Teleconference), Rockville, MD 20855. Contact Person:...

  13. 78 FR 21615 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-11

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Initial ] Review... Foster, Ph.D., Scientific Review Administrator, National Institutes on Alcohol Abuse &...

  14. 78 FR 38353 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... personal privacy. Name of Committee: National Institute on Alcohol Abuse and Alcoholism Special Emphasis Panel; Review of Applications on HIV- AIDS/Alcohol Comparative Effectiveness & Implementation...

  15. Problem Gambling Treatment within the British National Health Service

    ERIC Educational Resources Information Center

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

    According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study…

  16. Staff Attitudes and Services Provided by Community-Based Organizations for Alcohol and Other Drug Users in Cape Town, South Africa: Implications for Training and Education

    ERIC Educational Resources Information Center

    Pasche, Sonja; Myers, Bronwyn; Louw, Johann

    2008-01-01

    Aims: The aims of this study were: (i) to describe the nature of and the extent to which community-based organizations (CBOs) in Cape Town provide services to people who have alcohol and other drug (AOD) problems; (ii) to examine the relationship between CBOs' attitudes towards individuals with AOD problems and the types of services provided; and…

  17. Toward a Developmentally Centered Approach to Adolescent Alcohol and Substance Use Treatment.

    PubMed

    Settles, Regan E; Smith, Gregory T

    2015-01-01

    Adolescent alcohol and drug use disorders pose significant risks to adolescents' future functioning. Unfortunately, relapse rates following treatment for these disorders are high. The newest generation of interventions, designed in part to address this problem, place greater focus on the developmental needs of adolescents. In this review, we highlight the importance and promise of this progress in the field. We also argue for a further, more complete, integration of development and treatment: Instead of a focus on developmental issues as part of the process of substance use treatment, we argue for an approach in which healthy development is an outcome of equal importance to changes in substance use and risk behaviors. From this perspective, treatment should address the skills necessary for social, emotional, achievement, and identity development, with substance abuse understood as one example of dysfunctional development. We argue that this approach holds the greatest promise for providing adolescents in treatment with the skills they need to maintain successful post-treatment trajectories. In this paper, we offer theory underlying this perspective, a definition of the outcomes of healthy development that can guide researchers and clinicians, as well as proposals for both researchers and clinicians to continue to push the developmental sensitivity of adolescent substance use treatment forward.

  18. Intraprostatic injection of alcohol gel for the treatment of benign prostatic hyperplasia: preliminary clinical results.

    PubMed

    Larson, Benjamin T; Netto, Nelson; Huidobro, Christian; de Lima, Marcelo Lopez; Matheus, Wagner; Acevedo, Cristian; Larson, Thayne R

    2006-09-06

    Benign prostatic hyperplasia (BPH) is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH. A total of 65 patients with lower urinary tract symptoms (LUTS) due to BPH were treated with intraprostatic injections of alcohol gel. The gel is composed of 97% denatured alcohol and a patented polymer to cause viscosity. Three different methods of injection were utilized: transrectal (TR) injections (8), transurethral (TU) injections (36), and transperineal (TP) injections guided by biplaned ultrasound (21). Each method provided easy access to the center of the prostate, where a volume of gel, approximately 20-30% of the prostatic volume, was injected. Follow-up was based on changes in peak urinary flow (Qmax), IPSS scores, quality of life scores (QoL), adverse effects, and failures. Data are available at 3 and 12 months. The procedure was well tolerated with only local or no anesthesia in the TR and TP groups; the TU group received spinal anesthesia. All groups showed statistically significant (p < 0.0001) improvements in Qmax, IPSS, and QoL. The mean amount of gel injected was 8.05 ml, representing 21.56% of the prostatic volume. Qmax increased from a baseline mean of 8.50 to 12.01 ml/s at 3 months, and to 11.29 ml/s at 12 months. IPSS scores improved from a baseline mean of 21.12 to 10.00 at 3 months, and to 11.84 at 12 months. QoL scores were only available for 55 patients. QoL scores improved from a baseline of 3.93 to 1.98 at 3 months, and to 2.18 at 12 months. No extraprostatic injury or adverse effects were reported due to treatment. This preliminary study presents significant results

  19. Profile of Class I Histone Deacetylases (HDAC) by Human Dendritic Cells after Alcohol Consumption and In Vitro Alcohol Treatment and Their Implication in Oxidative Stress: Role of HDAC Inhibitors Trichostatin A and Mocetinostat.

    PubMed

    Agudelo, Marisela; Figueroa, Gloria; Parira, Tiyash; Yndart, Adriana; Muñoz, Karla; Atluri, Venkata; Samikkannu, Thangavel; Nair, Madhavan P

    2016-01-01

    Epigenetic mechanisms have been shown to play a role in alcohol use disorders (AUDs) and may prove to be valuable therapeutic targets. However, the involvement of histone deacetylases (HDACs) on alcohol-induced oxidative stress of human primary monocyte-derived dendritic cells (MDDCs) has not been elucidated. In the current study, we took a novel approach combining ex vivo, in vitro and in silico analyses to elucidate the mechanisms of alcohol-induced oxidative stress and role of HDACs in the periphery. ex vivo and in vitro analyses of alcohol-modulation of class I HDACs and activity by MDDCs from self-reported alcohol users and non-alcohol users was performed. Additionally, MDDCs treated with alcohol were assessed using qRT-PCR, western blot, and fluorometric assay. The functional effects of alcohol-induce oxidative stress were measured in vitro using PCR array and in silico using gene expression network analysis. Our findings show, for the first time, that MDDCs from self-reported alcohol users have higher levels of class I HDACs compare to controls and alcohol treatment in vitro differentially modulates HDACs expression. Further, HDAC inhibitors (HDACi) blocked alcohol-induction of class I HDACs and modulated alcohol-induced oxidative stress related genes expressed by MDDCs. In silico analysis revealed new target genes and pathways on the mode of action of alcohol and HDACi. Findings elucidating the ability of alcohol to modulate class I HDACs may be useful for the treatment of alcohol-induced oxidative damage and may delineate new potential immune-modulatory mechanisms.

  20. Outpatient Mental Health Services in Mozambique: Use and Treatments.

    PubMed

    Wagenaar, Bradley H; Cumbe, Vasco; Raunig-Berhó, Manuela; Rao, Deepa; Kohrt, Brandon A; Stergachis, Andy; Napúa, Manuel; Sherr, Kenneth

    2016-06-01

    To describe current outpatient mental health service use and treatments in Mozambique, the authors reviewed registry entries for 2,071 outpatient psychiatric visits at the Beira Central Hospital in Sofala Province from January 2012 to September 2014. Service use was most common for schizophrenia, followed by epilepsy, delirium, and organic behavioral disorders. Only 3% of consultations for schizophrenia were first-visit patients. Treatment seeking among women was more likely for mood and neurotic disorders and less likely for substance use disorders and epilepsy. First-generation antipsychotics, most often paired with promethazine, dominated treatment regimens. Evidence-based reforms are needed to improve identification of mood disorders and broaden care beyond severe mental disorders.

  1. Aripiprazole in the treatment of patients with alcohol dependence: a double-blind, comparison trial vs. naltrexone.

    PubMed

    Martinotti, G; Di Nicola, M; Di Giannantonio, M; Janiri, L

    2009-03-01

    Substantial evidence suggests that both partial dopamine agents and mixed 5-HT1A/2A receptor drugs independently show significant efficacy in reducing alcohol use in both animals and humans. Aripiprazole, which acts as a dopamine/5-HT system stabilizer, approaches the optimal characteristics sought in medication to be considered for testing in the treatment of alcohol dependence. In this randomised, double-blind, confrontation trial with naltrexone, we aimed to investigate the efficacy of aripiprazole on alcohol-drinking indices. Craving and psychiatric symptom improvements were the secondary end points. Seventy-five alcohol dependent subjects were detoxified and were subsequently randomised into two groups, receiving 50 mg of naltrexone and 5-15 mg of aripiprazole, respectively. Craving (Visual Analogue Scale; Obsessive and Compulsive Drinking Scale) and withdrawal (Clinical Institute Withdrawal Assessment) rating scales were applied; psychiatric symptoms were evaluated through the Symptom Check List 90-Revised. The number of subjects remained alcohol free for the entire study period (16 weeks) and the number of subjects relapsed were not significantly different in the two groups. The survival function showed that patients treated with aripiprazole remained abstinent from any alcohol amount for a longer time with respect to those treated with naltrexone. As for craving scores, patients treated with naltrexone showed a better outcome. Results from this study globally place aripiprazole at the same range of efficacy of naltrexone, one of the approved drugs used in alcohol relapse prevention. If it could be demonstrated in placebo-controlled trials that aripiprazole is efficacious in decreasing alcohol use, lessening craving, and attenuating psychopathological symptom severity, we will have gained a powerful agent for the treatment of alcohol-dependent subjects.

  2. Diethylcarbamazine: possible therapeutic alternative in the treatment of alcoholic liver disease in C57BL/6 mice.

    PubMed

    Rodrigues, Gabriel Barros; Rocha, Sura Wanessa Santos; Dos Santos, Laise Aline Martins; de Oliveira, Wilma Helena; Gomes, Fabiana Oliveira Dos Santos; de França, Maria Eduarda da Rocha; Lós, Deniele Bezerra; Peixoto, Christina Alves

    2015-04-01

    Alcoholic liver disease is a major cause of chronic liver disease worldwide. Diethylcarbamazine (DEC) is a drug that has anti-inflammatory properties due to its effects on the metabolism of arachidonic acid. The present study examined the anti-inflammatory effects of DEC on the mechanisms of alcoholic liver disease. C57BL/6 mice were divided into seven groups: (i) control; (ii) DEC 50 mg/kg; (iii) alcohol; (iv) alcohol + DEC 50 mg/kg; (v) alcohol + celecoxib 50 mg/kg; (vi) alcohol + pyrrolidine dithiocarbamate 100 mg/kg; and (vii) alcohol + pyrrolidine dithiocarbamate 100 mg/kg + DEC 50 mg/kg. Liver fragments were stained with haemotoxylin-eosin and Sirius red, and processed for immunofluorescence, western blot, and immunohistochemistry. Serum was also collected for biochemical measurements. Alcohol induced liver damage, elevated collagen content, and increased expression of nuclear factor kappa-light-chain-enhancer of activated B cells and inflammatory markers (tumour necrosis factor-α, interferon-γ, interleukin-1β, inducible nitric oxide synthase, cyclooxygenases-2, and transforming growth factor-β). Treatment with DEC was able to reduce liver damage, collagen content, the expression of nuclear factor kappa-light-chain-enhancer of activated B cells and inflammatory markers; it also ameliorated biochemistry parameters (total cholesterol, high-density lipoprotein cholesterol, triglyceride content and aspartate aminotransferase) and increased the expression of anti-inflammatory markers (p-5' adenosine monophosphate-activated protein kinase and interleukin-10). Future clinical trials may demonstrate that oral administration of DEC may be suitable for the treatment of alcoholic liver disease and other liver diseases.

  3. Changes in Professionals’ Attitudes and Approaches to Parents in the Drug and Alcohol Treatment

    PubMed Central

    Missouridou, Evdokia; Esseridou, Despina

    2016-01-01

    Background: Parental involvement with drug and alcohol services remains limited. Aim: to illuminate changes in addiction professionals’ subjective attitudes and approaches of parents over time in their career. Methods: Overall, twenty seven drug and alcohol professionals participated in the study. Results: Themes depicting changes on therapists’ attitudes, beliefs and experiences of working with the families of their clients are ‘Redefining therapeutic role and expectations’, ‘Increased understanding and acceptance’, ‘Finding the right distance in relationships’, ‘Ability to contain feelings and experiences’, ‘Being selective in collaborations with professionals’, ‘Empathy for coworkers and increased collaboration’. Therapists described their interaction with families of their clients in their earlier years of practice as a challenging and often overwhelming experience generating intense anger and frustration which sometimes led to acting outs and tempted them to give up their efforts to build an alliance with family members. Nevertheless, experience, clinical supervision and personal growth contributed in being gradually more capable in managing their emotional reactions, setting limits, having less and more realistic expectations from family members and finally providing the latter with the necessary experience of being understood. Conclusions: Overall, addiction therapists feel unprepared for meeting the challenging experience of collaborating with families in their earlier years of practice requiring educational support and clinical supervision. Further research is required on addiction professionals-parents alliance and countertransference issues. PMID:28144196

  4. State Resources and Services for Alcohol and Drug Abuse Problems. Fiscal Year 1985.

    ERIC Educational Resources Information Center

    Butynski, William; And Others

    This report presents and analyzes the results of the State Alcohol and Drug Abuse Profile data for the states' 1985 fiscal year (FY). Included is information from the 50 states, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands. Highlights, an executive summary, an introduction, and a section on the study purpose and methodology…

  5. HIV Treatment for Alcohol and Non-Injection Drug Users in El Salvador

    PubMed Central

    Dickson-Gomez, Julia; Bodnar, Gloria; Petroll, Andy; Johnson, Kali; Glasman, Laura

    2016-01-01

    Since the mid-1990s, many developing countries have introduced and expanded the availability of combination antiretroviral therapy (cART) to persons living with HIV (PLH). However, AIDS-related mortality continues to be high particularly among drug users. In this article, we present results from in-depth interviews with 13 HIV medical providers and 29 crack cocaine and alcohol using PLH in El Salvador. Providers endorsed negative attitudes toward substance using PLH and warned PLH that combining cART with drugs and alcohol would damage their livers and kidneys resulting in death. Upon diagnosis, PLH received little information about HIV treatment and many suffered depression and escalated their drug use. PLH reported suspending cART when they drank or used drugs because of providers’ warnings. Substance using PLH were given few strategies and resources to quit using drugs. Messages from medical providers discourage drug users from initiating or adhering to antiretroviral therapy (ART) and may contribute to treatment abandonment. PMID:25595149

  6. HIV Treatment for Alcohol and Non-Injection Drug Users in El Salvador.

    PubMed

    Dickson-Gomez, Julia; Bodnar, Gloria; Petroll, Andy; Johnson, Kali; Glasman, Laura

    2015-12-01

    Since the mid-1990 s, many developing countries have introduced and expanded the availability of combination antiretroviral therapy (cART) to persons living with HIV (PLH). However, AIDS-related mortality continues to be high particularly among drug users. In this article, we present results from in-depth interviews with 13 HIV medical providers and 29 crack cocaine and alcohol using PLH in El Salvador. Providers endorsed negative attitudes toward substance using PLH and warned PLH that combining cART with drugs and alcohol would damage their livers and kidneys resulting in death. Upon diagnosis, PLH received little information about HIV treatment and many suffered depression and escalated their drug use. PLH reported suspending cART when they drank or used drugs because of providers' warnings. Substance using PLH were given few strategies and resources to quit using drugs. Messages from medical providers discourage drug users from initiating or adhering to antiretroviral therapy (ART) and may contribute to treatment abandonment.

  7. Focus on emerging drugs for the treatment of patients with non-alcoholic fatty liver disease

    PubMed Central

    Federico, Alessandro; Zulli, Claudio; de Sio, Ilario; Del Prete, Anna; Dallio, Marcello; Masarone, Mario; Loguercio, Carmela

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disorder in Western countries and is increasingly being recognized in developing nations. Fatty liver disease encompasses a spectrum of hepatic pathology, ranging from simple steatosis to non-alcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma and end-stage liver disease. Moreover, NAFLD is often associated with other metabolic conditions, such as diabetes mellitus type 2, dyslipidemia and visceral obesity. The most recent guidelines suggest the management and treatment of patients with NAFLD considering both the liver disease and the associated metabolic co-morbidities. Diet and physical exercise are considered the first line of treatment for patients with NAFLD, but their results on therapeutic efficacy are often contrasting. Behavior therapy is necessary most of the time to achieve a sufficient result. Pharmacological therapy includes a wide variety of classes of molecules with different therapeutic targets and, often, little evidence supporting the real efficacy. Despite the abundance of clinical trials, NAFLD therapy remains a challenge for the scientific community, and there are no licensed therapies for NAFLD. Urgently, new pharmacological approaches are needed. Here, we will focus on the challenges facing actual therapeutic strategies and the most recent investigated molecules. PMID:25492998

  8. Syngas production by plasma treatments of alcohols, bio-oils and wood

    NASA Astrophysics Data System (ADS)

    Arabi, K.; Aubry, O.; Khacef, A.; Cormier, J.-M.

    2012-12-01

    Exploitation of forest resources for energy production includes various methods of biomass processing. Gasification is one of the ways to recover energy from biomass. The Syngas produced from biomass can be used to power internal combustion engines, or, after purification, to supply fuel cells. The paper is summarizing results obtained through a non thermal arc plasma reactor at laboratory scale. A stationary discharge (I = 150mA) is used to perform physical diagnostics and also chemical analysis. The arc is formed between two electrodes made of graphite. We first present results on plasma-steam reforming of alcohols and bio-oils mixed in water. The outlet gas compositions are given from various alcohols and-bio-oils obtained at different experimental conditions. The second part of the paper is dedicated to a direct plasma treatment of wood (beech) at laboratory scale. One of the electrodes is surrounded by wood. The final part of the paper is a general discussion about efficiencies and comparisons of plasma treatments presented. The results obtained are discussed by considering the steam reforming reactions and the water gas shift reaction.

  9. Betaine treatment decreased oxidative stress, inflammation, and stellate cell activation in rats with alcoholic liver fibrosis.

    PubMed

    Bingül, İlknur; Başaran-Küçükgergin, Canan; Aydın, A Fatih; Çoban, Jale; Doğan-Ekici, Işın; Doğru-Abbasoğlu, Semra; Uysal, Müjdat

    2016-07-01

    The aim of this study was to investigate the effect of betaine (BET) on alcoholic liver fibrosis in rats. Fibrosis was experimentally generated with ethanol plus carbon tetrachloride (ETH+CCl4) treatment. Rats were treated with ETH (5% v/v in drinking water) for 14 weeks. CCl4 was administered intraperitoneally (i.p.) 0.2mL/kg twice a week to rats in the last 6 weeks with/without commercial food containing BET (2% w/w). Serum hepatic damage markers, tumor necrosis factor-α, hepatic triglyceride (TG) and hydroxyproline (HYP) levels, and oxidative stress parameters were measured together with histopathologic observations. In addition, α-smooth muscle-actin (α-SMA), transforming growth factor-β1 (TGF-β1) and type I collagen (COL1A1) protein expressions were assayed immunohistochemically to evaluate stellate cell (HSC) activation. mRNA expressions of matrix metalloproteinase-2 (MMP-2) and its inhibitors (TIMP-1 and TIMP-2) were also determined. BET treatment diminished TG and HYP levels; prooxidant status and fibrotic changes; α-SMA, COL1A1 and TGF-β protein expressions; MMP-2, TIMP-1 and TIMP-2 mRNA expressions in the liver of fibrotic rats. In conclusion, these results indicate that the antifibrotic effect of BET may be related to its suppressive effects on oxidant and inflammatory processes together with HSC activation in alcoholic liver fibrosis.

  10. Alcohol and Health. Ninth Special Report to the U.S. Congress from the Secretary of Health and Human Services.

    ERIC Educational Resources Information Center

    National Inst. on Alcohol Abuse and Alcoholism (DHHS), Rockville, MD.

    This report provides current information on the health consequences of using alcoholic beverages and a description on current research findings on alcohol abuse and alcoholism. The focus is on research advances since September, 1993. The chapters are as follows: (1) "Epidemiology of Alcohol Use and Alcohol-Related Consequences"; (2) "Genetic,…

  11. Alcohol and Health. Seventh Special Report to the U.S. Congress from the Secretary of Health and Human Services.

    ERIC Educational Resources Information Center

    National Inst. on Alcohol Abuse and Alcoholism (DHHS), Rockville, MD.

    This report describes recent progress in knowledge on alcohol abuse and alcoholism. These topics are covered: (1) alcohol abuse and alcoholism, including drinking patterns, etiology, and alcohol dependence as a disease; (2) epidemiology, including morbidity and deaths; (3) genetics and environment, including twin and adoption studies, animal…

  12. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees'...

  13. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees'...

  14. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees'...

  15. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees'...

  16. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees'...

  17. Improving Access to Maternity Care for Women with Opioid Use Disorders: Colocation of Midwifery Services at an Addiction Treatment Program.

    PubMed

    Goodman, Daisy

    2015-01-01

    Perinatal drug and alcohol use is associated with serious medical and psychiatric morbidity for pregnant and postpartum women and their newborns. Participation in prenatal care has been shown to improve outcomes, even in the absence of treatment for substance use disorders. Unfortunately, women with substance use disorders often do not receive adequate prenatal care. Barriers to accessing care for pregnant women with substance use disorders include medical and psychiatric comorbidities, transportation, caring for existing children, housing and food insecurity, and overall lack of resources. In a health care system where care is delivered by each discipline separately, lack of communication between providers causes poorly coordinated services and missed opportunities. The integration of mental health and substance use treatment services in medical settings is a goal of health care reform. However, this approach has not been widely promoted in the context of maternity care. The Dartmouth-Hitchcock Medical Center Perinatal Addiction Treatment Program provides an integrated model of care for pregnant and postpartum women with substance use disorders, including the colocation of midwifery services in the context of a dedicated addiction treatment program. A structured approach to screening and intervention for drug and alcohol use in the outpatient prenatal clinic facilitates referral to treatment at the appropriate level. Providing midwifery care within the context of a substance use treatment program improves access to prenatal care, continuity of care throughout pregnancy and the postpartum, and availability of family planning services. The evolution of this innovative approach is described. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.

  18. Transition to a smoke-free culture within mental health and drug and alcohol services: A survey of key stakeholders.

    PubMed

    Glover, Marewa; Fraser, Trish; Bullen, Chris; Wallace-Bell, Mark; McRobbie, Hayden; Hadwen, Georgy

    2014-04-01

    Tobacco smoking is common among people with mental illnesses, and they carry a higher burden of smoking-related illnesses. Despite this, smoke-free policies and systems for supporting cessation have proved difficult to introduce in mental health and drug and alcohol services (MHDAS). This paper examines the barriers to becoming smoke free within New Zealand services. Key informants, including staff, smoke-free coordinators, and cessation specialists were interviewed. Of the 142 invited informants 61 agreed (42%) to participate in a telephone interview, and 56 provided useable data. Organizations had a permissive or transitioning smoking culture, or were smoke free, defined by smoke-free environments, smoke-free-promoting attitudes and behaviours of management and staff, and cessation support. Most organizations were on a continuum between permissive and transitional cultures. Only eight services had a fully smoke-free culture. MHDAS face many challenges in the transition to a smoke-free culture. They are not helped by exemptions in smoke-free policies for mental health services, staff smoking, negative staff attitudes to becoming smoke free, poor knowledge of nicotine dependence, smoking-related harm and comorbidities, and poor knowledge and skills regarding cessation-support options. Health inequalities will continue across both service and socioeconomic divides without a concerted effort to address smoking.

  19. The Indian Health Service Model From the Treatment Perspective.

    PubMed

    Smith, Mandie L

    2015-01-01

    The nonprofit dental delivery model is appropriate for the needs of specific patient populations. The Indian Health Service is an example of how care can be provided where traditional fee-for-service and indemnity mechanisms may be insufficient. Separating care from management in this context gives dentists greater power over individual treatment decisions, increased choice of patient-relevant care options, and control over development of the practice model and its evolution. The needs of various populations groups and the funding or profit model inevitably influence the composition of the dental team and assignment of dental duties.

  20. Ultrasound-guided alcohol neurolysis and radiofrequency ablation of painful stump neuroma: effective treatments for post-amputation pain

    PubMed Central

    Zhang, Xin; Xu, Yongming; Zhou, Jin; Pu, Shaofeng; Lv, Yingying; Chen, Yueping; Du, Dongping

    2017-01-01

    Background Post-amputation pain (PAP) is highly prevalent after limb amputation, and stump neuromas play a key role in the generation of the pain. Presently, PAP refractory to medical management is frequently treated with minimally invasive procedures guided by ultrasound, such as alcohol neurolysis and radiofrequency ablation (RFA). Objective To record the immediate and long-term efficacy of alcohol neurolysis and RFA. We first used alcohol neurolysis and then, when necessary, we performed RFA on PAP patients. Study design Prospective case series. Setting Pain management center. Methods Thirteen subjects were treated with ultrasound-guided procedures. Results All patients were treated with neurolysis using alcohol solutions guided by ultrasound. Seven (54%) of 13 subjects achieved pain relief after 1–3 alcohol injection treatments. The remaining 6 subjects obtained pain relief after receiving 2 administrations of ultrasound-guided RFA. After a 6-month follow-up evaluation period, pain quantities were also assessed. Both stump pain (including intermittent sharp pain and continuous burning pain) and phantom pain were relieved. The frequency of intermittent sharp pain was decreased, and no complications were noted during the observation. Conclusion The use of ultrasound guidance for alcohol injection and RFA of painful stump neuromas is a simple, radiation-free, safe, and effective procedure that provides sustained pain relief in PAP patients. In this case series, RFA was found to be an effective alternative to alcohol injection. PMID:28223839

  1. Adult heavy and low users of dental services: treatment provided.

    PubMed

    Nihtilä, Annamari; Widström, Eeva; Elonheimo, Outi

    2016-01-01

    The aim of this study was to compare treatment provided to adult heavy and low users of dental services in the Finnish Public Dental Service (PDS) and to analyse changes in patients' oral health status. We assigned all adults who attended the PDS in Espoo in 2004 to a group of heavy users (n = 3,173) if they had made six or more dental visits and to a comparison group of low users (n = 22,820), if they had made three or fewer dental visits. Data were obtained from the patient register of the PDS. A sample of 320 patients was randomly selected from each group. Baseline information (year 2004) on age, sex, number and types of visits, oral health status and treatment provided was collected from treatment records. Both groups were followed-up for five years. Restorative treatment measures dominated the heavy and low users'treatments; 88.8% of heavy users and 79.6% low users had received restorations during the five-year period. Fixed prosthetic treatments were provided to just 2% of the heavy users and 0.8% of the low users. Emergency visits were more common for heavy users (74.8%) than for low users (21.6%) (p < 0.001). Fewer than half of the heavy (46.1%) or low (46.5%) users were examined twice. Typical for heavy use of oral health services was a cycle of repetitive repair or replacement of restorations, often as emergency treatment, a lack of proper examinations and preventive care; crown therapy was seldom used. Immediately after the major dental care reform in Finland, the PDS in Espoo had problems providing good quality dental care for the new adult patients. Older patients with lower social class background were not accustomed to regular dental care and the PDS did not actively propose proper comprehensive regular care for adults.

  2. Closing the Need-Service Gap: Gender Differences in Matching Services to Client Needs in Comprehensive Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Marsh, Jeanne C.; Cao, Dingcai; Shin, Hee-Choon

    2009-01-01

    Despite the broad recognition in social work that services are more effective when they are tailored to individual client needs, we have only limited evidence of the impact that services matched to client needs have on treatment outcomes. This study examines gender differences in the impact of matched services, access services, and…

  3. Environmental Management: An Approach to Alcohol and Other Drug Prevention. Prevention Updates

    ERIC Educational Resources Information Center

    Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention, 2002

    2002-01-01

    Most campus alcohol and other drug (AOD) programs include prevention, intervention, and treatment services designed to address individual students' knowledge of the consequences of alcohol and other drug use, to improve their skills in resisting such behavior, or to address existing problematic use of or addiction to alcohol or other drugs.…

  4. High-dose baclofen for the treatment of alcohol dependence (BACLAD study): a randomized, placebo-controlled trial.

    PubMed

    Müller, Christian A; Geisel, Olga; Pelz, Patricia; Higl, Verena; Krüger, Josephine; Stickel, Anna; Beck, Anne; Wernecke, Klaus-Dieter; Hellweg, Rainer; Heinz, Andreas

    2015-08-01

    Previous randomized, placebo-controlled trials (RCTs) assessing the efficacy of the selective γ-aminobutyric acid (GABA)-B receptor agonist baclofen in the treatment of alcohol dependence have reported divergent results, possibly related to the low to medium dosages of baclofen used in these studies (30-80mg/d). Based on preclinical observations of a dose-dependent effect and positive case reports in alcohol-dependent patients, the present RCT aimed to assess the efficacy and safety of individually titrated high-dose baclofen for the treatment of alcohol dependence. Out of 93 alcohol-dependent patients initially screened, 56 were randomly assigned to a double-blind treatment with individually titrated baclofen or placebo using dosages of 30-270mg/d. The multiple primary outcome measures were (1) total abstinence and (2) cumulative abstinence duration during a 12-week high-dose phase. More patients of the baclofen group maintained total abstinence during the high-dose phase than those receiving placebo (15/22, 68.2% vs. 5/21, 23.8%, p=0.014). Cumulative abstinence duration was significantly higher in patients given baclofen compared to patients of the placebo group (mean 67.8 (SD 30) vs. 51.8 (SD 29.6) days, p=0.047). No drug-related serious adverse events were observed during the trial. Individually titrated high-dose baclofen effectively supported alcohol-dependent patients in maintaining alcohol abstinence and showed a high tolerability, even in the event of relapse. These results provide further evidence for the potential of baclofen, thereby possibly extending the current pharmacological treatment options in alcohol dependence.

  5. Metabolites and biodegradation pathways of fatty alcohol ethoxylates in microbial biocenoses of sewage treatment plants.

    PubMed Central

    Steber, J; Wierich, P

    1985-01-01

    The biodegradation of fatty alcohol polyglycol ethers was studied by analyzing the 14C-labeled intermediates isolated from the effluent of a model continuous-flow sewage treatment plant after dosage of either alkyl- or heptaglycol-labeled stearyl alcohol ethoxylate (SA-7EO). In each case, uncharged and carboxylated (mainly dicarboxylated) polyethylene glycols constituted the most prominent metabolites. The results indicate that there is a faster degradation of the alkyl than the polyethylene glycol moiety and that there are two distinct primary degradation mechanisms acting simultaneously in microbial biocenoses: intramolecular scission of the surfactant as well as omega- and beta-oxidation of the alkyl chain. Characterization of the bulk of 14C-labeled metabolites as a homologous series of neutral and acidic polyglycol units and identification of several C2-fragments accounted for the depolymerization of the hydrophilic part of the surfactant by stepwise cleavage of ether-bound EO units; from additional degradation studies employing either neutral or carboxylated 14C-labeled polyethylene glycols as model metabolites, it was concluded that hydrolytic as well as oxidative cleavage of C2-units is involved. Most of the identified low-molecular-weight 14C-labeled acids suggest an ultimate degradation of EO monomers by the oxidative dicarbonic acid cycle or the glycerate pathway or both. In addition, the finding of considerable amounts of oxalic and formic acids allow consideration of an additional mineralization route via glyoxylic, oxalic, and formic acids. The simultaneous action of different degradation mechanisms indicates the involvement of several distinct bacterial groups in the biodegradation of fatty alcohol ethoxylates under environmental conditions. PMID:3994363

  6. Effect of acid concentration and treatment time on acid-alcohol modified jackfruit seed starch properties.

    PubMed

    Dutta, Himjyoti; Paul, Sanjib Kumar; Kalita, Dipankar; Mahanta, Charu Lata

    2011-09-15

    The properties of starch extracted from jackfruit (Artocarpus heterophyllus Lam.) seeds, collected from west Assam after acid-alcohol modification by short term treatment (ST) for 15-30min with concentrated hydrochloric acid and long term treatment (LT) for 1-15days with 1M hydrochloric acid, were investigated. Granule density, freeze thaw stability, solubility and light transmittance of the treated starches increased. A maximum decrease in the degree of polymerisation occurred in ST of 30min (2607.6). Jackfruit starch had 27.1±0.04% amylose content (db), which in ST initially decreased and then increased with the severity of treatment; in LT the effect was irregular. The pasting profile and granule morphology of the treated samples were severely modified. Native starch had the A-type crystalline pattern and crystalline structure increased on treatment. FTIR spectra revealed slight changes in bond stretching and bending. Colour measurement indicated that whiteness increased on treatment. Acid modified jackfruit seed starch can have applications in the food industry.

  7. Emergency department outpatient treatment of alcohol-intoxicated bicyclists increases the cost of medical care in Japan

    PubMed Central

    Yamauchi, Sunao; Mizobe, Michiko; Nakashima, Yoshiyuki; Takahashi, Jin; Funakoshi, Hiraku; Urayama, Kevin Y.; Ohde, Sachiko; Takahashi, Osamu; Shiga, Takashi

    2017-01-01

    Riding a bicycle under the influence of alcohol is illegal in Japan. Nevertheless, intoxicated bicyclists are frequently treated at hospital emergency departments for bicycle-related injuries. This patient population usually requires more hospital resources, even for relatively minor injuries. Therefore, we hypothesized that bicycle-related crashes involving bicyclists under the influence of alcohol cost more to treat than those that do not involve alcohol intoxication. The aim of the present study was to examine the costs associated with bicycle-related minor injuries and alcohol intoxication of the bicyclist. The study was conducted at the Tokyo Bay Urayasu Ichikawa Medical Center Emergency Department, Japan. All minor bicycle crashes involving 217 individuals aged ≥20 years treated from September 1, 2012 to August 31, 2013 were included in the analysis of data obtained from medical records. Variables included alcohol intoxication, sex, age, collision with a motor vehicle, Glasgow Coma Scale, injury severity score (ISS), laboratory tests, treatment of wounds, number of X-ray images, number of computed tomography scans, and medical costs. Multiple linear regression analysis was performed to evaluate the association between alcohol intoxication and medical costs. Seventy (32%) patients consumed alcohol, and the median medical cost was 253 USD (interquartile range [IQR], 164–330). Multivariable analysis showed that alcohol intoxication was independently associated with higher medical costs (p = 0.030, adjusted R-square value = 0.55). These findings support our hypothesis and should encourage authorities to implement comprehensive measures to prohibit bicycling under the influence of alcohol to prevent injuries and to reduce medical costs. PMID:28329002

  8. Service dog training program for treatment of posttraumatic stress in service members.

    PubMed

    Yount, Rick A; Olmert, Meg D; Lee, Mary R

    2012-01-01

    In July 2008, social worker and certified service dog trainer Rick Yount created the first Warrior dog-training program designed to be a safe, effective, nonpharmaceutical intervention to treat the symptoms of posttraumatic stress disorder (PTSD) and traumatic brain injury in Veterans and service members undergoing treatment at a large Veterans Administration residential treatment facility. In 2009, Yount was asked to establish the program at a prominent Department of Defense medical center. In October 2010, Yount was invited to create a service dog training program to support the research and treatment mission at the new National Intrepid Center of Excellence (NICoE), in Bethesda, Maryland. This program, now being offered through the nonprofit foundation Warrior Canine Connection, continues to produce anecdotal evidence that training service dogs reduces the PTSD symptoms of Warrior-trainers and that the presence of the dogs enhances the sense of wellness in the NICoE staff and the families of our Wounded Warriors. Under the research leadership of the NICoE, the Warrior Canine Connection research team plans to systematically investigate the physiological, psychological, and behavioral benefits of this program.

  9. Subject Eligibility Criteria Can Substantially Influencethe Results of Alcohol-Treatment Outcome Research*

    PubMed Central

    Humphreys, Keith; Harris, Alex H.S.; Weingardt, Kenneth R.

    2008-01-01

    Objective: Most alcohol-treatment studies exclude some patients from participation based on particular criteria (e.g., comorbid illegal drug abuse, homelessness). The current study evaluated whether such eligibility criteria can change the outcome results a study obtains. Method: Five widely used treatment research eligibility criteria—(1) psychiatric problems, (2) medical problems, (3) social-residential instability, (4) low motivation/noncompliance, and (5) drug problems—were applied to two samples of real-world alcohol patients whose outcomes were known. Comparing outcomes of the samples with and without the application of eligibility criteria produced estimates of bias in outcome results, as well as an assessment of change in statistical power. Results: Medical and psychiatric eligibility criteria produced a moderate bias in outcome estimates (e.g., a 10% or less change in outcome results). In contrast, social-residential instability, low motivation/noncompliance, and drug use produced a large (e.g., up to an 18% change) to a very large (e.g., up to a 51% change) bias in outcome estimates. Sensitivity analyses showed that these biases are even larger if eligibility criteria are operationalized in a broad rather than a narrow fashion. Contrary to expectation, eligibility criteria did not produce their theoretically expected benefit of increased statistical power. Conclusions: Researchers who use eligibility criteria should do so judiciously and interpret outcome results in light of potential bias introduced by the ineligibility of some patients for study enrollment. Efforts to integrate findings across treatment outcome studies should also consider how conclusions might be affected by the eligibility criteria used in different research areas. PMID:18781251

  10. The role of nutraceuticals for the treatment of non-alcoholic fatty liver disease.

    PubMed

    Del Ben, Maria; Polimeni, Licia; Baratta, Francesco; Pastori, Daniele; Angelico, Francesco

    2017-01-01

    Non-alcoholic fatty liver disease (NAFLD) represents the most common chronic liver disease. It is characterized by a wide spectrum of hepatic changes, which may progress to liver fibrosis and to cirrhosis. NAFLD is considered as the hepatic component of the metabolic syndrome but mechanisms underlying the onset and progression of NAFLD are still under investigation. The traditional 'two hit hypothesis' has been developed within a more complex 'multiple parallel hit hypothesis' which comprises a wide spectrum of parallel hits. Many therapeutic approaches have been proposed so far and several types of nutraceuticals have been suggested for the treatment of NAFLD and non-alcoholic steatohepatitis (NASH), the most promising of which are those with antioxidant effects. In particular, vitamin E appears to be effective for the treatment of nondiabetic subjects with more advanced NASH, although the high suggested daily dosages are a matter of concern. Moreover, polyphenols reduce liver fat accumulation, mainly by inhibiting lipogenesis. At present, there are insufficient data to support the use of vitamin C supplements in patients with NAFLD. Data on polyunsaturated fatty acid (PUFA) supplementation are heterogeneous, and no well-designed randomized controlled studies (RCTs) of adequate size, with histological assessment of steatosis, have been conducted. Based on the available data, silymarin supplementation for the treatment of NAFLD seems to have a favourable effect. The results with anti-inflammatory agents, such as vitamin D and carnitine are uncertain. In conclusion, there are insufficient data either to support or refute the use of nutraceuticals for subjects with NAFLD. Further RTCs, with histological changes as an outcome measure, are needed.

  11. Dietary sodium, potassium, and alcohol: key players in the pathophysiology, prevention, and treatment of human hypertension.

    PubMed

    Koliaki, Chrysi; Katsilambros, Nicholas

    2013-06-01

    Western industrialized societies are currently experiencing an epidemic expansion of hypertension (HTN), which extends alarmingly even to children and adolescents. HTN constitutes an independent risk factor for cardiorenal disease and represents an extremely common comorbidity of diabetes and obesity. Numerous randomized clinical trials and meta-analyses have provided robust scientific evidence that reduced dietary salt intake, increased dietary potassium intake, moderation of alcohol consumption, optimal weight maintenance, and the adoption of "heart-friendly" dietary patterns such as the Dietary Approaches to Stop Hypertension or the Mediterranean diet can effectively lower blood pressure. Interestingly, the susceptibility of blood pressure to nutritional interventions is greatly variable among individuals, depending on age, race, genetic background, and comorbidities. The purpose of this review is to provide a comprehensive overview of currently available scientific evidence in the constantly evolving field of diet and HTN, placing particular emphasis on the key role of dietary sodium, dietary potassium, and alcohol intake in the pathophysiology, prevention, and treatment of human hypertension.

  12. Practitioner Review: Adolescent Alcohol Use Disorders--Assessment and Treatment Issues

    ERIC Educational Resources Information Center

    Perepletchikova, Francheska; Krystal, John H.; Kaufman, Joan

    2008-01-01

    Background: Alcohol use disorders in adolescents are associated with significant morbidity and mortality. Over the past decade, there has been a burgeoning of research on adolescent alcohol use disorders. Methods: A summary of the alcohol assessment tools is provided, and randomized studies reviewed and synthesized to provide an overview of state…

  13. Collaborative Services: Children Experiencing Neglect and the Side Effects of Prenatal Alcohol Exposure

    ERIC Educational Resources Information Center

    Rogers-Adkinson, Diana L.; Stuart, Shannon K.

    2007-01-01

    Purpose: The purpose of this article is to provide critical knowledge regarding children who are served by the child welfare system and how these children's specialized needs affect speech-language services. Specifically, the structure of social services system models is presented, with an emphasis on the cultural and systemic interactions between…

  14. Baseline predictors of treatment outcome in Internet-based alcohol interventions: a recursive partitioning analysis alongside a randomized trial

    PubMed Central

    2013-01-01

    Background Internet-based interventions are seen as attractive for harmful users of alcohol and lead to desirable clinical outcomes. Some participants will however not achieve the desired results. In this study, harmful users of alcohol have been partitioned in subgroups with low, intermediate or high probability of positive treatment outcome, using recursive partitioning classification tree analysis. Methods Data were obtained from a randomized controlled trial assessing the effectiveness of two Internet-based alcohol interventions. The main outcome variable was treatment response, a dichotomous outcome measure for treatment success. Candidate predictors for the classification analysis were first selected using univariate regression. Next, a tree decision model to classify participants in categories with a low, medium and high probability of treatment response was constructed using recursive partitioning software. Results Based on literature review, 46 potentially relevant baseline predictors were identified. Five variables were selected using univariate regression as candidate predictors for the classification analysis. Two variables were found most relevant for classification and selected for the decision tree model: ‘living alone’, and ‘interpersonal sensitivity’. Using sensitivity analysis, the robustness of the decision tree model was supported. Conclusions Harmful alcohol users in a shared living situation, with high interpersonal sensitivity, have a significantly higher probability of positive treatment outcome. The resulting decision tree model may be used as part of a decision support system but is on its own insufficient as a screening algorithm with satisfactory clinical utility. Trial registration Netherlands Trial Register (Cochrane Collaboration): NTR-TC1155. PMID:23651767

  15. Critical Transitions: A Mixed Methods Examination of Sleep from Inpatient Alcohol Rehabilitation Treatment to the Community

    PubMed Central

    Brooks, Alyssa Todaro; Krumlauf, Michael; Fryer, Craig S.; Beck, Kenneth H.; Yang, Li; Ramchandani, Vijay A.; Wallen, Gwenyth R.

    2016-01-01

    Aims This prospective, repeated measures study utilized a convergent parallel mixed methods approach to assess sleep experiences among individuals who were alcohol-dependent undergoing inpatient detoxification and treatment at a clinical research facility across the transition periods associated with the rehabilitation process: the initial adjustment to becoming an inpatient and the transition from inpatient to outpatient status. Methods This study included individual semi-structured interviews and quantitative measures relating to psychological distress, sleep quality, daytime sleepiness, and sleep-related beliefs and behavior (n = 33; 66.7% male). Interviews were conducted and questionnaires were administered within one week of participants’ scheduled discharge date and again four to six weeks post-discharge when they returned for a follow-up visit (or via phone). Results Participants self-reported significant sleep disturbances at both study time points. Of those participants with valid data at both time points (n = 28), there were no significant changes in mean scores from pre- to post-discharge with the exception of self-efficacy for sleep (SE-S) being significantly higher post-discharge. Preliminary qualitative findings suggested differences between those with ongoing sleep disturbances, those whose sleep disturbances had resolved, and those with no sleep disturbances at either time point. Conclusions This analysis highlights individual variation in sleep throughout the process of inpatient treatment and transition to outpatient aftercare in individuals with alcohol dependence. Collecting quantitative and qualitative data concurrently and combining emerging themes from qualitative data with quantitative analyses allowed for a more thorough examination of this relatively novel area of research and provided information that can be utilized to inform future behavioral sleep interventions. PMID:27571353

  16. The Influence of Parental Emotional Neglect on Assault Victims Seeking Treatment for Depressed Mood and Alcohol Misuse: A Pilot Study.

    PubMed

    Bailey, Kylie A; Baker, Amanda L; McElduff, Patrick; Kavanagh, David J

    2016-10-09

    This study explores the relationship between reported parental emotional neglect when a child, assault type experienced, posttraumatic stress symptoms (PTSS), depression, and alcohol consumption in treatment seekers for comorbid depressive symptoms and alcohol misuse. Participants (n = 220) with concurrent depression and alcohol misuse were recruited from the DAISI (Depression and Alcohol Integrated and Single-focussed Interventions) project. Assault type and PTSS were retrospectively assessed by the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style is a self-report measure that retrospectively assessed emotional neglect experienced as a child. An exploratory factor analysis using the tetrachoric correlation matrix (applying principal factor extraction with a varimax rotation) identified the two assault factors of sexual assault (SA) and physical assault (PA). A path analysis revealed that Maternal Emotional Neglect increased the impact of PTSS and depression. Paternal Emotional Neglect increased the impact of PA on PTSS and alcohol dependence symptoms. There appears to be differential effects of assault type and Maternal/Paternal emotional neglect on depression and alcohol misuse, suggesting that parenting roles serve distinct protective functions.

  17. The Influence of Parental Emotional Neglect on Assault Victims Seeking Treatment for Depressed Mood and Alcohol Misuse: A Pilot Study

    PubMed Central

    Bailey, Kylie A.; Baker, Amanda L.; McElduff, Patrick; Kavanagh, David J.

    2016-01-01

    This study explores the relationship between reported parental emotional neglect when a child, assault type experienced, posttraumatic stress symptoms (PTSS), depression, and alcohol consumption in treatment seekers for comorbid depressive symptoms and alcohol misuse. Participants (n = 220) with concurrent depression and alcohol misuse were recruited from the DAISI (Depression and Alcohol Integrated and Single-focussed Interventions) project. Assault type and PTSS were retrospectively assessed by the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style is a self-report measure that retrospectively assessed emotional neglect experienced as a child. An exploratory factor analysis using the tetrachoric correlation matrix (applying principal factor extraction with a varimax rotation) identified the two assault factors of sexual assault (SA) and physical assault (PA). A path analysis revealed that Maternal Emotional Neglect increased the impact of PTSS and depression. Paternal Emotional Neglect increased the impact of PA on PTSS and alcohol dependence symptoms. There appears to be differential effects of assault type and Maternal/Paternal emotional neglect on depression and alcohol misuse, suggesting that parenting roles serve distinct protective functions. PMID:27735838

  18. A tailored curriculum of alcohol screening, brief intervention, and referral to treatment (SBIRT) for nurses in inpatient settings.

    PubMed

    Broyles, Lauren M; Kraemer, Kevin L; Kengor, Caroline; Gordon, Adam J

    2013-01-01

    A package of clinical strategies known as alcohol screening, brief intervention, and referral to treatment (SBIRT) is increasingly recommended for reducing unhealthy alcohol use, the spectrum of alcohol consumption from at-risk drinking (defined as consumption above recommended guidelines) to alcohol abuse and alcohol dependence. The United States' Joint Commission issued new SBIRT-related hospital accreditation measures for alcohol. Ongoing initiatives aim to promote, support, and sustain SBIRT implementation in hospital settings. In hospital settings, nurse-delivered SBIRT may be a particularly viable and efficient model for SBIRT implementation. However, like physicians, most nurses have not been trained in how to perform SBIRT, and few authors have described alcohol-related curricula specifically for nurses. In addition, historical differences in nurse and physician professional scopes of practice, role perceptions, and patterns of care delivery suggest the need for effective SBIRT initial and continuing education and training that are tailored to the nursing profession and inpatient environments. In this article, we provide an in-depth description of the registered nurse SBIRT curriculum and describe its development and contents as well as various nurse- and setting-specific adaptations. In addition, we describe how we engaged nursing stakeholders in the development and implementation of the curriculum and discuss potential implications for future SBIRT training and delivery by nurses. SBIRT continuing education and training for nurses represents one of the first steps in expanded SBIRT implementation. Comprehensive workforce and organizational development of inpatient and nurse-delivered SBIRT may provide the means to address the entire spectrum of unhealthy alcohol use across healthcare settings.

  19. Alcohol withdrawal

    MedlinePlus

    ... Seeing or feeling things that aren't there (hallucinations) Seizures Severe confusion ... alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens. Treatment may ...

  20. Medical cost-offset following treatment referral for alcohol and other drug use disorders in a group model HMO.

    PubMed

    Polen, Michael R; Freeborn, Donald K; Lynch, Frances L; Mullooly, John P; Dickinson, Daniel M

    2006-07-01

    The purpose of this study was to determine whether specialty alcohol and other drug (AOD) treatment is associated with reduced subsequent medical care costs. AOD treatment costs and medical costs in a group model health maintenance organization (HMO) were collected for up to 6 years on 1,472 HMO members who were recommended for specialty AOD treatment, and on 738 members without AOD diagnoses or treatment. Addiction Severity Index measures were also obtained from a sample of 293 of those recommended for treatment. Changes in medical costs did not differ between treatment and comparison groups. Nor did individuals with improved treatment outcomes have greater reductions in medical costs. AOD treatment costs were not inversely related to subsequent medical costs, except for a subgroup with recent AOD treatment. In the interviewed sample, better treatment outcomes did not predict lower subsequent medical costs. Multiple treatment episodes may hold promise for producing cost-offsets.

  1. Alcohol-Impaired Driving Behavior and Sensation-Seeking Disposition in a College Population Receiving Routine Care at Campus Health Services Centers

    PubMed Central

    Zakletskaia, Larissa I.; Mundt, Marlon P.; Balousek, Stacey L.; Wilson, Ellen L.; Fleming, Michael F.

    2009-01-01

    Accidents stemming from alcohol-impaired driving are the leading cause of injury and death among college students. Research has implicated certain driver personality characteristics in the majority of these motor vehicle crashes. Sensation seeking in particular has been linked to risky driving, alcohol consumption, and driving while intoxicated. This study investigated the effect of sensation-seeking on self-reported alcohol-impaired driving behavior in a college student population while adjusting for demographics, residence and drinking locations. A total of 1,587 college students over the age of 18 completed a health screening survey while presenting for routine, non-urgent care at campus heath services centers. Student demographics, living situation, most common drinking location, heavy episodic drinking, sensation-seeking disposition and alcohol-impaired driving behavior were assessed. Using a full-form logistic regression model to isolate sensation seeking after adjusting for covariates, sensation seeking remains a statistically significant independent predictor of alcohol-impaired driving behavior (OR=1.52;CI=1.19–1.94; p<0.001). Older, white, sensation-seeking college students who engage in heavy episodic drinking, live off-campus, and go to bars are at highest risk for alcohol-impaired driving behaviors. Interventions should target sensation seekers and environmental factors that mediate the link between sensation seeking and alcohol-impaired driving behaviors. PMID:19393782

  2. Do Alcohol Misuse, Service Utilisation, and Demographic Characteristics Differ between UK Veterans and Members of the General Public Attending an NHS General Hospital?

    PubMed Central

    Murphy, Dominic; Palmer, Emily; Westwood, Greta; Busuttil, Walter; Greenberg, Neil

    2016-01-01

    The aim of this paper was to provide insights into alcohol misuse within UK veterans to inform as to whether their presentations differ from the general public. This was done by exploring differences in the severity of alcohol misuse between UK veterans and the general public admitted to a general NHS hospital over an 18 month period using retrospective data. All patients admitted to the hospital were screened for alcohol misuse. Those deemed as experiencing problems were referred for specialist nurse-led support. A total of 2331 individuals were referred for this supported and administered with a standardised assessment that included measures of the severity of alcohol difficulties (AUDIT), dependency levels (LDQ), and assessed for the presence of withdrawal symptoms (CIWA-Ar). In addition, information was collected on service utilisation, referral category (medical or mental health), other substance misuse, and demographic characteristics. No differences were found between the severity of reported alcohol difficulties between veterans and non-veterans. Evidence was found to suggest that veterans were more likely to be referred for support with alcohol difficulties at an older age and to be admitted to hospital for longer periods of time. This could have considerable cost implications for the NHS. It was more common for veterans to present at hospital with physical health difficulties prior to being referred for support for alcohol. PMID:27827830

  3. Coupled electron beam radiation and MBR treatment of textile wastewater containing polyvinyl alcohol.

    PubMed

    Sun, Weihua; Chen, Jun; Chen, Lujun; Wang, Jianlong; Zhang, Yongming

    2016-07-01

    Advanced oxidation processes (AOP) can be combined with biological treatments for recalcitrant organic pollutant decomposition. However, there has been no thorough investigation on the coupling of AOPs and membrane bioreactors (MBR) to treat polymer organic pollutants. This study proposes a new AOP that couples electron beam (EB) radiation and MBR treatment. This method was applied to treat real textile effluents containing polyvinyl alcohol (PVA). During the stable operation stage, 31 ± 7% (n = 28) COD was removed by the EB-MBR process. COD removal was enhanced to 45% at the end of the research period without process optimization. In addition, both the membrane flux and activated sludge system exhibited good stability. Only a 2% membrane flux decreased was observed after a 46 d operation period. PVA radiolysis and biofacies analysis mechanisms are also discussed. By contrast, PVA degradation using only the MBR treatment was ineffective in this study. This ineffectiveness was caused by membrane interception and floccule formation by PVA and activated sludge.

  4. A pharmaceutical industry perspective on the economics of treatments for alcohol and opioid use disorders.

    PubMed

    Gastfriend, David R

    2014-10-01

    Individuals with alcohol and/or drug use disorders often fail to receive care, or evidence-based care, yet the literature shows health economic benefits. Comparative effectiveness research is emerging that examines approved approaches in terms of real, total healthcare cost/utilization. Comprehensive retrospective insurance claims analyses are few but tend to be nationally distributed and large. The emerging pattern is that, while treatment in general is cost effective, specific therapeutics can yield different health economic outcomes. Cost/utilization data consistently show greater savings with pharmacotherapies (despite their costs) versus psychosocial treatment alone. All FDA-approved addiction pharmacotherapies (oral naltrexone, extended-release naltrexone, acamprosate, disulfiram, buprenorphine, buprenorphine/naloxone, and methadone) are intended for use in conjunction with psychosocial management, not as stand-alone therapeutics; hence, pharmacotherapy costs must offer benefits in addition to abstinence alone or psychological therapy. Patient persistence is problematic, and (despite its cost) extended-release pharmacotherapy may be associated with lower or no greater total healthcare cost, mostly due to reduced hospitalization. The reviewed studies use rigorous case-mix adjustment to balance treatment cohorts but lack the randomization that clinical trials use to protect against confounding. Unlike trials, however, these studies can offer generalizability to diverse populations, providers, and payment models--and are of particular salience to payers.

  5. A pharmaceutical industry perspective on the economics of treatments for alcohol and opioid use disorders

    PubMed Central

    Gastfriend, David R

    2014-01-01

    Individuals with alcohol and/or drug use disorders often fail to receive care, or evidence-based care, yet the literature shows health economic benefits. Comparative effectiveness research is emerging that examines approved approaches in terms of real, total healthcare cost/utilization. Comprehensive retrospective insurance claims analyses are few but tend to be nationally distributed and large. The emerging pattern is that, while treatment in general is cost effective, specific therapeutics can yield different health economic outcomes. Cost/utilization data consistently show greater savings with pharmacotherapies (despite their costs) versus psychosocial treatment alone. All FDA-approved addiction pharmacotherapies (oral naltrexone, extended-release naltrexone, acamprosate, disulfiram, buprenorphine, buprenorphine/naloxone, and methadone) are intended for use in conjunction with psychosocial management, not as stand-alone therapeutics; hence, pharmacotherapy costs must offer benefits in addition to abstinence alone or psychological therapy. Patient persistence is problematic, and (despite its cost) extended-release pharmacotherapy may be associated with lower or no greater total healthcare cost, mostly due to reduced hospitalization. The reviewed studies use rigorous case-mix adjustment to balance treatment cohorts but lack the randomization that clinical trials use to protect against confounding. Unlike trials, however, these studies can offer generalizability to diverse populations, providers, and payment models—and are of particular salience to payers. PMID:25236185

  6. Alcohol Abuse Disorders Among U.S. Service Members With Mild Traumatic Brain Injury

    DTIC Science & Technology

    2011-02-01

    were collected from the standard inpatient and ambulatory data records , Overall, a slightly higher proportion of service members with MTBI were...disorders were collected from the standard inpatient and ambulatory data records . Overall, a slightly higher proportion of service members with MTBI were...Measures Combat injuries (any injury that resulted from hostile action) were classified with a thorough review of EMED records by the clinical

  7. Proceedings of a Symposium on the Use of Group Procedures in the Prevention and Treatment of Drug and Alcohol Addiction.

    ERIC Educational Resources Information Center

    Gazda, George M., Ed.

    The theme of the fifth annual Symposium on Group Procedures was "The Use of Group Procedures in the Prevention and Treatment of Drug and Alcohol Addiction." Symposium participants included professionals in counseling; clinical, school, and educational psychology, psychiatry, and social work. In addition, invitations were sent to members of…

  8. Elevated baseline serum glutamate as a pharmacometabolomic biomarker for acamprosate treatment outcome in alcohol-dependent subjects

    PubMed Central

    Nam, H W; Karpyak, V M; Hinton, D J; Geske, J R; Ho, A M C; Prieto, M L; Biernacka, J M; Frye, M A; Weinshilboum, R M; Choi, D-S

    2015-01-01

    Acamprosate has been widely used since the Food and Drug Administration approved the medication for treatment of alcohol use disorders (AUDs) in 2004. Although the detailed molecular mechanism of acamprosate remains unclear, it has been largely known that acamprosate inhibits glutamate action in the brain. However, AUD is a complex and heterogeneous disorder. Thus, biomarkers are required to prescribe this medication to patients who will have the highest likelihood of responding positively. To identify pharmacometabolomic biomarkers of acamprosate response, we utilized serum samples from 120 alcohol-dependent subjects, including 71 responders (maintained continuous abstinence) and 49 non-responders (any alcohol use) during 12 weeks of acamprosate treatment. Notably, baseline serum glutamate levels were significantly higher in responders compared with non-responders. Importantly, serum glutamate levels of responders are normalized after acamprosate treatment, whereas there was no significant glutamate change in non-responders. Subsequent functional studies in animal models revealed that, in the absence of alcohol, acamprosate activates glutamine synthetase, which synthesizes glutamine from glutamate and ammonia. These results suggest that acamprosate reduces serum glutamate levels for those who have elevated baseline serum glutamate levels among responders. Taken together, our findings demonstrate that elevated baseline serum glutamate levels are a potential biomarker associated with positive acamprosate response, which is an important step towards development of a personalized approach to treatment for AUD. PMID:26285131

  9. Young Children of Alcoholics: Little People with Big Needs.

    ERIC Educational Resources Information Center

    O'Rourke, Kathy

    Although clinicians have recently come to view children of alcoholics as primary patients who deserve treatment in their own right, such youngsters have little access to appropriate services. Experts estimate that less than five percent of children of alcoholic parents receive the help they need. Recent research indicates that the younger the…

  10. Drinking to cope with negative emotions moderates alcohol use disorder treatment response in patients with co-occurring anxiety disorder

    PubMed Central

    Anker, J.J.; Kushner, M.G.; Thuras, P.; Menk, J.; Unruh, A.S.

    2016-01-01

    Background Epidemiological studies and theory implicate drinking to cope (DTC) with anxiety as a potent moderator of the association between anxiety disorder (AnxD) and problematic alcohol use. However, the relevance of DTC to the treatment of alcohol use disorder (AUD) in those with a co-occurring AnxD has not been well studied. To address this, we examined whether DTC moderates the impact of two therapies: (1) a cognitive behavioral therapy (CBT) designed to reduce DTC and anxiety symptoms; (2) a progressive muscle relaxation training (PMRT) program designed to reduce anxiety symptoms only. Methods Patients undergoing a standard AUD residential treatment with a co-occurring AnxD (N = 218) were randomly assigned to also receive either the CBT or PMRT. DTC in the 30 days prior to treatment was measured using the Unpleasant Emotions subscale of the Inventory of Drinking Situations. Results Confirming the predicted moderator model, the results indicated a significant interaction between treatment group and level of pre-treatment DTC behavior. Probing this interaction revealed that for those reporting more pre-treatment DTC behavior, 4-month alcohol outcomes were superior in the CBT group relative to the PMRT group. For those reporting less pre-treatment DTC behavior, however, 4-month alcohol outcomes were similar and relatively good in both treatment groups. Conclusions These findings establish a meaningful clinical distinction among those with co-occurring AUD-AnxD based on the degree to which the symptoms of the two disorders are functionally linked through DTC. Those whose co-occurring AUD-AnxD is more versus less strongly linked via DTC are especially likely to benefit from standard AUD treatment that is augmented by a brief CBT designed to disrupt this functional link. PMID:26718394

  11. Service-user and carer perspectives on compliance and compulsory treatment in community mental health services.

    PubMed

    Gault, Iris

    2009-09-01

    This paper reports on a qualitative study analyzing service-user (SU) and carer perspectives on medication compliance and their experience of compulsory treatment. Eleven SUs and eight carers were interviewed. The research is set against the background of changes to mental health legislation in England, in the form of Supervised Community Treatment. This signals a change in community mental health practice and urges a reconsideration of concepts such as compliance, concordance and coercion. These concepts are discussed in the context of legislative changes and in relation to the perspectives of service-SUs and carers. Five themes emerged from qualitative interview data, analysed using an adapted form of grounded theory: loss of credible identity, playing the game, medicalization, therapeutic competence and incompetence and increased control. The findings suggest that SUs are initially reluctant to comply with mental health treatment, but do eventually accept the need for treatment; they also stress the significance of respectful relationships with professionals and the importance of communicative competence.

  12. Developmentally informed research on the effectiveness of clinical trials: a primer for assessing how developmental issues may influence treatment responses among adolescents with alcohol use problems.

    PubMed

    Wagner, Eric F

    2008-04-01

    The goal of this article is to familiarize readers with the adolescent developmental issues and processes most likely to affect responses to treatment for alcohol use problems. Although the need for research that blends developmental science and treatment outcome research is widely acknowledged, scant information exists about developmentally informed approaches to treatment research with alcohol-abusing teens. Exactly how developmental issues may influence treatment responses among adolescents with alcohol use problems remains an open question. In the hope of moving developmentally informed research forward, this article reports findings from a literature review regarding the degree to which developmental issues and processes have been considered in adolescent alcohol treatment research. Moreover, promising concepts and methods from applied developmental science are discussed, as are various developmental processes and transitions that may influence adolescent risk behavior. Finally, guidance is provided regarding how applied developmental science conceptualizations and methods may be incorporated successfully into randomized, clinical trials with adolescents with alcohol use problems.

  13. Involvement of the TAGE-RAGE system in non-alcoholic steatohepatitis: Novel treatment strategies

    PubMed Central

    Takeuchi, Masayoshi; Takino, Jun-ichi; Sakasai-Sakai, Akiko; Takata, Takanobu; Ueda, Tadashi; Tsutsumi, Mikihiro; Hyogo, Hideyuki; Yamagishi, Sho-ichi

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease around the world. It includes a spectrum of conditions from simple steatosis to non-alcoholic steatohepatitis (NASH) and can lead to fibrosis, cirrhosis, liver failure, and/or hepatocellular carcinoma. NAFLD is also associated with other medical conditions such as obesity, diabetes mellitus (DM), metabolic syndrome, hypertension, insulin resistance, hyperlipidemia, and cardiovascular disease (CVD). In diabetes, chronic hyperglycemia contributes to the development of both macro- and microvascular conditions through a variety of metabolic pathways. Thus, it can cause a variety of metabolic and hemodynamic conditions, including upregulated advanced glycation end-products (AGEs) synthesis. In our previous study, the most abundant type of toxic AGEs (TAGE); i.e., glyceraldehyde-derived AGEs, were found to make a significant contribution to the pathogenesis of DM-induced angiopathy. Furthermore, accumulating evidence suggests that the binding of TAGE with their receptor (RAGE) induces oxidative damage, promotes inflammation, and causes changes in intracellular signaling and the expression levels of certain genes in various cell populations including hepatocytes and hepatic stellate cells. All of these effects could facilitate the pathogenesis of hypertension, cancer, diabetic vascular complications, CVD, dementia, and NASH. Thus, inhibiting TAGE synthesis, preventing TAGE from binding to RAGE, and downregulating RAGE expression and/or the expression of associated effector molecules all have potential as therapeutic strategies against NASH. Here, we examine the contributions of RAGE and TAGE to various conditions and novel treatments that target them in order to prevent the development and/or progression of NASH. PMID:25544875

  14. Enhancing Learning Environments for Students Affected by Fetal Alcohol Spectrum Disorders: An Exploratory Study of Canadian Pre-Service Teacher Knowledge and Conceptions

    ERIC Educational Resources Information Center

    Pei, Jacqueline; Job, Jenelle; Poth, Cheryl; O'Brien-Langer, Anna; Tang, Wei

    2015-01-01

    There is a pressing need for enhancing the learning environment for students affected by Fetal Alcohol Spectrum Disorders (FASDs). To develop relevant professional learning opportunities for teachers, a logical initial step is to explore the extent to which pre-service teachers accurately understand the unique neuropsychological functioning…

  15. Alcoholic metabolic emergencies.

    PubMed

    Allison, Michael G; McCurdy, Michael T

    2014-05-01

    Ethanol intoxication and ethanol use are associated with a variety of metabolic derangements encountered in the Emergency Department. In this article, the authors discuss alcohol intoxication and its treatment, dispel the myth that alcohol intoxication is associated with hypoglycemia, comment on electrolyte derangements and their management, review alcoholic ketoacidosis, and end with a section on alcoholic encephalopathy.

  16. Nurses' Attitudes towards Alcoholics.

    ERIC Educational Resources Information Center

    Speer, Rita D.

    Nurses' attitudes toward the alcoholic can have a profound impact on the person suffering from alcoholism. These attitudes can affect the alcoholic's care and even whether the alcoholic chooses to recover. This study investigated attitudes of approximately 68 nurses employed in hospitals, 49 nurses in treatment facilities, 58 nursing students, and…

  17. Non-alcoholic fatty liver diseases: update on the challenge of diagnosis and treatment

    PubMed Central

    Oh, Hyunwoo; Jun, Dae Won; Saeed, Waqar K; Nguyen, Mindie H

    2016-01-01

    The prevalence of non-alcoholic fatty liver disease (NAFLD) is estimated to be 25-30% of the population, and is the most common cause of elevated liver enzymes in Korea. NAFLD is a “hot potato” for pharmaceutical companies. Many clinical trials are underway to develop a first-in-class drug to treat NAFLD. However, there are several challenging issues regarding the diagnosis of NAFLD. Currently, liver biopsy is the gold standard method for the diagnosis of NAFLD and steatohepatitis. Ideally, globally recognized standards for histological diagnosis and methods to optimize observer agreement on biopsy interpretation should be developed. Liver biopsy is the best method rather than a perfect one. Recently, multi-parametric magnetic resonance imagery can estimate the amount of intrahepatic fat successfully and is widely used in clinical trials. But no diagnostic method can discriminate between steatohepatitis and simple steatosis. The other unresolved issue in regard to NAFLD is the absence of satisfactory treatment options. Vitamin E and obeticholic acid have shown protective effects in randomized controlled trials, but this drug has not been approved for use in Korea. This study will provide a description of diagnostic methods and treatments that are currently recommended for NAFLD. PMID:27729634

  18. Non-alcoholic fatty liver disease in children now: lifestyle changes and pharmacologic treatments.

    PubMed

    Alisi, Anna; Nobili, Valerio

    2012-07-01

    Over the past decade, non-alcoholic fatty liver disease (NAFLD) has become one of most common chronic liver diseases in children. A greater understanding about the risk factors and molecular pathogenesis of NAFLD suggests that lifestyle interventions aiming to decrease obesity/body mass index and metabolic derangement are the first line of treatments adopted in children affected by this disease. However, because these therapeutic options are often at the beginning misjudged by the patients and their parents, the use of pharmacologic agents may help to protect the liver and other organs from further irreversible tissue damage. Pharmacologic therapies against one or more specific factors and/or molecules involved in the development of NAFLD (i.e., insulin resistance, free fatty acid lipid toxicity, and oxidative stress) also might slow the progression of this increasingly prevalent pediatric disorder. On this basis, insulin sensitizers, antioxidants, cytoprotective agents, and dietary supplementations have been evaluated in pediatric clinical trials. In this review, we discuss the efficacy of the dietary approaches, possibly coupled with regular exercise, on decreasing the metabolic and histologic damage in pediatric NAFLD. We also emphasize several advantages of the pharmacologic treatments adopted or adoptable in combination with lifestyle interventions in children with NAFLD.

  19. Recent Advances in the Herbal Treatment of Non-Alcoholic Fatty Liver Disease

    PubMed Central

    Xiao, Jia; Fai So, Kwok; Liong, Emily C.; Tipoe, George L.

    2013-01-01

    Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver injury across the world. It is also strongly related to other pathological conditions, including obesity, diabetes, cardiovascular diseases, and symptoms of metabolic syndrome. Pathogenesis of NAFLD remains not fully characterized but is generally attributed to the occurrence of insulin resistance, lipid metabolism dysfunction,0 oxidative stress, inflammation, and necro-apoptosis. Every potential therapeutic strategy should target one or some of these pathological events in the liver. Over the past decades, application of herbal treatment for NAFLD has received increasing attention due to its wide availability, low side effects, and proven therapeutic mechanisms and benefits. In recent years, some monomers and certain functional mixtures of herbs have been extensively examined for their potential uses in NAFLD treatment. In the present review, we selected several herbal derivatives under intense basic and/or clinical investigations by carrying out a PubMed search of English language articles relevant to herbal derivatives and NAFLD, such as polysaccharide portion of wolfberry, garlic-derived monomers, red grape–derived resveratrol, and milk thistle–derived substances. They have been shown to target the pathological events during NAFLD initiation and progression both in pre-clinical studies and clinical trials. Although more detailed mechanistic researches and long-term clinical evaluations are needed for their future applications, they offer unanticipated and great health benefits without obvious adverse effects in NAFLD therapy. PMID:24716162

  20. Dexmedetomidine for the treatment of alcohol withdrawal syndrome: rationale and current status of research.

    PubMed

    Muzyk, Andrew J; Kerns, Suzanne; Brudney, Scott; Gagliardi, Jane P

    2013-11-01

    Dexmedetomidine is currently used in the US in the treatment of alcohol withdrawal syndrome (AWS) in the intensive care unit (ICU) setting, although data to support this practice are limited. Dexmedetomidine targets the noradrenergic system, an important but frequently overlooked secondary mechanism in the development of AWS, and, in doing so, may reduce the need for excessive benzodiazepine use which can increase the risk of γ-aminobutyric acid (GABA)-mediated deliriogenesis and respiratory depression. The purpose of this narrative review is to evaluate available literature reporting on the safety and efficacy of dexmedetomidine for AWS in the ICU setting. An English-language MEDLINE search (1966 to July 2013) was performed to identify articles evaluating the efficacy and safety of dexmedetomidine for AWS. Case series, case reports and controlled trials were evaluated for topic relevance and clinical applicability. Reference lists of articles retrieved through this search were reviewed to identify any relevant publications. Studies focusing on the safety and efficacy of dexmedetomidine for AWS in humans were selected. Studies were included if they were published as full articles; abstracts alone were not included in this review. Eight published case studies and case series were identified. Based on a limited body of evidence, dexmedetomidine shows promise as a potentially safe and possibly effective adjuvant treatment for AWS in the ICU. Prospective, well-controlled studies are needed to confirm the safety and efficacy of the use of dexmedetomidine in AWS.

  1. A Brief Up-Date of the Use of Sodium Oxybate for the Treatment of Alcohol Use Disorder

    PubMed Central

    Caputo, Fabio; Vignoli, Teo; Tarli, Claudia; Domenicali, Marco; Zoli, Giorgio; Bernardi, Mauro; Addolorato, Giovanni

    2016-01-01

    The treatment of alcohol use disorder (AUD) with sodium oxybate (SMO) or gamma-hydroxybutyric acid (GHB) was introduced in Italy and Austria more than 20 years and 15 years ago, respectively, and it is now widely employed to treat alcohol withdrawal syndrome (AWS) and to maintain alcohol abstinence. These indications derive from its similar structure to the inhibitory neurotransmitter γ-amino-butyric acid (GABA), exerting an ethanol-mimicking effect, because it binds to GABAB receptors. Craving for, and abuse of, SMO remain a controversial issue; even though these unfavorable effects are evident in poly-drug addicted patients and in those with psychiatric diagnosis of borderline personality disorder. In addition, despite cases of severe intoxication and deaths being widely documented when GHB is used as “street drug”; its clinical use remains safe. Thus, the aim of the present review is to examine the role of SMO in the treatment of AUD, its possible implications in reducing alcohol consumption, and cases of abuse, and severe intoxication due to SMO during its clinical use in the treatment of AUD. PMID:26959045

  2. Probiotics as a Novel Treatment for Non-Alcoholic Fatty Liver Disease; A Systematic Review on the Current Evidences

    PubMed Central

    Kelishadi, Roya; Farajian, Sanam; Mirlohi, Maryam

    2013-01-01

    Context Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease, with 5-10% of liver having extra fat. Increase in its prevalence in all age groups is linked with obesity and Type II diabetes. The treatment of NAFLD remains controversial. A growing body of evidence suggests a relation between overgrowth of gut microbiota with NAFLD and non-alcoholic steatohepatitis (NASH). The objective of this review is to provide an overview on experimental and clinical studies assessing all positive and negative effects of probiotics. Evidence Acquisition We made a critical appraisal on various types of documents published from 1999 to March 2012 in journals, electronic books, seminars, and symposium contexts including Medline, PubMed, and Cochrane Central Register of Controlled Trials databases. We used the key words: “non-alcoholic fatty liver disease, probiotics, non-alcoholic steatohepatitis, liver disease, and fatty liver”. Results Probiotics, as biological factors, control the gut microbiota and result in its progression. It is in this sense that they are suggestive of a new and a natural way of promoting liver function. Correspondingly, limited evidence suggests that probiotics could be considered as a new way of treatment for NAFLD. Conclusions Various experimental studies and clinical trials revealed promising effects of probiotics in improving NAFLD; however given the limited experience in this field, generalization of probiotics as treatment of NAFLD needs substantiation through more trials with a larger sample sizes and with longer-term follow up. PMID:23885277

  3. Changes in hospital and out-patient events and costs following implant naltrexone treatment for problematic alcohol use.

    PubMed

    Kelty, Erin; Hayes, Lesleigh; O'Neil, Graeme; Kyle, Sarah; Jeffrey, Gary P; O'Neil, George; Hendrie, Delia; Mukhtar, Aqif; Hulse, Gary

    2014-08-01

    The harmful use of alcohol places a considerable burden on the community, both socially and financially. The aim of this study was to determine if the use of implant naltrexone is associated with a reduction in health care events and costs in patients treated for problematic alcohol use. Ninety four patients (60.6% male) treated between 2002 and 2007 were matched against state hospital, emergency department (ED), mental health out-patients and mortality data sets for 6 months prior to and 6 months post treatment. The number of patients, events, and costs associated with each health event were compared before and after treatment. Overall health care events and costs were reduced from $509033 prior to treatment to $270001 following treatment. Costs associated with hospital admission showed the most significant reduction, falling from $424605 (82 admissions/36 patients) before treatment to $203462 (43 admission/24 patients) after. While costs associated with ED attendances also fell ($74885 to $54712), costs associated with mental health out-patient attendances increased ($9543 to $11827). The use of implant naltrexone was associated with a reduction health events and costs in patients with problematic alcohol use in the first 6 months following treatment.

  4. The relationship of alcohol-use disorders and depressive symptoms to tryptophan metabolism: cross-sectional data from a Nepalese alcohol treatment sample

    PubMed Central

    Neupane, Sudan Prasad; Lien, Lars; Martinez, Priscilla; Hestad, Knut; Bramness, Jørgen G.

    2015-01-01

    Background Activation of the kynurenine pathway of tryptophan metabolism results in increased production of potentially depressogenic tryptophan catabolites and a reduction in tryptophan availability for serotonin synthesis. Since alcohol consumption affects tryptophan metabolism and disposition, we determined serum levels of kynurenine, tryptophan and the kynurenine/tryptophan ratio (KT ratio) in alcohol-use disorder (AUD) patients and compared their levels considering abstinence duration, AUD severity and comorbid depression. Methods The study sample included 169 AUD inpatients from eight alcohol treatment facilities in Kathmandu, Nepal. The Composite International Diagnostic Interview was administered to generate the AUD diagnosis. The Alcohol Use Disorder Identification Test (AUDIT) captured AUD severity and patterns of alcohol use. The Hopkins Symptom Checklist-25 was used to reveal current depressive symptoms. Serum kynurenine and tryptophan levels were determined by high-performance liquid chromatography and tryptophan degradation was measured by KT ratio (kynurenine/tryptophan × 103). Results Patients with above average AUDIT scores had higher mean serum levels of kynurenine (2.1μM±0.7 vs 1.8 μM ±0.6, p= 0.006) and KT ratios (48.6±17.6 vs 40.4±14.3, p=0.002) than those with below average scores. Patients with current depressive symptoms had higher mean tryptophan concentrations (49.9 μM ±13 vs 45.7 μM±14.1, p= 0.047) and lower KT ratios (41.4 μM ±14 vs 47.5 μM ±17.6, p=0.028) compared to patients whose reported depressive symptoms were below the standard cut-off. Higher tryptophan levels and lower KT ratios in the depressed group was specific to patients with longer abstinence and higher AUD severity. Conclusions Depression-related deregulation in tryptophan metabolism was found to depend on length of abstinence and on AUD severity. Together, results suggest that in AUD populations, peripheral tryptophan metabolism is subject to interactions

  5. Children attending addiction treatment services in Dublin, 1990-1999.

    PubMed

    Smyth, Bobby P; O'Brien, Mary

    2004-01-01

    In Europe, adolescent substance misuse increased during the 1990s. Ireland has among the highest rates of substance misuse among schoolchildren in Europe. We sought to describe the socio-demographic and drug misuse profile of children presenting to addiction treatment services in Dublin during the 1990s. Of the 9,874 individuals who sought addiction treatment, 1,953 (20%) were aged less than 18 years. There was a sharp increase in the number of children after 1993. The main drug of abuse was an opiate in 48% of cases. Compared to adults, the children were more likely to be female and less likely to inject. As the decade progressed the proportion of girls increased, injecting was reported more frequently and there was a dramatic rise in heroin misuse. Child heroin users were more likely to be female and to be homeless compared to their adult counterparts. This study highlights the need for a dedicated service for child drug users in Dublin.

  6. Introduction to the Special Issue “Pharmacotherapies for the Treatment of Alcohol Abuse and Dependence” and a Summary of Patents Targeting other Neurotransmitter Systems

    PubMed Central

    Bell, Richard L.; Franklin, Kelle M.; Hauser, Sheketha R.; Zhou, Feng C.

    2013-01-01

    This paper introduces the Special Section: Pharmacotherapies for the Treatment of Alcohol Abuse and Dependence and provides a summary of patents targeting neurotransmitter systems not covered in the other four chapters. The World Health Organization notes that alcoholic-type drinking results in 2.5 million deaths per year, and these deaths occur to a disproportionately greater extent among adolescents and young adults. Developing a pharmacological treatment targeting alcohol abuse and dependence is complicated by (a) the heterogeneous nature of the disease(s), (b) alcohol affecting multiple neurotransmitter and neuromodulator systems, and (c) alcohol affecting multiple organ systems which in turn influence the function of the central nervous system. Presently, the USA Federal Drug Administration has approved three pharmacotherapies for alcoholism: disulfiram, naltrexone, and acamprosate. This chapter provides a summary of the following systems, which are not covered in the accompanying chapters; alcohol and acetaldehyde metabolism, opioid, glycinergic, GABA-A, neurosteroid, dopaminergic, serotonergic, and endocannabinoid, as well as patents targeting these systems for the treatment of alcoholism. Finally, an overview is presented on the use of pharmacogenetics and pharmacogenomics in tailoring treatments for certain subpopulations of alcoholics, which is expected to continue in the future. PMID:22574678

  7. Perinatal Alcohol and Drug Use: Access to Essential Services in 12 California Counties. CPS Report.

    ERIC Educational Resources Information Center

    Soman, Laurie A.; And Others

    A research project acquired and compiled information on the services (from state and federally funded programs in California) available for chemically dependent pregnant and parenting women and young drug-exposed children from birth to age 3. The research methods consisted of a literature review and a survey of 13 key state and federally funded…

  8. Medications for addiction treatment: an opportunity for prescribing clinicians to facilitate remission from alcohol and opioid use disorders.

    PubMed

    Park, Tae Woo; Friedmann, Peter D

    2014-10-01

    Substance use disorders are a leading cause of morbidity and mortality in the United States. Medications for the treatment of substance use disorders are effective yet underutilized. This article reviews recent literature examining medications used for the treatment of alcohol and opioid use disorders. The neurobehavioral rationale for medication treatment and the most common ways medications work in the treatment of substance use disorders are discussed. Finally, the medications and the evidence behind their effectiveness are briefly reviewed. Physicians and other prescribing clinicians should take an active role in facilitating remission and recovery from substance use disorders by prescribing these effective medications with brief medical management counseling.

  9. Preventive Services by Medical and Dental Providers and Treatment Outcomes

    PubMed Central

    Kranz, A.M.; Rozier, R.G.; Preisser, J.S.; Stearns, S.C.; Weinberger, M.; Lee, J.Y.

    2014-01-01

    Objective: Nearly all state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children; yet, little is known about how treatment outcomes compare with children visiting dentists. This study compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. Methods: We conducted a retrospective study of young children enrolled in North Carolina Medicaid during 2000 to 2006. The annual number of CRT and CRT payments per child between the ages of 3 and 5 yr were estimated with a zero-inflated negative binomial regression and a hurdle model, respectively. Models were adjusted for relevant child- and county-level characteristics and used propensity score weighting to address observed confounding. Results: We examined 41,453 children with > 1 preventive oral health visit from a PCP, dentist, or both before their third birthday. Unadjusted annual mean CRT and payments were lowest among children who had only PCP visits (CRT = 0.87, payment = $172) and higher among children with only dentist visits (CRT = 1.48, payment = $234) and both PCP and dentist visits (CRT = 1.52, payment = $273). Adjusted results indicated that children who had dentist visits (with or without PCP visits) had significantly more CRT and higher CRT payments per year during the ages of 3 and 4 yr than children who had only PCP visits. However, these differences attenuated each year after age 3 yr. Conclusions: Because of children’s increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone. This study supports guidelines and reimbursement policies that allow preventive dental visits based on individual needs. PMID:24891593

  10. Psychiatric comorbidity and plasma levels of 2-acyl-glycerols in outpatient treatment alcohol users. Analysis of gender differences.

    PubMed

    García Marchena, Nuria; Araos, Pedro; Pavón, Francisco Javier; Ponce, Guillermo; Pedraz, María; Serrano, Antonia; Arias, Francisco; Romero-Sanchiz, Pablo; Suárez, Juan; Pastor, Antoni; De la Torre, Rafael; Torrens, Marta; Rubio, Gabriel; Rodríguez de Fonseca, Fernando

    2016-09-29

    Alcohol addiction is associated with high psychiatric comorbidity. Objective stratification of patients is necessary to optimize care and improve prognosis. The present study is designed to gain insights into this challenge by addressing the following objectives: a) to estimate the prevalence of psychiatric comorbidities in a sample of outpatients seeking treatment for alcohol use disorder, b) to describe the existence of gender differences and c) to validate 2-acyl-glycerols as biomarkers of alcohol use disorder and/or psychiatric comorbidity. One hundred and sixty-two patients were recruited and evaluated with the semi-structured interview PRISM. The presence of psychopathology was associated with a greater number of criteria for alcohol abuse and dependence according to DSM-IV-TR. We found gender differences in psychiatric comorbidity, e.g., mood disorder, as well as in comorbid substance use disorders. The prevalence of lifetime psychiatric comorbidity was 68.5%, with mood disorders the most frequent (37%), followed by attention deficit disorder (24.7%) and anxiety disorders (17.9%). Substance-induced disorders were more frequent in mood and psychotic disorders, whereas the primary disorders were more prevalent in patients with comorbid anxiety disorders. We found that 2-acyl-glycerols were significantly decreased in comorbid anxiety disorders in alcohol dependent patients in the last year, which makes them a potential biomarker for this psychopathological condition.

  11. Relationship status acceptance, alcohol use, and the perpetration of verbal aggression among males mandated to treatment for intimate partner violence.

    PubMed

    Crane, Cory A; Hawes, Samuel W; Oberleitner, Lindsay M S; Mandel, Dolores; Easton, Caroline J

    2013-09-01

    Forty substance using, male offenders of intimate partner violence completed measures of alcohol use and relationship status acceptance during a pretreatment screening session. They also completed a measure of verbal aggression after each month of a 12-week intervention program. Treatment length, heavy episodic drinking, and relationship status acceptance were used to assess the frequency of verbal aggression at each of the four assessment periods in a repeated measures ANCOVA. Main effects were detected for both alcohol and acceptance variables such that greater verbal aggression was observed among participants with a recent history of heavy episodic drinking and failure to accept the status of the relationship with their female victim. The interaction between time in treatment and relationship status acceptance was significant and showed that participants who accepted their relationship status reported low verbal aggression across measurement occasions while those who did not accept their relationship status reported high initial verbal aggression that decreased over treatment.

  12. Alcoholism & depression.

    PubMed

    Hall, Mellisa

    2012-10-01

    One out of 2 Americans report drinking on a routine basis, making the excessive consumption of alcohol the third leading cause of preventable death in America (). Alcoholism and depression are common comorbidities that home healthcare professionals frequently encounter. To achieve the best patient outcomes, alcoholism should be addressed initially. Although all age groups are at risk, alcoholism and depression occur in more than 8 percent of older adults. Prevention through identifying alcohol use early in adolescence is vital to reduce the likelihood of alcohol dependence. This article provides an overview of the long-term effects of alcohol abuse, including alcoholic cirrhosis and hepatic encephalopathy. The diagnostic criteria for substance dependence and ideas for nonthreatening screening questions to use with patients who are adolescent or older are discussed. While providing patient care, home healthcare nurses share the patient's intimate home environment. This environment is perceived as a safe haven by the patient and home care nurses can take advantage of counseling and treatment opportunities in this nonthreatening environment.

  13. An Overview of Shiraz Emergency Medical Services, Dispatch to Treatment

    PubMed Central

    Peyravi, Mahmoudreza; Örtenwal, Per; Djalali, Ahmadreza; Khorram-Manesh, Amir

    2013-01-01

    Background Advanced ambulance service (Emergency Medical Services/EMS) is considered to be an integral part of emergency medical care as the first assets responding to emergencies and disasters in the prehospital setting in most developed countries. Objectives The aim of this study was to evaluate the current situation of Shiraz’s EMS by comparing data obtained during two different time periods. Materials and Methods This is a retrospective analytic and comparative study in which data obtained from Shiraz EMS during two one-year periods (21st of March 2011 to 20th of March 2012 and 22nd of September 1999 to 21st of September 2000) were compared. Furthermore, these data were also compared with available data from Gothenburg’s EMS (2010). Results Of 84084 missions performed by Shiraz EMS during one year trauma cases were the most common [39282 (46.7%)]. The most common cause of trauma was road traffic accidents (RTA) (27257; 76.5%). Near 56% of all patients were transported to hospitals; some 47% by ambulances and 8.8% by private cars. Around 36.2% of patients received definitive medical treatment at the scene. While there was an increase in response and evacuation times, the number of deaths at scene before ambulance arrival decreased. Conclusions Although Shiraz’s EMS has expanded during last decade and the mortality rate at scene has decreased, the number of RTA-related trauma cases, along with the response and evacuation time, has increased. More than one third of the patients received definitive treatment and could be dismissed directly from the scene. Standardized triage and treatment protocols are needed to improve the EMS activity. PMID:24616794

  14. Serotonin transporter polymorphism as a predictor for escitalopram treatment of major depressive disorder comorbid with alcohol dependence.

    PubMed

    Muhonen, Leea H; Lahti, Jari; Alho, Hannu; Lönnqvist, Jouko; Haukka, Jari; Saarikoski, Sirkku T

    2011-03-30

    The aim of this study was to determine whether the serotonin transporter gene polymorphism (5-HTTLPR) is associated with the treatment outcomes of escitalopram for patients with comorbid major depression and alcohol dependence. Eighty treatment-seeking patients were randomly assigned to either receive 20mg of escitalopram or a control of 20mg of the non-serotonergically acting memantine. Depression was measured by the Montgomery-Asberg Depression Rating Scale (MADRS) and alcoholism by the Alcohol Use Disorders Identification Test (AUDIT). Twenty-nine participants in each treatment group completed the study, and from those DNA was given by 27 in the escitalopram group and 21 in the memantine group. In the escitalopram group linear regression showed that LL genotype predicted greater decrease in MADRS scores compared with the SS/SL genotypes (p=0.04) after a 3month treatment period. Moreover, each L allele associated with MADRS score decrease by 15% (p=0.04) in the escitalopram group. In the memantine group, however, no association between LL genotype and MADRS decrease was detected. AUDIT decrease was not associated with the 5-HTTLPR genotype for either medication. This is the first study in the treatment of depression in dual diagnosis patients to report a significant association between outcomes with escitalopram and the 5-HTTLPR gene polymorphism.

  15. Charting a New Course: Finding Alcohol Treatment for Native American Women.

    ERIC Educational Resources Information Center

    Moss, Kary L.

    Although the incidence of fetal alcohol syndrome (FAS) has been called an "epidemic" on some American Indian reservations, solutions for Native American women with alcohol and drug dependency problems have largely been ignored by the federal government. FAS prevention policy, originating around 1979, has been driven by the simplistic…

  16. Intervention for Individuals with Fetal Alcohol Spectrum Disorders: Treatment Approaches and Case Management

    ERIC Educational Resources Information Center

    Paley, Blair; O'Connor, Mary J.

    2009-01-01

    Exposure to alcohol in utero is considered to be the leading cause of developmental disabilities of known etiology. The most severe consequence of such exposure, fetal alcohol syndrome (FAS), is characterized by a distinct constellation of characteristic facial anomalies, growth retardation, and central nervous system (CNS) dysfunction. Some…

  17. Nearly Half of College Student Treatment Admissions Were for Primary Alcohol Abuse. Data Spotlight

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration, 2012

    2012-01-01

    Many students, and the public in general, believe that drinking alcohol is a normal part of the college experience. Unfortunately, students' efforts to "be sociable" or "fit in" can escalate into substance use behavior that puts their health and well-being at risk: One in four full-time college students have experienced past year alcohol abuse or…

  18. A Research Study of Casa Del Sol: A Viable Chicano Bilingual-Bicultural Alcoholism Treatment Modality.

    ERIC Educational Resources Information Center

    Bueno, Domingo

    Alcoholism among Chicanos is principally due to structural deficiencies in the surrounding society. The frustrations and limitations brought on by the social structure constitute the principal cause of Chicano alcoholism. These include the major causative factors of poverty, racism and acculturation. In an attempt to address the problem of…

  19. Possible new ways in the pharmacological treatment of bipolar disorder and comorbid alcoholism.

    PubMed

    Azorin, Jean-Michel; Bowden, Charles L; Garay, Ricardo P; Perugi, Giulio; Vieta, Eduard; Young, Allan H

    2010-03-24

    About half of all bipolar patients have an alcohol abuse problem at some point of their lifetime. However, only one randomized, controlled trial of pharmacotherapy (valproate) in this patient population was published as of 2006. Therefore, we reviewed clinical trials in this indication of the last four years (using mood stabilizers, atypical antipsychotics, and other drugs). Priority was given to randomized trials, comparing drugs with placebo or active comparator. Published studies were found through systematic database search (PubMed, Scirus, EMBASE, Cochrane Library, Science Direct). In these last four years, the only randomized, clinically relevant study in bipolar patients with comorbid alcoholism is that of Brown and colleagues (2008) showing that quetiapine therapy decreased depressive symptoms in the early weeks of use, without modifying alcohol use. Several other open-label trials have been generally positive and support the efficacy and tolerability of agents from different classes in this patient population. Valproate efficacy to reduce excessive alcohol consumption in bipolar patients was confirmed and new controlled studies revealed its therapeutic benefit to prevent relapse in newly abstinent alcoholics and to improve alcohol hallucinosis. Topiramate deserves to be investigated in bipolar patients with comorbid alcoholism since this compound effectively improves physical health and quality of life of alcohol-dependent individuals. In conclusion, randomized, controlled research is still needed to provide guidelines for possible use of valproate and other agents in patients with a dual diagnosis of bipolar disorder and substance abuse or dependence.

  20. Stress Moderates the Effect of Childhood Trauma and Adversity on Recent Drinking in Treatment-seeking Alcohol-dependent Men

    PubMed Central

    Eames, Sarah F.; Businelle, Michael S.; Suris, Alina; Walker, Robrina; Rao, Uma; North, Carol S.; Xiao, Hong; Adinoff, Bryon

    2014-01-01

    Objective This study sought to clarify the relationship between childhood trauma and adversity with later alcohol consumption and the moderating effects of adult psychosocial stress. Method Seventy-seven recently abstinent alcohol-dependent men attending residential treatment programs were assessed. Childhood trauma/adversity was assessed with the Childhood Trauma Questionnaire (CTQ), drinks per drinking day (DDD) with the TimeLine Follow Back, and chronic psychosocial stress with the UCLA Stress Interview. Drinking and stress were retrospectively assessed for six months prior to the present treatment episode. Direct associations between childhood trauma/adversity and alcohol consumption and the moderating effects of recent psychosocial stress were assessed. All measures were considered as continuous variables. Results Pretreatment drinking severity (DDD) was associated with CTQ Total score (p = .009) and the Emotional Abuse (p < .001) and Physical Abuse (p < .01) subscales. UCLA Total Stress significantly moderated the effects of CTQ Total score on drinking severity (p = .04). Whereas higher CTQ scores were significantly associated with a greater amount of pretreatment drinking in participants with high UCLA stress scores (p = .01), CTQ scores were not associated with the amount of drinking in those with low UCLA stress scores (p = .63). Conclusions Childhood trauma predicts drinking severity in alcohol-dependent men and this effect is stronger in participants with ongoing stress in adult life. These findings suggest that early childhood trauma/adversity may sensitize stress-response systems. PMID:24635549