RESUMEN
We interviewed 70 substance abusers in methadone maintenance treatment regarding the life experiences of their 188 children. Sixty-four percent of the mothers reported using psychoactive drugs during their pregnancies. Eighty percent of parents reported an arrest during the time the child was growing up, 34% reported receiving treatment for an emotional disorder, and 14% were hospitalized. Four percent of the parents reported that their children had been placed in adoptive care, 9% in foster care, and 1% had a child in a group home. Forty-one percent of the parents reported that at least one of their children repeated a grade in school, 19% were involved in truancy, and 30% had been suspended from school. Twenty percent of parents reported their children's involvement with the law, and 17% reported drug or alcohol use. Problems with the law correlated highly with 1) being held back a grade, 2) truancy, 3) suspension from school, 4) expulsion from school, and 5) treatment for alcohol or drug abuse.
Asunto(s)
Hijo de Padres Discapacitados/psicología , Metadona/uso terapéutico , Trastornos Relacionados con Opioides/rehabilitación , Desarrollo de la Personalidad , Adolescente , Adulto , Trastorno de Personalidad Antisocial/epidemiología , Trastorno de Personalidad Antisocial/psicología , Trastorno Bipolar/epidemiología , Trastorno Bipolar/psicología , Niño , Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricos , Abuso Sexual Infantil/epidemiología , Abuso Sexual Infantil/psicología , Trastornos de la Conducta Infantil/epidemiología , Trastornos de la Conducta Infantil/psicología , Hijo de Padres Discapacitados/estadística & datos numéricos , Preescolar , Estudios Transversales , Trastorno Depresivo/epidemiología , Trastorno Depresivo/psicología , Composición Familiar , Femenino , Humanos , Incidencia , Discapacidades para el Aprendizaje/epidemiología , Discapacidades para el Aprendizaje/psicología , Acontecimientos que Cambian la Vida , Masculino , Maryland/epidemiología , Trastornos Relacionados con Opioides/epidemiología , Trastornos Relacionados con Opioides/psicología , Determinación de la Personalidad , Embarazo , Efectos Tardíos de la Exposición Prenatal , Factores SocioeconómicosRESUMEN
We conducted a pilot study (N = 22) comparing the efficacy of desipramine and amantadine for treatment of cocaine dependence in methadone maintenance clients. The study which lasted 12 weeks, was double-blind, randomly assigned, and placebo-controlled. Subjects met DSM-III-R criteria for active cocaine dependence. All three groups' cocaine use, craving, and depressive symptoms declined significantly, but intergroup differences were not significant. Clients receiving desipramine were significantly more likely to remain in treatment and to be cocaine free at study completion. The results emphasize the importance of delivering comprehensive services to the cocaine user in methadone treatment. Further evaluations of these two medications as adjuncts in the treatment of cocaine dependence are needed.
Asunto(s)
Amantadina/uso terapéutico , Cocaína , Desipramina/uso terapéutico , Metadona/uso terapéutico , Trastornos Relacionados con Opioides/rehabilitación , Trastornos Relacionados con Sustancias/rehabilitación , Adolescente , Adulto , Amantadina/administración & dosificación , Baltimore , Desipramina/administración & dosificación , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Trastornos Relacionados con Opioides/complicaciones , Proyectos Piloto , Placebos , Proyectos de Investigación , Centros de Tratamiento de Abuso de Sustancias , Síndrome de Abstinencia a Sustancias/prevención & control , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/tratamiento farmacológico , Estados UnidosRESUMEN
A study was made of the perceptions of risk and of the sources of information about risk regarding cocaine. Subjects were adult (N = 90) and juvenile (N = 20) cocaine abusers in seven Baltimore area treatment programs. Using structured interview, it was found that 87.8% of adults and 80.0% of youth had experienced at least one negative consequence of their cocaine use, other than addiction, prior to entry into treatment. The most common negative experience reported by both groups was the loss of reality testing. Moreover, 86.6% of adults and 65.0% of youth reported becoming addicted to cocaine before entering treatment. While juveniles sampled had entered treatment within a year of first cocaine use, adults entered treatment 7.9 years after first use and reported an average of 6.6 years of cocaine use before experiencing the first negative consequences. Television received consistently high ratings as an accessible and credible source of information about cocaine. Adolescents rated schools relatively high on the amount and accuracy of cocaine-related information provided.
Asunto(s)
Actitud Frente a la Salud , Cocaína/efectos adversos , Educación en Salud , Trastornos Relacionados con Sustancias/prevención & control , Trastornos Relacionados con Sustancias/psicología , Adolescente , Adulto , Baltimore , Femenino , Humanos , Masculino , Factores de Riesgo , Trastornos Relacionados con Sustancias/rehabilitaciónRESUMEN
We conducted a single-blind, random assignment, placebo-controlled, 12-week comparison of desipramine hydrochloride and amantadine hydrochloride as adjunctive treatments to counseling for cocaine dependence. Subjects were 54 outpatients who met DSM III-R criteria for active cocaine dependence and who completed a minimum of 2 weeks of treatment. Subjects treated with fixed doses of 200 mg/day desipramine (N = 17), 400 mg/day amantadine-placebo (N = 16), and placebo (N = 21) did not differ for lifetime cocaine use, lifetime histories of psychopathology, admission scores on psychometric assessments, and sociodemographics. All treatment groups demonstrated dramatic and persistent decreases in cocaine use, craving for cocaine, and psychiatric symptoms consequent to treatment. Although there was a trend for more dropouts by subjects taking desipramine, there were no significant differences among treatment groups regarding retention in treatment, craving for cocaine, and decreased cocaine use confirmed by urine toxicology. There was a trend for subjects treated with desipramine to maintain longer periods of cocaine abstinence. Mean plasma concentration of desipramine in a subsample of our subjects was less than that recommended for treatment of depression, thus the dosage of desipramine may have been subtherapeutic.
Asunto(s)
Amantadina/administración & dosificación , Cocaína , Desipramina/administración & dosificación , Psicoterapia , Trastornos Relacionados con Sustancias/rehabilitación , Adulto , Amantadina/farmacocinética , Terapia Combinada , Desipramina/farmacocinética , Relación Dosis-Respuesta a Droga , Femenino , Estudios de Seguimiento , Humanos , Masculino , Método Simple Ciego , Trastornos Relacionados con Sustancias/sangre , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
We surveyed 11 methadone maintenance treatment programs in the Baltimore, Maryland, area to examine cocaine use among their 2414 clients and the methods employed to cope with that use. The percent of clients with at least one urine sample positive for cocaine during the month previous to study was 15.7% (379/2414) and ranged from 5.9% to 33.0% among the 11 programs. We determined the programs' use of monitoring strategies, treatment services, and administrative controls. We discuss the policy implications of our findings for methadone maintenance programs' efforts to address cocaine use with particular regard to the epidemic of human immunodeficiency virus (HIV) among intravenous drug users, their sexual partners, and offspring.