Substance Abuse

This study provides psychometric findings for the scale "Service to Others in Sobriety (SOS)", a brief assessment of AA-related helping (AAH). Data are derived from a sample of treatment-seeking alcoholics, and SOS validity and response stability is reported by using a test-retest sample

Report describes increased use and abuse of prescription pain medicines and strategies for pain management with less reliance on opioids.

Thesis from the University of New Mexico

"The Women's Recovery Group study was a Stage I randomized clinical trial comparing a new manual-based group treatment for women with substance use disorders with Group Drug Counseling. Data from this study were examined to determine whether co-occurring symptoms of depression and anxiety would improve with treatment and whether these improvements would demonstrate durability over the follow-up period. The sample consisted of 36 women (29 WRG, 7 GDC) who were administered self-report and clinician-rated measures of anxiety, depression, and general psychiatric symptoms. Although there were no group differences in psychiatric symptom improvement, analyses demonstrated significant within-subject improvement in depression, anxiety, and general psychiatric symptoms. Symptom reduction was not mediated by changes in substance use. This study demonstrated significant psychiatric symptom reduction that remained durable through 6 months of follow-up for women receiving group therapy focused on substance abuse relapse prevention. Reduction in psychiatric symptoms may be an additional benefit of substance abuse group therapy for women. "

Abstract: "We present two studies testing whether self-efficacy mediates the relationship between depression symptoms and initial abstinence duration after substance abuse treatment in adolescents and adults. Study 1: Adolescents (N = 208) were recruited from substance abuse treatment in an urban/suburban area in the United States between 1999-2005, and followed monthly after discharge. Measures used were affective state (depression symptoms), drug-taking coping self-efficacy, and length of abstinence after treatment. Self-efficacy fully mediated the relationship between depression and time to use. Study 2: In a similar study design, adult Veterans (N = 160) in outpatient substance abuse treatment were interviewed during treatment and monthly following treatment. Depression was negatively associated with self-efficacy, and self-efficacy predicted time to first substance use, but there was no mediation. Study implications and limitations are noted."

"This review focuses on studies that used PET to characterize the brain DA system in addicted subjects"

An analysis of the Higher Power concept in 12-step drug addiction recovery programs

" Methods: A randomized controlled trial in outpatient clinics for people suffering from alcohol dependence (AD) and alcohol-related problems; 165 adult patients in an outpatient setting in a specialized alcohol treatment unit were randomized 1:1 to either a symptom-triggered self-medication or tapered dose, using chlordiazepoxide. Alcohol withdrawal symptoms, amount of medication, duration of symptoms, time to relapse and patient satisfaction were measured. Patients assessed their symptoms using the Short Alcohol Withdrawal Scale (SAWS). Patient satisfaction was monitored by the Diabetes Treatment Satisfaction Questionnaire. We used the Well-Being Index and the European addiction severity index for the 1-year follow-up. Results: We found no differences in the quantity of medication consumed, time to relapse, well being or treatment satisfaction. Conclusion: Symptom-triggered self-medication was as safe as fixed-schedule medication in treating outpatients with AD and mild to moderate symptoms of AWS. The SAWS is a powerful monitoring tool, because it is brief and permits the subject to log the withdrawal symptoms. "

From the abstract: "Aims: To examine whether individual changes in alcohol consumption among female alcoholics under treatment are predicted by level of and changes in depression and dysfunctional attitudes. Method: A total of 120 women who were treated for alcohol addiction at the Karolinska Hospital in Stockholm (Sweden) were assessed twice over a 2-year period using the Depression scale from the Symptom Checklist-90, the Alcohol Use Inventory and the Dysfunctional Attitude Scale (DAS). Latent growth curve analysis was used. Results: Decrease in alcohol consumption, depression and dysfunctional attitude variables were found at group level. The results also showed significant individual variation in change. Changes in alcohol consumption were predicted by baseline alcohol drinking, as well as by level and changes in depression. Stronger reduction in depression was related to higher level of depression at baseline, and with reduction in dysfunctional attitudes. Different DAS sub-scales resulted in different magnitude of the model relations. Good treatment compliance was related to lower baseline level in depression, but also with higher baseline level in dysfunctional attitudes, and predicted stronger reduction in alcohol consumption. Conclusion: This paper shows the importance of incorporating both individual level and change in depression as predictors of change in alcohol consumption among subjects treated for alcohol addiction. Also, dysfunctional attitudes are both indirectly and directly related to treatment outcome. By incorporating alcohol consumption, depression and dysfunctional attitudes as targets of intervention, treatment compliance and outcome may be enhanced. "

From the abstract: "Results from the DBT condition revealed that the intervention had a significant positive effect on behavioural and attitudinal features of disordered eating, substance use severity and use, negative mood regulation and depressive symptoms. Finally, increases in participants' perceived ability to regulate and cope with negative emotional states were significantly associated with decreases in emotional eating and increases in levels of confidence in ability to resist urges for substance use."

" To investigate whether substance abuse (alcohol or illegal drugs) in patients with first-episode psychosis (FEP) influenced treatment outcomes such as involuntary hospitalization during follow-up."

"This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT)." Orgs surveyd on data from 2003-2008

From the abstract: "Young people presenting to engagement-focused substance use services report similar difficulties to those at mental health services across most areas of psychosocial functioning. Addiction services may require equivalent staffing expertise and workforce development to that in mental health to effectively meet young people's needs. "

Abstract: "Alcohol addiction is associated with alterations of central nervous dopaminergic and serotonergic functions. Acute tryptophan depletion has not yet been applied in detoxified alcohol-addicted patients in order to investigate its impact on psychopathology, psychoneuroendocrinology, and substance craving behaviour. 25 alcohol-addicted males randomly either received a tryptophan-free or tryptophan-containing amino acid drink and 7 days later the respective other drink. Anxiety, depression, and craving were assessed before and 5 h after the drink. Tryptophan, 5-HIAA, dopamine, norepinephrine, epinephrine, and HVA in serum were measured before and after both treatments. Nocturnal urinary cortisol measurements and genotyping for the HTTLPR polymorphism of the SLC6A4 gene were performed. Tryptophan depletion resulted in a significant reduction of total and free serum tryptophan while the tryptophan-rich drink increased serum levels. Both treatments caused a significant increase of serum serotonin levels, however, serum 5-HIAA was decreased after depletion but increased after sham depletion. Dopamine and norepinephrine were elevated after tryptophan depletion and sham. Depletion increased depression scores (MADRS), while the full amino acid drink improved state and trait anxiety ratings (STAI) and substance craving. Urinary cortisol excretion was not affected by both treatments. Patients with the ll genotype of the serotonin transporter gene displayed lower baseline tryptophan levels compared to patients with the heterozygous genotype. Results suggest an impaired serotonergic function in alcohol-addicted males."

From the abstract: "This contribution aims to examine systematically the evidence on the impact of the quality of unrecorded alcohol products on health consequences. "

A literature review