Using research to guide culturally appropriate drug abuse prevention.

Several ways in which research can be an important tool in creating culturally appropriate prevention programs are suggested. To illustrate cultural vulnerability, the authors present data from a study of 5th-grade African-American and European-American students. These data describe rates of early initiation, levels of exposure to identified risk factors, and degree to which identified risk factors predict substances initiated. Results indicate that European-American Ss have higher rates of tobacco and alcohol initiation, that the same risk factors predict the variety of substances initiated for African-American and European-American Ss, and that several differences exist in the level of exposure to risk factors between the 2 groups. Implications of the findings for developing culturally appropriate drug abuse prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV/AIDS and drug abuse: epidemiology and prevention

In the United States, the AIDS epidemic is a dynamic process with increasing rates of AIDS reported among women, minority populations, heterosexual men, and users of drugs by routes other than injection. The 1993 CDC AIDS definition change has created some difficulties in interpreting trends in the United States. Drug use continues to represent a significant problem among HIV-infected persons. Several strategies have been advanced to decrease transmission of HIV among drug users, their sexual partners and children. However, more effective and comprehensive prevention and treatment strategies are needed.     

Reinforcing operants other than abstinence in drug abuse treatment: An effective alternative for reducing drug use.

This study examines the effectiveness of using vouchers to reinforce either the provision of urine samples testing negative for illicit drugs (UA group) or the completion of objective, individually defined, treatment-plan-related tasks (TP group). A third group was assigned to the clinic's standard treatment (STD group). Participants were randomly assigned to groups after a 6-week baseline stabilization period. Urine specimens were collected thrice weekly throughout the study. In the UA condition, participants earned $5 (U.S. dollars) in vouchers for each drug-free urine submitted. In the TP condition, participants earned up to $15 in vouchers per week for demonstrating completion of treatment plan tasks assigned by their counselors. Contingencies were in effect for 12 weeks, after which all participants received the clinic's standard treatment. Urinalysis results indicate that the TP intervention was significantly more effective in reducing illicit drug use than either the UA or STD interventions. These effects were maintained with a trend toward continuing improvement for the TP groups even after contingencies were discontinued. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification of drug abuse

Drug abuse poses health and safety hazards, both in the workplace and in the wider community. There is increasing pressure to use urine drug tests to determine the prevalence of drug abuse, to deter illicit use of drugs, and to identify drug abusers for rehabilitation. Drug-abuse testing programs have been implemented for employees, job applicants, policemen, firemen, enlisted personnel of the army, athletes, and workers in occupations that are considered critical to public safety and health, such as those in nuclear power plants and the transportation industry. Since the consequences of a positive test can be quite severe, there is a need to develop uniform and internationally recognized methods for identifying drug abuse. The paper discusses selection of biological specimens for drug-abuse testing, main characteristics of drugs of abuse and recommended analytical techniques for their determination. The importance of a quality assurance program for drug-testing laboratories is emphasised.     

Treatment of drug abuse syndromes

This article serves as an introduction to the treatment of the various drug abuse syndromes. The theoretical concept underlying all diagnoses in drug dependence is presented first in detail, along with an extensive discussion of how these diagnoses are operationalized. Tolerance and dependence among the various drugs of abuse are considered. The review of treatment approaches divides drugs of abuse into pharmacologic categories and treatment into time segments, acute detoxification, intermediate-term, and long-term treatment. Pharmacotherapies for each of the categories of substance abuse and for each of the time periods are presented in a treatment-oriented fashion. Drug substitution therapy is considered. Individual and group therapy are discussed, as is education in the form of group process and peer feedback. The role of peer support groups is stressed. Finally, patient placement criteria across levels of care are explained.     

Primary prevention of child abuse.

Following a discussion of the ecological theory base for the study and design of child abuse prevention programs, the authors examine 3 categories of primary programs: competency enhancement, preventing the onset of abusive behavior, and targeting high-risk groups. Programs that enhance competencies of families focus on parent skills, child development information, and coping strategies to reduce stress. Programs that prevent the onset of abusive behavior involve media campaigns; information, crisis, and referral services; and social networks at the community and neighborhood levels. Programs that target high-risk groups (e.g., low-SES, single parents, complicated pregnancies) focus on therapeutic strategies. Methodological problems in evaluating child abuse prevention include the lack of appropriate comparison groups, poor choice of outcome measures, and the failure to measure proximal programmatic objectives and distal prevention goals. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relative effectiveness of comprehensive community programming for drug abuse prevention with high-risk and low-risk adolescents.

This article reviews major risk factors for cigarette smoking, alcohol, and other drug abuse and promising community-based approaches to primary prevention. In a longitudinal experimental study, 8 representative Kansas City communities were assigned randomly to program (school, parent, mass media, and community organization) and control (mass media and community organization only) conditions. Programs were delivered at either 6th or 7th grade, and panels were followed through Grade 9 or 10. The primary findings were (a) significant reductions at 3 years in tobacco and marijuana use and (b) equivalent reductions for youth at different levels of risk. This study provides evidence that a comprehensive community program-based approach can prevent the onset of substance abuse and that the benefits are experienced equally by youth at high and low risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Uncovering drug abuse by alcoholics and alcohol abuse by addicts

Substance abuse histories from 1,544 men and women receiving treatment at 10 federally funded centers indicated that 80% had abused, either sequentially and/or concurrently, two or more substances at some time during their lives. The equivalent figure for the last 3 months before being interviewed was 56%. These data indicated a preponderance of multiple substance abuse, especially of alcohol and various other drugs, over single substance abuse (SSA). SSA nearly always involved alcohol and was reported mostly by those 40 years or older. Lines of inquiry for diagnosing alcohol abuse by addicts and drug abuse by alcoholics are provided.     

Cocaine abuse counseling as HIV prevention

The synthesis and hemoglobin cross-linking studies of a novel organic reagent, bis[2-(4-carboxyphenoxy)carbonylethyl]phosphinic acid (BCCEP; 2) has been reported. The reagent was synthesized in four steps from hydroxybenzoic acid. The tri-sodium salt of BCCEP was employed to cross-link oxyHb, and the product was purified by DEAE-cellulose chromatography. The purified material was analyzed by SDS-PAGE, IEF, and HPLC analyses, which clearly showed the formation of covalent, intramolecular cross-links. While SDS-PAGE analyses of individual bands pointed to the molecular weight range of 32 kDa, the HPLC analyses suggested that the cross-links had formed between beta 1-beta 2 subunits. The oxygen equilibrium measurements and the Hill plots were performed on the purified bands to assess oxygen affinity as well as cooperativity of oxygen binding of the modified hemoglobins. All bands corresponding to modified hemoglobins showed significantly reduced oxygen affinity as compared with that of cell-free hemoglobin, as desired. The modified hemoglobins, however, exhibited somewhat reduced oxygen-binding cooperativity as contrasted with human stroma-free hemoglobin. Molecular dynamics simulation studies (Insight II/Discover/Biosym) on the Reagent-HbA0 complex suggested that the most likely amino acid residues involved in the cross-linking are Lys82 or N-terminal Val1 on one of the beta chains, and Lys144 on the other.     

Stimulant abuse treatment as HIV prevention

In the past several years, the greatest proportionate increase in AIDS diagnoses has occurred among women. Yet, while the risk of HIV infection increases, female college students continue to report inconsistent HIV prevention behaviors. Past research on condom use among college women has focused on intrapersonal aspects of the behavior, and little is known about the influence of interpersonal factors on women's condom use. In this study we examined the relative salience of both intra and interpersonal factors on African American and white women's use of condoms. We found that interpersonal variables were particularly salient predictors of condom use. There were no ethnic differences in the effects of interpersonal variables; however, there were differences in the effects of self-efficacy on condom use.     

Failures in prevention: Why we can't prevent the devastating effect of alcoholism and drug abuse.

A review of alcoholism prevention efforts on federal, state, and local levels reveals the following: (a) Prevention has ranked lowest among all alcoholism and drug-dependence funding priorities established by the US government; (b) prevention is an infrequent component of employee assistance programs in industry, despite its proven favorable cost–benefit ratio; (c) prevention activities directed to groups at risk for alcoholism (including women, youth, minority groups, and the elderly) have increased in number but failed to yield reductions in drinking rates by target groups; (d) although drunk driving and fetal alcohol syndrome are now recognized as major public health problems and have begun to be serious targets for prevention, debilitating disagreement interferes with efforts to prevent drunk driving, and the incidence of fetal alcohol syndrome remains unconscionably high. (1? p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescents' perceptions of substance abuse prevention strategies

As part of a 3-year evaluation of substance abuse prevention strategies (Harding, Safer, Kavanagh, Bania, Carty, Lisnov, & Wysockey, 1996), this study examined the perceptions of 719 sixth- through ninth-grade Chicago public school students. School-based programs were rated as significantly more effective on six prevention objectives than were television ads, testimonials by famous people, billboards, and print ads displayed on public transportation. Students perceived the two school-based programs, Project DARE (a national program conducted through local police departments) and Captain Clean (an intense live theater program coordinated with student participation), as being equally effective overall, although the interactive theater program was rated as significantly better at encouraging students to talk about their feelings concerning substance abuse issues and at relating to the students' ethnic/racial backgrounds. When students were categorized according to frequency of alcohol use, nonusers, infrequent users, and frequent users differed significantly in their ratings of the school-based programs.     

Screening for alcohol and drug abuse

Homeopathy is widely used around the world and is regaining popularity in the United States where it enjoyed popular and therapeutic success in the 1800s. Relying on systematic principles of health and disease first set forth by Samuel Hahnemann in 1810, it offers a powerful and inexpensive means of promoting self-care and of augmenting therapeutic options for the family physician. History, theory and practical considerations are reviewed.     

Drug abuse treatment as HIV prevention: changes in social drug use patterns might also reduce risk

Fifty one individuals (37 male and 14 female) were asked to report on the social and behavioral circumstances related to their opiate drug use prior to and during a 90-day methadone detoxification treatment. Data were collected by means of a weekly structured interview. Questions were asked about each occasion of opiate use in the previous week with respect to time, source, cost, social circumstance, etc. Monitored urine samples were tested x 3/week to verify verbal reports. The study demonstrated beneficial effects of the detoxification treatment by showing dramatic decreases in rates and amounts of opiate drug use during treatment. Of perhaps greater significance, large scale changes were also noted in the frequency of use with others. This decline in use with others was most dramatic with respect to strangers and acquaintances. Implications of these observations for HIV transmission are discussed.     

Toward effective community-based interventions in child abuse.

Argues that traditional individual and family-oriented clinical and educational approaches to treating child-abusing parents seem to have limited effectiveness. Within an ecological framework, causal factors bearing on the problem of child abuse can be amenable to community intervention through the use of such concepts as natural support systems and community development activities. An example of community development intervention is described, and guidelines for community-level interventions are suggested. The consultation and education program of the community mental health center is cited as one such approach to this problem. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rapid assessment of drug abuse in Kenya

A country-wide needs assessment study undertaken in 1994 by the Government of Kenya and the United Nations International Drug Control Programme (UNDCP) revealed that drug abuse has permeated all strata of Kenyan society, youth and young adults being the most affected groups. The traditional cultural values and discipline of African society prescribed the circumstances under which drugs and intoxicants could be obtained, used and consumed. Perhaps as a result of the erosion of the powers of censure and control at the family and community levels, fewer stigmas are associated today with the use of intoxicants (especially alcohol and tobacco). One of the main recommendations of the study is that the Government of Kenya should set up specific demand reduction programmes to enlighten and educate the public on the problem of drug abuse. The need for a reassessment of government policy on the treatment of addicts is stressed, and it is suggested that the establishment of non-stigmatizing treatment and rehabilitation centres should be considered. Intersectoral collaboration between different government departments and non-governmental organizations is also proposed.     

Rapid assessment of drug abuse in Cameroon

The present paper describes a rapid assessment that was carried out in Cameroon from March to November 1994 and presents a summary of the findings and recommendations. It was the first rapid assessment study conducted by Cameroon in collaboration with the Economic Community of Central African States, with technical assistance from the World Health Organization and the support of the United Nations International Drug Control Programme. It was hoped that the study would help to fill gaps in the information available on drug abuser profiles, the types of drugs abused and the response of the community to drug abuse in Cameroon. In focus group discussions, key informant interviews and interviews with drug abusers, it was revealed that Cameroon was not only used by drug traffickers as a transit country, but was also a drug-consuming country. The drug consumers were both males and females from all age groups. The drugs consumed ranged from traditional drugs to imported cocaine and heroin. Cannabis was the most frequently consumed drug, followed by amphetamine-type tablets and a broad range of pharmaceuticals. Solvents were mainly consumed by street children in northern Cameroon. Local beer and gin also held a special place in society. In order to tackle the existing problems, programmes offering preventive education and alternative forms of recreation for youth were necessary, and national policies on demand and supply reduction should be harmonized.