Environments as cues to smoke: Implications for human extinction-based research and treatment.

Animal research has shown that the environments, or contexts, in which drug use occurs can play a key role in how animals respond to drug-related cues. Less is known about the role of environmental contexts in human drug-dependence research. Traditionally, cue-based studies and treatments focus on conditioned cues most proximal to drug administration (e.g., lit cigarettes, pictorial stimuli of drug paraphernalia). However, there is reason to believe that more distal cues, such as the environments in which drugs were previously used, might similarly gain associative control over human responding. This article describes a body of systematic research aimed at identifying and studying the impact of environmental contexts on smokers' cue reactivity in the laboratory. Overall, results of this program of research demonstrate that exposure to environments associated with smoking, but completely devoid of proximal smoking cues, can function as conditioned stimuli capable of evoking strong subjective responding from abstinent smokers. Furthermore, more robust reactivity can be achieved if environmental context cues are personalized using novel techniques described in this article. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug testing, drug treatment, and marijuana use: A fairness perspective.

The authors conducted a random statewide telephone survey of 1,484 individuals to study the relationship between marijuana use (in terms of participants' history of marijuana use) and reactions to drug testing and to study 2 hypothetical drug-treatment policies. Job safety sensitivity was related to perceived fairness of drug testing for the participant's job, and more recent marijuana use was associated with more negative reactions. Safety sensitivity was related to perceived fairness of drug treatment. Organizations with voluntary treatment were more attractive than ones with monitored treatment. Marijuana use interacted with drug treatment policy type in predicting reactions to drug treatment. Results suggest that organizations should consider job and employee characteristics when developing a drug treatment policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Potential Role of Drug Onset Cues in Drug Dependence and Withdrawal: Reply to Bardo (2004), Bossert and Shaham (2004), Bouton (2004), and Stewart (2004).

In responding to commentaries (M. Bardo, see record 2004-10475-002; J. Bossert and Y. Shaham, see record 2004-10475-003; M. Bouton, see record 2004-10475-004; J. Stewart, see record 2004-10475-005) on their original article (see record 2004-10475-001), the authors agree that the basic mechanisms underlying intra-administration associations may be extensible to a much wider range of phenomena, including both other examinations of conditioned drug effects (e.g., conditioned place preference) and human psychological disorders. The authors also address the concerns of a number of the commenting authors regarding discrepancies in the literature concerning the effects of drug priming in both human and animal studies of reinstatement of drug self-administration. Finally, the authors accept and endorse the calls by several of these commenting authors for further studies required to generate additional support for their model of conditioned drug effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two views of the addiction elephant: Comment on McSweeney, Murphy, and Kowal (2005).

F. K. McSweeney, E. S. Murphy, and B. P. Kowal (see record 2005-10634-001) present a convincing case that the literature on habituation and sensitization to the sensory properties of conventional reinforcers is relevant to understanding a variety of addictive behaviors. They note that their model has advantages over a number of alternative formulations. However, in discussing one particular such alternative, a Pavlovian conditioning analysis of drug tolerance and withdrawal, F. K. McSweeney et al. overstate the advantages of their reinforcer habituation/sensitization model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bridging the gap between alcoholism treatment research and practice: Identifying what works and why.

Despite the proliferation of alcoholism treatment research over the past 2 decades, there is a continued gap between what has been shown to be promising in the extant literature and what is commonly practiced by clinicians in the alcohol treatment field. The present article is an effort to bridge this gap by examining findings from the broad body of alcoholism treatment outcome research to determine how these findings may optimally be used by treatment providers. To this end, the authors provide clinicians with a succinct review of the current alcoholism treatment outcome literature and identify hallmarks of the most empirically supported treatments. Clinical implications of this literature for practitioners working with client with alcohol use disorders are discussed, with a focus on factors underlying effective treatments and on how these factors can be transferred from research to practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Opioid Craving and Seeking Behavior in Physically Dependent Volunteers: Effects of Acute Withdrawal and Drug Reinforcement Opportunity.

This study examined whether acute opioid withdrawal and drug reinforcement opportunity increase opioid craving and seeking behavior. The author used a 3 × 2 within-subject randomized crossover design to assess craving and operant behavioral effects of 3 pretreatments (naloxone 0.1 mg/70 kg, fentanyl 0.75 mg/70 kg, or saline iv) and drug or money reinforcement opportunity in 8 methadone-maintained volunteers. Each pretreatment was paired with response-contingent (15 × fixed-ratio 100) delivery of drug (fentanyl 1.5 mg/70 kg iv) and money (rated equivalent of fentanyl) in different sessions. Naloxone significantly increased opioid craving, withdrawal signs, and symptoms, but not operant behavior, relative to saline and fentanyl pretreatment. However, drug versus money reinforcement opportunity did not significantly increase opioid craving or seeking behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the Nature of the Intra-Administration Unconditioned Stimulus: Comment on McDonald and Siegel (2004).

R. V. McDonald and S. Siegel (see record 2004-10475-001) present convincing evidence that a small dose of morphine (5 mg/kg) may elicit withdrawal signs in rats previously injected on a number of occasions with a large dose of morphine (50 mg/kg), thus suggesting that intra-administration associations may be involved in drug withdrawal. This finding is important for basic and applied researchers studying drug reward mechanisms. Although R. V. McDonald and S. Siegel point out that the morphine conditional stimulus (CS) and unconditioned stimulus (US) making up the intra-administration association differ in onset and magnitude, the author of this comment argues that the CS and US may also differ in terms of pharmacologic activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repeated dosing with oral cocaine in humans: Assessment of direct effects, withdrawal, and pharmacokinetics.

Cocaine withdrawal symptoms are thought to play a role in relapse; studies characterizing the symptomatology have yielded mixed findings. This study sought to examine the pharmacodynamic/pharmacokinetic profile of repeated high dose exposure to oral cocaine and characterize acute and protracted withdrawal in cocaine abusers. This study employed a repeated-dosing, single-blind design in which subjects (n = 9), resided for 40 days on a closed ward. They were maintained for two 4-day cocaine exposure periods (Days 1–4 & Days 9–12, cocaine 175 mg, p.o.; 5 hourly doses; 875 mg/day) separated by a 4-day matched placebo exposure period (Days 5–8). After these 12 days, an additional period of 28 days of placebo maintenance followed (Days 13–40). Test sessions were conducted during each phase; measures of mood, drug effects, sleep, pharmacokinetics, and prolactin were collected throughout the study. The dosing regimen produced cocaine plasma concentrations (Cmax of 680 ng/mL) two to threefold higher than typically seen in acute dose studies. Prototypic psychostimulant effects, including subjective ratings of euphoric effects (liking, high, good effects) and significant cardiopressor effects, were sustained during the active dosing periods, corresponding to the rise and fall of plasma cocaine. Withdrawal-like symptoms (i.e., disruptions of sleep, increased ratings of anxiety, irritability, crashing) were observed within 24-hr after cessation of dosing. Cocaine reduced prolactin acutely, but no sustained alterations were observed for this measure or for other signs or symptoms during the 28-day abstinence period. These findings indicate that exposure to controlled high doses of cocaine produces modest symptoms consistent with cocaine withdrawal within hours of cessation of dosing but provide no evidence of symptoms persisting beyond 24 hours. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disentangling the Sources of Opioid Withdrawal Responses: Comment on McDonald and Siegel (2004).

R. V. McDonald and S. Siegel (see record 2004-10475-001) present new evidence for the idea that opioid drug-opposite responses can become conditioned to cues of initial drug onset and that they could, therefore, play a role in the development of tolerance of some drug effects and a role in the elicitation of withdrawal-like symptoms in cases in which addicted individuals are exposed to small doses of the drug they normally consume. In this comment, some puzzling features of the data are discussed, and alternative explanations are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of smoking and methadone dose in drug treatment patients.

Cigarette smoking prevalence is very high, and cessation rates are very low, among people in methadone treatment. This may in part be due to interactions between methadone administration and cigarette smoking. The present study explores relationships between methadone dose timing and smoking rates. Twenty methadone patients, over a period of 19 days, used electronic cigarette packs to record their smoking patterns and called a voice mailbox daily to report their methadone dose and timing. The average proportion of daily cigarettes smoked was calculated for 2-hr blocks preceding and following methadone dose administration. For all participants, peak smoking rates occurred after methadone administration. Participants smoked a greater proportion of cigarettes in their first 2-hr block after methadone dosing (M = 0.368, SD = 0.135) than during their first 2-hr block of smoking of the day (M = 0.245, SD = 0.010; S = 85.5, p     

Atomoxetine: A Selective Norepinephrine Reuptake Inhibitor for the Treatment of Attention-Deficit/Hyperactivity Disorder.

This column offers data related to attention deficit disorder with hyperactivity and related psychopharmacological treatments. The author focuses on atomoxetime, a selective norepinephrine reuptake inhibitor, and offers efficacy and safety data. Conclusions point out the limitations of stimulant use and praise the alleged non-abusive nature of atomoxetine. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Research Advances in Alcohol and Drug Problems.

Reviews the book, Research Advances in Alcohol and Drug Problems edited by Yedy Israel, Frederick B. Glaser, Harold Kalant, Robert E. Popham, Wolfgang Schmidt, and Reginald G. Smart (1981). This book is the sixth volume of the series, Research Advances in Alcohol and Drug Problems. The purpose of this series, as stated by the editors, is not to provide an annual review each year on a fixed selection of topics but rather "to present each year evaluative papers on topics in which enough recent progress has been made to alter the general scope in a particular area." In Volume 6 several chapters deal with highly specialized topics such as: Tolerance to sensitization to central stimulants, brain peptides, liver functions, and mutagenicity of alcohol and tobacco smoke. The prohibitive price $59.50 (U.S. dollars) and highly specialized and diverse nature of many of the chapters in this book, will likely prevent this book from finding its way into many personal libraries. This work would, however, be a worthwhile acquisition for any university or alcohol treatment library. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The mind-matter-relation: Out of metaphysics and into the laboratory.

The new area of science is recognized after the gathering, by scientific methods, of a coherent body of empirical findings. The proposition that this paper argues is that still another of these transitions is ready for recognition; that still another classical question has recently been whittled away from philosophy. That classical issue is the mind-matter relationship. There is now a clean scientific method for research on it. Use of the method has yielded a substantial amount of data, sufficiently consistent to be considered replicable, and coherent with physical and psychological theory. The findings demonstrate a direct relationship, without the intervention of the known effectors, between changes in mental events and changes in the physical world. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acceptability and availability of harm-reduction interventions for drug abuse in American substance abuse treatment agencies.

[Correction Notice: An erratum for this article was reported in Vol 18(1) of Psychology of Addictive Behaviors (see record 2007-16711-001). On page 208, the first sentence in the note of Table 4 incorrectly reads as follows: "Numbers in parentheses are ns of respondents who provided an 'other' reason for this specific intervention." The sentence should read as follows: "Numbers in parentheses are ns of respondents whose agencies do not offer this intervention."] This study assessed acceptability, availability, and reasons for nonavailability of interventions designed to prevent drug use related harm by substituting pharmaceuticals for illicit drugs; facilitating detoxification; and reducing the occurrence of HIV transmission, relapse, and opiate overdose. A survey was mailed to a sample of 500 randomly selected American substance abuse treatment agencies. Of 435 potentially eligible respondents, 222 (51%) returned usable data. A subset of interventions--including harm reduction education, cue exposure therapy, needle exchange, substitute opiate prescribing, various detoxification regimes, and complementary therapies--were rated as somewhat or completely acceptable by 50% or more of the respondents. Regardless of their acceptability, listed interventions were generally not available from responding agencies; respondents typically attributed unavailability to lack of resources and inconsistency of an intervention with agency philosophy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of voucher-based intervention on abstinence and retention in an outpatient treatment for cocaine addiction: A randomized controlled trial.

The aims of this study were to assess whether voucher magnitude improved cocaine abstinence and retention in an outpatient treatment for cocaine dependence, and to determine the effectiveness of a contingency management intervention in a European cultural context. A randomized controlled trial was conducted in which 96 participants who were randomly assigned to 1 of 3 treatment conditions in a community setting: standard outpatient treatment, community reinforcement approach (CRA) plus low monetary value vouchers (each point earned was equivalent to 0.125? US$ 0.18), and CRA plus high monetary value vouchers (each point was worth 0.25? US$ 0.36). In the standard treatment group, mean percentage of cocaine-negative samples was 88.45%, versus 96.09% in the CRA plus low-vouchers group, and 97.07% in the CRA plus high-vouchers group. Retention rate at 6 months was 36.5% in the standard treatment group, 53.3% in the CRA plus low-vouchers group, and 69.0% in the CRA plus high-vouchers group. The CRA plus vouchers groups obtained better results than the standard program. This study showed that treating cocaine addiction by combining CRA with vouchers was more effective than standard treatment in community outpatient programs in Spain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The causal generalization paradox: The case of treatment outcome research.

Data from psychological experiments pose a causal generalization paradox. Unless the experimental results have some generality, they contribute little to scientific knowledge. Yet, because most experiments use convenience samples rather than probability-based samples, there is almost never a formal justification, or set of rigorous guidelines, for generalizing the study's findings to other populations. This article discusses the causal generalization paradox in the context of outcome findings from experimental evaluations of psychological treatment programs and services. In grappling with the generalization paradox, researchers often make misleading (or at least oversimplified) assumptions. The article analyzes 10 such assumptions, including the belief that a significant experimental treatment effect is likely to be causally generalizable and the belief that the magnitude of a significant experimental effect provides a sound effect size estimate for causal generalization. The article then outlines 10 constructive strategies for assessing and enhancing causal generality. They include strategies involving the scaling level of outcome measures, variable treatment dosages, effectiveness designs, multiple measures, corroboration from observational designs, and the synthesis of multiple studies. Finally, the article's discussion section reviews the conditions under which causal generalizations are justified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enrolling and retaining mothers of substance-exposed infants in drug abuse treatment.

This study provided an experimental test of a drug abuse treatment enrollment and retention intervention in a sample of 103 Black mothers of substance-exposed infants. Significantly more women assigned to the Engaging Moms Program enrolled into drug abuse treatment than did women assigned to the control condition (88% vs. 46%). Sixty-seven percent of participants in the Engaging Moms Program received at least 4 weeks of drug abuse treatment compared with 38% of the control women. However, there were no differences between the groups 90 days following treatment entry. Logistic regressions revealed that readiness for treatment predicted both short-term and long-term treatment retention. The Engaging Moms Program has considerable promise in facilitating treatment entry and short-term retention, but it did not influence long-term retention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment integrity in psychotherapy research: Analysis of the studies and examination of the associated factors.

Treatment integrity refers to the degree to which an intervention is delivered as intended. Two studies evaluated the adequacy of treatment integrity procedures (including establishing, assessing, evaluating, and reporting integrity; therapist treatment adherence; and therapist competence) implemented in psychotherapy research, as well as predictors of their implementation. Randomized controlled trials of psychosocial interventions published in 6 influential psychological and psychiatric journals were reviewed and coded for treatment integrity implementation. Results indicate that investigations that systematically addressed treatment integrity procedures are virtually absent in the literature. Treatment integrity was adequately addressed for only 3.50% of the evaluated psychosocial interventions. Journal of publication and treatment approach predicted integrity implementation. Skill-building treatments (e.g., cognitive-behavioral) as compared with non-skill-building interventions (e.g., psychodynamic, nondirective counseling) were implemented with higher attention to integrity procedures. Guidelines for implementation of treatment integrity procedures need to be reevaluated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Inventory of Gambling Situations in problem and pathological gamblers seeking alcohol and drug abuse treatment.

Identifying situations in which individuals gamble may be important for developing or improving treatments, but few instruments exist for examining high-risk gambling situations. This study evaluated the factor structure of the Inventory of Gambling Situations (IGS), an instrument that assesses situations that may lead to gambling episodes. Individuals seeking alcohol and drug abuse treatment who were identified as problem or pathological gamblers (N = 283) completed the IGS, and principal component analysis revealed a 4-factor solution best fit the data; the factors represented items related to Negative Affect, Positive Affect, Gambling Cues, and Social Situations. Across the whole scale, Cronbach's alpha was 0.97, ranging from 0.83 to 0.96 for the four factors. IGS total scores correlated with other indices of gambling problems, including number of pathological gambling criteria endorsed and frequency and intensity of gambling. Race, education, and severity of psychiatric, drug, and alcohol problems were significantly predictive of some factor scores. Specifically, African Americans were more likely to gamble in response to Negative Affect situations than Caucasians, and education was inversely associated with wagering in response to Gambling Cues. Psychiatric symptoms were predictive of gambling in response to both Positive and Negative Affect situations and Gambling Cues. Severity of drug and alcohol problems were related to gambling in Social Situations. Results from this study indicate that the IGS has good psychometric properties and suggest areas in which intervention efforts may be tailored to prevent or treat gambling problems among individuals seeking substance abuse treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)