A behavioral approach to achieving initial cocaine abstinence
Article Abstract:
More than 22 million people in the US have tried cocaine, and 1 to 2 million are dependent on this drug. The likelihood of intravenous use, which is particularly dangerous, increases with the frequency of cocaine use. It is estimated that at least 8 percent of cocaine users inject the drug, and many of these users engage in prostitution to support their habit. In the 1980s, there has been an increase in the number of cocaine users seeking treatment. However, there a lack of understanding of this disorder and still no standard treatment has been agreed upon for these patients. Needless to say, treatment is often ineffective. The present study compared the results of a behavioral approach to treating cocaine abuse and dependence to another counseling approach that involved a 12-step program (e.g., Cocaine Anonymous). Thirteen patients were offered behavioral therapy using a contingency management approach. They provided urine specimens for drug screening four times per week and were awarded points equalling 15 cents per point each time they provided 'clean' urine specimens. The first clean specimen was worth 10 points, and the value of each increased as more clean urine was provided. A $10.00 bonus was earned for each four consecutive clean urine specimens. Points were subtracted for urine containing traces of cocaine. There was also a community counseling component to the behavioral approach, consisting of twice-weekly one-hour sessions for 12 weeks. Fifteen patients were offered an alternative counseling program, the authors termed a 12-step counseling approach, consisting of a similar schedule of urine testing (with no rewards) and instructions to attend a 12-step meeting once a week in addition to counseling. Of the 13 patients in the behavioral treatment program, 11 were retained for the duration of the 12-week program. Ten of these individuals achieved abstinence from cocaine for at least four weeks. Of the 12 patients in the 12-step group, 5 completed the 12 weeks of treatment. Three of these patients achieved abstinence from cocaine for at least four weeks. Positive drug tests were obtained for other drugs from the subjects in both groups during the treatment period; a significantly higher number of positive test results for marijuana was noted in the behavioral program group. The authors concluded that the behavioral strategy was more effective than the 12-step strategy in obtaining short-term abstinence from cocaine. (It should be noted that the participation in a 12-step program as described is not reflective of what is normally recommended. Also, verification of whether subjects were compliant is not mentioned.) (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Psychological absorption: affect investment in marijuana intoxication
Article Abstract:
The trait of absorption refers to the capacity for increased attention and engagement in perceptual, imaginative and creative processes. In order to understand the relationship between absorption and marijuana intoxication, 492 male and female university students were studied. Students were categorized as users or nonusers of marijuana. Users were then divided into three groups: just tried; regular users; and polydrug users. They were asked to take an absorption scale twice (while in a nonintoxicated state). Instructions were the same for each student on the first administration. On the second, each student was given a test booklet containing instructions appropriate for her or his drug-use history. Half of the students in each drug group received instructions that told them to endorse items which referred to occasions when they were marijuana intoxicated. The other half were told to exclude drug-related experiences when responding to test items. Nonusers were told to endorse items they believed a marijuana intoxicated person would select. There were no differences between groups on the first absorption scale. On the second scale, the polydrug and regular marijuana users who had been instructed to endorse experiences that occurred only when intoxicated, demonstrated a significant increase in absorption scores. The finding that the heavier marijuana users associated more pleasant affect with absorption scale experiences suggests that increased absorption may be a significant reinforcer for marijuana abusers. If so, successful treatment of marijuana abuse may benefit from imagery or meditation exercises, which tend to enhance absorption. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Nervous and Mental Disease
Subject: Psychology and mental health
ISSN: 0022-3018
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Sudden death from acute cocaine intoxication in Virginia in 1988
Article Abstract:
The prevalence of cocaine use has caused an increase in the rates of death from acute cocaine intoxication. Individuals without previous indications of cardiac disease may suffer a heart attack or other life-threatening complication after cocaine use. The medical circumstances leading to the deaths of 33 Virginia residents after cocaine use were investigated. The autopsy reports of these individuals, who were between the ages of 19 and 45, indicated that they all died from acute cocaine intoxication. The cases were identified by examination of the Chief Medical Examiner's records for the year of 1988. Demographic features of these patients that were noted included the following: 29 of the 33 subjects were men; two thirds were white; the presence of other drugs was common, with alcohol the most frequently detected; and 22 of the subjects had injected cocaine. There was no evidence that indicated that this group predominantly consisted of those with existing heart disease or else with a predisposition to such a condition. Coronary artery disease was found in two subjects and evidence of myocardial fibrosis was detected in three. Because this report is retrospective, and the information on each case was limited to the content of the autopsy report, the interrelationships between the variables that may have contributed to death from cocaine intoxication are not clear. For example, the degree of tolerance to other drugs was not established and it therefore could not be determined whether detected levels were toxic. Another unknown variable was the frequency of use of inhalable cocaine ('crack') among these subjects. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychiatry
Subject: Psychology and mental health
ISSN: 0002-953X
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: An error components approach to segmentation and modelling brand choice dynamics. Bargaining behavior and payoff uncertainty: experimental evidence
- Abstracts: Physical activity behavior change: issues in adoption and maintenance. Understanding action control: predicting physical activity intention-behavior profiles across 6 months in a Canadian sample
- Abstracts: On the baby and the bath water: ecological approaches to development. Are we misconstruing children or scientists?
- Abstracts: Reconnecting communities through community-based action research. Theft reduction in a grocery store through product identification
- Abstracts: An Adaptive Role Strategy: one technique for studying participants' role in educational organizations. Alternative adaptive models of rape