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TREATMENT / OPIOIDS <55>
Database EMBASE
Accession Number 2005532024
Authors Ling W. Compton P.
Institution
(Ling) Integrated Substance Abuse Programs, UCLA, David Geffen School of Medicine, 11075 Santa Monica Blvd.,
Los Angeles, CA 90025, United States.
(Compton) School of Nursing, UCLA, Los Angeles, CA, United States.
Country of Publication
United Kingdom
Title
Recent advances in the treatment of opiate addiction.
Source
Clinical Neuroscience Research. 5(2-4)(pp 161-167), 2005. Date of Publication: Nov 2005.
Abstract
Advances in the modern treatment of opiate addiction are the result of an evolutionary
process often attributed to the introduction of methadone maintenance in the 1960s. The
underpinnings and the forces that shaped these advances, however, date back to the rise of
the prohibition movement at the turn of the century, which culminated in passage of the
Harrison Narcotic Act, signaling a major shift in US social attitudes towards heroin addicts and
their addiction. Subsequent US social and political attitudes have shaped the course of
treatment practices in parallel with scientific advances and pharmacological developments,
from the establishment of methadone treatment in specialized narcotics treatment clinics to
the introduction of buprenorphine and the concomitant legislative mandate that made it
available to general physicians, reflecting again the current societal attitude. While
pharmacological progress may appear to be related to scientific advancement, the major
driving force behind the direction of treatment development and its implementation into the
treatment community is deeply ingrained in the concurrent evolution of societal attitudes and
political policies. Moreover, the undisputed US dominance in science and politics lends global
impetus to these developments. copyright 2005 Association for Research in Nervous and
Mental Disease. Published by Elsevier B.V. All rights reserved.
ISSN 1566-2772
Publication Type Journal: Article
Journal Name Clinical Neuroscience Research
Volume 5
Issue Part 2-4
Page 161-167
Year of Publication 2005
Date of Publication Nov 2005
TREATMENT <56>
Database EMBASE
Accession Number 2005529696
Authors Kleber H.D.
Institution
(Kleber) Columbia University, College of Physicians and Surgeons, New York State Psychiatric Institute, 1051
Riverside Drive, New York, NY 10032, United States.
Country of Publication
United Kingdom
Title
Future advances in addiction treatment.
Source
Clinical Neuroscience Research. 5(2-4)(pp 201-205), 2005. Date of Publication: Nov 2005.
Abstract
In the next decade, we should witness a number of treatment advances for opioids,
stimulants, and cannabis derivatives. For opioids, this will include long acting, i.e., one month
to one year, injectable or implants of the antagonist naltrexone, injectable or implants of the
partial agonist buprenorphine, and innovative detoxification methods using buprenorphine. In
addition, there should be much wider office based prescribing of buprenorphine for
maintenance as financial, stigma, and numerical prescribing barriers are overcome. Possible
new developments for cocaine dependence include vaccines that provide either active or
passive immunization; agonists that could decrease craving without producing euphoria;
blocking agents that do not block normal pleasures; and CRF (corticotrophin releasing factor)
antagonists which could decrease both craving and relapse. In the short term, medications
currently marketed for other indications that show promise for cocaine include modafinil,
tiagabine, topiramate, and disulfiram. Until recently, there has been little effort toward
developing medications to treat marijuana abuse/dependence. Potential medications now
being considered include the agonist dronabinol, rimonabant, an antagonist and inverse
agonist, and Sativex, an aerosol combining THC and cannabidiol, a non-psychoactive
cannabis ingredient. Behavioral interventions will continue to be necessary, not just to
increase the likelihood that patients will take effective medications but also to assist them in
improving their interpersonal, educational, and vocational skills so as to develop positive
rather than just negative reasons for wanting to stop drug use. copyright 2005 Association for
Research in Nervous and Mental Disease. Published by Elsevier B.V. All rights reserved.
ISSN 1566-2772
Publication Type Journal: Article
Journal Name Clinical Neuroscience Research
Volume 5
Issue Part 2-4
Page 201-205
Year of Publication 2005
Date of Publication Nov 2005
TREATMENT <82>
Database EMBASE
Accession Number 2005516816
Authors McKay J.R.
Institution
(McKay) University of Pennsylvania, Treatment Research Institute, Philadelphia, PA, United States.
(McKay) University of Pennsylvania, Treatment Research Center, 3900 Chestnut Street, Philadelphia, PA 19104,
United States.
Country of Publication
United Kingdom
Title
Is there a case for extended interventions for alcohol and drug use disorders?
Source
Addiction. 100(11)(pp 1594-1610), 2005. Date of Publication: Nov 2005.
Abstract
Aims: To determine whether there is evidence to support the implementation of extended
interventions (i.e. longer than 6 months) for individuals with alcohol or other drug use
disorders. Methods: Literature on extended behavioral and pharmacotherapy interventions
was reviewed, along with findings from studies of extended monitoring and monitoring paired
with adjunctive counseling. Studies were identified through database searches, citations in
prior reviews and examinations of recent volumes of relevant journals. Key terms were
defined, and a theoretical rationale was presented for extended treatment. Several adaptive
treatment studies that made use of stepped care or continuation protocols were also
described. Measurements: The primary outcomes that were considered were alcohol and
drug use during the intervention and post-intervention follow-ups. Other outcomes were
examined when they were included in the articles reviewed. Findings: Most of the studies in
the review provided support for the effectiveness of extended interventions for alcohol and
drug abusers, whether the extended care was delivered through face-to-face contact or via
the telephone. These findings held across all types of interventions that were examined (e.g.
behavioral treatment, pharmacotherapy and monitoring). However, only a few studies directly
compared extended and standard length version of the same intervention. New developments
in addiction treatment with implications for extended care models were also described and
discussed. Conclusions: The findings of the review indicate that maintaining therapeutic
contact for extended periods of time with individuals with alcohol and other drug disorders
appears to promote better long-term outcomes than 'treatment as usual', although more
studies are needed that compare extended and standard versions of interventions. Achieving
good compliance and successful disease management with extended interventions will
probably require adaptive protocols in which the intensity of treatment can be adjusted up or
down in response to changes in symptoms and functioning over time. Future directions in
research on extended interventions were discussed. copyright 2005 Society for the Study of
Addiction.
ISSN 0965-2140
Publication Type Journal: Review
Journal Name Addiction
Volume 100
Issue Part 11
Page 1594-1610
Year of Publication 2005
Date of Publication Nov 2005
TREATMENT <158>
Database EMBASE
Accession Number 2005419163
Authors Greenfield S.F. Sugarman D.E. Nargiso J. Weiss R.D.
Institution
(Greenfield, Sugarman, Nargiso, Weiss) Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont,
MA, United States.
(Greenfield, Weiss) Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
(Sugarman) Department of Psychology, Syracuse University, Syracuse, NY, United States.
(Nargiso) Department of Psychology, University of Rhode Island, Kingston, RI, United States.
(Greenfield) 115 Mill Street, Belmont, MA 02478, United States.
Country of Publication
United Kingdom
Title
Readability of patient handout materials in a nationwide sample of alcohol and drug
abuse treatment programs.
Source
American Journal on Addictions. 14(4)(pp 339-345), 2005. Date of Publication: Jul 2005.
Abstract
The objective of this study was to assess the readability of a nationwide sample of alcohol
and drug abuse treatment programs' materials. Of 646 programs that were randomly selected
from the National Clearinghouse for Alcohol and Drug Information directory, 52 programs
returned completed materials. The average readability grade level of materials was 11.84 (SD
= 0.94). The program staff estimations were significantly lower than actual reading levels of
materials, and no program characteristics correlated with readability levels. Thus, it was
concluded that materials written at high readability levels may not be effective tools for all
patients. Integrating knowledge regarding program materials' readability level and literacy
levels of different populations could be successful aides to substance abuse treatment.
Copyright copyright American Academy of Addiction Psychiatry.
ISSN 1055-0496
Publication Type Journal: Article
Journal Name American Journal on Addictions
Volume 14
Issue Part 4
Page 339-345
Year of Publication 2005
Date of Publication Jul 2005
TREATMENT <159>
Database EMBASE
Accession Number 2005419162
Authors Cook L.S. Epperson L. Gariti P.
Institution
(Cook) School of Nursing and the Health Sciences, Texas a and M University-Corpus Christi, Corpus Christi, TX,
United States.
(Epperson, Gariti) University of Pennsylvania Treatment Research Center, Philadelphia, PA, United States.
(Cook) Department of Nursing, College of Nursing and Health Science, Texas A and M University - Corpus Christi,
Corpus Christi, TX, United States.
(Cook) Sandpiper 203, Texas a and M University - Corpus Christi, 6300 Ocean Dr., Corpus Christi, TX 78412,
United States.
Country of Publication
United Kingdom
Title
Determining the need for gender-specific chemical dependence treatment:
Assessment of treatment variables.
Source
American Journal on Addictions. 14(4)(pp 328-338), 2005. Date of Publication: Jul 2005.
Abstract
The effects of gender on selected treatment variables of substance-abusing persons were
investigated with the long-term goal of designing gender-appropriate programs for the
treatment of addiction. A population of 120 male and female substance abusers was drawn
from two urban outpatient drug treatment centers and one HIV outpatient counseling center.
Participants were given questionnaires to measure the following variables: trait anxiety,
depression, coping style, and level of differentiation of self. Results demonstrated significant
gender differences in differentiation of self (p < .005) and coping styles (p < .02) but no
significant differences in anxiety or depression. Copyright copyright American Academy of
Addiction Psychiatry.
ISSN 1055-0496
Publication Type Journal: Article
Journal Name American Journal on Addictions
Volume 14
Issue Part 4
Page 328-338
Year of Publication 2005
Date of Publication Jul 2005
TREATMENT <301>
Database EMBASE
Accession Number 2005282909
Authors Nabitz U. Van Den Brink W. Jansen P.
Institution
(Nabitz) Amsterdam Institute for Addiction Research, Post Box 3907, 1001 AS Amsterdam, Netherlands.
(Van Den Brink) University of Amsterdam, Amsterdam, Netherlands.
(Jansen) Free University of Amsterdam, Amsterdam, Netherlands.
Country of Publication
United Kingdom
Title
Using concept mapping to design an indicator framework for addiction treatment
centres.
Source
International Journal for Quality in Health Care. 17(3)(pp 193-201), 2005. Date of
Publication: Jun 2005.
Abstract
Objective. The objective of this study is to determine an indicator framework for addiction
treatment centres based on the demands of stakeholders and in alignment with the European
Foundation for Quality Management (EFQM) Excellence Model. Setting. The setting is the
Jellinek Centre based in Amsterdam, the Netherlands, which serves as a prototype for an
addiction treatment centre. Method. Concept mapping was used in the construction of the
indicator framework. During the 1-day workshop, 16 stake-holders generated, prioritized and
sorted 73 items concerning quality and performance. Multidimensional scaling and cluster
analysis was applied in constructing a framework consisting of two dimensions and eight
clusters. Results. The horizontal axis of the indicator framework is named 'Organization' and
has two poles, namely, 'Processes' and 'Results'. The vertical axis is named 'Task' and the
poles are named 'Efficient treatment' and 'Prevention programs'. The eight clusters in the twodimensional framework are arranged in the following, prioritized sequence: 'Efficient treatment
network', 'Effective service', 'Target group', 'Quality of life', 'Efficient service', 'Knowledge
transfer', 'Reducing addiction related problems', and 'Prevention programs'. The most
important items in the framework are: 'patients are satisfied with their treatment', 'early
interventions', and 'efficient treatment chain'. Conclusion. The indicator framework aligns with
three clusters of the results criteria of the EFQM Excellence Model. It is based on the
stakeholders' perspectives and is believed to be specific for addiction treatment centres. The
study demonstrates that concept mapping is a suitable strategy for generating indicator
frameworks. copyright The Author 2005. Published by Oxford University Press on behalf of
International Society for Quality in Health Care; all rights reserved.
ISSN 1353-4505
Publication Type Journal: Article
Journal Name International Journal for Quality in Health Care
Volume 17
Issue Part 3
Page 193-201
Year of Publication 2005
Date of Publication Jun 2005
TREATMENT <336>
Database EMBASE
Accession Number 2005248198
Authors Berglund M.
Institution
(Berglund) Department of Clinical Alcohol Research, Lund University, University Hospital MAS, Malmo, Sweden.
(Berglund) Department of Clinical Alcohol Research, University Hospital MAS, SE-205 02 Malmo, Sweden.
Country of Publication
United Kingdom
Title
A better widget? Three lessons for improving addiction treatment from a metaanalytical study.
Source
Addiction. 100(6)(pp 742-750), 2005. Date of Publication: Jun 2005.
Abstract
Objective: To discuss how to develop more effective treatment programmes than those
currently available for addictive disorders. Data sources: The Swedish SBU report, published
in English in 2003, was used as a database. It includes 641 randomized controlled trials and
seven longitudinal prospective studies. Methods: Meta-analytical calculations were performed
in several areas using standardized mean differences (d) effect-size estimate and
homogeneity testing. Three critical issues have been the focus of the present analysis: the
early intervention phase, treatment procedures and their additive properties and the
transitional period between early and late effects of treatment. Results: The main findings
while integrating the results in a new way were that intervention studies with one single
session showed a small but robust homogeneous effect size, whereas studies of interventions
with several sessions were heterogeneous with large and small effect sizes among the
included studies. Similar effect sizes were found in alcohol, opioid and cocaine treatment
studies. Agonist treatment yielded the highest effect sizes. Some evidence was found for a
possible additive effect for cognitive behaviour therapy and naltrexone as well as for aversive
treatment (disulfiram) and psychosocial treatment in alcohol dependence. So far studies on
the transition period between short- and long-term outcome are few and inconclusive.
Conclusions: There is a prospect of improving addiction treatment, and the following areas
are suggested by meta-analysis for future research: (a) to examine in more detail the process
between the first and second session of intervention; (b) to randomize simultaneously for
independent categories of psychosocial and psychopharmacological treatment; and (c) to
intensify studies on the transitional period between short- and long-term outcome. copyright
2005 Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Review
Journal Name Addiction
Volume 100
Issue Part 6
Page 742-750
Year of Publication 2005
Date of Publication Jun 2005
TREATMENT <339>
Database EMBASE
Accession Number 2005242226
Authors Nabitz U. Van Den Brink W. Walburg J.
Institution
(Nabitz) Amsterdam Institute for Addiction Research, Jellinek Centre, Post Box 3907, 1001 AS Amsterdam,
Netherlands.
(Van Den Brink) University of Amsterdam, Amsterdam, Netherlands.
(Walburg) Trimbos Institute, Utrecht, Netherlands.
Country of Publication
United Kingdom
Title
A quality framework for addiction treatment programs.
Source
Addictive Behaviors. 30(6)(pp 1254-1260), 2005. Date of Publication: Jul 2005.
Abstract
Aim: To identify and specify the structure and the elements of a quality framework for
addiction treatment programs. Method: Concept mapping strategy was applied. In brainstorm
sessions, 70 statements were generated and rated by 90 representatives of three stakeholder
groups. Using multivariate statistical analyses, the statements were positioned on a map.
Results: Two dimensions 'Best Practice' and 'Performance' and nine clusters were identified.
The three most important clusters were 'Attitude of staff', 'Client orientation' and 'Treatment
practice'. The most important statement was effectiveness. Conclusion: The specific quality
framework identified has some similarity with existing non-specific frameworks. copyright
2005 Elsevier Ltd. All rights reserved.
ISSN 0306-4603
Publication Type Journal: Article
Journal Name Addictive Behaviors
Volume 30
Issue Part 6
Page 1254-1260
Year of Publication 2005
Date of Publication Jul 2005
TREATMENT <357>
Database EMBASE
Accession Number 2005223132
Authors Wits E.G. Knibbe R.A. van de Mheen D.H.
Institution
(Wits, Knibbe, van de Mheen) Addiction Research Institute, Heemraadssingel 194, 3021 DM, Rotterdam,
Netherlands.
Country of Publication
United Kingdom
Title
Feasibility of a guideline to improve the match between needs and services for
chronic addicts with multiple problems.
Source
Journal of Substance Use. 10(2-3)(pp 119-127), 2005. Date of Publication: Apr 2005.
Abstract
In The Netherlands, a substantial part of the population of chronic hard drug users and
alcoholics is reached by offering low-threshold services addressing basic needs such as
shelter, health care and methadone substitution. It is known, however, that the needs of this
category of addicts are more differentiated than can be demonstrated in the context of these
low-threshold services. Therefore, a guideline to help target-group analyses was developed
for addiction care agencies, resulting in so-called "client profiles". First, the workability of the
guideline was tested in the restructuring of methadone programs in two regions of The
Netherlands. Second, we investigated to what extent the resulting client profiles offer the
addiction care agencies relevant and sufficient information for the development of tailor-made
care. A process evaluation supported the application of the guideline. The results show that
the guideline is feasible, but could be improved by more simplified instructions and by adding
a step-by-step plan. The resulting client profiles proved to be relevant and informative for the
process of developing tailor-made care for chronic addicts. copyright 2005 Taylor & Francis
Group Ltd.
ISSN 1465-9891
Publication Type Journal: Article
Journal Name Journal of Substance Use
Volume 10
Issue Part 2-3
Page 119-127
Year of Publication 2005
Date of Publication Apr 2005
TREATMENT <374>
Database
EMBASE
Accession Number
2005212915
Authors
Moos R.H.
Institution
(Moos) Center for Health Care Evaluation, Department of Veterans Affairs, Stanford University School of Medicine,
Palo Alto, CA, United States.
(Moos) Center for Health Care Evaluation (152-MPD), VA Health Care System, 795 Willow Road, Menlo Park, CA
94025, United States.
Country of Publication
United Kingdom
Title
Iatrogenic effects of psychosocial interventions for substance use disorders:
Prevalence, predictors, prevention.
Source
Addiction. 100(5)(pp 595-604), 2005. Date of Publication: May 2005.
Abstract
Aims: To examine the prevalence and personal and intervention-related predictors of
potential iatrogenic effects associated with psychosocial interventions for substance use
disorders and provide a conceptual framework to guide further research on such effects.
Method: A review of relevant studies focuses on the prevalence and predictors of potential
iatrogenic effects of psychosocial treatment and prevention programs for substance use
disorders. Results: Between 7% and 15% of patients who participate in psychosocial
treatment for substance use disorders may be worse off subsequent to treatment than before.
In addition, several controlled trials of substance use prevention have shown some apparent
iatrogenic effects, including more positive expectations about substance use and a rise in
alcohol use and alcohol-related problems. Probable person-related predictors of deterioration
associated with treatment include younger age and unmarried status, more serious current
diagnoses and substance use problems and more psychiatric and interpersonal problems.
Probable intervention-related predictors of deterioration include lack of bonding: lack of
monitoring; confrontation, criticism and high emotional arousal; deviancy modeling; and
stigma, low or inappropriate expectations and lack of challenge. Conclusion: A significant
minority of individuals with substance use problems appear to deteriorate during or shortly
after participation in treatment or prevention programs. Safety standards and monitoring
procedures are needed to routinely identify potential adverse consequences of intervention
programs; research is needed to clarify whether deterioration is due to iatrogenic effects of
interventions and to identify new approaches to counteract any such effects. copyright 2005
Society for the Study of Addiction.
ISSN 0965-2140
Publication Type Journal: Review
Journal Name Addiction
Volume 100
Issue Part 5
Page 595-604
Year of Publication 2005
Date of Publication May 2005