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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