Abstract:
:Persons presenting with concurrent psychiatric and substance problems present unique challenges for diagnosis and for effective and rational treatment planning. This is especially true for psychiatrists attempting to prescribe pharmacologic interventions which will promote recovery from both disorders and improve function. In order to be effective in this endeavor it is important to have a clear understanding of the dynamics of addiction as well as the particular issues and struggles related to mental illness which will affect an individual's attitude toward and use of medication. This article discusses some of the common problems related to diagnostic decision making and initiation of medication in persons with co-occurring disorders. An algorithm for guiding these decisions is presented. Common misconceptions held by these individuals regarding medication, as distinguished from "drugs," are considered. Unique psychodynamic issues that may lead these persons to actively seek medication as a solution to their problems, or which may, conversely, lead them to an outright rejection of medication as a part of their recovery, are discussed. Countertransferential issues influencing the physician's approach to prescribing for this population are also considered. The article concludes with recommendations for pharmacologic approaches to address specific psychiatric syndromes which may present in this population.
journal_name
J Psychoactive Drugsjournal_title
Journal of psychoactive drugsauthors
Sowers W,Golden Sdoi
10.1080/02791072.1999.10471727subject
Has Abstractpub_date
1999-01-01 00:00:00pages
59-70issue
1eissn
0279-1072issn
2159-9777journal_volume
31pub_type
杂志文章,评审abstract::Blood pressure and headache frequency were evaluated in normotensive male and female cocaine-dependent patients (N=43) participating in a placebo-controlled, double-blind trial of amlodipine for the treatment of cocaine dependence. Amlodipine produced a significant reduction in both systolic (p=0.04) and diastolic (p=...
journal_title:Journal of psychoactive drugs
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/02791072.2002.10399983
更新日期:2002-10-01 00:00:00
abstract::The initiation of the first methadone maintenance treatment program (MMT) in Macao was founded in collaboration between MMT clinics in the USA and Israel. All patients admitted into treatment between October 2005 and October 2008 were prospectively followed through March 2010. Of the 163 patients, 81% were male, the m...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2013.825032
更新日期:2013-09-01 00:00:00
abstract::Holotropic states (a large special subgroup of nonordinary states of consciousness) have been the focus of many fields of modern research, such as experiential psychotherapy, clinical and laboratory work with psychedelic substances, field anthropology, thanatology, and therapy with individuals undergoing psychospiritu...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章,评审
doi:10.1080/02791072.1998.10399710
更新日期:1998-10-01 00:00:00
abstract::It is important to identify social conditions, program factors, and client characteristics that predict retention because time in substance abuse treatment is associated with improved health, mood, and social functioning. Treatment dropouts also are at high risk for serious harms, including relapse. Most opioid-depend...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2006.10399832
更新日期:2006-03-01 00:00:00
abstract::The purpose of this study is to describe treatment utilization and relapse and examine possible predictors of time to relapse after treatment for methamphetamine (MA) use. This analysis is based on natural history interview data from 98 subjects treated for MA use in publicly-funded programs in Los Angeles County in 1...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2000.10400231
更新日期:2000-04-01 00:00:00
abstract::Addiction is a primary, chronic disease involving brain reward, motivation, memory and related circuitry; it can lead to relapse, progressive development, and the potential for fatality if not treated. While pathological use of alcohol and, more recently, psychoactive substances have been accepted as addictive disease...
journal_title:Journal of psychoactive drugs
pub_type: 社论
doi:10.1080/02791072.2012.662105
更新日期:2012-01-01 00:00:00
abstract::The Smoking Cessation Leadership Center (SCLC) was established in 2003 to increase the rate of smoking cessation attempts and the likelihood those efforts would succeed. Although smoking remains the number one cause of preventable death and disability, clinicians underperform in smoking cessation. Furthermore, many cl...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2017.1412546
更新日期:2018-01-01 00:00:00
abstract::This article reports on the results observed in a series of focus groups and in-depth interviews with injection drug users (IDUs) and drug dealers in Odessa, Ukraine. Ukraine has the highest rate of HIV infection in Eastern as well as Western Europe, and Odessa ranks among the cities in that country with the highest s...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2003.10400488
更新日期:2003-10-01 00:00:00
abstract::Participation in aftercare may reduce risk of recidivism among women offenders with substance use problems following their release to the community. This study examines motivation to participate in aftercare among women offenders and whether their participation in both in-custody and aftercare treatment reduces their ...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2011.602275
更新日期:2011-09-01 00:00:00
abstract::There is a body of methamphetamine-themed poetry that speaks regretfully of the highly negative experiences of those in recovery from methamphetamine (MA) addiction or who feel trapped in an MA-using lifestyle. During ethnographic research in western Kentucky, the author collected two MA-themed poems from active MA us...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2010.10400700
更新日期:2010-09-01 00:00:00
abstract::The central nervous system rewarding properties of ethanol, cocaine, and heroin may activate a common catecholaminergic reward system in the mesolimbic circuitry of the brain. Driving-under-the-influence (DUI) offenders with either alcohol- or cocaine-related problems were studied. The neuronutrients SAAVE and Tropami...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.1990.10472542
更新日期:1990-04-01 00:00:00
abstract::Using secondary data analysis,this study compares alcohol and other drug (AOD) problems experienced by African-American students attending a historically Black university who use alcohol only versus those who use alcohol plus marijuana. Results indicate that students who used marijuana plus alcohol experienced more AO...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2008.10400631
更新日期:2008-06-01 00:00:00
abstract::In this article the authors explore the experience of craving of methamphetamine users and seek to illuminate how differences in craving contribute to use patterns. Using in-depth interviewing, data were collected from 82 active methamphetamine users in the metropolitan Atlanta area. The constant comparison method com...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2006.10400602
更新日期:2006-11-01 00:00:00
abstract::This article presents an outcome study of the Family Rehabilitation Program (FRP), a unique network of community-based programs in New York City that provides comprehensive services to families with drug-dependent parents, most caring for prenatally cocaine-exposed newborns. An admission sample of 173 mothers in 17 FR...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章,多中心研究
doi:10.1080/02791072.1999.10471763
更新日期:1999-10-01 00:00:00
abstract::A systematic random sample of 267 patients who were involved in outpatient detoxification was surveyed. Their records were evaluated, and the demographics, psychiatric diagnoses, and type(s) of substance of abuse of each patient were recorded. The results indicated that there was a significant relationship between an ...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2009.10400675
更新日期:2009-03-01 00:00:00
abstract::This study arose out of a prominent clinical need: effective treatment for comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) in civilian men. This dual diagnosis is estimated to occur in up to 38% of men in substance abuse treatment, and generally portends a more severe clinical course tha...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2005.10399816
更新日期:2005-12-01 00:00:00
abstract::Recent prevalence studies in California indicate that perinatal alcohol and other drug use remains a serious issue for large numbers of women and their children. In response, national, state and local policymakers have taken steps to address the problem, including increasing funding for treatment services. To gauge th...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.1996.10471710
更新日期:1996-01-01 00:00:00
abstract::Given the dearth of information concerning outcomes for adolescents who have been in treatment for substance abuse and related problems, the purpose of the present article is to examine the posttreatment status of adolescents who have been in residential therapeutic communities (TCs). One-year posttreatment outcome da...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2000.10400214
更新日期:2000-01-01 00:00:00
abstract::Diseases that threaten life raise existential questions that can be a source of psychological distress. Studies with psychedelics demonstrate therapeutic effects for anxiety and depression associated with life-threatening illnesses. Ayahuasca has been proposed as a possible therapeutic agent in the treatment of psychi...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2020.1854399
更新日期:2020-12-07 00:00:00
abstract::This study examines hypotheses and builds models to help clarify the causal connections between drugs and violence outcomes among Mexican-American male gang members. The study uses cross-sectional data of 160 male gang members sampled from 26 gangs in a Southwestern city. A life-history /intensive interview using clos...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2006.10399835
更新日期:2006-06-01 00:00:00
abstract::Scientific literature increasingly calls for studies to translate evidence-based interventions into real-world contexts balancing fidelity to the original design and fit to the new setting. The Risk Avoidance Partnership (RAP) is a health promotion intervention originally designed to train active drug users to become ...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2015.1050535
更新日期:2015-07-01 00:00:00
abstract::This paper proposes that a comprehensive, long-term program with a case-management focus will produce better outcomes and be more cost-effective than the current approach to managing the illnesses of women on Temporary Assistance for Needy Families (or TANF, formerly known as AFDC) who are afflicted with both drug dep...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章,评审
doi:10.1080/02791072.1997.10400563
更新日期:1997-10-01 00:00:00
abstract::Few studies have examined the prevalence of nitrous oxide (NO) inhalation or co-occurrence of NO and volatile solvent (VS) use in adolescents. Study aims were to (1) describe the independent and conjoint prevalence of NO and VS use in incarcerated youth, (2) compare adolescent users of both NO and VS inhalants (NO+VS)...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2009.10399771
更新日期:2009-12-01 00:00:00
abstract::There has been increased recognition of the clinical treatment needs of patients with co-occurring mental and substance use disorders and the heterogeneity of this group with regard to types of substances used and mental disorders. This article examines differences between men and women diagnosed with mood or psychoti...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2003.10400512
更新日期:2003-05-01 00:00:00
abstract::In light of New York's recently reinforced strategy to end the AIDS epidemic by expanding testing, treatment, and access to pre-exposure prophylaxis (PrEP), we assessed drug use and sexual risk behaviors, along with HIV/Hepatitis C virus (HCV) transmission and prevention knowledge among non-treatment-seeking adults wi...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2016.1259518
更新日期:2017-01-01 00:00:00
abstract::Data from the Partnership Attitude Tracking Study are analyzed to provide a greater understanding of the contributing factors to alcohol and other drug use among children and adolescents. The data were collected from children (ages 9 to 12) and teenagers (ages 13 to 17) in central locations (usually shopping malls) lo...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.1993.10472273
更新日期:1993-07-01 00:00:00
abstract::Using signs, symptoms and serum methadone levels to guide evaluation, the authors treated 164 patients in a methadone maintenance program with doses of methadone exceeding 100 mg/d. The mean dose of these higher dose (HD) patients was 211 mg/d (range 110-780 mg/d). A comparison group (C) of 101 patients was randomly s...
journal_title:Journal of psychoactive drugs
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/02791072.1999.10471730
更新日期:1999-04-01 00:00:00
abstract::The current study examined the association between support and comfort derived from religion or spirituality and abstinence from illicit drugs in a sample of 43 HIV-positive injection drug users entering a methadone maintenance program. Patients with high ratings of perceived spiritual or religious support were abstin...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2001.10400467
更新日期:2001-01-01 00:00:00
abstract::Childhood maltreatment and alcohol problems are common among young adults with attention-deficit hyperactivity disorder (ADHD). However, little is known about the degree to which maltreatment and alcohol problems are associated; potential pertinent mediating or moderating mechanisms, such as emotional lability; and wh...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2017.1325031
更新日期:2017-09-01 00:00:00
abstract::Inhalant use is a serious global problem with consequences equal to or surpassing those of other drugs. Regrettably, few prior studies have examined inhalant users' patterns of service and treatment utilization. The purpose of this study is to identify factors associated with service use and barriers to treatment amon...
journal_title:Journal of psychoactive drugs
pub_type: 杂志文章
doi:10.1080/02791072.2011.566504
更新日期:2011-01-01 00:00:00