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Biomedical subjects

B S Brown

Publications and source records attributed to B S Brown.

At least 19 recordsLinked to original sources
PubMed1992

Treatment of cocaine dependence in methadone maintenance clients: a pilot study comparing the efficacy of desipramine and amantadine.

We conducted a pilot study (N = 22) comparing the efficacy of desipramine and amantadine for treatment of cocaine dependence in methadone maintenance clients. The study which lasted 12 weeks, was double-blind, randomly assigned, and placebo-controlled. Subjects met DSM-III-R criteria for active cocaine dependence. All three groups' cocaine use, craving, and depressive symptoms declined significantly, but intergroup differences were not significant. Clients receiving desipramine were significantly more likely to remain in treatment and to be cocaine free at study completion. The results emphasize the importance of delivering comprehensive services to the cocaine user in methadone treatment. Further evaluations of these two medications as adjuncts in the treatment of cocaine dependence are needed.

Adolescent↗
PubMed1992

Program models.

Explore the source record for details and available documents.

Humans↗
PubMed1991

Comparison of amantadine and desipramine combined with psychotherapy for treatment of cocaine dependence.

We conducted a single-blind, random assignment, placebo-controlled, 12-week comparison of desipramine hydrochloride and amantadine hydrochloride as adjunctive treatments to counseling for cocaine dependence. Subjects were 54 outpatients who met DSM III-R criteria for active cocaine dependence and who completed a minimum of 2 weeks of treatment. Subjects treated with fixed doses of 200 mg/day desipramine (N = 17), 400 mg/day amantadine-placebo (N = 16), and placebo (N = 21) did not differ for lifetime cocaine use, lifetime histories of psychopathology, admission scores on psychometric assessments, and sociodemographics. All treatment groups demonstrated dramatic and persistent decreases in cocaine use, craving for cocaine, and psychiatric symptoms consequent to treatment. Although there was a trend for more dropouts by subjects taking desipramine, there were no significant differences among treatment groups regarding retention in treatment, craving for cocaine, and decreased cocaine use confirmed by urine toxicology. There was a trend for subjects treated with desipramine to maintain longer periods of cocaine abstinence. Mean plasma concentration of desipramine in a subsample of our subjects was less than that recommended for treatment of depression, thus the dosage of desipramine may have been subtherapeutic.

Adult↗
PubMed1991

Psychological reactions and retention by cocaine addicts during treatment according to HIV-serostatus: a matched-control study.

We compared retention in treatment and psychological reactions during drug abuse treatment by 22 HIV-antibody positive, physically asymptomatic cocaine addicts to 22 matched HIV-seronegative cocaine addicts. All subjects participated in an outpatient clinical research project. There were no significant differences between groups in sociodemographics and psychiatric symptom scores on entrance or cocaine use except for route of administration (chi 2 = 11.59, df = 2, p less than .005). There were no significant differences among groups regarding being informed of serostatus and beginning treatment. There was a trend (p = .079) for more seropositives to complete treatment. Using end-point analysis to compare 11 seropositive subjects who completed a minimum of 2 weeks of treatment to a matched seronegative comparison groups, there were no significant differences in mood states except for "anger/hostility" (interaction of group x time; F = 2.24, df = 13/260, p less than .05). Informing drug abusers in treatment regarding positive HIV-serostatus was not associated with a lower treatment-retention rate or adverse psychological reactions when counseling regarding HIV issues was integrated with drug abuse treatment.

AIDS Serodiagnosis↗
PubMed1991

Perceived risk and sources of information regarding cocaine.

A study was made of the perceptions of risk and of the sources of information about risk regarding cocaine. Subjects were adult (N = 90) and juvenile (N = 20) cocaine abusers in seven Baltimore area treatment programs. Using structured interview, it was found that 87.8% of adults and 80.0% of youth had experienced at least one negative consequence of their cocaine use, other than addiction, prior to entry into treatment. The most common negative experience reported by both groups was the loss of reality testing. Moreover, 86.6% of adults and 65.0% of youth reported becoming addicted to cocaine before entering treatment. While juveniles sampled had entered treatment within a year of first cocaine use, adults entered treatment 7.9 years after first use and reported an average of 6.6 years of cocaine use before experiencing the first negative consequences. Television received consistently high ratings as an accessible and credible source of information about cocaine. Adolescents rated schools relatively high on the amount and accuracy of cocaine-related information provided.

Adolescent↗
PubMed1990

Changes in mood, craving, and sleep during short-term abstinence reported by male cocaine addicts. A controlled, residential study.

We examined changes over 28 days in mood states, craving for cocaine, and sleep during short-term abstinence reported by 12 male, predominantly intravenous-using, cocaine-addicted subjects residing in a research facility. For comparison, we examined 10 nonaddicted control subjects. There were no significant differences between cocaine addicts and controls regarding demographics and selected DSM-III-R diagnoses other than psychoactive substance use disorder and antisocial personality disorder. There were significantly higher scores of psychiatric symptoms reported by cocaine addicts 1 week before admission. Mood-distress and depression scores recorded at admission and during short-term abstinence were significantly greater than those reported by controls. Addicts' mood-distress scores and craving for cocaine were greatest at admission and decreased gradually and steadily during the 28-day study. There were no significant differences between groups regarding reports of sleep other than difficulty falling asleep and clearheadedness on arising. Although there were significant differences in resting heart rate at admission and over time, there were no significant differences in weight gain or blood pressure. Given the absence of a classic "withdrawal" pattern, "short-term abstinence" may be a more appropriate classification of psychological and physical phenomena experienced by cocaine addicts who initiate abstinence in a controlled environment.

Adult↗
PubMed1990

Effects of self-reported drug use and antisocial behavior on evoked potentials in adolescents.

From a sample of 35 adolescents, 17 were chosen who represented extremes of self-reported drug use and delinquent behavior. Three comparison groups were derived: Group 1, n = 7, high drug use/high delinquency; Group 2, n = 4 no drug use/high delinquency; Group 3, n = 6, no drug use/no delinquency. The three groups were similar for age, IQ, race and neighborhood characteristics. Group 1 showed significantly more drug use than Groups 2 and 3; Groups 1 and 2 had comparable levels of delinquency which were significantly greater than Group 3. The subjects performed the auditory oddball task under conditions of low and high background noise. In the high background noise condition, Group 1 had longer latency P300 responses than Groups 2 and 3, while Group 2 had smaller N100 amplitude than Groups 1 and 3. Performance was similar for each group and no group differences occurred in the low background noise condition. The results support and extend previous research on the relationship between attentional and cognitive processes, and delinquent and drug using behaviors.

Adolescent↗
PubMed1990

A treatment crisis: cocaine use by clients in methadone maintenance programs.

We surveyed 11 methadone maintenance treatment programs in the Baltimore, Maryland, area to examine cocaine use among their 2414 clients and the methods employed to cope with that use. The percent of clients with at least one urine sample positive for cocaine during the month previous to study was 15.7% (379/2414) and ranged from 5.9% to 33.0% among the 11 programs. We determined the programs' use of monitoring strategies, treatment services, and administrative controls. We discuss the policy implications of our findings for methadone maintenance programs' efforts to address cocaine use with particular regard to the epidemic of human immunodeficiency virus (HIV) among intravenous drug users, their sexual partners, and offspring.

Baltimore↗
PubMed1990

The action of diazoxide and minoxidil sulphate on rat blood vessels: a comparison with cromakalim.

1. The actions of diazoxide and minoxidil sulphate have been compared with those of cromakalim in rat aorta and portal vein. 2. Diazoxide and minoxidil sulphate hyperpolarized the rat portal vein in a similar manner to cromakalim. 3. Cromakalim, diazoxide and minoxidil sulphate increased 42K and 86Rb efflux from rat portal vein, although minoxidil sulphate had only a small effect on 86Rb efflux. 4. Cromakalim, diazoxide and minoxidil sulphate increased 42K efflux from rat aorta but only cromakalim and diazoxide increased 86Rb efflux from this tissue. 5. Glibenclamide inhibited the relaxant actions of cromakalim, diazoxide and minoxidil sulphate on rat aorta and the increase in 42K efflux produced by these agents in this tissue. 6. Diazoxide relaxed an 80 mM KCl-induced contraction of rat aorta, whilst cromakalim and minoxidil sulphate were without effect. 7. Cromakalim, diazoxide and minoxidil sulphate had no effect on cyclic AMP or cyclic GMP concentrations in rat aorta. 8. It is concluded that diazoxide and minoxidil sulphate like cromakalim exhibit K+ channel opening properties in vascular smooth muscle. Diazoxide exerts an additional inhibitory action not related to the production of cyclic AMP or cyclic GMP. The action of minoxidil sulphate may be primarily located at a K+ channel which is relatively impermeable to 86Rb.

Animals↗
PubMed1990

Avoidable claims in the liability experience of Virginia FPs insured by the reciprocal.

In response to the threat of litigation, physicians practice defensive medicine. A more effective means of reducing malpractice liability and improving the quality of patient care is to practice defensible medicine, i.e., those practice patterns that reduce the potential for claims and increase the likelihood that when claims do arise, they can be successfully defended. Unlike hospital-based specialists, family physicians can directly influence a significant portion of their risk of suit. By focusing management time and attention on the factors in their office practices that are linked to malpractice claims activity, family physicians can reduce the likelihood of being involved in claims.

Adult↗
PubMed1989

Kids and cocaine--a treatment dilemma.

Despite aggressive efforts to recruit into treatment cocaine users 21 years and younger, we obtained only 12 such clients over a period of 9 months, while recruiting 122 adult cocaine clients during a comparable time frame. An examination of admissions data for the city, state, and nation indicated that our experience was typical. However, data from the most recent national household survey indicate that, to the extent need for treatment is determined by frequency of cocaine use, we should anticipate a much greater proportion of admissions to treatment to come from persons 21 years of age and younger. Yet, there appears to be an under-recruitment of youth into treatment, particularly evidenced by low rates of self-referral for juvenile as compared to older treatment admissions. Younger cocaine users may be less severely impaired and/or dependent, or may be more reluctant to use the treatment resources available. Whatever the barriers are to getting help, it becomes the special task of agencies and individuals in the community to help assure that younger cocaine users will obtain the assistance they need. Four community resources are seen as particularly relevant: family, schools, the medical community, and public agencies in the areas of health, social services, and criminal justice. The capacity of each to take action and possible impediments to that action are discussed.

Adolescent↗
PubMed1989

Counseling regarding human immunodeficiency virus-antibody testing: an interactional method of knowledge and risk assessment.

The purposes of this paper are to summarize issues regarding the administration of HIV-antibody testing and to present an interactional method of communicating information to patients regarding AIDS, transmission of HIV, and the meaning of HIV-antibody test results. HIV-antibody testing, when associated with pretest and posttest counseling, can be used to educate individuals at risk for HIV infection and AIDS and can serve as an intervention to prevent the spread of HIV. We have used the interactional method with over 250 outpatients who sought treatment for cocaine dependency. We found the method to be easily administered by medical and nonmedical staff and well accepted by patients.

AIDS Serodiagnosis↗