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Biomedical subjects

C Casriel

Publications and source records attributed to C Casriel.

6 recordsLinked to original sources
PubMed1992

AIDS and the transition to illicit drug injection--results of a randomized trial prevention program.

Illicit drug injection is a major component of the AIDS epidemic in the United States, Europe and some developing countries. Prevention of illicit drug injection would not only reduce HIV transmission but would also reduce the other health, psychological and social problems associated with illicit drug injection. One hundred and four subjects who were using heroin intranasally ('sniffing') were recruited for a study of the transition to drug injection. Eligibility criteria included sniffing as the most frequent route of administration and no more than 60 injections in the past 2 years. All subjects received thorough basic information about AIDS, including HIV antibody test counseling. Subjects were then randomly assigned to a four-session social learning based AIDS/drug injection prevention program or a control condition. Eighty-three subjects were successfully followed at a mean time of 8.9 months. Twenty (24%) of the followed subjects reported injecting illicit drugs during the follow-up period. Drug injection during follow-up was associated with being in the control group, intensity of non-injected drug use, prior injection, and having close personal relationships with current intravenous (IV) drug users.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Working with heroin sniffers: clinical issues in preventing drug injection.

Preventing illicit drug injection would be the ideal point for preventing HIV infection and AIDS among illicit drug injectors. This paper reports on clinical issues that arose in a program for intranasal ("sniffer") heroin users who were at high risk of injecting drugs. Extensive field notes were kept by the staff of the project. A generalized mistrust of authorities, denial of problems associated with non-injected drug use, and ambivalence about injecting were the major issues that arose during subject recruitment and the group sessions. The staff underwent trial and error learning, both becoming more confident in working with heroin sniffers, and finding better results for later participants in the study.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Contingency contracting with polydrug-abusing methadone patients.

The study assessed the effects of contingency contracting for medication take-home privileges on the polydrug use of methadone patients. Comparisons were made among 20 patients using cocaine, 13 using other illicit drugs, and seven exhibiting other noncompliant behavior. A within-subjects reversal design showed that there was no overall difference in the percentage of positive urines between the pre-contingency and contingency periods, nor between the pre- and post-contingency periods. During the first contingency month, however, one group of patients eliminated drug use, while the remaining had an increased percentage of positive urines. This increase may have been due to the heightened urinalysis regimen during the contingency period rather than to more actual drug use. During the first month, drug-related contracts not involving cocaine were more successful than those targeting cocaine, and non-drug-related contracts were more successful than drug-related ones. The study concluded that contracting had a favorable, though transient, effect primarily on non-cocaine-abusing methadone patients. Further research using stronger or multiple reinforcers is indicated.

Adult↗
PubMed1988

Patient-staff governance in methadone maintenance treatment: a study in participative decision making.

To help counteract some methadone patients' unfavorable attitudes to treatment and consequent antitherapeutic behaviors, a participative decision-making model was implemented in two methadone maintenance programs. Team building was used to initiate collaboration between patients and staff, resulting in the establishment of joint patient-staff governance committees. Outcomes as measured by the Client Attitudes Toward Methadone Programs (CAMP) Scale (a new instrument developed for the study) and by patients' supplementary drug use showed no statistically significant changes. The process evaluation, however, indicated that the committees had positive results in increasing communication and understanding between patients and staff, and in improving the efficiency of certain clinic procedures. The study analyzes the organizational dilemmas encountered in implementing participative decision making in drug treatment programs and gives recommendations for promoting future work in this area.

Adult↗
PubMed1987

The validity of methadone clients' self-reported drug use.

Drug use self-reports were compared with urinalysis for 248 clients in four methadone treatment programs. The validity of self-reporting based on urinalysis as a criterion depended on the type of drug examined. Opiate reporting was least valid, while benzodiazepine and cocaine reporting were moderately and highly valid, respectively. EMIT urinalysis was far more useful as a criterion of validity than TLC urinalysis. Self-reports helped identify drug users who were missed by urinalysis because of the latter's limited detection period, but urinalysis in turn detected an equal number of drug users missed by the interviews. The age of clients and the type of interviewer directly affected the rate of underreporting. Some respondents systematically denied disvalued behaviors (i.e., drug use and criminality), leading to a spurious correlation between these behaviors. This has important implications for future research.

Humans↗