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Biomedical subjects

Carl Leukefeld

Publications and source records attributed to Carl Leukefeld.

9 recordsLinked to original sources
PubMed2003

Relation between childhood disruptive behavior disorders and substance use and dependence symptoms in young adulthood: individuals with symptoms of attention-deficit/hyperactivity disorder and conduct disorder are uniquely at risk.

Most prior literature examining the relations among attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and substance use and abuse suggests that CD fully account for the ADHD-substance abuse relation. This study sought to test an alternate theory that individuals with symptoms of both ADHD and CD are at a special risk for substance abuse. Relations between childhood ADHD and CD symptoms, and young adult tobacco, alcohol, marijuana, and hard drug use and dependence symptoms, were examined in a sample of 481 young adults. ADHD and CD symptoms interacted to predict marijuana dependence symptoms and hard drug use and dependence symptoms, such that individuals with high levels of both ADHD and CD had the highest levels of these outcomes.

Adult↗
PubMed2003

Targeting HIV prevention on African American crack and injection drug users.

The use of drugs in the African American community, particularly crack cocaine, has been linked to sexual risk-taking behavior, which increases the likelihood that persons will become infected with Human Immuno Virus. In order to more fully understand risk-taking behavior and to target interventions among African American men and women, this study used data collected from 1277 individuals residing in Lexington and Louisville, Kentucky, who were recruited into National Institute on Drug Abuse (NIDA) Cooperative Agreement Project from 1993 to 1998. The study compared African Americans treated for Sexually transmitted diseases (STDs) (n = 292) with African Americans who reported never being treated for a STD (n = 504) with regard to HIV information, awareness, and the number of HIV tests between those with and without STD exposure. Additionally, we examine gender differences among African Americans who have and have not been exposed to STDs on risk behaviors and HIV knowledge, awareness, and testing. It was hypothesized that African American drug users in the STD group would engage in more risk behaviors than those who reported no STDs. Results indicated that individuals in both groups, the STD exposure group and the no STD group, engaged in similar HIV-risky behaviors. However, the STD group used a greater number of different drugs in their lifetime. The STD group reported they were more likely to get HIV and were more frequently tested for HIV. Females with an STD history were more likely to have been in drug user treatment and to perceive themselves as homeless. Both males and females in the STD group were more likely to report involvement in exchanging sex.

AIDS Serodiagnosis↗
PubMed2003

Substance use, health, and mental health: problems and service utilization among incarcerated women.

This article profiles self-reported substance use, health, and mental health problems among a sample of incarcerated women in Kentucky as well as lifetime service utilization. Findings indicate that a high percentage of women reported use of alcohol, cocaine, and multiple substances during the month before incarceration. In addition, participants reported common health problems such as dental, female reproductive, physical injuries, and mental health problems including depression and anxiety. Participants reported moderate use of emergency room and mental health treatment but limited substance abuse treatment utilization. Implications for criminal justice programs and linkages with community-based aftercare services for women are recommended based on findings that health and mental health problems are associated with service utilization before incarceration.

Adult↗
PubMed2002

The relations among personality, symptoms of alcohol and marijuana abuse, and symptoms of comorbid psychopathology: results from a community sample.

This study examined the relation of the Five-Factor Model (FFM) of personality to symptoms of alcohol and marijuana abuse before and after controlling for symptoms of antisocial personality disorder (APD) and internalizing psychopathology. The 481 participants completed a well-validated measure of the FFM and a structured diagnostic interview at age 21 years. Hierarchical regression analyses indicated that unique constellations of personality characteristics were associated with symptoms of alcohol abuse, marijuana abuse, APD, and internalizing disorders. For example, symptoms of alcohol abuse were associated with high Extraversion and low Conscientiousness, whereas symptoms of marijuana abuse were characterized by low Extraversion and high Openness to Experience. Findings have implications for models of the etiology and treatment of substance use and abuse.

Adult↗
PubMed2002

Women, sex, and HIV: social and contextual factors, meta-analysis of published interventions, and implications for practice and research.

This article is focused on examining social and contextual factors related to HIV-risk behavior for women. Specifically, this article has three main purposes: to review the literature on selected social and contextual factors that contribute to the risk for the heterosexual transmission of HIV and AIDS, to review and conduct a meta-analysis of HIV-prevention interventions targeting adult heterosexual populations, and to suggest future directions for HIV-prevention intervention research and practice. Results suggest that the HIV-prevention interventions reviewed for this article had little impact on sexual risk behavior, that social and contextual factors are often minimally addressed, and that there was a large gap between research and the practice of HIV-prevention intervention.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Developing, implementing, and evaluating a treatment protocol for rural substance abusers.

Substance abuse is a significant social and public health problem facing rural Americans. However, most treatment protocols have been developed in urban areas. This article describes the development, implementation, and evaluation of an innovative substance abuse treatment designed with the collaboration of rural professionals and consumers specifically for rural clients and delivered by rural clinicians. Results of the process evaluation of Structured Behavioral Outpatient Rural Therapy (SBORT) produced findings about the experiences of participating clients, clinicians, and program directors. Most clients perceived SBORT as a helpful learning process that used multiple treatment strategies and presented an alternative to 12-step programs. Clients also reported that treatment was stressful even when beneficial, and that clinician support was critical for remaining in treatment. Most clinicians found that SBORT challenged their "old" treatment frameworks, was demanding to learn and adopt, and that the training and supervision involved in the project implementation helped remedy rural isolation from the treatment community. Interestingly, agency approach to program implementation strongly influenced clinician responses to the innovation. Agency program directors' appraisals of SBORT included observations that the therapy was viable because of its rural-specific design and that most staff were able to adapt to the changes demanded by the manualized protocol. All three groups reported that they saw the emphasis and acceptance of motivation as an emergent process as important to the treatment. This project highlighted the challenge and importance of testing rural substance abuse treatment protocols in naturalistic settings.

Behavior Therapy↗
PubMedDate not supplied

Pharmacist ambivalence about sale of syringes to injection drug users.

OBJECTIVE: To examine pharmacists' attitudes and practices surrounding human immunodeficiency virus (HIV) prevention among injection drug users. DESIGN: Focus groups. SETTING: Urban and rural sites in Colorado, Connecticut, Kentucky, and Missouri. PATIENTS OR OTHER PARTICIPANTS: Eight focus groups, with 4 to 11 pharmacists participating in each group. INTERVENTIONS: Transcripts of focus group discussions were evaluated for common themes by the authors and through the use of NUD*IST. MAIN OUTCOME MEASURES: Willingness to sell syringes to all customers, views on syringe exchange programs (SEPs), knowledge of laws governing syringe sales and racial, ethnic, or gender biases in syringe selling practices. RESULTS: Two pharmacists established their own policies of selling syringes to everyone, and three expressed a willingness to have their pharmacies serve as SEPs. A total of 20% of the pharmacists expressed an interest in learning more about the efficacy of SEPs and distribution of syringes by pharmacists, and were willing to change their views based on this information. Many also indicated a general willingness to work with SEPs or to participate in the effort to curb the spread of HIV. However, a majority of pharmacists opposed having SEPs in their pharmacies and reported selling syringes only within specific limits: to known diabetics, to individuals who looked reasonable, or to individuals who presented a logical explanation. No racial, ethnic, or gender bias was observed. CONCLUSION: Opinions among pharmacists varied across and within sites. While a majority of pharmacists would not establish SEPs in their own pharmacies, nearly all would participate in other HIV-prevention programs. Educational programs for pharmacists may be valuable in HIV-prevention efforts.

Attitude of Health Personnel↗
PubMedDate not supplied

Injection drug users report good access to pharmacy sale of syringes.

OBJECTIVE: To examine injection drug users (IDUs) opinions and behavior regarding purchase of sterile syringes from pharmacies. DESIGN: Focus groups. SETTING: Urban and rural sites in Colorado, Connecticut, Kentucky, and Missouri. PATIENTS OR OTHER PARTICIPANTS: Eight focus groups, with 4 to 15 IDU participants per group. INTERVENTIONS: Transcripts of focus group discussions were evaluated for common themes by the authors and through the use of the software program NUD*IST. MAIN OUTCOME MEASURES: Knowledge of human immunodeficiency virus (HIV), pharmacy use, barriers to access from pharmacies, high-risk and risk-reducing behavior, and rural/urban difference. RESULTS: Almost all participants knew the importance of using sterile syringes for disease prevention and reported buying syringes from pharmacies more than from any other source. Two IDUs believed pharmacists knew the syringes were being used for injecting drugs and perceived pharmacists' sales of syringes to be an attempt to contribute to HIV prevention. Most IDUs reported that sterile syringes were relativity easy to buy from pharmacies, but most also reported barriers to access, such as having to buy in packs of 50 or 100, being made to sign a book, having to make up a story about being diabetic, or having the feeling that the pharmacists were demeaning them. While the majority of IDUs reported properly cleaning or not sharing syringes and safely disposing of them, others reported inadequate cleaning of syringes and instances of sharing syringes or of improper disposal. There were few differences in IDUs' reported ability to buy syringes among states or between urban and rural sites, although the data suggest that IDUs could buy syringes more easily in the urban settings. CONCLUSION: For the most part, participants understood the need for sterile syringes in order to protect themselves from HIV, hepatitis B virus, and hepatitis C virus and saw pharmacies as the best source of sterile syringes. Although these data are not generalizable, they suggest that pharmacists can and do serve as HIV-prevention service providers in their communities.

Attitude of Health Personnel↗