PubMed Health⌕ Search

Biomedical subjects

D C Alston

Publications and source records attributed to D C Alston.

5 recordsLinked to original sources
PubMed1977

Who should be counselors in methadone maintenance programs: ex-addicts or nonaddicts?

Counselors play a central role in most methadone maintenance programs. Yet the choice of who should be employed as counselors is based on little more than personal whims of decision makers. And in evaluating the effectiveness of this highly controlled rehabilitative therapy, the influence of the counselors as an important factor is often ignored. The total changeover of the counselors from an ex-addict to a nonaddict group in an otherwise stable clinic provided an unusual opportunity to compared the performance of the two groups. Both the objective and subjective data supported the hypothesis that ex-addicts as a group compared unfavorably with a similar group of nonaddicts when employed as counselors in a methadone maintenance clinic.

Adult↗
PubMed1977

Comparison of the effect of high and low doses of methadone on treatment outcome.

The results of a 2-year-study of the relationship between methadone dosage and treatment outcome are reported. For discharged patients, higher doses of methadone were significantly related to successful treatment and lower doses to treatment failure. Based on these findings and the review of literature as well as the senior author's clinical experience, a theoretical formulation is offered to provide a rationale for methadone maintenance treatment. The tenability of the formulation is readily testable by clinical research.

Adult↗
PubMed1976

Methadone maintenance and the problem with alcohol.

There is a growing concern with the rapid pace of physical and psychosocial deterioration of methadone patients who abuse alcohol. The need for a sample method for determining the extent of the problem, as well as the presence of an alcohol problem in individual patients, led the authors to test the validity of the Michigan Alcoholism Sreen Test (MAST) in a small urban methadone maintenance clinic (N = 125). The MAST was administered to every patient by their counselors, and the nursing staff was asked to independently rate each patient according to Keller's definition of alcoholism. The authors compared the patients' MAST scores with the global ratings of the nursing staff. Forty-six percent (n = 58) of the patients scored in the alcoholism range of the MAST questionnaire, while 34% (n = 43) of the patients were diagnosed as alcoholics by the nursing staff. There was 75% (n = 94) agreement between the MAST findings and the nurses' global ratings (p less than .001). The authors suggest that the MAST could be an effective screening tool in the area of alcohol abuse in methadone clinics. Going beyond the data, the authors recommend reexamination by psychiatrists of their peripheral role in the treatment of these difficult and multihandicapped patients.

Adult↗