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Biomedical subjects

D J Ottenberg

Publications and source records attributed to D J Ottenberg.

10 recordsLinked to original sources
PubMed1984

Mortality of treated alcoholics and drug addicts: the benefits of abstinence.

A study of 2-yr treatment outcome and of mortality in the following 8 yr was conducted on all first admissions to Eagleville Hospital in 1970 (503 alcoholics and 221 drug addicts; 9% women). The average age of the alcoholics was 41.6 vs 23.0 for the drug addicts. Status (misusing vs not misusing) 2 yr after admission for treatment or at death was ascertained for 92% of the subjects. The 108 known deaths occurred in 18.5% of the alcoholics and 6.8% of the addicts. Death rates per 1000 person yr at risk were compared with expected general population rates, controlling for age, race and sex. Overall, mortality per 1000 person yr was 25.9 for alcoholics and 8.8 for addicts, each higher than expectancy (p less than .001). Ratios of observed to expected rates were similar (2.5 and 3.1, respectively). Excess mortality occurred only among those misusing alcohol or drugs at 2 yr; nonmisusers had expected death rates. Disease and violent deaths were excessive among alcoholics, but only violent deaths exceeded expectancy among drug addicts. Of the 108 deaths, 66 were excess deaths, attributable to substance misuse and the associated way of life. However, among the 254 who were not misusing on follow-up, 19 died rather than the 51 who would have died if their mortality had been that of the persistent misusers.

Accidents↗
PubMed1977

The reluctance to combine.

The shifting of substance abuse in this country away from a pattern of single substance dependence toward multiple substance abuse has been accompanied by renewed interest in the possibilities of so-called combined treatment and its ideological base, a generic conceptualization that encompasses and integrates into a unitary theory all types of substance abuse. This view maintains that many of the differences separating alcoholic persons from other substance abusers have more to do with factors like age, ethnic, social and cultural background--and prejudice--than with real differences in the addictive processes or therapeutic needs. Some careful studies of combined treatment have found it no less effective than substance segregated treatment. Some persons are helped, others are not. Until we have reliable ways to select out those who would benefit form combined treatment from those who would not, the method remains experimental, not yet to be advocated for mass use. What is needed at once is a generic concept of substance abuse. This would prepare the way for planning, legislation, program organization, national data systems, and research that could be designed for the most effective response to today's needs and problems. An especially pressing need is for generic training and credentialling of workers in the alcohol and drug fields. As the many questions raised by a generic viewpoint are considered, one can observe that much of the resistance to this concept among professionals is attributable to fear of the unfamiliar, protection of vested interest, misapprehension about consequences and, not least, prejudice reflecting the stereotyped ideas of the general population.

Alcoholism↗
PubMedDate not supplied

The "new" drug-free therapeutic community. Challenging encounter of classic and open therapeutic communities.

In view of a rapidly changing society, reflected in many changes within the drug-free Therapeutic Communities (TCs), the question has been raised: "What can and cannot be changed in this modality?" This question was addressed at a European conference of experienced therapeutic community workers, who concluded that many changes have occurred and will continue to occur, but some basic concepts should be preserved. The changes inherent in postmodern society are examined here in an effort to foresee their impact on the evolution of the TC. Necessary changes and additions are discussed.

Congresses as Topic↗
PubMedDate not supplied

Retrospective study of similarities and relations between American drug-free and European therapeutic communities for children and adults.

This article focuses on the similarities and relations between the European therapeutic community for children and adults on the one hand and the American drug-free "concept" therapeutic community on the other. Both approaches are reviewed in a historical and comparative perspective with special attention to several critical issues: democracy versus hierarchy, self-help versus professionalism, psychoanalysis versus behaviorism and concept versus social learning. These two different TC-approaches can be considered as subdivisions of one modality, namely an environment for social learning in which living together in a group can be regarded as the primary agent of growth and human development. In recent years there has been a tendency towards further integration of these two approaches.

Adult↗