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Biomedical subjects

G De Leon

Publications and source records attributed to G De Leon.

At least 19 recordsLinked to original sources
PubMed1992

Crack/cocaine abusers in the general hospital: assessment and initiation of care.

OBJECTIVE: Cocaine, either smoked (as "crack") or taken intranasally, is now a common cause of psychiatric illness. This study was designed to assess the impact of cocaine abuse on a general psychiatric service and an obstetrics service in an urban general hospital and to evaluate a program for engaging affected patients in addiction treatment. METHOD: The charts of 300 general psychiatric patients (not admitted for addiction treatment) and 60 cocaine-abusing prenatal or postpartum patients were reviewed. A treatment referral program based on professionally directed peer leadership was established for patients with cocaine abuse. Results of evaluation and referral of 100 other cocaine-abusing psychiatric patients and the 60 prenatal or postpartum patients were then determined. RESULTS: Fully 64% (N = 191) of the 300 psychiatric patients were diagnosed as substance abusers; 38% (N = 113) of them abused cocaine. Almost one-third of these cocaine abusers had no axis I diagnosis other than substance abuse/dependence, and the majority were homeless. Urine samples were positive for cocaine in a majority of the obstetric patients studied. A majority of the psychiatric patients who were referred through the peer-led program enrolled in outpatient cocaine treatment--three times as many as in the chart review group. Most of the obstetric patients suitable for referral enrolled for treatment as well. CONCLUSIONS: Cocaine abuse may be responsible for a large portion of psychiatric admissions in urban public general hospitals. Cocaine abusers in psychiatric and obstetrics services are apparently responsive to a peer-oriented mode of referral into treatment.

Adult↗
PubMed1987

Alcohol use among drug abusers: treatment outcome in a therapeutic community.

Male and female dropouts and graduates (N = 248) from a traditional drug-free therapeutic community were followed 2 years after treatment. A 4-hr face-to-face interview traced the social adjustment one year pre-, through all years posttreatment. Results showed that (a) success (no crime and no opioid and/or no use of nonopioid primary drug) was maintained through 2 years of follow-up by 34% of the dropouts and 68% of the graduates; (b) success rates were highest among opioid abusers and the lowest among primary alcohol abusers; (c) among the latter, however, abstinence rates were significantly increased and daily use of alcohol significantly decreased as did criminal involvement; (d) among the opioid abstinent group, alcohol use increased posttreatment but heavy drinking was not prominent indicating no significant shift in substance dependency. Overall, the therapeutic community appears most effective for opioid abusers but has a clear impact on a considerable number of those primarily involved with alcohol and other substance use.

Alcohol Drinking↗
PubMed1984

Therapeutic communities: what are the retention rates?

The present research is the first in a systematic investigation of retention in therapeutic communities (TCs). Findings are reported from an interrelated set of analyses clarifying retention rates and the temporal pattern of dropout. Retention information was obtained on all admissions to a nonrandom sample of seven traditional (long-term) TCs during February 1-August 15, 1979. Results showed that: (a) Across the seven programs, the 12-month retention rates ranged from 4 to 21%. Program differences were generally nonsignificant. (b) Less than 17% of admissions were readmissions. Among these, however, the number of days before initial dropout was a significant predictor of long-term retention. (c) The temporal pattern of dropout was uniform across programs. Dropout was highest within the first 14 d and declined thereafter, indicating that practically all dropouts leave within 3 months. (d) Based upon rates adjusted for those who had left treatment ("survivor rates"), estimates indicated that the likelihood of continued retention increased significantly with longer stay in treatment. (e) The temporal pattern of dropout was remarkably stable, evident in both replicational and comparative analyses; the latter involved the entire residential drug-free modality in several data systems. The present findings establish that the temporal pattern of retention is orderly, predictable, and has utility for program management and treatment planning, although the phenomenon of retention itself remains to be explained.

Adult↗
PubMed1982

The therapeutic community: success and improvement rates 5 years after treatment.

Dropouts (N = 162) and graduates (N = 75) from the 1970-1971 residential population in Phoenix House were interviewed 5 years after treatment. Composite indices of criminality, drug use, and employment described client status on a four-point outcome scale. Success reflected absence of crime and drug use through all years of follow-up; improvement represented a positive change over pretreatment status. Graduate success and improvement rates were 75% and 93%, respectively. Among dropouts, the rates were 31% and 56%, respectively, but increased by time in program from less than 1 month to greater than 20 months (Success = 0-57%; Improvement = 5-89%). Results at 2-year follow-up were replicated in a 1974 cohort, providing convincing evidence for the effectiveness of treatment in the therapeutic community.

Adult↗
PubMed1979

Therapeutic community dropouts: criminal behavior five years after treatment.

Two hundred and two male dropouts, mainly heroin abusers averaging 3 to 6 years out of treatment, were sampled from the 1970-1971 Phoenix House admissions by race and time in program (less than 1 month to more than 2 years). Criminal justice arrest records were compared between three pre- and all posttreatment years. Percent and rate of arrest declined significantly in followup. Magnitude of reductions was uniform across race and legal status, varied by age, but increased systematically by time in program. Results replicated and extended earlier findings, confirming long-term positive change in criminal behavior associated with length of stay in the therapeutic community.

Adult↗
PubMed1977

The therapeutic community: multivariate prediction of retention.

Multiple regression procedures were employed to study the profile of resident time in program, demographic, sociobackground, and psychological variables in relationship to retention. The sample consisted of 809 Phoenix House residents who were primarily male (81.4%) and Black (64.9%). A psychological battery was administered on a cross-sectional basis. The multiple R of .44 and R2 of .19 were large for this type of research. Time in program accounted for over half the variance explained. Ten other measures contributed significantly to the explained variance. Residents who dropped out were less likely to be Blacks and more often came from lower SES families but with less family deviance; they made fewer prior attempts at giving up drugs and had lower education levels. Psychologically, they were generally more defensive and disturbed.

Adult↗