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Biomedical subjects

G W Joe

Publications and source records attributed to G W Joe.

At least 37 records · Page 2Linked to original sources
PubMed1995

Suicidality in a sample of methadone maintenance clients.

Previous work has shown that suicide is a significant cause of death among substance abusers, including methadone-maintained clients, and that the prediction of suicidal ideation and behavior is difficult. Preliminary review of data collected at admission on a population of 438 methadone-maintained clients found 55 expressing some level of suicidal behaviors during the course of treatment. These clients were compared with a randomly selected comparison group of 55 nonsuicide clients matched for gender and race/ethnicity on measures of psychological dysfunction, drug use, family dysfunction, and help-seeking behaviors. Results showed that at time of admission suicidal clients reported: 1) more psychological dysfunction as evidenced by higher levels of depression, social dysfunction, hostility, risk-taking, and previous thoughts of suicide; 2) less family support at the present time and during childhood; and 3) more help-seeking behavior as evidenced by self-referral, number of previous treatment episodes, attendance at self-help meetings, and higher scores on motivational measures of desire for help. Differences in preadmission drug-using behaviors were not found between the two groups.

Adult↗
PubMed1995

Attentional difficulties and the effectiveness of a visual representation strategy for counseling drug-addicted clients.

Three hundred thirty-one opioid-addicted clients in methadone treatment were randomly assigned to counselors who used either mapping-enhanced or standard counseling. Those counseled with mapping had lower percentages of during-treatment urine specimens that were positive for either cocaine or opiates, and they were rated by their counselors as having higher rapport, motivation, and self-confidence. Clients were further classified into those exhibiting either good or poor attention during an intake interview. The results suggest that clients with poor attention are more likely to have positive urines, but that this tendency appears to be reduced under mapping-enhanced counseling.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Node-link mapping for counseling cocaine users in methadone treatment.

Treatment engagement problems associated with cocaine-using opioid addicts were addressed using a cognitively enhanced counseling strategy. Analysis of client urines, participation, and counselor ratings of clients over a 6-month period during treatment indicated that the use of node-link mapping--a multipurpose visual representation strategy for communication--produced better results for both low and high cocaine-using opioid addicts in methadone maintenance than those treated without this enhancement.

Adult↗
PubMed1994

Treatment process and relapse to opioid use during methadone maintenance.

A general framework for studying drug abuse treatment process factors is presented, and components are then used to predict relapse to opioid use during treatment in methadone maintenance. Major domains of the treatment process research framework include client variables at entry, program characteristics, treatment events, and client outcomes. The analyses rely on the use of proportional hazards models to identify significant outcome predictors in a sample of 590 methadone maintenance clients from 21 clinics in the Research Triangle Institute/Treatment Outcome Prospective Study (RTI/TOPS) data system who remained in treatment at least 3 months. The analyses were performed on the total sample and separately on clients from three groups of clinics classified on the basis of the distribution of client relapse rates and tenure in treatment. Relapse rates were related to dosage level, client monitoring with urinalyses, and methadone take-home privileges in some clinics, and hence, these time-varying treatment events were important factors in treatment outcomes. Even at entry to treatment, some measures were found to be related to how the client later performed during treatment. Finally, it was also found that the particular area of professional speciality of the staff making client diagnosis at intake and preparing treatment plans was associated with client outcomes.

Adult↗
PubMed1994

The role of node-link mapping in individual and group counseling.

The value of using a visual representation strategy, called node-linking mapping, was evaluated in individual and group drug abuse counseling settings. Methadone maintenance clients were randomly assigned to counselors trained to use mapping techniques (n = 57), and those who used standard counseling (n = 51). Clients in the mapping counseling group had more favorable perceptions of their own therapeutic engagement and progress as indicated by ratings of cognitive-behavioral and motivational attributes than did those in standard counseling. Overall, individual sessions were viewed by clients as being more valuable than group counseling, but the use of mapping increased the helpfulness attributed to group counseling to near the same level as individual counseling.

Adult↗
PubMed1991

Treatment predictors of tenure in methadone maintenance.

Tenure in methadone maintenance treatment was analyzed in terms of treatment process factors using a survival curve regression analysis. The treatment process framework included client variables at entry, program characteristics, treatment events, and client attitudes and satisfaction. The sample consisted of 606 methadone maintenance clients from 21 different clinics. Significant predictors included professional classifications of the diagnosing and treatment-planning staff members, measures of early treatment services, client attitudes and satisfaction, methadone dosage level, and frequency of urine monitoring. The results showed higher tenure rates when specialized professionals diagnosed problems and defined treatment plans, when service needs were addressed, when client attitudes and satisfaction were high, and when methadone dose was higher. Lower tenure rates were found among blacks and clients with lower sociodemographic status. Lower tenure also occurred among those who perceived the program as less accessible or less structured in its procedures.

Black or African American↗
PubMed1991

Depression and decision-making among intravenous drug users.

Two short scales, the TCU Depression Scale and the TCU Decision-making Scale, were psychometrically evaluated in a sample of 145 intravenous drug users. Coefficient alpha reliabilities were .78 for the 6-item TCU Depression Scale and .77 for the 9-item TCU Decision-making Scale. Concurrent validity of the former scale was assessed by correlating scores with those on the Beck Depression Inventory, r = .75. Based on the Beck Depression Inventory Clinical cutoff scores, 83% of the sample showed some depression, with 23% severely depressed, 39% moderately depressed, and 21% mildly depressed. Individuals scoring higher on depression on both tests tended to score lower on decision-making. Significant demographic associations of age, gender, education, and race-ethnicity were found for the depression and decision-making scales. More depression was noted for women, those younger, white, and having less education. Older and more educated intravenous drug users tended to score higher on decision-making. Validity for the depression and decision-making scales was assessed by examining correlations with behaviors. Significant positive correlations were found between depression scores and intravenous use of cocaine only, heroin and cocaine combined, and heroin only. Also, intravenous use of cocaine only and of cocaine and heroin combined were negatively related to decision-making. AIDS sex-risky behavior was positively correlated with depression and negatively correlated with decision-making.

AIDS Serodiagnosis↗
PubMed1991

Unmet service needs in methadone maintenance.

Most drug abuse treatment agencies maintain a wide array of ancillary services, either on-site or through off-site referral resources, for helping meet the diverse social, medical, and psychological needs of clients. The extent to which these needs are met may be an important factor in client retention and outcomes. Perceived unmet service needs and their relationship to client outcomes were therefore studied in relationship to a framework for studying drug abuse treatment process factors. The outcomes in the present study were time in treatment and relapse to opioid use during treatment, and these were examined in relation to perceived need for services and their delivery (whether or not these services were received). The sample consisted of 590 methadone maintenance clients in 21 clinics in the RTI/TOPS data system. The results showed that the measure of unmet needs for services was not significantly related to time to relapse or to time in treatment. However, there appeared to be an indirect effect. There were differences for clinic type and a few significant interactions with other predictor variables used to study treatment process.

Combined Modality Therapy↗
PubMed1990

Availability of drugs and psychological proneness in opioid addiction.

The role of drug availability and psychological proneness in opioid addiction was examined using longitudinal data from the Drug Abuse Reporting Program (DARP). The sample included 424 addicts who were followed up and interviewed approximately 12 years after admission to treatment in the DARP, and for whom admission, during-treatment, and 6-year follow-up data were also available. Drug availability and proneness were both found to be important for drug use at any given time--from initial stages of addiction as well as in Year 12 of the follow-up--but proneness was rated as relatively more important for opioid use in the later stages of the addiction career. Proneness measures contributed more to the prediction of long-term drug use outcomes.

Adult↗
PubMed1987

Mortality rates among opioid addicts in a longitudinal study.

Mortality rates and survival curves were estimated for a sample of opioid addicts who had survived to an initial six-year follow-up interview. A total of 52 of the 555 addicts died between the six-year and 12-year follow-up interviews, which corresponds to an average of 13.8 deaths/1,000 person years. This rate is 6.9 times greater than the general population, adjusting for age. Approximately 29 per cent of the deaths were due to violence and 48 per cent to drugs.

Adult↗
PubMed1986

Estimated intelligence and long-term outcomes of opioid addicts.

This study estimated intellectual functioning based upon a demographic profile (DP) for Wechsler Adult Intelligence Scale-Revised (WAIS-R) Full Scale IQ in order to determine its relationship with variables representing initiation, continuation, relapse, and cessation of daily opioid use. The DP Estimated IQs were used to describe a large former opioid addict sample from the 12-year follow-up study of the Drug Abuse Reporting Program (DARP). Results were compared with those from previous studies using meta-analysis. In addition, a correlational analysis was performed. Average DP Estimated IQs for the DARP sample were comparable to mean IQs for both the WAIS-R standardization sample and previous studies. DP Estimated IQ was significantly related to length of addiction career; the higher the estimated IQ, the shorter the career. Other more complex relationships were found for variables used to represent intraindividual factors such as satisfaction with self or family, interpersonal factors such as family or peer influences, and other variables of interest.

Adult↗
PubMed1985

Minority group status and treatment retention.

Study was made of the extent to which majority/minority status within program was associated with treatment outcome. Examining situations in which Blacks, Mexican-Americans, and Whites constituted significant majorities or minorities within each of three treatment modalities, it was found that minority status had particular relevance for treatment retention and for type of discharge in drug-free outpatient programs. Minority status was less significant to treatment outcome in methadone maintenance and residential programming. Several hypotheses are offered to explain the greater significance of race/ethnic issues for outpatient drug-free programming.

Black or African American↗
PubMed1983

Retention in outpatient drug free treatment clinics.

This study examined time in treatment and the percentage of clients who quit or were expelled from drug treatment clinics as dependent measures in a general model including socioecological aspects of the clinic neighborhood environment, the clinic structure (attributes, e.g., size, and services and staffing), and the client composition of the clinic (sociodemographic and deviance). In this study the clinic was the unit of analysis. The data were analyzed by means of path analysis, for (1) drug free outpatient, nonopiate orientation (DFO-N) and (2) drug free outpatient, opiate orientation (DFO-O). There were 204 DFO-N and 130 DFO-O clinics. The path analytic model proved to be useful for the explanation of clinic retention outcomes. The socioecological variables predicted the types of clients who entered treatment. These in turn along with clinic attributes were significant predictors of clinic retention. Clinic attributes also predicted clinic services and staffing. The results suggested that both clinic variables and client composition variables are important predictors of clinic retention.

Adult↗
PubMed1983

Agency differences in posttreatment outcomes: a follow-up of drug abuse treatment clients.

The present study examined variations in posttreatment outcomes for clients treated in the same modality but in different treatment agencies located across the United States. Three modalities were studied, represented by seven methadone maintenance (MM) programs, seven therapeutic community (TC) programs, and nine outpatient drug-free (DF) programs. Agency differences within MM and TC programs were not significantly different on posttreatment outcomes for opioid use, nonopioid use, alcohol use, productive activities, and criminality. There were significant outcome differences among the DF agencies, but they were explained by variations in the background characteristics of the particular types of clients served by each agency. In particular, these posttreatment outcome differences appeared to be related to programs treating primarily opioid addicts versus primarily nonopioid users.

Alcoholism↗
PubMed1982

Six-year follow-up of opioid addicts after admission to treatment.

Long-term behavioral outcome status of 990 daily opioid users, recorded in follow-up interviews about six years after admission to community-based treatment programs, was classified in terms of longitudinal patterns of opioid use. Sixty-one percent of these individuals had achieved abstinence from opioid drugs for a year or longer immediately before the follow-up interview. Compared with those who continued heavy opioid drug use, and with others who had problems with nonopioid drugs or alcohol over time, persons who achieved abstinence also had significantly better long-term outcomes on criminality, use of nonopioid drugs and alcohol, and productive activities. Except for criminal history, outcome status was generally unrelated to client demographic and background predictors, but behavioral improvements over time were strongly associated with participation in drug abuse treatment.

Adult↗
PubMed1982

Addict death rates during a four-year posttreatment follow-up.

Mortality rates were examined among 3,324 Black and White daily opioid drug users for a four-year period following treatment in community-based agencies located across the United States. A total of 179 of these addicts died during this follow-up period, yielding a death rate of 15.2 per 1,000 person-years at risk. When adjusted for age, addict death rates were found to be three to 14 times higher than those in the general US population. Life table analysis was also used to examine these rates in relation to client demographic, background, and treatment variables obtained prospectively, both prior to and during treatment. Age, alcohol use, and criminal history were positively associated with higher death rates. With regard to causes of death, age proved to be the only significant predictor; older addicts (over 30) had the highest percentages of deaths due to "natural" causes, while over three-fourths of the deaths among younger addicts were drug related or involved violence.

Adult↗
PubMed1980

Treatment histories of clients treated for drug abuse.

History of drug abuse treatments was examined for clients included in a national follow-up study based on admissions to the Drug Abuse Reporting Program (DARP) during 1969-1972. Clients were sampled from DARP methadone maintenance, therapeutic community, outpatient drug-free, and outpatient detoxification programs, as well as an intake only comparison group. Pre-DARP treatment was reported by 40% of the total sample, with detoxification being the most common. Treatments in the first three years after DARP were reported by 51%, with methadone maintenance being the most common. There was an overall trend toward methadone maintenance as the predominant treatment after DARP regardless of the type of treatment a client received in the DARP, and approximately one-third of the total sample reported no other treatments either before or after DARP.

Adult↗