Biomedical subjects

H Rhoades

Publications and source records attributed to H Rhoades.

25 records · Page 2Linked to original sources

PubMedDate not supplied

Behavioral treatment of cocaine-dependent pregnant women and TB-exposed patients.

Health-compromised drug-dependent patients require specialized treatment that addresses both drug use and health risks. This preliminary study examines the efficacy of a contingency management procedure (shaping) on decreasing cocaine use and increasing compliance with the prescribed treatment regimens in two health-compromised cocaine-dependent populations: (i) tuberculin (TB) exposed patients (n = 5) and (ii) pregnant women (n = 7). A multiple-baseline across-subjects design was used. There were no contingencies on cocaine use during baseline. During the contingent phase, patients received a monetary reinforcer for (a) successive decreases in the quantity of cocaine and (b) cocaine-free samples. They received a weekly reinforcer if all samples per week met criteria for (a) or (b). During the contingent phase, there was a significant decrease in cocaine metabolite levels and an increase in cocaine-free samples in both populations, with a more robust effect in the TB-exposed group. There was an increase in compliance with prenatal visits among the pregnant women during the contingent phase. Implications for health care are discussed.

Adult↗

PubMedDate not supplied

Cessation of cocaine use during pregnancy: a preliminary comparison.

This preliminary study examined differences between cocaine-dependent pregnant women who received "baseline" drug treatment (N = 13) and those requiring additional "intensive" treatment (N = 9). Baseline drug treatment consisted of weekly individual counseling sessions. Intensive treatment, in the form of contingency management procedures, was added for patients who showed no reduction in cocaine use during the first 4 weeks of treatment. There were no differences between the two groups in terms of demographic and pregnancy characteristics or history of cocaine use. Significantly more patients in the baseline treatment group were cocaine-free at intake and had a higher rate of compliance with scheduled prenatal clinical visits. These findings may indicate a decision to cease cocaine use prior to entering treatment, and a high degree of motivation to remain drug-free. Despite the small sample size, the finding that a substantial proportion of cocaine-dependent pregnant women remain cocaine-free during treatment is encouraging.

Cocaine↗

PubMedDate not supplied

A substance-abuse research-treatment clinic: effective procedures and systems.

Drug abuse treatment clinics vary widely. This article presents a model of a research-treatment clinic in which effective procedures and systems were instituted. These systems produce an environment in which both excellent research can be conducted and effective treatment provided, by a team of researchers and clinicians. Many of the procedures overcome frequently occurring problems at drug treatment clinics. The potential applicability of these procedures and systems to standard drug treatment clinics is discussed.

Adult↗

PubMedDate not supplied

Compliance with tuberculosis treatment in methadone-maintained patients: behavioral interventions.

UNLABELLED: Tuberculosis has increased dramatically in the United States. Noncompliance with treatment is high. The purpose of this investigation was to achieve compliance with prophylactic TB treatment and simultaneously decrease drug use in a high-risk group of intravenous drug users. Two studies were conducted. Study 1: Subjects were 9 chronic opiate users who tested positive for tuberculosis and were placed on isoniazid (INH) and methadone. Methadone was dispensed contingent upon INH ingestion throughout. A within-subject, A-B design with contingency management interventions on drug use was implemented. RESULTS: Compliance with INH was 100% in 8 patients. Cocaine use remained high. Study 2: Two patients, meeting same criteria as Study 1, participated in a within-subject A-B multiple baseline design. Methadone was dispensed contingent upon INH ingestion throughout. Successive decreases in cocaine use were reinforced in the contingent phase. RESULTS: Compliance with INH was high. During contingency, both patients had over 40% cocaine-free urine samples compared with 0% at baseline. This investigation serves as a model for achieving compliance with TB treatment in opiate users.

Adult↗

PubMedDate not supplied

A menu of potential reinforcers in a methadone maintenance program.

This study demonstrates the use of paired comparisons and interval scaling techniques for measuring the relative priority of program privileges available at a methadone maintenance clinic. Fifteen methadone program privileges were combined in all possible pairs (N = 105) on a reinforcer menu and administered to a group of 12 methadone patients and a second group of counselors (N = 4). Data were converted to interval scales using the law of comparative judgment to form a quantitative continuum from least to most preferable. Free methadone, free dental service, and more take-homes were ranked highest in both groups; however, patients showed less differentiation in their preference for these privileges. Dose decreases were least preferred. Results are discussed in terms of their clinical applicability in identifying privileges for potential use in modifying the behavior of drug abusers. The method of paired comparisons has excellent psychometric properties and may offer some advantages over other response scale formats.

Adult↗

PubMedDate not supplied

Brain interactions in chronic schizophrenics under resting and activation conditions.

The metabolic patterns of correlation among brain images obtained during resting conditions and during an eye tracking task were investigated in 12 controls and 18 chronic schizophrenics using positron emission tomography (PET) and deoxy[11C]glucose. Analyses of the interaction between brain regions revealed highly significant differences between groups under both test conditions. Schizophrenics showed lower correlations between anterior and posterior areas and between thalamus and cortical areas than the normals and less change between the baseline and the task than the normals. The schizophrenic subjects showed derangements in the pattern of interactions among brain areas, both under baseline and under activation as compared to the control group.

Adult↗

PubMedDate not supplied

Cessation of cocaine use during pregnancy: effects of contingency management interventions on maintaining abstinence and complying with prenatal care.

Previous studies have reported cessation of cocaine use in pregnant women prior to treatment entry. This study examined the relative effectiveness of adjunctive contingency management interventions in maintaining abstinence and enhancing compliance with prenatal care in this unique population. Pregnant cocaine-dependent women who had used the drug during this pregnancy but had ceased use prior to study entry (N = 12) were randomly assigned to one of two treatment groups. All patients received a multifaceted treatment including behaviorally based drug counseling and weekly prenatal visits. Patients in the experimental condition also received contingent reinforcement for cocaine abstinence and attendance at prenatal visits. There was a high rate of retention and abstinence from cocaine in both groups. However, patients in the experimental group had a higher rate of attendance at prenatal visits, and none of the patients in this group experienced adverse perinatal outcome(s), compared to 80% of patients in the control group. This finding has important implications for cost-effective treatments and prevention of illness.

Adult↗