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Biomedical subjects

M D Anglin

Publications and source records attributed to M D Anglin.

At least 19 recordsLinked to original sources

The role of alcohol in cocaine dependence.

The relationships between the patterns of alcohol and cocaine use are examined using information derived from the authors' research data and from the literature. Excessive alcohol drinking was very prevalent among males seeking treatment for cocaine dependence at a Veterans Administration hospital in West Los Angeles. Fifty percent met DSM-III-R criteria for alcohol dependence. The drug-related behaviors of patients with the diagnosis of dependence on cocaine only were compared with those of patients dependent on cocaine and alcohol. The progression of the cocaine addiction was not significantly different in those two groups. However, patients with dependence on cocaine and alcohol were more likely to be users of other drugs of abuse. Concerning psychosocial behaviors, both groups maintained employment and stable interpersonal relationships throughout significant periods of their addictive career. One year after drug treatment, both subsamples showed significant improvement in terms of cocaine and alcohol use and social adjustment. Research implications and the possibility that both dependent conditions may share neurobehavioral reinforcing mechanisms are discussed.

Adult

HIV-related risk behaviors among cocaine users.

Risk behaviors related to human immunodeficiency virus (HIV) infection and transmission were studied in a sample of 167 male cocaine users admitted during a 5-month period to an inpatient drug treatment program. Data obtained included drug history and related behaviors, sexual behaviors, knowledge, and attitudes regarding HIV infection and AIDS. Approximately 20% of the sample had used IV drugs in the year prior to the interview and 94% of these reported sharing needles; 20% of the IV drug users (IVDUs) reported always using bleach to clean needles. With regard to sexual practices, 7% of the total sample reported sex with other males in the year prior to the interview; 86% of the total sample reported having sex with females and 80% of these noted they never or rarely used condoms during vaginal sex. Respondents generally did not believe they themselves were at high risk for HIV infection, yet they continued to engage in acknowledged high-risk behaviors. These findings suggest that IVDUs and non-IV cocaine users are likely to contribute to the spread of HIV in several populations.

Acquired Immunodeficiency Syndrome

AIDS knowledge and attitudes among injection drug users: the issue of reliability.

Among injection drug users (IDUs), AIDS-related knowledge and attitudes have not consistently predicted AIDS risk behavior. This may be due in part to the limited reliability of indexes used to measure drug users' AIDS knowledge and attitudes. In addition, the substantive interpretation of findings is confounded if index reliability is lower for particular demographic groups (e.g., ethnic populations and women). This report is based on 8 measures of AIDS-related knowledge and attitudes in a sample of 332 injection drug users in Los Angeles. The reliability of knowledge and attitude indexes for the overall sample is generally acceptable for the purpose of group comparison (average alpha = .60). But reliability is consistently lower for respondents who are Hispanic (average alpha = .49) and respondents with less formal education (alpha = .56). The reliability of 2 measures of sex-related attitudes is lower for female respondents. It is therefore important that the reliability of knowledge and attitude indexes be assessed not just for drug-user samples as a whole, but also within demographic groups of substantive interest.

Acquired Immunodeficiency Syndrome

Prevalence of substance abuse in a psychiatric evaluation unit.

The prevalence of substance abuse and psychiatric illness was studied in a Psychiatric Evaluations Unit. Twenty-six percent of the subjects received a psychiatric diagnosis only with no concomitant substance use disorder. Thirty-four percent were diagnosed with a substance use disorder but with no other psychiatric disorders. Thirty-nine percent of the subjects had a history of both psychiatric and substance use disorder; 62% of these substance abusers with a psychiatric illness reported using drugs (including alcohol) the week before the interview; 56% used illicit drugs while 44% used alcohol only. Differences among substance abusers with a psychiatric illness, those with a substance abuse diagnosis alone, and those with a psychiatric diagnosis alone are presented.

Adult

Conditional factors of maturing out: legal supervision and treatment.

This study is third in a series exploring the conditional nature of the process of maturing out of narcotics addiction over time. Hypotheses are tested about the relationship of two selected social interventions, legal supervision and methadone maintenance treatment, on maturing out. The technique of log linear modeling is used on long-term follow-up data from 375 admissions to the California Civil Addict Program. Results suggest that maturing out may be conditional on methadone treatment participation, which reduces addicted use to a greater extent for older addicts, but does not seem to be related to legal supervision, which is equally effective regardless of age.

Adult

Longitudinal patterns of alcohol use by narcotics addicts.

Longitudinal patterns of alcohol use by narcotics addicts sampled from a drug-free treatment program and from several methadone maintenance treatment programs were examined. Overall, a high prevalence of alcohol use was found in both samples across several stages of the addicts' careers. Many addicts were also using nonnarcotic drugs and marijuana concurrently. Generally, levels of alcohol, as well as of other substances use, decreased as the narcotics addiction career began. Unlike other drug use, however, only alcohol consumption increased whenever a decrease occurred in narcotics use. Effects of ethnicity, gender, parental alcohol problems, and opiate and alcohol use onset sequence on the alcohol- and narcotics-related behavior are examined in detail. A pattern of early onset of heavy alcohol consumption before initial narcotics addiction was more common among Chicanos and was associated with a positive parental alcohol history. Women addicts typically had a much lower alcohol consumption level than their male counterparts. Among the 160 deaths of the original 581 addicts followed during the 20 years of the study, alcohol-related deaths accounted for 17.5% of the total. Treatment implications for addicts with an alcohol problem are discussed.

Adolescent

Consequences and costs of shutting off methadone.

In the face of rising fiscal conservatism, many states and localities with sizable addict populations have reduced or eliminated public funding for methadone maintenance (MM) programs and permitted private-fee-for-service programs to replace them. The social and economic costs of these changed funding policies with reference to the California experience were analyzed. A two-and-a-half year follow-up of a sample of San Diego MM clients (195 men, 129 women) terminated from a public subsidized program compared outcome results to clients from publicly funded MM programs in Orange, Riverside and San Bernardino counties (129 men, 131 women). In a secondary analysis, San Diego clients who transferred into private (fee-for-service) treatment programs were compared with those who did not transfer. Major adverse consequences were found for clients unable or unwilling to transfer to private programs: higher crime and dealing rates, more contact with the criminal justice system, and higher rates of illicit drug use were demonstrated by nontransfer clients. Moreover, the savings resulting from a reduction of MM program costs were nearly offset by increased direct costs for incarceration, legal supervision, and other government-funded drug treatment. Indirect costs were not assessed.

Adult

Alcohol use by heroin addicts: evidence for an inverse relationship. A study of methadone maintenance and drug-free treatment samples.

This study examines the relationship between the patterns of use of alcohol and heroin by narcotics addicts, and evaluates the hypothesis--frequently reported during methadone maintenance--that this form of treatment can be causally implicated in an increased consumption of alcohol. Data were obtained on lifetime patterns of alcohol and heroin use of 375 Anglo and Chicano male addicts sampled from two treatment sources: the nonmethadone (drug-free) California Civil Addict Program (CAP) and several Southern California Methadone Maintenance (MM) programs. Repeated-measures MANOVAs revealed that alcohol and heroin consumption were inversely related throughout the addicts' careers. This pattern was evident in the addiction, treatment, and postdischarge stages of Anglo and Chicano addict careers, in both the CAP and MM samples. Consequently, the authors reject the hypothesis that increased alcohol consumption is caused solely by addicts' participation in methadone maintenance treatment. Rather, the findings suggest that addicts' alcohol use during methadone treatment reflects a lifetime pattern of increased alcohol use following any decline in heroin intake.

Adult

The MMPI profiles of narcotics addicts. I. A review of the literature.

This paper reviews three approaches to using the Minnesota Multiphasic Personality Inventory (MMPI) in the assessment of narcotics addicts' psychopathology. Two approaches examine the relationship of MMPI profiles to established sociodemographic or psychiatric typologies; the third pertains solely to MMPI-derived personality typologies. Findings from the research literature are presented and their implications for clinical assessment and treatment are discussed.

Heroin Dependence

The MMPI profiles of narcotics addicts. II. Ethnic and criminal history effects.

Data from 240 male heroin addicts admitted to the California Civil Addict Program (CAP) were analyzed to determine if incarceration before or after first narcotics use--a behavioral marker termed "sequence"--was significantly related to MMPI profile scores. Furthermore, this relationship was examined separately for Anglos and Chicanos. Results indicate that those Anglo addicts who had been incarcerated before they first used narcotics had significantly elevated scores for Paranoia (Pa) and Schizophrenia (Sc), two scales of the psychotic triad. A significant sequence-by-ethnicity interaction was found, in which the sequence effect was not manifested in Chicano addicts.

Adolescent

The epidemiology of alcohol consumption in Spain.

This paper is a comprehensive review of the available information about alcohol consumption in Spain. Alcohol use is the most severe drug problem among both young people and adults; almost half the Spanish population drink daily, and more than a fourth drink a quantity of alcohol sufficient to cause health problems in the long term. The consumption of alcohol may be considered to be culturally rooted when compared with other drug use which follows a more recent epidemic pattern. For those who use other drugs, for example cannabis and cocaine, alcohol is commonly used in conjunction. Clearly the level of alcohol use and abuse is high in Spain and constitutes a severe public health and socioeconomic problem.

Adolescent

Ethnic differences in narcotics addiction. II. Chicano and Anglo addiction career patterns.

Part I of this series compared characteristics of 546 Chicanos and Anglo men and women methadone maintenance (MM) clients. In Part II, specific differences between Chicanos and Anglos are analyzed, by sex, for each of five stages in the addiction career: preexperimentation, experimentation addiction, initial MM treatment, and posttreatment. The analysis examines narcotic and other drug use, arrest, incarceration and legal supervision histories, criminal involvement, employment, interpersonal relationships, and treatment history. Whereas preaddiction differences between addicts parallel ethnic differences found in the general population, after addiction occurs the similarities are greater than the dissimilarities between ethnic groups, except for Chicanas. Chicanos appear to continue to function as part of their community after addiction, but Chicanas appear to risk becoming marginal. Treatment outcomes for Chicanos were, in general, less successful than for Anglos.

Adult

Ethnic differences in narcotics addiction. I. Characteristics of Chicano and Anglo methadone maintenance clients.

This paper reviews the research literature comparing Chicano (Mexican American) to Anglo heroin addicts. In addition, characteristics of 546 Chicano and Anglo men and women who had been clients of southern California methadone maintenance programs in 1978 are compared. Background factors examined include nativity, family socioeconomic status (SES) and family interpersonal relationships, education, and gang membership. Lifetime characteristics and status at follow-up interview are reported with particular attention to legal status, criminality, employment, and interpersonal relationships. Drug experimentation history and circumstances surrounding narcotics initiation are also compared. Most observed differences prior to addiction are similar to ethnic differences found in the general population. Part II analyzes ethnic differences progressing through five stages of the addiction career.

Adult