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Biomedical subjects

M D Anglin

Publications and source records attributed to M D Anglin.

At least 37 records · Page 2Linked to original sources
PubMed1999

Predicting posttreatment cocaine abstinence for first-time admissions and treatment repeaters.

OBJECTIVES: This study examined client and program characteristics that predict posttreatment cocaine abstinence among cocaine abusers with different treatment histories. METHODS: Cocaine abusers (n = 507) treated in 18 residential programs were interviewed at intake and 1-year follow-up as part of the nationwide Drug Abuse Treatment Outcome Study (DATOS). Program directors provided the program-level data in a mail survey. We applied the hierarchical linear modeling approach for the analysis. RESULTS: No prior treatment and longer retention in DATOS programs were positive predictors of posttreatment abstinence. The interactive effect of these 2 variables was also significantly positive. Program that offered legal services and included recovering staff increased their clients' likelihood of cocaine abstinence. Crack use at both the client and program level predicted negative impact. None of the program variables assessed differentially affected the outcomes of first-timers and repeaters. CONCLUSIONS: Although treatment repeaters were relatively difficult to treat, their likelihood of achieving abstinence was similar to that of first-timers if they were retained in treatment for a sufficient time. First-timers and repeaters responded similarly to the treatment program characteristics examined. The treatment and policy implications of these findings are discussed.

Adult↗
PubMed1998

Long-term trends in self-reported HIV risk behavior: injection drug users in Los Angeles, 1987 through 1995.

This article reviews trends in self-reported HIV risk behaviors across serial samples of injection drug-using (IDU) arrestees interviewed in Los Angeles. Between 1987 and 1995, a gradual decrease occurred in the percentage who share needles. However, measured over a past-year recall period, the prevalence of needle sharing remained high until 1994 to 1995, when it abruptly declined. Needle sharing with strangers and needle sharing at shooting galleries declined gradually throughout the study period. Among IDUs who shared needles, bleach use increased rapidly until 1991 but leveled off thereafter. No change occurred in number of sex partners, but condom use gradually increased among IDUs with 2 or more partners. Concurrent change in local needle exchange policy and practice may explain the abrupt decline in past-year needle sharing. New strategies may be needed to promote further increases in bleach use and condom use.

Condoms↗
PubMed1998

A differential assessment of the cumulative versus stabilizing effect of methadone maintenance treatment.

Differential response effectiveness is examined for patients during multiple episodes of methadone maintenance (MM) treatment. Subjects were 251 narcotics addicts who were divided into three groups based on their daily narcotics use pattern during their first two MM treatment periods: (1) a "stabilizing group"--showing no daily use for both periods, (2) a "cumulative group"--showing a lower level of daily use during the second period compared to the first, and (3) a "deteriorating group"--showing higher daily use during the second period. Behavioral measures for various narcotics-related variables were plotted over 4 time periods (pre-MM, during first MM, between first and second episodes, and during second MM) were compared. Results indicated several individual differences related to patients' response to multiple episodes of MM. Clinical, research, and policy implications are discussed.

Adolescent↗
PubMed1998

A regression analysis estimating the number of drug-using arrestees in 185 US cities.

OBJECTIVES: This study sought to provide population-based estimates of drug-using arrestees in the 185 largest US cities. METHODS: A prevalence model for drug-using arrestees was developed by relating selected social indicators (from 1990 census data) and drug use rates (from Drug Use Forecasting program data) via logistic regression analysis. RESULTS: It was estimated that in 1990, across the 185 cities, about 925,000 arrestees used cocaine, 317,000 used opiates, 213,000 used amphetamines, 389,000 were drug injectors, and 1,296,000 used an illicit drug. CONCLUSIONS: This approach represents a cost-efficient method for prevalence estimation based on empirically demonstrable relationships between social indicators and drug use rates.

Adolescent↗
PubMed1998

Interaction effects of client and treatment program characteristics on retention: an exploratory analysis using hierarchical linear models.

This paper applied a hierarchical linear modeling approach to explore the interaction effects of treatment program and client characteristics on client retention in treatment for drug users. Program characteristics included services provision, funding sources, and staff-client gender congruence, and client characteristics included gender, age at admission, and drug use level prior to admission. The same model was applied separately to three modalities: residential, methadone maintenance, and outpatient drug-free programs. Data were obtained from 59 treatment programs and 3,764 of their clients who had discharge records. The most noteworthy significant interaction effect detected was program's funding source and client's gender on treatment retention in the outpatient drug-free modality. For example, female clients remained less time in the programs that accepted only public funding than in the programs that accepted both public and private funding. Male clients remained in the treatment an average of 25.3 fewer days than female clients in drug-free programs that only accepted public fund, but stayed about the same time as females if the programs received mixed funding.

Adult↗
PubMed1998

Drug-user treatment programs in a large metropolitan area.

This paper discusses the results of a comprehensive survey of one of the largest drug-user treatment systems in the United States--the system in Los Angeles County, California, which contains more than 300 programs, covers over 4,000 square miles, and serves clients from a notably heterogeneous population of almost nine million people. The survey reported on here was distinct from similar surveys in that it provided simultaneously comprehensive and in-depth descriptions of formal treatment programs in a defined local area. The authors believe that this survey is the first local drug-user treatment program survey of its scope and magnitude in the United States.

Adult↗
PubMed1998

Drug use and crime: a historical review of research conducted by the UCLA Drug Abuse Research Center.

The UCLA Drug Abuse Research Center (DARC) has become one of the nation's most respected research organizations involved in the study of drug abuse by providing reliable, comprehensive findings. This article provides an encapsulation of the crime-related research conducted at DARC during the past quarter century. Research has focused on the correlates of drug use and criminal behavior and the effects of treatment and criminal justice interventions on subsequent drug use and criminal offending. The relationships have been examined, both directly and by statistical modeling, to assess the degree to which criminal behavior covaries with levels of drug use. The article discusses implications from the findings and makes recommendations regarding future directions for policy and research.

California↗
PubMed1998

Relationship of HIV testing and high-risk behaviors among clients in methadone maintenance treatment.

This article reports on the association between frequency of HIV testing and high-risk behaviors among 339 individuals in the Los Angeles Enhanced Methadone Maintenance Project. Individuals who reported taking three or more HIV tests prior to entering treatment (45% of the sample) were more likely to know someone who was HIV positive, to engage in illegal activity, to perceive their risk for HIV as high, and to use condoms; they were less likely to disinfect injection equipment; and they scored higher on measures of HIV knowledge and depression as compared with less frequent testers. The strongest predictor of frequent HIV testing (three or more tests) after treatment entry, reported by 43% of the sample, was having a high number of injection-sharing partners. Although a substantial number of individuals in methadone maintenance treatment continued to take HIV tests, test taking was more strongly related to high-risk injection behavior than to sexual behavior.

Adult↗
PubMed1998

Perceived AIDS risk among adult arrestee injection drug users in Los Angeles county.

In this paper we examine the determinants of perceived risk for getting HIV and AIDS among adult Los Angeles arrestees reporting any lifetime injection drug use (N = 958). Our sample, drawn from the Drug Use Forecasting program, is 60% male and 40% female. Higher rates of reported risky drug and sexual behaviors than in the general population make this a particularly relevant sample within which to explore correlates of perceived risk for getting HIV and AIDS. We used multiple logistic regression to assess the relationship between perceived risk and a variety of demographic, behavioral, and psychosocial variables. Arrestees reporting celibacy in the past year, having an injection-drug-using sexual partner, having more than 20 sexual partners, engaging in sex while high, knowing someone with AIDS, and having been tested for HIV antibodies were more likely to perceive themselves at greater risk of getting HIV and AIDS. African American arrestees and arrestees reporting having attempted to reduce their sexual risks were less likely to perceive themselves at greater risk for getting AIDS. Implications for AIDS education and prevention are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Patterns and predictors of cocaine and crack use by clients in standard and enhanced methadone maintenance treatment.

This paper reports on the patterns of cocaine use among subjects (N = 427) admitted to a methadone maintenance treatment demonstration project designed to reduce risk for HIV. Assessments were conducted at intake and at approximately 18-24 months after treatment admission. Self-reported data on cocaine use was compared with results of urinalysis tests at both intake and follow-up; 29 subjects who falsely reported no use were recorded as users. Over one-third used some form of cocaine at both intake and follow-up, while approximately 30% abstained at both points. Approximately 20% ceased as well as initiated cocaine use between intake and follow-up. Use of powder cocaine, either alone or combined with heroin in "speedballs," decreased at follow-up, whereas crack use increased. Discriminant function analyses were performed to determine the predictors of the different patterns of cocaine use by type. Receipt of enhanced methadone treatment compared with standard methadone treatment, treatment duration, or average duration of counselor contact appeared unrelated to cocaine use. Cocaine use at follow-up was associated with polydrug and alcohol use, illegal activity, a negative emotional state, and sex work. Crack users were more likely to be African American than nonusers; continuous users of powder cocaine were more likely to also be using heroin than were nonusers; and continuous speedball users were more likely to be women sex workers with high levels of depression. This analysis demonstrated that cessation or continuation of cocaine use after entry into methadone maintenance treatment is not uniform across different types of cocaine.

Adult↗
PubMed1997

Does increasing the opportunity for counseling increase the effectiveness of outpatient drug treatment?

Increasing the opportunity for group and individual counseling in outpatient drug treatment programs could increase client participation in counseling which, in turn, may enhance program effectiveness. Findings from the evaluation of the Los Angeles Target Cities Enhancement Project indicate that the Target Cities programs successfully increased client participation in group and individual counseling-an increase that cannot be attributed to client characteristics. Further, the magnitude of the increase in group and individual counseling was sufficient to increase the overall effectiveness of Target Cities programs. These findings support the widely held contention among drug treatment providers and policy makers that frequent counseling in necessary for treatment success. They suggest that counselors and other service providers should encourage and facilitate frequent participation in group and individual counseling. Most importantly, the findings indicate that increasing the opportunity for group and individual counseling will increase client participation in counseling, and this increased participation will elevate the overall effectiveness of outpatient drug treatment.

Adolescent↗
PubMed1997

Drug treatment: explaining the gender paradox.

There is something of a gender paradox in drug user treatment. Research consistently indicates that women possess "risk factors" associated with drug use relapse, yet women are no more likely, and possibly less likely, to relapse to drug use. Efforts to explain this paradox involve a longitudinal study of 330 women and men participating in outpatient drug-user treatment associated with the evaluation of the Los Angeles Target Cities Project funded by the Center for Substance Abuse Treatment. The findings offer no support for the drug severity and social support hypotheses, but some support for the treatment engagement hypothesis. Specifically, women participate more frequently in group counseling which, in turn, lowers their rate of relapse in spite of having more "risk factors." Further analyses indicate that the greater participation of women in group counseling does not stem from child-custody or other gender differences in the reasons for entering treatment, nor does it result from the enhanced services associated with the Target Cities Project. Rather, the differences in treatment engagement for women and men may result from gender norms concerning help-seeking, personal independence, strength, and control. The treatment and policy implications of these findings and recommendations for further research are discussed.

Adolescent↗
PubMed1997

Psychosocial antecedents of needle/syringe disinfection by drug users: a theory-based prospective analysis.

Working from the AIDS risk reduction model and other theories of behavior change, we tested psychosocial antecedents of needle/syringe disinfection by 136 injection drug users. High perceived self-efficacy for risk reduction exerted a positive effect on needles/syringe disinfection attempts 1 year later. Self-efficacy was, in turn, related to lower perceived infection risk, peer norms more favorable to risk reduction, and greater knowledge of AIDS. Behavioral intention had no significant effect on subsequent disinfection attempts. These results suggest that disinfecting needles/syringes is partly non-volitional; that high perceived infection risk may be counterproductive to injection risk reduction; and that perceive self-efficacy, but not intention to change behavior, may be a useful leverage point for AIDS preventive intervention.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Ethnic differences in the psychosocial antecedents of needle/syringe disinfection.

This study examined psychosocial antecedents of needle/syringe disinfection by 209 injection drug users in three ethnic groups. Among Whites, high perceived self-efficacy for risk reduction had a positive effect on subsequent disinfection attempts. Among African Americans and Mexican Americans, peer norms favorable to risk reduction had a positive effect on subsequent disinfection attempts, while self-efficacy had no effect. These results suggest that risk-reduction capabilities may be rooted in individualistic perceptions of the self among White drug users, while 'collective self' perceptions are more relevant to these capabilities among African American and Mexican American drug users. HIV risk intervention may have more impact in specific ethnic groups if these distinctions are taken into account. Results also demonstrate the importance of comparing models of behavior change across ethnic groups.

Acquired Immunodeficiency Syndrome↗