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Biomedical subjects

M D Anglin

Publications and source records attributed to M D Anglin.

119 records · Page 7Linked to original sources
PubMedDate not supplied

Ethnic differences in HIV risk behaviors, self-perceptions, and treatment outcomes among women in methadone maintenance treatment.

This study examined the HIV risk profiles of White, African-American, and Latina women enrolled in the UCLA Enhanced Methadone Maintenance Project, a NIDA-funded research demonstration project with the goal of reducing risk of HIV infection and/or transmission. Each group demonstrated distinct patterns associated with family relationships, sources of income, sexual and injection behaviors, and self-perceptions, although they were similar in their employment, drug use, mental health, and criminal behavior histories. In general, Latinas were more likely to report familial influences and to display evidence of low self-esteem and self-efficacy, inconsistent condom use, and high-risk injection behavior. White women reported the highest levels of regular condom use at follow-up; however, they were the least likely to report safer injection practices. African-American women expressed the highest levels self-esteem, yet they reported more alcohol use at intake and crack cocaine use both before and after treatment entry. They showed the greatest gains in adopting safer injection practices and were the least likely to report multiple sex partners after treatment entry. These findings can be used to improve the potential of methadone maintenance treatment for HIV risk reduction for women and to aid in developing culturally sensitive treatment protocols.

Adult↗
PubMedDate not supplied

Levo-alpha-acetylmethadol (LAAM): clinical, research, and policy issues of a new pharmacotherapy for opioid addiction.

A number of issues are relevant to the development and use of levo-alpha-acetylmethadol (LAAM) as a treatment alternative to methadone. A brief history of methadone maintenance treatment is provided and variants of standard methadone treatment are discussed. The history and current status of LAAm are discussed, as well as its advantages over methadone. In addition, relevant clinical, research, and policy issues are addressed. LAAm has advantages over methadone specifically with regard to thrice-weekly dosing, potential to reduce HIV/AIDS risk, possible cost savings, and possible improved clinic-community relations. The effective and cost-effective implementation of LAAM as a new treatment for opioid addiction requires attention to a number of issues: (1) LAAM as an HIV prevention measure through its potential risk-reduction effects, (2) the sue of LAAM with specific high-risk subgroups, (3) causes of differential rates of treatment dropout and their amenability to intervention, (4) the role fo patient choice in long-term maintenance treatment, (5) the impact of LAAM on clinic operations, (6) the potential for LAAM as a take-home medication, and (7) the costs of implementing and sustaining LAAM maintenance services.

Heroin Dependence↗
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Sexual abuse, physical abuse, and posttraumatic stress disorder among women participating in outpatient drug abuse treatment.

Findings from a prospective, longitudinal study of 182 women and 148 men in outpatient drug abuse treatment programs indicate that women are significantly more likely than men to experience sexual and physical abuse. Sexual and physical abuse are associated with higher levels of posttraumatic stress disorder (PTSD) symptomatology. Moreover, women are more likely than men to possess an array of psychological factors that predict relapse to drug use after treatment, including low self-esteem, depression, anxiety, and suicidal behavior, among others. But contrary to expectation, PTSD is not associated with relapse to drug use, nor are women more likely than men to relapse within a six-month posttreatment interval. Further analysis indicates that while women have more psychological risk factors associated with relapse, they are more likely than men to engage in the treatment process. Engagement in treatment, notably frequent participation in group counseling, appears to mitigate the higher risk of relapse for women.

Adolescent↗
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Afterword. Future directions for perinatal alcohol and drug treatment services.

Although comprehensive strategies to promote recovery from the abuse of alcohol and other drugs require a significant commitment of resources and time, these strategies are considered ultimately to be cost-effective in both dollars and human lives, especially concerning perinatal populations. The development and funding of innovative approaches and the continued support of existing programs are important steps in recognizing and addressing the problem of perinatal substance abuse, and encouraging family and community stability. The extensive use and abuse of alcohol and other drugs in our society clearly necessitates innovative ways to integrate prevention, treatment, and relapse prevention efforts along with a variety of existing social, health, and support efforts. While the stigma associated with alcohol and drug dependence continues to act as a barrier, professionals and policymakers are recognizing the intertwining and clustering of social problems. Addressing those problems will require additional efforts aimed at inducing individual behavioral change within the context of social changes that support and enhance a drug-free lifestyle. Given the changing funding streams and the likely reductions in public funding of treatment, health, and social service programs, policymakers and programs will need to be especially creative in developing strategies that respond to the needs of AOD-dependent women and their children. Understanding the necessity of early investment in prevention and treatment and the personal cost savings associated with these efforts is essential to the creation of cost-effective and responsive strategies that produce ongoing and long-term benefits.

Adult↗
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History of the methamphetamine problem.

Methamphetamine, called meth, crystal, or speed, is a central nervous system stimulant that can be injected, smoked, snorted, or ingested orally; prolonged use at high levels results in dependence. Methamphetamine (MA) is a derivative of amphetamine, which was widely prescribed in the 1950s and 1960s as a medication for depression and obesity, reaching a peak of 31 million prescriptions in the United States in 1967. Until the late 1980s, illicit use and manufacture of MA was endemic to California, but the MA user population has recently broadened in nature and in regional distribution, with increased use occurring in midwestern states. An estimated 4.7 million Americans (2.1% of the U.S. population) have tried MA at some time in their lives. Short- and long-term health effects of MA use include stroke, cardiac arrhythmia, stomach cramps, shaking, anxiety, insomnia, paranoia, hallucinations, and structural changes to the brain. Children of MA abusers are at risk of neglect and abuse, and the use of MA by pregnant women can cause growth retardation, premature birth, and developmental disorders in neonates and enduring cognitive deficits in children. MA-related deaths and admissions to hospital emergency rooms are increasing. Although inpatient hospitalization may be indicated to treat severe cases of long-term MA dependence, optimum treatment for MA abusers relies on an intensive outpatient setting with three to five visits per week of comprehensive counseling for at least the first three months. The burgeoning problems of increased MA use must be addressed by adequate treatment programs suitable for a variety of user types.

Central Nervous System Stimulants↗
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Predictors of relapse after treatment for methamphetamine use.

The purpose of this study is to describe treatment utilization and relapse and examine possible predictors of time to relapse after treatment for methamphetamine (MA) use. This analysis is based on natural history interview data from 98 subjects treated for MA use in publicly-funded programs in Los Angeles County in 1995-97 and interviewed two to three years following their treatment admission. Results showed that half of the subjects had resumed MA use: 36% within six months of the end of treatment, and 15% more within seven to 19 months. Survival analysis methods showed significant predictors of (shorter) time to relapse were shorter length of treatment, older age of first substance use, and involvement in selling MA; ethnicity (being Hispanic) and more previous time in treatment had weaker effects.

Adolescent↗
PubMedDate not supplied

Correlates of outpatient drug treatment drop-out among methamphetamine users.

This article explores correlates of retention among the 2.337 methamphetamine (MA) users entering public outpatient treatment programs in California from January 1, 1994 through September 30, 1997. A secondary analysis of data from the California Alcohol and Drug Data System (CADDS) was performed and predictors of drop-out before treatment completion (as measured by a retention of 180 days or more) were determined using logistic regression. Overall, 23.3% of MA users completed treatment, a rate similar to that for users of other drugs throughout California. As expected, MA users who were older (40 years or over), had less severe drug use patterns (used less than daily or did not inject), or who were under coerced treatment were significantly more likely to complete treatment that other MA users. Surprisingly, men were significantly more likely than women to drop out of treatment before 180 days. Until studies currently collecting primary data on MA treatment are completed, the present secondary analysis provides a useful foundation upon which future research and intervention strategies may be based.

Adolescent↗
PubMedDate not supplied

A survival analysis of gender and ethnic differences in responsiveness to methadone maintenance treatment.

Survivorship analysis was applied to evaluate treatment responsiveness among four groups of heroin addicts (male and female Whites and Chicanos). Multiple outcome measures included rates of retention, incarceration, addiction, property crime, drug dealing, legal supervision, alcohol abuse, employment, and interpersonal involvement. Differential treatment responsiveness among groups was found depending on the measure in use and the time point of evaluation. Relationships between selected predictors and treatment retention were tested using the Cox proportional hazards model. Young male addicts who were using narcotics daily during treatment and who were unemployed and unmarried were at highest risk for dropping out of treatment.

Adult↗
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A multimethod assessment of social intervention effects on narcotics use and property crime.

Log-linear modeling, structural equation modeling, repeated measures analysis of variance, and time series analysis are discussed for their utility in evaluating the temporal effects of social interventions. Methods are illustrated by applications examining the independent and joint temporal effects of methadone maintenance treatment and legal supervision on narcotics use and property crime among narcotics addicts. Convergent results from a multimethod assessment of the issue show that methadone maintenance has long-term and short-term suppressive effects on narcotics use and property crime. More complicated but complementary findings have been found in evaluating the effectiveness of legal supervision.

Analysis of Variance↗