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Biomedical subjects

M L Stitzer

Publications and source records attributed to M L Stitzer.

At least 163 records · Page 9Linked to original sources
PubMed1983

Oral methadone self-administration: effects of dose and alternative reinforcers.

We examined the efficacy of oral methadone as a reinforcer by offering methadone maintenance patients the chance to self-administer extra doses of methadone occasionally in addition to their regular dose. Seven maintenance patients received twice-weekly choices between methadone doses or money. Doses were 0, 1, 5, 10, 25, or 50 mg methadone; the alternative money option was $1 or $5. Extra methadone doses were reliably self-administered by maintenance patients, and percent of dose choices rose as the size of the dose offered increased. Thus extra methadone doses functioned as reinforcers in this situation. Further, across the entire dose range, more dose choices were selected when $1 was offered than when $5 was offered as an alternative. Thus methadone self-administration was influenced by the alternative reinforcers available for drug refusal. Neither reports of subjective withdrawal symptoms nor reduction of symptoms after extra methadone predicted methadone self-administration, but dose selections were more likely when urinalysis results indicated recent illicit opiate use. The reinforcing effects of oral methadone in methadone-tolerant patients may be an important factor in the popularity of this treatment among drug abusers and in the long-term treatment retention generally observed during methadone maintenance.

Adult↗
PubMed1982

Rapid resumption of cigarette smoking following myocardial infarction: inverse relation to MI severity.

In order to identify factors associated with relapse to cigarette smoking, medical and interview data were collected from 66 chronic smokers hospitalized for acute myocardial infarction (MI). Relapse to smoking during the in-hospital recovery period was prevalent (38% of patients). The major correlate of smoking relapse was MI severity, with relapse probability declining as MI severity increased; patients who relapsed to smoking during the recovery period had experienced less severe MIs, as indicated by their serum creatine phosphokinase (CPK) enzyme levels and their requiring significantly shorter intensive-care treatment. Smoking relapse was not related to patients' smoking histories, their reported craving experiences, their reported health beliefs or demographic characteristics. The fact that relapse is most likely among patients with the best medical prognostic status suggests that the benefits of post-MI smoking cessation may have been underestimated in previous studies.

Attitude to Health↗
PubMed1982

Techniques used by smokers during contingency motivated smoking reduction.

This study investigated the smoking reduction strategies used by smokers who were not enrolled in formal treatment. Twenty-four smokers were interviewed following a study in which they were contingently reinforced for reductions in alveolar carbon monoxide levels but not provided with specific reduction strategies. Results indicated that smokers who consumed more food or liquids to avoid smoking and/or who avoided other related substances such as alcohol and coffee were more successful in reducing carbon monoxide levels than subjects who did not use these techniques (p less than 0.05). Conversely, subjects who stated that they attempted to reduce without a specific plan were less successful in reducing carbon monoxide levels (p less than 0.05).

Adult↗
PubMed1982

Contingent reinforcement for reduced carbon monoxide levels in cigarette smokers.

Expired air carbon monoxide (CO) was evaluated simultaneously as the target for a contingent reinforcement intervention to promote smoking reduction and as a measure of within-subject changes in recent smoking rates and patterns. Eleven volunteer smokers participated in a three-week study which utilized an A-B-A design. CO levels were measured on weekday afternoons between 3:00 and 4:30 p.m. and detailed self-report records of smoking were kept by subjects throughout the study. A monetary payment of +5.00 was available during study week 2 for CO readings which were 50% or less of the average reading obtained for that subject during study week 1. Contingent payment was withdrawn during study week 3. Three measures of smoking changed in an orderly manner during the study. CO readings were reduced from initial baseline levels during study week 2 but generally did not return to original baseline levels when the contingency was withdrawn. Number of daytime cigarettes recorded decreased and minutes of cigarette abstinence prior to the afternoon study contact increased during the contingent intervention period compared to baseline study phases. The average within-subject correlation between expired air CO level and number of daytime cigarettes was 0.67 (p less than 0.01), that between CO and time since last cigarette was -0.59 (p less than 0.05). Expired air CO appears to be an appropriate target for contingent reinforcement intervention as well as an objective measure which reflects rates and patterns of recent smoking in individual subjects.

Adult↗
PubMed1982

Short-term effects of oral methadone in methadone maintenance subjects.

In two experiments the physiologic and subjective status of methadone maintenance patients was assessed during the presumed peak (0 to 6 hr postmethadone) and during the presumed nadir of the daily methadone effect (18 to 30 hr postmethadone). In the first experiment physiologic and subjective responses were measured in seven ambulatory subjects at 2, 4, and 6 hr after a regular daily dose of methadone or placebo. In the second, physiologic measures were continuously monitored for 4 hr in six inactive seated subjects. In both studies, pupil diameter decreased after moderate to high methadone doses (35 to 80 mg). In the second experiment, heart rate fell and skin temperature rose significantly after methadone. Responses to the morphine-benzedrine group scale of the Addiction Research Center Inventory were elevated after methadone for most subjects in both studies, although there were individual differences in the magnitude and time course of this effect. Finally, low methadone maintenance doses of 10 and 20 mg/day had little or no effect on physiologic or subjective responses in two subjects. These studies showed that short-term effects of oral methadone can be readily detected during a 24-hr dosing regimen. The changes in function after the regular maintenance dose may result both from short-term opiate effects and relief of mild withdrawal.

Adult↗
PubMed1982

Contingent reinforcement for benzodiazepine-free urines: evaluation of a drug abuse treatment intervention.

This study evaluated contingent reinforcement for benzodiazepine-free urines as a therapeutic intervention for promoting reduced use of supplemental benzodiazepine drugs among methadone maintenance outpatients. Ten methadone maintenance patients were selected for participation on the basis of positive urinalysis results. During a 12-week intervention period these patients were offered clinic privileges, including monetary payments or methadone take-home doses, contingent on benzodiazepine negative urinalysis test results. Eight of ten participants responded to the intervention with at least 2.5 weeks of consecutive clean urines. An increase in benzodiazepine-negative tests during the contingent reinforcement period was significant for the group as a whole. The results suggest that more widespread application of contingent reinforcement procedures may be warranted in drug abuse treatment clinics.

Adult↗
PubMed1981

Human social conversation: effects of ethanol, secobarbital and chlorpromazine.

Effects of oral ethanol, secobarbital and chlorpromazine on human vocalization were studied in a dyadic social situation using repeated observations within subject pairs. Throat microphones and voice operated relays were used to measure quantitative aspects of vocalization (conversational speech) during daily experimental sessions. Ethanol (1-6 oz of 95-proof) and secobarbital (30-300 mg) produced dose-related increases in vocalization by the subject who received active drug, while vocalization by the partner who received placebo only was not generally altered systematically. Chlorpromazine (25-100 mg) produced dose-related decreases in amount of vocalization by the subject and vocalization by partners tended to decrease as well on days when the subject received active drug. Selected scales from the Addiction Research Center Inventory were administered following social sessions to assess subjective drug effects. No consistent changes on ARCI scales were obtained after ethanol or secobarbital, while chlorpromazine produced dose-related increases on the PCAG scale. Overall, quantitative measures of vocalization in a social context provided a reliable and sensitive indicator of dose-related drug effects.

Adolescent↗
PubMed1981

Diazepam use among methadone maintenance patients: patterns and dosages.

Methadone maintenance patients who use benzodiazepine drugs were interviewed about the dosage levels, patterns, frequency and motives for their use of these drugs. The sample was drawn from two treatment clinics, one in Baltimore (N = 12) and one in Philadelphia (N = 17). Benzodiazepine use was prevalent at both of these clinics - 65 -70% of maintenance patients had positive urinalysis tests during a single month. Ninety-three per cent of survey participants identified diazepam as the drug which they used most often. The median value of the usual daily dose was 40 - 45 mg; 31% reported usual daily doses between 70 and 300 mg and 62% had experience with doses of 100 mg and higher. The majority of the sample reported taking diazepam in a single daily dose within one hour of the time that they ingested their daily methadone; 72% of the sample indicated that diazepam boosts the effects obtained from the daily methadone dose. Another sample of addicts who reported extensive experience with both benzodiazepines and barbiturates indicated that diazepam increases the effects of methadone while barbiturates produce no change in the effects of methadone. Results of this study suggest that patterns and dosages of diazepam use among methadone maintenance patients are primarily abusive rather than therapeutic.

Adult↗