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Biomedical subjects

M Stitzer

Publications and source records attributed to M Stitzer.

At least 19 recordsLinked to original sources
PubMed2001

The effectiveness of incentives in enhancing treatment attendance and drug abstinence in methadone-maintained pregnant women.

This study examined the effectiveness of short-term contingency management for eliminating cocaine use and increasing full day treatment attendance with pregnant methadone-maintained women randomly assigned to either an escalating voucher incentive schedule (n=44) or non-incentive (n=36) conditions. Full day treatment attendance and urine toxicology for cocaine and heroin were assessed and consequated for 14 days. The escalating voucher incentive schedule significantly increased full day treatment attendance and drug abstinence compared to the non-incentive schedule. These results suggest that reinforcing the co-occurrence of two required behaviors (treatment attendance and abstinence from illicit drug use) is effective, and may be an important adjunct to methadone pharmacotherapy for treating pregnant drug dependent women.

Adult↗
PubMed1999

Contingent reinforcement sustains post-detoxification abstinence from multiple drugs: a preliminary study with methadone patients.

This study examined the efficacy of a urinalysis-based contingency management program for preventing relapse to abused drugs following a brief residential detoxification. Fourteen methadone maintenance patients who were chronic benzodiazepine users were enrolled in a 7-day inpatient benzodiazepine detoxification and randomly assigned to receive Contingency Management (N = 7) or Standard Care (N = 7) therapy upon return to outpatient methadone treatment. In the Contingency Management condition, a methadone take-home dose or a US $25 voucher (patient's choice) could be earned for each urine sample submitted on a Monday, Wednesday or Friday that was free of opiates, cocaine and benzodiazepines. Data analysis and interpretation focused on within-group post-hoc differences due to group differences on employment and legal status, potentially confounding baseline variables. Repeated measures analysis of variance showed that Contingency Management patients submitted significantly more drug-free urine samples during the intervention compared to pre-detoxification (p < 0.01), whereas no significance changes were observed from pre- to post-detoxification in the Standard Care patients. Employment and legal status of patients may have facilitated response to contingency management procedures, but did not prevent relapse when contingency management procedures were withdrawn. Overall, these preliminary results suggest that abstinence-based contingency management is a promising strategy for preventing relapse to multiple drugs of abuse in a subset of methadone maintenance patients when abstinence has been initiated through brief inpatient treatment.

Adult↗
PubMed1997

Smoking habits and attitudes in a methadone maintenance treatment population.

This study characterized smoking habits and attitudes about quitting in methadone maintenance treatment (MMT) patients, with attention to race and gender differences. Of 179 patients surveyed, 92% (n = 165) were current smokers. These patients reported smoking a mean of 24.8 cigarettes per day. Mean age at smoking initiation was 13.6 years with 53% starting at age 13 or younger. The mean Fagerstrom tolerance questionnaire (FTQ) score was 7.5. Blacks as compared to Whites smoked fewer cigarettes per day (21.6 versus 27.5), had lower expired CO levels (18.8 versus 21.6 ppm), but higher urinary cotinine levels (1812 versus 1419 ng/ml) and were more likely to smoke menthol cigarettes (95 versus 46%). Females scored higher than males on the FTQ measures of nicotine dependence (8.0 versus 7.2), and lower than males on a measure of quit smoking self-efficacy. Subjects in the sample as a whole were well aware of health risks of smoking, as indicated by high scores on health risk perception questions. Sixty-one percent (n = 110) of subjects planned to quit within the next 6 months, 57% were 'very interested' in an on-site quit smoking program and 80% expressed interest in using nicotine replacement products. Overall, these results indicate high rates of smoking in MMT patients, confirm within a drug abusing population prior findings of racial differences in smoking habits, and suggest that MMT patients are interested in quitting and in using nicotine replacement products. The data support feasibility of implementing smoking cessation treatments with this population in a setting that allows for convenient access to patients and close monitoring of progress.

Adult↗
PubMed1997

Sedative use disorders in opiate-dependent patients: association with psychiatric and other substance use disorders.

Opiate-dependent patients (N = 231), classified by sedative disorder status, were characterized according to DSM-IIIR on substance use and psychiatric disorders. Twenty-one percent currently (CUR+) had sedative use disorder, 39% had a history (HX+) of sedative use disorder, and 40% had no history (HX-) of this disorder. Several group differences were found. The HX+ and CUR+ groups had more lifetime drug use disorders (means = 4.5 and 4.3 vs. 3.2 in the HX- group), including alcohol, cannabis, stimulants, cocaine, and hallucinogens. In contrast, other psychiatric disorders (e.g., anxiety and depression) were low in prevalence and did not differ across groups, with the exception of a higher prevalence of antisocial personality disorder in the HX+ and CUR+ groups (39.6% and 38.5% vs. 17.9% in HX- group). The results suggest that sedative use disorder is related more to a severe spectrum of multiple substance abuse than it is to self-medication of underlying mood or anxiety disorders.

Adult↗
PubMed1980

Narcotics addiction treatment: behavioral methods concurrent with methadone maintenance.

Methadone maintenance patients were assigned among four treatment cells involving contingency management, emotionally-based behavior therapy, a combination of these, or a control condition receiving counseling but no behavioral treatment. With 60 patients who remained in treatment at least 6 months, treatment outcomes were compared using objective measures: hours employed, urinalysis results, and counseling participation. No significant differences were found between modalities. Case studies suggested that under appropriate conditions, contingency management might reduce illicit drug use. It is suggested that focused experimental studies may be more productive than broad clinical outcome evaluations.

Adult↗
PubMed1978

Contingency management in a methadone maintenance program: availability of reinforcers.

A survey was conducted to identify clinic privileges that might serve as reinforcers for a group of methadone maintenance clients. Fifty-three clients ranked nine clinic privileges according to their desirability. The opportunity to take medication home from the clinic on 4 days of the week was ranked as most desirable, on the average, followed by receiving cash payments ($30 and $10) and the opportunity for limited dosage self-control. Medication take-home privileges appear to be the most potent potential reinforcer available in the context of a methadone clinic.

Adult↗
PubMed1977

Drug-produced changes in human social behavior: facilitation by d-amphetamine.

The effects of oral d-amphetamine 5-30 mg on human social and verbal behavior were studied using repeated observations within subjects under a time-sampling observation procedure in a residential research ward. d-Amphetamine increased socializing in all three subjects studied, but only increased standing in one of the subjects. In the second experiment throat microphones and voice-operated relays were used to measure automatically quantitative aspects of dyadic verbal interactions during 1-hr daily sessions. Total speaking time showed dose-related increases in 5 of the 7 subjects receiving d-amphetamine. Adjective checklist self-report scores indicating stimulant drug effects were as sensitive and reliable as the speaking measure to the effects of d-amphetamine in these subjects. Speaking time also increased in 2 of the 8 partners who received placebo when the subjects with whom they were paired received d-amphetamine. This represents a socially mediated indirect drug effect. Adjective checklist scores of the partners receiving placebo were not changed when the paired subjects received d-amphetamine. Under controlled experimental conditions the naturalistic human behaviors of socializing and speaking are sensitive dependent variables for behavioral pharmacology research.

Adult↗
PubMed1977

Drug effects on fixed-interval responding with pause requirements for food presentation.

In pigeons performing under a multiple schedule of food presentation, low key-pecking rates (0.18 to 0.29 responses per second) were maintained during 3-min fixed-interval components by requiring a 4-, 5-, or 6-sec pause preceding the food-delivery response (tandem DRL), while higher rates (0.70 to 1.37 responses per second) were maintained in alternative fixed-interval components by requiring a pause of no more than 40 msec preceding the food-delivery response (tandem DRH). Thus, reinforcement density was equal but overall response rates markedly different in the two schedule components. Pentobarbital (3, 10 mg/kg) had effects on overall rates of responding consistent with a rate-dependency interpretation (low rates were increased while higher rates were decreased), but d-amphetamine (0.03 to 3 mg/kg) either failed to increase low overall rates in the tandem DRL components or increased them only slightly. Effects of both drugs on local responding within the fixed-intervals were always related in an orderly way to control response rate, but the extent of rate increases produced by d-amphetamine was modifed in some birds by pause requirements such that the drug increased comparable rates less when these occurred in the tandem DRL component than when they occurred in the tandem DRH components. Control rate is an important determinant of drug effects, independent DRH components. Control rate is an important determinant of drug effects, independent of reinforcement density maintaining rates, and independent of environmental influences, such as response-spacing requirements for food presentation, that can modify the extent of some drug-produced rate changes.

Animals↗