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Results for “Behavior, Addictive”

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PubMed2006

Changing patterns of addiction and public aid receipt: tracking the unintended consequences of welfare reform.

Sharp declines in welfare rolls since the passage of welfare reform legislation have led many to label it a social policy success. Using data from prereform and postreform samples of welfare applicants and recipients, as well as ethnographic data on welfare reform implementation, we examine three hypotheses based on concerns raised during the welfare reform debate about the possible effects of new policies on substance abusers and addicts: First, they would be "scared off," or discouraged from applying to aid by welfare's new requirements surrounding work and treatment. Second, they might be "weeded out," or face discrimination in the application process because of concerns about the difficulty of moving them successfully from welfare to work. Third, they might be "bumped down," or shifted to local aid programs rather than moving from welfare to self-sufficiency. Our empirical analysis finds no evidence of scaring off or weeding out, and some evidence of bumping down. Using ethnographic data, we offer some possible explanations for these findings by placing them in the context of policy change and implementation in the years following welfare reform.

Adult↗

PubMedDate not supplied

Development and validation of the drug-taking confidence questionnaire: a measure of coping self-efficacy.

The Drug-Taking Confidence Questionnaire (DTCQ; Annis & Martin, 1985) is a 50-item self-report questionnaire developed to assess situation-specific coping self-efficacy for use of a particular substance of abuse (e.g., cocaine, heroin, alcohol, cannabis, etc.). Results from exploratory and confirmatory factor analyses of the DTCQ on 713 clients seeking treatment at an addiction treatment facility provided strong evidence for the situation-specificity of efficacy beliefs. An 8-factor first-order model, based on the eight high-risk categories for relapse identified by G.A. Marlatt (Marlatt & Gordon, 1980) and a 3-factor second-order model (i.e., negative situations, positive situations, and temptation situations) provided the best fit to the data. All eight subscales of the DTCQ were shown to have good reliability (alphas .79 to .95). Extensive convergent and discriminant validity analyses for the DTCQ and its subscales in relation to ADS, DAST, OES, DRIE, SCQ, SCL-90R, BDI, HS, and SOCRATES substantiate that the DTCQ is a promising tool for further research and clinical application.

Adaptation, Psychological↗

PubMed1997

Development of a therapeutic vaccine for the treatment of cocaine addiction.

No pharmacotherapies have yet been approved for the treatment of cocaine addiction. One new approach is to block the effects of cocaine with anti-cocaine antibodies induced by a therapeutic cocaine vaccine. A cocaine vaccine has been developed which induces a cocaine-specific antibody response in rodents. The antibody binds to cocaine in the circulation and can be shown to inhibit the ability of cocaine to enter the brain. Furthermore, anti-cocaine antibody can inhibit cocaine self-administration in rats. These data suggest that a cocaine vaccine may be a powerful therapeutic tool. The intent is to immunized motivated patients with the vaccine as part of a comprehensive treatment program. If the patient uses cocaine after being vaccinated, the antibody will inhibit the reinforcing activity of cocaine and decrease the likelihood of relapse.

Animals↗

PubMed2004

The near-universal experience of regret among smokers in four countries: findings from the International Tobacco Control Policy Evaluation Survey.

Regret may be a key variable in understanding the experience of smokers, the vast majority of whom continue to smoke while desiring to quit. We present data from the baseline wave (October-December 2002) of the International Tobacco Control Policy Evaluation Survey, a random-digit-dialed telephone survey of a cohort of over 8,000 adult smokers across four countries--Canada, the United States, the United Kingdom, and Australia--to estimate the prevalence of regret and to identify its predictors. The proportion of smokers who agreed or agreed strongly with the statement "If you had to do it over again, you would not have started smoking" was extremely high--about 90%--and nearly identical across the four countries. Regret was more likely to be experienced by older smokers, women, those who had tried to quit more often, those who perceived quitting as conferring benefits, those with higher levels of perceived addiction, those who worried about future damage to health, those who perceived smoking as lowering their quality of life, those who perceived higher monetary costs of smoking, and those who believed that smoking is not socially acceptable. This predictive model was the same in all four countries. Regret is thus a near-universal experience among smokers in all four countries, and the factors that predict regret are universal across these four countries. Among other implications for cessation treatment and smoking prevention, this near universality of regret casts doubt on the view of some policy analysts and economists that the decisions to take up and continue smoking are welfare-maximizing for the consumer.

Adult↗

PubMed1998

Money as a tool to extinguish conditioned responses to cocaine in addicts.

Classical conditioning principles offer a nondrug way to treat cocaine dependence. Eleven male subjects with the primary diagnosis of cocaine dependence were placed into one of two groups. The experimental group was asked to handle $500 cash in a mock budgetary task. The control group was asked to just imagine handling and budgeting the money. The subjects rated their craving-related feelings before and after each task. The experimental group showed significantly more craving after the money-handling task as compared to the control group, and the scores improved with time and as more tasks were completed. These data show that craving induced by handling cash is powerful and can be attenuated, at least on a short-term basis, using classical extinction procedures.

Analysis of Variance↗

PubMed2006

New paradigms and tools in drug design for pain and addiction.

New modalities providing safe and effective treatment of pain, especially prolonged pathological pain, have not appeared despite much effort. In this mini-review/overview we suggest that new paradigms of drug design are required to counter the underlying changes that occur in the nervous system that may elicit chronic pain states. We illustrate this approach with the example of designing, in a single ligand, molecules that have agonist activity at mu and delta opioid receptors and antagonist activities at cholecystokinin (CCK) receptors. Our findings thus far provide evidence in support of this new approach to drug design. We also report on a new biophysical method, plasmon waveguide resonance (PWR) spectroscopy, which can provide new insights into information transduction in G-protein coupled receptors (GPCRs) as illustrated by the delta opioid receptor.

Behavior, Addictive↗

PubMed2004

Perceptions about cigarette smoking and risks among college students.

The objective of the present study was to describe how college students perceive the risks of cigarette smoking and addiction to nicotine. Data came from a self-administered survey of 1,020 college students enrolled in two 4-year liberal arts colleges in the United States. The survey was conducted in the fall of 2001. Smokers and nonsmokers differed markedly in their perceptions about the health risks associated with short-term exposure to smoking. College students in this sample who smoked did not fully comprehend the risks associated with smoking. Smokers were half as likely as nonsmokers to believe that there are health risks from smoking only on weekends or a couple of days a week. Anti-tobacco messages for young adult smokers need to communicate more effectively the concept that each cigarette they smoke is doing them damage.

Adult↗

PubMedDate not supplied

Metacognition and substance use.

Metacognition has been defined as cognition about cognition. Metacognition can include beliefs and attitudes about cognitive events such as thoughts, feelings, memories, images, sensations, and perceptions. Cognitive models of addictions have addressed the role of beliefs and attitudes in substance misuse, but the role of metacognition has been neglected. Metacognitive effects (beliefs about the effect of psychoactive substances on cognition) is differentiated from metacognitive consequences (beliefs about the effect of refraining from psychoactive substances on cognitive experience). In this study of 20 types of cognitive experience in 108 treatment-seeking substance abusers, the major metacognitive effects of drugs and alcohol were reduction, detachment from, and intensification of the cognitive event. The major metacognitive consequences of not consuming a substance included beliefs that the cognitive experience would be too uncomfortable, sleep would be disturbed, persistence of the cognitive event, and intensification of the cognitive event. An interaction between metacognitive effects and consequences and the type of cognitive event was found.

Adult↗

PubMed2005

Screening for Internet addiction: an empirical study on cut-off points for the Chen Internet Addiction Scale.

The aim of this study was to establish the optimal cut-off points of the Chen Internet Addiction Scale (CIAS), to screen for and diagnose Internet addiction among adolescents in the community by using the well-established diagnostic criteria of Internet addiction. This survey of 454 adolescents used screening (57/58) and diagnostic (63/64) cut-off points of the CIAS, a self-reported instrument, based on the results of systematic diagnostic interviews by psychiatrists. The area under the curve of the receiver operating characteristic curve revealed that CIAS has good diagnostic accuracy (89.6%). The screening cut-off point had high sensitivity (85.6%) and the diagnostic cut-off point had the highest diagnostic accuracy, classifying 87.6% of participants correctly. Accordingly, the screening point of the CIAS could provide a screening function in two-stage diagnosis, and the diagnostic point could serve as a diagnostic criterion in one-stage massive epidemiologic research.

Adolescent↗

PubMedDate not supplied

Long-term alcohol self-administration with repeated alcohol deprivation phases: an animal model of alcoholism?

In order to study the neurobiological and molecular mechanisms of alcohol dependence and addiction, appropriate animal models are warranted. Although animal models cannot incorporate all aspects and criteria of an addictive behaviour to alcohol seen in human alcoholics, they can at least reflect some of the criteria given in the fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association (1994). Novel aspects of addictive behaviour to alcohol, craving and relapse might be uncovered by animal models of long-term, free-choice, alcohol self-administration followed by alcohol deprivation phases. After several months of voluntary alcohol consumption, the drug-taking behaviour following a deprivation (withdrawal) phase is characterized by increased alcohol intake and preference (alcohol deprivation effect) and changes in alcohol intake patterns where animals consume large amounts of highly concentrated alcohol solutions even at inappropriate times (e.g. during the inactive light phase when drinking activity is minimal). Altogether, alcohol drinking following alcohol deprivation seems to become uncontrolled and inelastic, reflecting an incentive demand for the drug in such a model. Furthermore, the alcohol deprivation effect outlasts very long abstinence phases, which indicates the persistence of a drug memory for alcohol.

Alcohol Drinking↗

PubMedDate not supplied

Low (40 mg) versus high (80 mg) dose methadone in a 180-day heroin detoxification program.

Methadone Transition Treatment (MTT) is a treatment program for opioid-addicted individuals that takes advantage of a 1989 change in federal guidelines permitting the establishment of 180-day detoxification programs. Thirty-eight subjects were assigned to either high-dose (80 mg) or low-dose (40 mg) methadone in a double-blind design. Both conditions showed initial dramatic decreases in illicit drug use and distress symptoms (opioid craving, withdrawal symptoms, and dysphoria). The high-dose condition showed a nonsignificant trend toward less frequent illicit drug use during the period of stable methadone dosing. We speculate that intensive psychosocial treatment, including weekly individual counseling and three-times a week group therapy, may have dampened outcome differences between high- and low-dose methadone conditions. Treatment retention was high for both dosage conditions.

Adult↗

PubMed2003

Patterns and correlates of Gamblers Anonymous attendance in pathological gamblers seeking professional treatment.

Although Gamblers Anonymous (GA) is a popular intervention for gamblers, many attendees later present for professional treatment. This study evaluated gambling and psychosocial problems in individuals seeking professional treatment for gambling and compared those with and without a history of GA attendance. At intake to treatment, 342 pathological gamblers completed the Addiction Severity Index (ASI) and South Oaks Gambling Screen (SOGS). Fifty-four percent attended GA previously. Compared to non-GA attendees, GA attendees were older, had higher incomes, and were less likely to be single. They had higher SOGS scores, more years of gambling problems, and larger debts. GA attendees also had more serious family conflicts and less serious drug problems. Individuals with a history of GA attendance were more likely to be abstinent from gambling 2 months after treatment initiation. Logistic regression revealed that the number of professional sessions and GA meetings attended during treatment was independently associated with short-term abstinence. These data suggest that individuals entering professional treatment for gambling with a history of GA attendance differ from those who do not, and these differences may impact treatment recommendations and outcomes.

Adult↗

PubMed2000

A controlled trial of daily versus thrice-weekly buprenorphine administration for the treatment of opioid dependence.

This study was aimed at determining whether thrice-weekly administration of buprenorphine is as effective as daily administration for treating opioid dependence. A total of 60 treatment-seeking opioid addicts were randomly assigned to take buprenorphine tablets sublingually either every day (8 mg) or thrice-weekly (16 mg on Mondays and Wednesdays and 24 mg on Fridays) over the course of a 12-week, double-blind, parallel trial. The buprenorphine dosing schedule had no significant effect on treatment retention. The rates of opioid-positive urine tests were significantly higher among those subjects who were given buprenorphine thrice weekly (58.5%) than among those who took it daily (46.6%). An analysis of the completers did not detect a significant effect of buprenorphine dosing schedule. The results obtained in our clinical trials indicate the advisability of daily doses of buprenorphine, at least at the beginning of a maintenance programme.

Adult↗

PubMed1994

The reliability and construct validity of two measures of addictive personality.

Gossop and Eysenck developed a subscale of the EPQ that discriminates between drug addicts in treatment and nonaddicts. They called this scale the Addiction Scale (AS). Previously, MacAndrew developed an Alcoholism Scale (MAC) by comparing alcoholics and nonalcoholic psychiatric patients' responses on the MMPI. In the present report both scales were completed by 615 men and 642 women as part of the Winnipeg Health and Drinking Survey, a longitudinal study of personality and health. The reliability of both scales is quite low, .64 for the AS and .57 for the MAC. Correlations with other personality measures indicate that the MAC is more associated with extraversion-related characteristics whereas the AS is more associated with neuroticism-related factors. The AS was not associated with the level of smoking, and the MAC was correlated with smoking for men only. Both scales were significantly correlated with various drinking measures, and the correlations were slightly higher for the MAC.

Adult↗

PubMed2003

Neurophysiological evidence for abnormal cognitive processing of drug cues in heroin dependence.

RATIONALE: Recent studies provide evidence for specific aspects of cue processing in addictive disorders. OBJECTIVE: The present study employs event related potentials (ERPs) to investigate heroin related visual information processing. METHODS: Neutral and heroin related pictures were presented to 19 male abstinent heroin dependent patients and 14 male healthy controls. RESULTS: Patients exhibited larger slow positive wave (SPW) components of the ERP on heroin related pictures than on neutral pictures. Within healthy control subjects there was no difference on the SPW between neutral and heroin pictures. Within heroin dependent patients, mean SPW response to heroin pictures was correlated with post-experiment craving. CONCLUSION: This study provides neurophysiological evidence that information processing of drug-related information is abnormal in heroin dependent patients. The results provide further evidence for the cognitive and neurobiological accounts of substance dependence such as the incentive-sensitization theory.

Behavior, Addictive↗

PubMed2000

What does cue-reactivity have to offer clinical research?

This paper examines the application of the cue-reactivity paradigm as a means of studying alcohol dependence in clinical populations. Three main areas of application will be examined: cue-reactivity as a means of understanding the nature of alcohol dependence; cue-reactivity as a predictor of relapse; and cue-reactivity as a method of studying treatment effects. The study of cue exposure and cue-reactivity has a long history but it is only relatively recently that the potential of cue-reactivity as a means of understanding and treating addictive behaviours has been studied in depth. The principal advantage of cue-reactivity over other existing paradigms to study addictive behaviour is in having a solid basis in widely studied general theories of behaviour. Cue-reactivity also provides a means of measuring and unpacking the concept of craving. Craving has long been believed to represent the underlying basis for addictive behaviour, and in the majority of research studies craving has been conceptualized and measured in relatively simplistic ways. Craving has generally been viewed as a unitary phenomenon and measured using self-reported questionnaires. Such approaches have had limited explanatory value, particularly in recent psychopharmacology research. There is clearly a need to develop new paradigms to study the effects of pharmacological agents aimed at attenuating drinking behaviour. It is in this area that cue-reactivity currently offers the greatest potential. In particular, the cue-reactivity paradigm draws an important distinction between cue mediated craving and withdrawal craving. This can be viewed as similar to the distinction between generalised anxiety and anxiety provoked by phobic stimuli. However, while much is now known about the phenomenon of cue-reactivity, several aspects require further elucidation and research investment.

Alcohol-Related Disorders↗

PubMed2005

Responses to positive and negative smoking-related images: effects of current smoking status and degree of smoking addiction.

The literature indicates that stimulant users of various dependency levels endorse and react differently to stimuli that portray the stimulant either positively or negatively, however these studies have not been extended to smoking. Here pictures are used to depict either positive or negative connotations of smoking. The current study concentrated on smokers with different levels of dependency. Seventy-three digital images were rated on both a smoking and emotional content scale. The pictures were rank ordered, yielding the 10 most positive and negative smoking-related pictures. Emotional content scores for these pictures were also recorded. Data from 148 subjects [light- (n=28), heavy- (n=17), ex- (n=32) and never-smokers (n=71)] were analysed. Using a mixed factorial ANOVA light- and heavy-smokers were found to score positive pictures significantly more positive than the never-smokers, they did not vary on negative or emotional ratings. Thus positive pictures did not distinguish heavy and light levels of substance use as suggested by the literature and this was not influenced by emotional content.

Adult↗

PubMedDate not supplied

Economic modelling of the gateway effect.

Although a significant number of empirical studies provide evidence of sequencing in drug use, economic theory remains focused on addiction to a single substance. This paper presents a general model of substance use that allows for the possibility of multi-commodity habit formation and can be used to analyse the intertemporal relationship between the consumption of legal and illicit drugs, or the gateway effect. A simple two-drug model is analysed and conditions for the existence of multi-commodity habit formation are examined. It is found in the case of multi-commodity habit formation that the marginal utility of initiating a new drug is higher when there is prior consumption of the other drug. Further, it is found that the individual will initiate drug consumption with that drug that has the lowest marginal cost. The particular sequencing of drug use that is observed in empirical data is explained by differences in the marginal cost of consuming legal and illegal drugs.

Alcoholism↗