The influence of psychiatric comorbidity on the course and outcome in a nationwide representative sample (n = 351) of treatment-seeking substance users over a 28-month period was studied prospectively. The patients were administered the Diagnostic Interview Schedule and a questionnaire on drinking history. At 16 and 28 months after admission the patients returned a questionnaire on drinking history and mental health. In cases of those lacking information on either follow-up (45%), details on drinking status was obtained from informants. Completely abstinent were 16%. Generalized anxiety disorder and/or social phobia at the index admission predicted abstinence during the follow-up [odds ratio (OR) = 0.25], whereas onset of alcoholism among these patients after age 25 years predicted a worse prognosis (OR = 13.5). Also increasing number of social consequences related to abuse (OR = 1.3) and drinking more than the median (OR = 2.1) predicted a poor outcome. The abstinent group had significantly better mental health at follow-up. The patients with comorbid psychiatric disorders at admission were worse at follow-up. Although substance use disorders and comorbid psychiatric disorders have to a certain degree separate courses, there is nevertheless significant interaction between them. Early treatment and recognition of comorbid psychiatric disorders among substance abusers is necessary.
The use for hallucinogenic purposes of an indigenous mushroom, Psilocybe semilanceata indigenous to Britain is reported in three patients. Typical psychedelic, transient psychotic and more prolonged schizophrenia-like states were seen, with sympathomimetic signs noted in two cases, in one being prolonged. Enquiry about such mushroom abuse should be considered in individuals presenting to medical or psychiatric emergency clinics.
Statistical associations between substance use and seroconversion among gay and bisexual men abound. However, these associations often ignore men's own interpretations of their seroconversion. Using in-depth interviews with gay and bisexual men who reported using drugs or alcohol at the time of their seroconversion, we identify how these men explain the events that led to HIV transmission. Whereas a small minority of respondents reported substance use to explain their seroconversion, the majority reported three competing explanations. These participants claimed that they lacked sufficient knowledge about the behavioral risks that led to their seroconversion; that their decision to engage in unsafe sex was because of negative personal affect; and that they "trusted the wrong person." We link these findings to prevention and suggest that gay and bisexual men who use substances for recreational purposes will benefit from prevention efforts designed to address issues of gay and bisexual men rather than substance-using men.
On the basis of the experience gained in the treatment of patients who are drug addicts a complex treatment-and-rehabilitation programme has been developed and adopted. It is a psychotherapeutically--oriented programme that includes the following steps: selection of patients, promotion of health of the family, staging, participation of social workers--former patients. The end objective is to achieve a lasting remission in addicted patients, promotion of health of their relatives and normalization of family relations. Such an approach to solving the problem differs from nonmedicamentous methods widely employed now in the Ukraine and UIS republics, which have not been associated with demonstrable effects in treatment and, more important, rehabilitation of addicted persons.
This exploratory study evaluated the benefits of adding auricular acupuncture to a 21-day outpatient structured psychoeducational treatment program for women with concurrent substance use problems, anxiety, and depression. Women receiving acupuncture (n = 185) reported having reduced physiological cravings for substances, felt significantly less depressed, less anxious, and were better able to reflect on and resolve difficulties than women in the control group (n = 101). It was found that auricular acupuncture, as an adjunct therapy to a comprehensive psychoeducational treatment program for women with addictions, shows promise in being an effective, more viable treatment alternative to anxiolytics.
This article explores the lived experiences of individuals who have participated in faith-based substance user rehabilitation programs in the Russian Federation. The Russian Federation has high rates of alcohol and opioid dependence and a dearth of professional treatment options. In the post-Soviet period, Evangelical Christian groups have developed substance user rehabilitation programs to attempt to address substance use and its related problems. Data were collected during 2010 via focus group interviews with participants in three Evangelical rehabilitation programs in the Volga region of the Russian Federation. Themes emerging from the qualitative data analysis process were classified into three broad categories: Typical Day, Personal Background/Decision to Enter Rehabilitation, and Helpful Aspects of Rehabilitation Process.
Erratum In: Subst Use Misuse. 2013 Sep;48(12):1218
Forty-nine women who attended a surgical emergency department after being battered are the subjects of this prospective study. The childhood and adolescence of the women had been marked by abuse and violence in the parental home. Most of the women had suffered prolonged, repeated battering. Fifty-one per cent of the women and 88% of their male assailants were considered to be heavy consumers of alcohol and in over half of the cases of battering both the man and the women had been drinking. In most cases the women's own children were present when the mother was beaten. One third of the women stated that they were highly dependent on the man in question emotionally. It is concluded that social heredity, heavy consumption of alcohol and emotional dependence on the male assailant are major reasons for the woman's inability to break away from a relationship characterized by repeated battering.