This article reviews epidemiological, neurological, cognitive, and imaging data on alcohol-induced dementia. Recent studies indicate that "heavy alcohol use" (variously defined) is a contributing factor in 21-24% of cases of dementia. Research difficulties include lack of positive diagnostic criteria, few post-mortem studies, and no accepted pathological mechanism. Sulcal widening and ventricular enlargement (occasionally reversible) are the strongest findings in patients with alcohol-induced dementia. There is evidence for peripheral neuropathy, ataxia, sparing of language, and improved prognosis when patients with alcohol-induced dementia are compared to other dements. Case examples, etiologic theories, and recommendations for research, training, and clinical practice are included.
A random sample of 1,200 employees of a steel manufacturing plant were randomly assigned to four different self-report methods of assessing illicit drug use: 1) Individual interview in the workplace, 2) group-administered questionnaire in the workplace, 3) telephone interview, and 4) individual interview off the worksite. Urine specimens were collected and analyzed on all 928 subjects participating in the study, and hair analysis was conducted on 307 of the subjects. Although self-reports produced the highest drug use prevalence rate, analyses combining the results of the three assessment methods showed that the actual prevalence rate was approximately 50% higher than the estimate produced by self-reports. The group-administered questionnaire condition produced prevalence rates that were roughly half those of the other self-report methods. The findings cast doubt on the validity of self-reports as a means of estimating drug use prevalence and suggest the need for multiple assessment methods.
The influence of religious values and religious affiliation on alcohol and drug use among American college students living in Germany is examined. Religious affiliation differentiates among Protestant, Catholic, and nonaffiliated groups for reported high school alcohol use but not for collegiate alcohol consumption. Groups defined by the importance of religious values differ on reported high school and college alcohol and drug use. Implications for prevention and future research are discussed.
Adaptation of therapeutic communities (TCs) for new clients and in different settings has resulted in a diversity of programs with unique treatment protocols and different planned duration of stays. The extent to which the various adaptations retain the essential elements of the TC model is not known, and moreover, casts questions about the general effectiveness of the therapeutic community modality. This paper outlines a theoretical framework of the addiction TC to advance research and guide training, practice, and program development. The essential elements of the TC are organized into four areas: its perspective, treatment approach, program model, and the treatment process. Some implications of a TC theory, model, and method are discussed in terms of research, treatment, and policy issues.
The purpose of this article is to test the effects of predictive and situational factors on alcohol use among a sample of rural youth. Five predictive factors accounted for 57% of the variance in frequency of alcohol use among the total sample, based on stepwise regression analysis. The predictive factors also accounted for 38% of the variance in frequency of drinking when the regression analysis was restricted only to those who drink. Controlling for these and entering situational factors into the regression analysis accounted for an additional 16% of the variance. Six situational factors were statistically significant, five of which concerned various locations for drinking.
(1995). Issues in Treatment Process and Services Research. International Journal of the Addictions: Vol. 30, No. 7, pp. 875-879.
Based on surveys and clinical data, it is concluded that the use of illegal drugs is spreading in Hungary. The social composition of drug users is changing and new forms of drugs and uses have appeared, such as heroin use and cocaine snorting. The legal regulation of access to drugs changed in 1993: stricter sentences can be imposed on drug traffickers, while the possibility has been created for drug users to undertake therapy in place of punishment. The Interministerial Committee on Drug Affairs and the Hungarian Association on Drug Use and Addiction have been set up. There are a few scientifically-based prevention programs. A number of clear paradigms have emerged in prevention policy and therapy, although it is not yet possible to see which of these will be confirmed by time and practice.
Analysis of Canadian data from the 1989 National Alcohol and Drugs Survey was used to identify profiles of alcohol and other drug-using behaviors among Canadian women of different ethnic or cultural groups. The profile considered 110 different substance use variables including alcohol or drug type used, quantity, frequency, drinking or drug-taking circumstances, beverage preference, reasons for drinking or not drinking, and opinions regarding appropriate drinking or drug-taking behavior of Canadian women who described themselves as belonging to the "Canadian," French, English, German/Dutch, Irish, Scottish, Ukrainian/Polish, Italian/Portuguese, and "Other" (Chinese, Jewish, and "Other") ethnic or cultural groups. Alcohol, tobacco, and drug use behavior was found to differ by ethnocultural group. Further, each ethnocultural group was found to differ from the national average. The amount of difference between the national average and each ethnocultural group was related to the period of arrival and the length of time that an ethnocultural group has been present in Canada. The degree of similarity or difference between each ethnocultural group and the mainstream national average for alcohol, tobacco, and drug use and drug-use behavior may be used to measure the degree of social integration of each ethnocultural group and the degree of acculturation of women of specific ethnocultural groups into mainstream Canadian society.
In a sample of 99 male alcoholics at an alcoholics' rehabilitation clinic we recorded drinking/abstinence behavior and depression up to 1 year after discharge. Seventy-eight patients completed the inpatient therapy, and of these, 39 respondents were recorded up to the final follow-up point. Generally, the initial, markedly elevated depression scores had declined significantly by the end of the inpatient treatment. In the abstainers, the depression scores continued to fall after release and remained low throughout the entire observation period. In patients who resumed alcohol use, relapses were accompanied by immediate, sharp increases in the scores, but declined upon a return to abstinence.
This paper reports outcome evaluation results of an AIDS education program for drug-using women in jail, of whom the majority were current drug injectors, had high-risk sexual partners, and never used condoms for insertive sex. The women participated in four small-group health/HIV education sessions. Education participants and controls were followed-up 7 months after their release from jail; the two groups did not differ significantly on drug- or sex-related HIV risk behaviors at follow-up. However, being in drug dependency treatment (primarily methadone maintenance) at follow-up was associated with reduced heroin use, crack use, drug dealing, and criminal activity. Although improved HIV education in jail is important, better networks of community resources, including more accessible community drug dependency treatment, also must be developed to support drug-dependent women after their release from jail.
An eighteen-item Addiction Belief Scale (ABS) was developed to assess strength of belief in the disease versus free-will model of addiction (alpha = .91). Factor analysis of the ABS revealed three dimensions to the disease-model controversy of addiction. These include beliefs regarding personal power (subscale alpha = .91, n = 274), dichotomous thinking (subscale alpha = .83, n = 285), and addiction as a way of coping with life (subscale alpha = .47, n = 286). A discussion of scale analysis and suggestions for application of the ABS as a clinical and research instrument are presented.
The Addiction Severity Index (ASI) was evaluated for its psychometric qualities in a Dutch alcoholic population admitted to an addiction treatment center in The Netherlands. Its factorial structure in this population was found to be consistent with the established six factor structure of the ASI. Reliability analysis revealed that the homogeneity of the subscales was acceptable with the exception of the Alcohol Scale. The six subscales were not highly intercorrelated. The results of this study indicate that the ASI is a useful instrument for the assessment of several problems associated with alcoholism. However, the Alcohol Scale appears to;be limited as a diagnostic and research instrument in the field of inpatient treatment of alcohol dependence in The Netherlands.
Debates over the prevalence of elderly illicit drug addicts in the population divert our attention from this group as a viable study population. Due to their decelerated lifestyle, low crime rates, and our attitudes toward the elderly as nonstreet drug users, they are likely to remain hidden from the public eye. This paper reviews past trends in drug misuse among the elderly, the lifestyle of those addicted to drugs, the complications associated with drug misuse and aging, and the problems that the elderly face with traditional treatment programs. Given our aging society, is the study of elderly street addicts and users an important area of concern?
Consecutive admissions (N = 843) to the Brecksville Veterans Addiction Recovery Center with a primary diagnosis of pathological gambler, alcoholic, or cocaine misuser were compared for differences on impulsivity, sensation seeking, and craving. In contrast to alcoholics and cocaine misusers, gamblers scored significantly higher on impulsivity and inability to resist craving; however, gamblers were not significantly higher than either alcoholics or cocaine misusers on sensation seeking. These findings suggest a need to address high impulsivity and inability to resist cravings in treatment and relapse prevention for gamblers.
This study analyzed the responses of 391 Mexican-Americans (44.9% males) and 531 Central Americans (40.2% males) who were between 21 and 65 years of age and resided in San Francisco, California. In general, Mexican-Americans were found to have a lower proportion of abstainers (56.8%) than Central Americans (64.4%). Mexican-Americans reported drinking more often and in greater quantities than Central Americans, and the proportion of "high" drinkers was higher among Mexican-American men and women than among the Central American respondents. Despite this diversity in the topography of alcoholic beverage consumption between Mexican-Americans and Central Americans, the role of gender and acculturation on shaping those variables was fairly consistent across groups. The acculturation level of the respondents was found to significantly affect the proportion of abstainers in both groups. Furthermore, gender was an important determinant of frequency, total number of drinks, and volume of drinking for Mexican-Americans and for Central Americans.
The first general population mail survey of the prevalence of drug use in Finland was conducted in 1992. The data consisted of 3,457 responses with a response rate of 70.7%. The persons surveyed were from 18 to 74 years old. These data are supplemented with data about "problem use" of drugs in Finland, which is mostly characterized by the mixed use of medicines (also medicines containing opiates) and alcohol. There were clear signs of an increase in the mixed use during the last few years. During the last year cannabis was used by 1% of the population. The use of opiates and amphetamines was very limited, and there had not been any special changes in their use. According to the statistics of social and health welfare sources, the need for services caused by the use of drugs had been only about 1% of the whole intoxicant (mostly alcohol) problem during the past few years.
A quasi-longitudinal, retrospective survey was used to examine the relationship of Greek affiliation and intensity of drinking in college. Explanations of higher levels of drinking among Greeks usually revolve around subcultural support, differential association, and reference group behavior. That is, association with pro-drinking students in a drinking subculture increases the members' drinking level. In this study, students' high-schooling drinking patterns were used to partially explain the decision to join Greek groups in order to continue prior drinking habits. Greek affiliation was found to serve as both a facilitating and enhancing factor in collegiate alcohol use.
