Clients in Treatment for Alcohol Problems: Treatment Experiencesand Outcomes

This report presents an analysis of National Treatment Improvement Evaluation Study data describing the characteristics and treatment experiences of clients entering treatment for alcohol problems. Three client groups were contrasted—those entering treatment for alcohol only, for alcohol plus other drugs, or for other drugs only. Clients using alcohol only were more often white, male, and currently employed. Alcohol only clients were treated predominantly in outpatient settings. Alcohol only clients were frequently referred to treatment by the criminal justice system, and less often self-referred. In all 3 study groups, employment, general health, and mental health outcomes were improved following treatment. Illicit drug use increased marginally for the alcohol only group following treatment. No significant posttreatment reductions in reports of total abstinencefrom alcohol were found for any of the groups. Findings are discussed as they relate to research, treatment practice, and policyareas.     

Treatment Populations,Services, and Outcomes for Cocaine and Crack-Cocaine Dependence

This paper analyzes demographic and other pretreatment characteristics, measures of treatment services received, and treatment outcomes of participantsin the National Treatment Improvement Evaluation Study (NTIES), a large-scale longitudinal study of substance abuse treatment (D. R. Gerstein et al., 1997; R. A. Johnson & D. R. Gerstein, 2000). The focus here is those treated primarily for cocaine powder or crack-cocaine dependence, compared with those in treatment for other substances, particularly heroin. Crack-dependent users tend to be female and black, older than primary marijuana or alcohol users but younger than those in treatment for heroin. Primary cocaine powder or crack users are likely to have entered treatment under pressure from the criminal justice system. After treatment there are substantial reductions in use of cocaine powder and crack, especially among participants with fewer prior treatment episodes and lower pretreatment intensity of use. Longer duration and intensity of treatment result in greater reductions in cocaine and crack use.     

Training of practitioners and beliefs about family skills in family-based prevention programmes

To ensure close adherence to the contents of a family-based cognitive-behavioural programme, and maintain a high standard of quality in its implementation, it is important that practitioners’ attitudes and beliefs regarding family skills coincide with those of the programme. This paper describes and analyses (observed) potential changes in these beliefs, after training courses held prior to the application of a prevention programme for families: the Family Competence Programme. A questionnaire was devised to examine practitioners’ beliefs regarding family skills; and completed both before and after the training course. The results point to significant changes in family dynamics, realistic expectations and active listening. Thus, it can be demonstrated that preliminary training courses promote practitioner attitudes and beliefs which are more coherent with a subsequent programme’s approach.     

干预胆碱M受体对药物成瘾的影响及其与多巴胺的关系

药物成瘾是一类精神及行为障碍, 涉及到中枢神经系统的病变。毒蕈碱受体(Muscarinic receptor, M受体)属于胆碱能受体, 分5种亚型。行为学研究表明, 干预M受体能有效影响药物成瘾行为, 但其神经机制还亟待探索。阿片类药物与精神活性药物均能激活中枢多巴胺系统, 而M受体与多巴胺系统在多个脑区产生了交互作用。其中激动M2及M4受体抑制了多巴胺系统功能, 而激动M5受体增强了多巴胺系统功能, 与干预M2、M4、M5受体对药物成瘾行为的影响相对应。以上证据提示, 干预M受体可能通过影响多巴胺系统对药物成瘾起作用。     

反义寡核苷酸--新型抗菌药物的曙光

细菌耐药性是一个严重的医学问题,并由于数量增加的耐药菌对多种结构无关的药物产生耐药而又无新的抗生素可使用而加剧.反义寡核苷酸可特异性抑制或下调同源基因表达,从而能成为基因治疗的首选药物.多年的研究表明:反义寡核苷酸能够有效抑制细菌代谢的基础酶类及致病基因;但也存在着一些尚未完全解决的问题.建议以科学哲学的方法论和系统方法为指导,展开多学科联合的科学活动,推动新型抗菌药的研发,使基因治疗早日实现.     

Drug Tolerance, Drug Addiction, and Drug Anticipation

ABSTRACT— Environmental cues associated with drugs often elicit withdrawal symptoms and relapse to drug use. Such cues also modulate drug tolerance. The contribution of drug-associated stimuli to withdrawal and tolerance is emphasized in a Pavlovian-conditioning analysis of drug administration. Conditional responses occur in the presence of cues that have been associated with the drug in the past, such as the setting in which the drug was taken. These conditional responses mediate the expression of tolerance and withdrawal symptoms. Recently, it has become apparent that internal predrug cues, as well as environmental cues, elicit pharmacological conditional responses that contribute to tolerance and withdrawal. Such internal cues include cognitive or proprioceptive cues incidental to self-administration, drug-onset cues that are experienced shortly after administration, and emotional cues. According to the conditioning analysis, addiction treatment should incorporate learning principles to extinguish the association between stimuli (environmental and internal) present at the time of drug administration and the effects of the addictive drug.     

颅脑手术戒毒的哲学与伦理思考

颅脑手术戒毒这项新的医疗技术在社会上引起很大反响,最近被卫生部紧急叫停.从颅脑手术戒毒的历史、存在的问题、哲学及伦理方面进行反思是有必要的.把一项临床科研项目直接变换成一项临床服务项目,既未经严格科学论证也不符合伦理与法规要求.     

积极心理学在戒毒人员团体辅导中的应用

戒毒人员的心理干预与矫治正日益受到重视。积极心理学关注人们发掘自身的积极品质和积极力量,戒毒人员同样拥有的积极力量。本研究对上海市某强制隔离戒毒所的戒毒人员开展了以积极心理学为理论基础的团体心理辅导。团体辅导之后,实验组在正性情感和乐观上的得分都显著高于团体辅导前,对照组在团体辅导前后则没有显著变化。可见,将积极心理学应用于戒毒人员的团体辅导具有积极意义,团体辅导是一种有效的戒毒心理矫治方式。     

门诊抗高血压用药分析

通过对天津市某医院的高血压患者发病和用药情况进行调查,了解此医院血压用药特点及其合理性和局限性。结果显示,用药频度的前三类分别是钙离子拮抗剂（CCB）、血管紧张素Ⅱ受体拮抗剂（ARB）、血管紧张素转换酶抑制剂（AcEI）;用药频度的前三个药分别是硝苯地平控释片、厄贝沙坦、贝那普利;使用一种降压药物的处方占49．25％,...