Ways of coping with excessive drug use in the family: A provisional typology based on the accounts of 50 close relatives

This paper outlines an eight-fold typology of coping actions based upon a qualitative analysis of the accounts provided by 50 close relatives of people with drug problems. In a number of different ways relatives draw attention to the contrasts between these distinguishable ways of coping. Emphasis is placed upon the provisional nature of this typology and upon the compromises between, and combinations of, ways of coping that are often used by relatives in practice. Different ways of coping represent alternative choices for relatives, often explicitly expressed by them as difficult dilemmas. Links are suggested between the ways of coping identified here and those discussed in the literature on coping with other disorders and disabilities in the family, with ways of coping described in the general literature on coping with stress, and with types of social action appearing in general models of interpersonal behaviour. Implications for counselling close relatives of people with drug problems are also outlined.     

FUNCTIONAL ASSESSMENT AND TREATMENT OF LIFE-THREATENING DRUG INGESTION IN A DUALLY DIAGNOSED YOUTH

Few data exist on operant mechanisms associated with drug overdose. In this investigation, a functional analysis indicated that life-threatening drug ingestion exhibited by a dually diagnosed youth was maintained by negative reinforcement. An operant intervention, derived from behavioral assessment data, reduced drug ingestion to near-zero levels.     

Effects of schedule of reinforcement on a pentobarbital discrimination in rats.

The purpose of this study was to determine the effects of the schedule of reinforcement on a pentobarbital discrimination in rats. Five rats were trained to discriminate 10 mg/kg pentobarbital from saline under a multiple fixed-interval 180-s fixed-ratio 20 schedule of reinforcement. During both saline and pentobarbital training sessions, subjects emitted a higher percentage of correct responses under the fixed-ratio component as compared to the fixed-interval component of the multiple schedule. Determination of the pentobarbital dose-response curve under the fixed-ratio component resulted in a steep curve characterized by responding on the saline lever at low doses and on the drug lever at higher doses. Under the fixed-interval component, a graded dose-effect curve was produced, with considerable responding on both levers after intermediate doses of pentobarbital. The administration of phencyclidine and MK-801 resulted in an intermediate level of drug-lever responding for some subjects. Administration of d-amphetamine resulted in saline (nondrug) appropriate responding. The results of this study demonstrate that the schedule of reinforcement is a determinant of drug stimulus control, just as it is a determinant of other drug effects.     

Similar consumption and responding across single and multiple sources of drug

Two experiments were conducted to assess whether total response output and total consumption would be similar when drugs are available from single and multiple sources of reinforcement, as predicted by behavioral economics. In Experiment 1, cigarette-deprived smokers were exposed to a concurrent-chains schedule in which equal fixed-ratio schedules served as the initial links, and different reinforcer magnitudes (i.e., number of cigarette puffs) were arranged across alternatives. After the session, obtained unit price was calculated and imposed in the next session when a different number of puffs was available according to a single fixed-ratio schedule. Thus, the unit price at which cigarette puffs could be earned was yoked within subjects across the single and concurrent-chains schedules. When plotted as a function of unit price, similar consumption and response rates were usually obtained across these schedules. Experiment 2 addressed a weakness of Experiment 1, namely, that responding was allocated exclusively to the larger reinforcer magnitude in concurrent-chains conditions, and therefore this schedule may have functioned as a single schedule. In Experiment 2, subjects were instructed to alternate responding between the two alternative schedules. Instructions produced approximately equal response allocation between the two alternatives. Again, similar consumption and response rates were observed across the single and instructed concurrent-chains schedules. These findings are discussed in the context of direct effects and behavioral economics perspectives of drug self-administration.     

Behavior of rats under fixed consecutive number schedules: effects of drugs of abuse.

Four rats responded under a simple fixed consecutive number schedule in which eight or more consecutive responses on the run lever, followed by a single response on the reinforcement lever, produced the food reinforcer. Under this simple schedule, dose-response curves were determined for diazepam, morphine, pentobarbital, and phencyclidine. The rats were then trained to respond under a multiple fixed consecutive number schedule in which a discriminative stimulus signaled when the response requirement on the run lever had been completed in one of the two fixed consecutive number component schedules. Under control conditions, the percentage of reinforced runs under the multiple-schedule component with the discriminative stimulus added was much higher than the percentage of reinforced runs under the multiple-schedule component without the discriminative stimulus. All of the drugs decreased the percentage of reinforced runs under each of the fixed consecutive number schedules by increasing the conditional probability of short run lengths. This effect was most consistently produced by morphine. The drugs produced few differences in responding between the multiple fixed consecutive number components. Responding under the simple fixed consecutive number schedule, however, was affected at lower doses of the drugs than was responding under the same fixed consecutive number schedule when it was a component of the multiple schedule. This result may be due to the difference in schedule context or, perhaps, to the order of the experiments.     

Comorbidity of drug abuse treatment

Research has suggested that comorbidity, the concurrence of substance abuse disorders with other psychiatric disorders, may have prognostic value and important implications for the treatment of substance abuse. Knowledge of the prevalence of comorbid disorder is important because it will enable treatment services to be appropriately configured and designed for clinical drug treatment populations. The form and duration of comorbidity may be influenced by a variety of factors, which include the class of drug being abused, the duration of drug use, the individual sensitivity to drug effects, and whether the drug effects are acute or due to withdrawal or residual conditions. This paper addresses three important scientific questions: (1) What is the prevalence of comorbid disorders in a drug abuser population? (2) What is the stability of psychiatric diagnoses in a drug abuser population? (3) Does the existence of a comorbid disorder influence the outcome of drug abuse treatment?     

AN EFFECTIVENESS TRIAL OF CONTINGENCY MANAGEMENT IN A FELONY PREADJUDICATION DRUG COURT

This study evaluated a contingency management (CM) program in a drug court. Gift certificates for compliance were delivered at 4‐ to 6‐week intervals (total value = $390.00). Participants in one condition earned gift certificates that escalated by $5.00 increments. Participants in a second condition began earning higher magnitude gift certificates, and the density of reinforcement was gradually decreased. No main effects of CM were detected, which appears to be attributable to a ceiling effect from the intensive contingencies already delivered in the drug court and the low density of reinforcement. Preplanned interaction analyses suggested that participants with more serious criminal backgrounds might have performed better in the CM conditions. This suggests that CM programs may be best suited for more incorrigible drug offenders.     

Drug addicts in therapy—changes in life space in the course of one year

In a residential community treatment setting, moods and emotional states of drug addicts were explored over a 1‐year period. The specific form of treatment of heroin addiction employed in the communities is based on the importance of interpersonal relationships for psychosocial transition. Twenty‐nine participants reported current mood, emotions, attributions, and motive activation using a time‐sampling diary for 2 weeks at the beginning of the treatment, and 6 and 12 months later. Results show an increase in positive emotions, and in subjective strength and freedom. Furthermore, participants report higher self‐esteem and use less fatalistic attributions. This is interpreted as indicating successful transition processes in terms of higher autonomy, a more extended life space and increased levels of realism. Copyright © 2002 John Wiley & Sons, Ltd.     

Beyond mere ownership: transaction demand as a moderator of the endowment effect

Transaction demand refers to the motivation to complete a transaction. As transaction demand increases, owners should sell at lower prices and buyers should buy at higher ones. It was predicted that the endowment effect—the tendency for minimum selling price to exceed maximum buying price for a particular commodity—should be minimized when buyers and sellers have high transaction demand. The results of two experiments supported this hypothesis: In Experiment 1, the endowment effect was observed when participants imagined another individual wanting to buy from or sell to them, but not when they imagined wanting to buy from or sell to another individual. In Experiment 2, a reversal of the endowment effect was observed when transaction demand was high for both prospective buyers and sellers. The findings highlight the importance of motivational factors in addition to other factors (e.g., loss aversion, reference dependence) in determining behavior.     

吸毒者：病人还是罪犯

如何认定吸毒者的社会身份是禁毒工作中亟待解决的问题。概述常见的毒品和吸毒的流行趋势。通过分析吸毒与医学和犯罪的关系,了解吸毒是病态还是犯罪。提出如何正确对待吸毒与戒毒,社会有关人员有责任关怀吸毒品走私案者,消除偏见,给予他们应有的帮助和治疗。