A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Drug Abuse: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83619-1 1. Drug Abuse-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail:
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on drug abuse. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON DRUG ABUSE............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Drug Abuse................................................................................... 7 E-Journals: PubMed Central ..................................................................................................... 138 The National Library of Medicine: PubMed .............................................................................. 139 CHAPTER 2. NUTRITION AND DRUG ABUSE ................................................................................. 265 Overview.................................................................................................................................... 265 Finding Nutrition Studies on Drug Abuse ............................................................................... 265 Federal Resources on Nutrition ................................................................................................. 267 Additional Web Resources ......................................................................................................... 267 CHAPTER 3. ALTERNATIVE MEDICINE AND DRUG ABUSE .......................................................... 269 Overview.................................................................................................................................... 269 The Combined Health Information Database............................................................................. 269 National Center for Complementary and Alternative Medicine................................................ 270 Additional Web Resources ......................................................................................................... 274 General References ..................................................................................................................... 276 CHAPTER 4. DISSERTATIONS ON DRUG ABUSE ............................................................................ 277 Overview.................................................................................................................................... 277 Dissertations on Drug Abuse .................................................................................................... 277 Keeping Current ........................................................................................................................ 294 CHAPTER 5. CLINICAL TRIALS AND DRUG ABUSE ....................................................................... 295 Overview.................................................................................................................................... 295 Recent Trials on Drug Abuse .................................................................................................... 295 Keeping Current on Clinical Trials ........................................................................................... 307 CHAPTER 6. PATENTS ON DRUG ABUSE ....................................................................................... 309 Overview.................................................................................................................................... 309 Patents on Drug Abuse.............................................................................................................. 309 Patent Applications on Drug Abuse.......................................................................................... 321 Keeping Current ........................................................................................................................ 326 CHAPTER 7. BOOKS ON DRUG ABUSE ........................................................................................... 327 Overview.................................................................................................................................... 327 Book Summaries: Federal Agencies............................................................................................ 327 Book Summaries: Online Booksellers......................................................................................... 334 The National Library of Medicine Book Index ........................................................................... 338 Chapters on Drug Abuse ........................................................................................................... 340 Directories.................................................................................................................................. 342 CHAPTER 8. MULTIMEDIA ON DRUG ABUSE ................................................................................ 345 Overview.................................................................................................................................... 345 Video Recordings ....................................................................................................................... 345 Audio Recordings....................................................................................................................... 349 Bibliography: Multimedia on Drug Abuse ................................................................................ 353 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 357 Overview.................................................................................................................................... 357 NIH Guidelines.......................................................................................................................... 357 NIH Databases........................................................................................................................... 359 Other Commercial Databases..................................................................................................... 370 The Genome Project and Drug Abuse........................................................................................ 370 APPENDIX B. PATIENT RESOURCES ............................................................................................... 375 Overview.................................................................................................................................... 375
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Patient Guideline Sources.......................................................................................................... 375 Associations and Drug Abuse.................................................................................................... 394 Finding Associations.................................................................................................................. 396 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 399 Overview.................................................................................................................................... 399 Preparation................................................................................................................................. 399 Finding a Local Medical Library................................................................................................ 399 Medical Libraries in the U.S. and Canada ................................................................................. 399 ONLINE GLOSSARIES................................................................................................................ 405 Online Dictionary Directories ................................................................................................... 411 DRUG ABUSE DICTIONARY .................................................................................................... 413 INDEX .............................................................................................................................................. 481
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with drug abuse is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about drug abuse, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to drug abuse, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on drug abuse. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to drug abuse, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on drug abuse. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON DRUG ABUSE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on drug abuse.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and drug abuse, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “drug abuse” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Use of Condoms by Heterosexually Active Drug Abusers Before and After AIDS Education Source: Sexually Transmitted Diseases; Vol. 20, No. 2. Contact: University of Massachusetts Amherst, School of Public Health, 111 Arnold House, Amherst, MA, 01003, (413) 545-0111. Summary: This study examines characteristics of condom use among drug abusers in a short-term inpatient detoxification program before and after three types of AIDS educational interventions. The 301 subjects were all heterosexually active. There was no differential intervention effect on changes in condom use, but modest increases were found in all groups. Following intervention, women were more likely to initiate condom use than to increase to consistent use with all partners, while men were more likely to
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Drug Abuse
increase use. Among women, having multiple partners was associated with condom use before intervention and led to a greater likelihood of increased use after intervention. Positive HIV status was associated with increased use among men but not among women. Among men, personal attitudes and beliefs -- such as increases in perceived benefits and self-efficacy -- were associated with greater use, while among women, perceptions of the attitudes of sexual partners were more important. The authors conclude that men have greater control over whether or not condoms are used in sexual encounters, and are able to feel greater reinforcement by their use. •
Seroprevalence of HTLV - I/II and HIV - 1 Infection Among Male Intravenous Drug Abusers in Chicago Source: Journal of Acquired Immune Deficiency Syndromes; Vol. 4, no. 9, 1991. Contact: Hines VA Hospital, Section of Infectious Diseases, Hines, IL, 60141. Summary: This reprint of a journal article describes a survey for serologic evidence of either Human immunodeficiency virus (HIV) or HTLV I/II infection in 387 male veterans at an inpatient drug treatment center. Serum was obtained after receiving informed consent. The specimens were tested by the enzyme-linked immunosorbent assay (ELISA) test, and sera that were repeatedly active were then tested by Western Blot. The testing showed that 65 of 387 patients were positive for HTLV-I/II antibodies, and 30 were positive for HIV antibodies. An additional nine patients were positive for both. HTLV I/II seropositivity was closely associated with Black race, age, and duration of I.V. drug use, but not with sexual history or with needle-sharing practices. A significant difference in the CD4/CD8 lymphocyte ratio was associated with HIV-1 seropositivity.
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Community Prevention Efforts to Reduce the Spread of AIDS Associated With Intravenous Drug Abuse Source: AIDS Education and Prevention. Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse, Center on AIDS and Other Medical Consequences of Drug Abuse, Rm 5213 MSC 9561, 6001 Executive Blvd, Bethesda, MD, 20892-9561, (301) 443-1124, http://www.nida.nih.gov. Summary: This reprint of a journal article reports on a meeting that took place at the National Institute on Drug Abuse (NIDA) on February 28-29, 1988. The meeting's purpose was twofold: One, to identify and describe innovative methods of Human immunodeficiency virus (HIV) prevention among Injecting drug users (IDU's) and their families, and Two, future directions for community-based prevention research within the context of decreasing HIV infection among IDU's. The article compares lifestyle changes needed to prevent HIV transmission to other behaviors such as dietary modification, smoking cessation, and exercise, and says that these types of change can be achieved within the context of the target group's community. It outlines a framework for community prevention, and says the program must go beyond providing facts and include behavior-change strategies. The article makes a number of recommendations.
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Drug Abuse? Use and Misuse of Psychotropic Drugs in Alzheimer's Care Source: Journal of Gerontological Nursing. 16(8): 4-10. August 1990. Summary: This article reviews the incidence of psychotropic drug use and reasons for misuse. Rational use of these drugs are discussed based on the assumption that, if
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administered and monitored appropriately, psychotropic drugs are indicated in some situations in the management of Alzheimer's disease. The nurse's role is to establish and monitor therapeutic goals and to assess the incidence and severity of predictable side effects. Each class of psychotropic drugs and appropriate pharmacological management in Alzheimer's disease is discussed. Guidelines for rational psychotropic drug use and federal indicators for antipsychotic and antidepressant drugs and sedative/hypnotic therapy are reviewed. 19 references. •
Clinical Aspects of Drug Abuse in Diabetes Source: Diabetes Spectrum. 4(1): 45-47. January-February 1991. Summary: This article focuses on the clinical challenges that occur when two medical disorders, diabetes mellitus and chemical dependency, occur concurrently in the same patient. Topics include the prevalence of diabetes and drug abuse, the influence of psychoactive drugs on glucose metabolism, and compliance issues among chemically dependent people with diabetes. The author notes that the rapidly changing and wide geographic variations in the types of drugs used and their routes of administration contribute to the inability of the medical profession to keep current on the consequences of drug abuse. The author calls for further research on the metabolic impact of drugs and an increased emphasis on drug-abuse issues in training health care professionals. 27 references.
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Psychiatric Aspects of Drug Abuse in Diabetes Source: Diabetes Spectrum. 3(6): 353-356. November-December 1990. Summary: Substance abuse may interfere with optimal glycemic control in many ways: directly, through metabolic alterations caused by drug use; indirectly, through drugmediated changes in appetite; or behaviorally, when the patient ignores dietary restrictions, does not correctly time insulin injections, or denies the magnitude of the problem. This article discusses the psychiatric aspects of drug abuse in diabetes. Topics addressed include the prevalence of drug abuse in people with diabetes, the effects of drug use on diabetes, the role of alcohol abuse in poor metabolic control, and the diagnostic criteria for psychoactive substance dependence and abuse. 1 table. 26 references.
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Renal Amyloidosis in a Drug Abuser Source: Journal of the American Society of Nephrology. 5(9): 1653-1658. March 1995. Contact: Available from Williams and Wilkins. 428 East Preston Street, Baltimore, MD 21202-3993. (800) 638-6423. Summary: In this article, the authors present the case of a patient who had a history of subcutaneous cocaine and heroin use and who developed nephrotic syndrome, with an elevated serum creatinine and a creatinine clearance of 61 mL/min. Renal biopsy demonstrated amyloidosis. Treatment with colchicine was initiated, and proteinuria decreased to near normal levels after 12 months. Concomitant with the decrease in proteinuria, creatinine clearance improved, although a repeat renal biopsy failed to show any significant improvement in amyloid burden. The authors suggest that colchicine may be a useful treatment in reversing the proteinuria of renal amyloidosis associated with drug abuse. Furthermore, clinical improvement may occur before any demonstrable regression in the amyloidosis. 1 figure. 3 tables. 25 references.
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HIV and Substance Abuse: An Overview Source: Focus on AIDS in New York State; Vol. 3, No. 1. Contact: New York Department of Health, AIDS Institute, Empire State Plz, Corning Tower Rm 1483, Albany, NY, 12237-0684, (518) 473-7238, http://www.health.state.ny.us/nysdoh/aids/hivtesti.htm. Summary: This journal article looks at the connection between HIV infection and substance abuse. In addition to the established risk associated with injection drug use, the article also analyzes risks associated with use of cocaine, alcohol, and other drugs. It looks at the disproportionate effect that HIV and drug abuse have had on Black and Hispanic communities, as well as the increasing number of individuals with a dual diagnosis of mental illness and substance abuse.
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Substance Abuse and HIV in Native Communities: How Substance Abuse Programs Are Addressing HIV Contact: National Native American AIDS Prevention Center, 436-14th St Ste1020, Oakland, CA, 94612, (510) 444-2051, http://www.nnaapc.org. Summary: The dual role of substance abuse counselors in Native American communities, which encompasses HIV education as well as prevention and treatment of substance abuse, is examined in this article. Four substance abuse programs are described which include how specific counselors accomplish HIV education. For example, a health coordinator on the Hoopa Reservation in California relates that upon noting the lack of HIV education by the substance abuse program, she established an AIDS task force. She uses a traditional salmon dinner to attract people and then presents HIV prevention education. She believes community outreach is the key to HIV education.
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AIDS - Risk Behavior Among Homosexual Males: The Role of Attitudes and Substance Abuse Source: Psychology and Health; Vol. 3. Contact: Gordon Breach Publishing Group, 2 Gateway Ctr, Newark, NJ, 07102, (201) 643-7500. Summary: This journal article reports the results of a survey of 2,600 urban homosexual males regarding perceived HIV vulnerability, psychosocial factors in behavioral change, and the effects of substance abuse on such behavior. A very high proportion reported both anxiety over possible HIV infection and a high probability of exposure to HIV. Although over 80 percent of respondents reported changes in sexual behavior, the frequency of monogamous, stable relationships was unchanged from that found 16 years earlier. Nineteen percent reported continued frequent sexual partners. Consistent with health belief models, fear of future exposure and perceived control over behavior were strongly related to behavioral change. However, those who felt they had already been exposed were not substantially more likely to decrease risky behavior. Alcohol and drug abuse were related to high-risk behavior, particularly among respondents who used substances to relieve tension or decrease self-awareness of risky behavior.
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Deaf Culture and Alcohol and Substance Abuse Source: Journal of Substance Abuse. 9(2): 103-110. 1992.
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Summary: This article addresses the issues of Deaf culture and alcohol and substance abuse. Topics covered include the problems of cultural influence, prevalence of the problem, and factors contributing to isolation and denial. In addition, the issues of accessibility and service delivery are explored. The author identifies current programs that are accessible and that provide alcohol and substance abuse recovery. The author concludes that individuals who are deaf and who abuse alcohol or drugs can achieve recovery only when advocacy promoting and achieving accessibility is the reality and not the rarity and when the Deaf community openly admits that alcoholism and drug abuse affects all cultures and that recovery is everyone's right. 1 appendix. 21 references. (AA-M).
Federally Funded Research on Drug Abuse The U.S. Government supports a variety of research studies relating to drug abuse. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to drug abuse. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore drug abuse. The following is typical of the type of information found when searching the CRISP database for drug abuse: •
Project Title: "ENGAGING MOMS." AN INTERVENTION FOR FAMILY DRUG COURT Principal Investigator & Institution: Dakof, Gayle A. Epidemiology and Public Health; University of Miami Box 016159 Miami, FL 33101 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-MAY-2007 Summary: (provided by applicant): During the last 15 years, there has been a dramatic increase in the incidence of both child abuse/neglect and drug abuse among women of childbearing age (Kandel, Warner, & Kessler, 1998; Reid, et al, 1999). Thus, the problem of child maltreatment and maternal substance abuse is a public health problem of the utmost significance (Magura & Laudet, 1996). Judicial and child welfare systems throughout the nation have turned to family drug courts as a possible solution to this problem. However, few scientifically rigorous investigations of drug courts have been done, and many questions remain regarding their effectiveness, essential features, and influence on drug and nondrug outcomes. In response to the growing need for effective family drug court interventions and empirical investigation of their outcomes, we propose a treatment development project exploring the use of a promising family-based intervention, the Engaging Moms Program, within the family drug court context. This
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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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application proposes a 4-year Stage 1a/1b Behavioral Therapies Development project with the overarching goal of further developing and pilot testing an innovative family drug court intervention designed to help drug abusing others succeed in family drug court. Initial studies of the Engaging Moms Program suggest that it holds sufficient promise to warrant further development and systematic testing (Dakof et al, in press; Dakof, Cohen & Quille, in preparation). This application has 4 primary aims: (1) develop a manualized, court-based family intervention, the Engaging Moms Program (EMP), as an alternative to standard family drug court case management services, (2) develop training manuals and materials, (3) develop adherence/competence measures, and (4) experimentally compare, in a randomized pilot study (N=60), acceptability and efficacy of the Engaging Moms Program (EMP) versus standard family drug court case management services (CMS). The pilot test of EMP will be carried out in the real-world setting of family drug court, using existing drug court staff to deliver the court-based interventions. Drug use outcomes and changes in psychosocial functioning (comorbidity, parenting skills, family environment) will be assessed at 5 assessment points, beginning with intake, that coincide with the phases of drug court (3, 6, 9, and 12 months post-intake). Drug court outcomes of graduation status and reunification status will also be assessed. If funded, this project would be one of the first scientific investigations of family drug court. It has the potential to make a major contribution to the enhancement of family drug court programs, and can provide the foundation for a full-scale Stage II clinical trial in this understudied area focusing on an underserved population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: A HARM REDUCTION APPROACH FOR REDUCING DWI RECIDIVISM Principal Investigator & Institution: Nochajski, Thomas H. Associate Professor; None; State University of New York at Buffalo 402 Crofts Hall Buffalo, NY 14260 Timing: Fiscal Year 2001; Project Start 29-SEP-1999; Project End 31-AUG-2004 Summary: Research with alcoholics and drug abusers has demonstrated that interventions focused on reducing the harmful consequences of future alcohol/drug consumption and increasing client motivation for change have a positive impact on treatment engagement and treatment outcome. In the present study, we propose an intervention for DWI offenders that includes the use of motivational interviewing strategies within the context of a comprehensive harm reduction approach focusing on decreasing future harm related to alcohol and drug use, including DWI recidivism. The sample will consist of 1,200 convicted DWI offenders participating in the New York State Drinking Driver Program (DDP). All subjects will participate in an initial comprehensive assessment session. Following the assessment session, subjects will be randomly assigned to one of three experimental conditions: information only (IO), motivational interview feedback session (MI), motivational interview feedback session plus six-treatment sessions focused on reducing the harmful consequences of alcohol use (MI+). One-week after the assessment session, individuals in the IO group will return for an alcohol information session that will consist of viewing a videotape concerning the effects of alcohol advertising on behavior. Individuals in the MI condition will return for a feedback session that will incorporate principles of motivational interviewing designed to increase the individuals motivation to make a change in their use of alcohol. Finally, individuals in the MI+ condition will return for a feedback session and the six-session harm reduction intervention. The MI and MI + interventions are designed to be easily portable to other treatment protocols. Aims of the
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proposal are as follows: 1. To assess the relative effects of experimental conditions on commitment to and involvement in changing drinking and drug use behavior over short-term and long-term follow-ups for a sample of convicted DWI offenders. 2. To assess systematically the relative effects of experimental conditions on the alcohol and drug use, and substance-related problems of convicted DWI offenders. 3. To assess whether the experimental conditions are related to DWI recidivism. In summary, the proposed research will provide important clinically-relevant data for DWI offenders on the effectiveness of brief harm reduction approaches designed to increase client motivation for changing drinking behavior, reduce client dropout from treatment, and reduce DWI recidivism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: A WEB-BASED PROGRAM TO PREVENT PRESCRIPTION DRUG ABUSE Principal Investigator & Institution: Deitz, Diane K.; Isa Associates, Inc. 201 N Union St, Ste 330 Alexandria, VA 22314 Timing: Fiscal Year 2003; Project Start 10-MAY-2003; Project End 09-OCT-2003 Summary: (provided by investigator): Prescription medications are an effective way to bring improvements in the health and well being of many people. Many patients, however, fail to receive proper screening and educational instruction on the prevention of prescription drug abuse. Critical to this issue is the fact that medications such as tranquilizers, sedatives, analgesics, and stimulants may lead to drug misuse, dependence, and addiction if not administered and managed properly. The National Institute on Drug Abuse recently noted that the abuse of prescription medications is on the rise and there appears to be increased concern for older adults, adolescents, and women. The purpose of the current project is to develop and test an innovative webbased educational program designed to prevent prescription drug abuse among women. The program will contain important information on the safe use of medications with abuse potential and on alternatives to taking medications. During Phase I of the project, the prototype structure and content will be developed and tested with focus groups of working women. In Phase II, the program will be expanded, field-tested, revised, and prepared for marketing to corporations and managed care organizations. There is currently a clear tack of an interactive, multimedia program for women addressing the issue of prescription drug use and abuse. Such a program is a much needed tool that should have substantial appeal to corporations wishing to provide their employees with information that can decrease their risk to drug misuse and increase morale and productivity at work. Managed care organizations should also be interested in a program that could help reduce the cost of prescription drug misuse and abuse in women of all ages. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ABUSE LIABILITY OF BENZODIAZEPINES AND CAFFEINE Principal Investigator & Institution: Griffiths, Roland R. Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 01-FEB-1975; Project End 28-FEB-2003 Summary: (Applicant's Abstract) Research in baboons is proposed to characterize the intravenous reinforcing and physical dependence-producing effects of benzodiazepines and also to examine caffeine reinforcement interactions with cocaine and nicotine. Two self-injection studies will determine whether physical dependence enhances the
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reinforcing effects of a benzodiazepine. A series of three studies will address concerns that the abuse liability of benzodiazepines is enhanced by interactions with opioids by determining whether chronic opioid exposure increases benzodiazepine self-injection and whether the discriminative stimulus effects of benzodiazepines and opioids mutually potentiate each other. One study will determine whether the abuse liability of sedative drugs can be reduced by slowing the rate of drug onset. A final self-injection study will explore the concern that flunitrazepam has a particularly high abuse liability. A second series of studies will examine benzodiazepine physical dependence. Studies will examine precipitated withdrawal effects produced by a series of novel partial/selective benzodiazepine receptor agonists in benzodiazepine-dependent baboons. Another study will use drug discrimination methods to examine the effects of these same compounds in benzodiazepine-dependent baboons that have been trained to discriminate the benzodiazepine antagonist flumazenil. A third study will explore using an antagonist to decrease the severity and/or shorten the time course of the spontaneous withdrawal syndrome. Finally, two studies will explore recent findings suggesting that caffeine potentiates the reinforcing effects of cocaine and nicotine by characterizing the effects of caffeine on the self-injection of cocaine and nicotine, and the effects of cocaine and nicotine on caffeine self-injection. Benzodiazepines are among the most widely prescribed of all psychotropic medications and caffeine is the most widely used psychotropic drug in the world. There are health risk concerns about benzodiazepine abuse and physical dependence among polydrug abusers and patients, and also about excessive caffeine use in a significant portion of the population. This research will advance our understanding of factors which contribute to the overuse, abuse and dependence on these widely self-administered drugs, provide valuable insights into possible interactions of these drugs with other widely abused drugs, and will ultimately contribute to the development of improved prevention, control and treatment procedures for various forms of drug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ADDRESSING NICOTINE ADDICTION IN DRUG ABUSE PATIENTS Principal Investigator & Institution: Richter, Kimber; Psychology and Sociology; University of Kansas Medical Center Msn 1039 Kansas City, KS 66160 Timing: Fiscal Year 2001; Project Start 05-FEB-2000; Project End 31-JAN-2005 Summary: Kimber P. Richter, Ph.D., M.P.H., is a behavioral psychologist with training in public health who will use the MRSDA to develop expertise in addressing nicotine addiction among persons in drug abuse treatment, an estimated 80 percent of whom smoke. The proposal combines her behavioral background in drug abuse prevention, drug abuse treatment, and cardiovascular disease risk reduction with a new focus on smoking cessation. This plan outlines the training and research experience she will need, over the next 5 years, to develop and launch a fully independent career addressing nicotine addiction among persons in drug abuse treatment. Career Development: Activities include training in the chemistry of the nervous system, advanced biostatistics, training in addictions treatment and research, a week-long internship with a nicotine/drug addictions researcher, and an intensive bioethics course. Research Program: The goal of the proposed research program is to better understand smoking behaviors and nicotine dependence among persons in treatment for chemical dependencies, and to identify acceptable and potentially effective methods for reducing cigarette smoking in this population. Specifically, the plan involves three studies that address five research questions. Study 1 examines key issues in smoking cessation from the patient's point of view. It consists of a series of two focus groups among each of four
Studies 11
subgroups of clients in methadone maintenance treatment (MMT) and other drug dependency programs. These 8 sessions is will identify clients' a) interest in quitting, b) barriers to quitting smoking, c) successful strategies used to quit smoking, d) strategies used to avoid illicit drug use that might be adapted for smoking cessation, and e) treatment preferences for quitting smoking. Study 2 is a descriptive study examining interactions in patterns of cigarette use and methadone maintenance. Twenty-one methadone patients will use electronic monitors to record the frequency and timing of their cigarette consumption. Data on methadone timing and dose, as well as carbon monoxide levels and psychological measures of nicotine craving and withdrawal, will be collected and analyzed to assess whether methadone dose and timing are associated with surges in cigarette consumption and smoking urges. Study 3 is a pilot study examining the feasibility and potential efficacy of a multicomponent intervention on smoking cessation. Sixty MMT patients will be randomly assigned to treatment (nicotine inhaler and motivational interviewing) or control (placebo inhaler and comparable staff contact). Primary outcomes include quit rates and avg. daily cigarette use. Pilot data will allow determination of sample sizes for a full-scale intervention trial, and will be used to assess the effects of variables such as age, gender, methadone dose on treatment effects. The research plan uses exploratory, descriptive, and intervention research to address fundamental issues of nicotine addiction. Each study stands on its own, but is designed to build on the findings of the prior study. This research may serve as a model for systematic research on nicotine addiction in patients with other drugs of dependence or who are in other drug abuse treatment modes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ADHERENCE IN RECENTLY SOBER HIV+ WOMEN: ECOSYSTEMIC TX Principal Investigator & Institution: Feaster, Daniel; Psychiatry and Behavioral Scis; University of Miami Box 016159 Miami, FL 33101 Timing: Fiscal Year 2002; Project Start 10-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant): This application proposes a structural ecosystemic intervention for HIV medical adherence (SETA) in recently sober women. Recently sober is defined in this proposal as DSM IV drug dependence or abuse within the last year and but not in the last 60 days. The 4-month intervention targets women, their families, and their social networks as the building blocks for the infrastructure to support HIV medical adherence, reduction in HIV transmission risk behaviors and drug abuse relapse prevention. An important part of this infrastructure is a constructive relationship between the HIV infected women and their health care system. This is buttressed with attention to 1) reducing the negativity former drug users experience from their families, 2) establishing firm boundaries to separate the women from drug using family and friends who can frequently trigger relapse to drug use, 3) for women with children, restoring the women=s role as a parent, improving her parenting abilities, and enhancing the support she receives for parenting functions and 4) developing well integrated, multiply connected pro-social support systems to reinforce the recovery process and maintain healthy behaviors including HIV transmission risk and HIV medical adherence. The study will enroll 196 women and randomly assign them to either the SETA intervention, or an HIV health group designed to match SETA for attention. Women are assessed at 2-month intervals for a period of 12 months. HIV medical adherence is measured by self-report, MEMS CAP, and viral load. The SETA intervention is hypothesized to improve HIV medical adherence relative to the HIV health control group. The hypothesized mediating factors are: family functioning, social
12 Drug Abuse
support, patient-doctor interactions, health beliefs, and drug abuse relapse. The effects of the intervention and the hypothesized mediators will be tested using Hierarchical Linear Modeling. This will be the first award for this investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AMBIVALENCE AND ADDICTION AMONG ADOLESCENTS Principal Investigator & Institution: Lende, Daniel H. Anthropology; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 01-SEP-2001 Summary: The long-term objective of this research is to develop integrated approaches to understanding drug use and abuse. Conceptually, this objective relies on (a) development of a biocultural anthropology approach to drug abuse, and (b) integration of the biocultural approach with more traditional theories of drug abuse, such as the biopsychosocial approach. Methodologically, this objective relies on (a) ethnographic research on ambivalence and drug use and abuse among adolescents in Bogota, Colombia, and (b) psychophysiological research testing a preliminary theoretical approach to drug abuse among these adolescents. This preliminary theory contains three aspects-wanting, frames, and self. Wanting refers to the implication of dopamine systems in drug abuse, frames to the role cognitive processes play, and self as an encompassing construct around wanting and frames. The psychophysiological research is the main emphasis of the present proposal, and relies on integrating physiological responses of the sympathetic nervous systems to verbal statements emphasizing "wanting" and "self" respects of drugs. Greater sympathetic response by drug abusers is predicted to wanting and self stimuli that emphasize drugs, as well as quicker response to a change (in frames) between these stimuli. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: AN ETHNOGRAPHY--DRUG USE AMONG AFRICAN AMERICAN WOMEN Principal Investigator & Institution: Brown, Emma J. Associate Professor; Nursing; University of Central Florida 4000 Central Florida Blvd Orlando, FL 32816 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 30-NOV-2003 Summary: (Applicant's Abstract): Research findings suggest that cocaine use is increasing among Blacks, although it is declining among young adults and whites. The escalation of crack cocaine-related problems has compounded drug abuse problems among African American populations. Yet, knowledge gaps exist about the impact of illicit drug abuse on Southern rural African American populations and especially among African American women. The purpose of this ethnographic study is to gain an understanding of the culture of Southern rural African American women who use crack cocaine. Four primary and three secondary aims will be addressed in this pursuit. The primary aims are: (1) to illustrate the familial and non-familial drug-use culture of the respondents, (2) to determine whether the respondents' social networks enable or oppose drug use, (3) to characterize the respondents' drug use patterns (types, frequency, and amount) and (4) to identify and characterize factors associated with the respondents' initiation, continuation, and cessation of the use of crack and other drugs. To enhance public health knowledge and to inform public health policy, the secondary aims are: (1) to document the respondents' behavioral habits and determine its impact on the community, (2) to categorize the respondents' sexual behavior (preventive or risky) for STDs including HIV and Hepatitis-C, and (3) to characterize the respondents'
Studies 13
knowledge of existing preventive health care and drug treatment services and note their use of these services. The design of this study is a holistic ethnographic approach, which will consist of participant observation, informal interviews, and intensive in-depth qualitative interviews of the respondents. Respondent sampling will be purposive using "snowball" recruitment. Demographic data will be analyzed with descriptive statistics and the qualitative data will be analyzed using constant comparative analysis and content analysis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AN INTERVIEW FOR FAMILIES OF DRUG USERS Principal Investigator & Institution: Kirby, Kimberly C. Associate Professor; Treatment Research Institute, Inc. (Tri) 600 Public Ledger Bldg Philadelphia, PA 19106 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2004 Summary: (Adapted from the Applicant's Abstract): This is a revision of grant application DA 1272-01, The Family Impact Survey: An Interview for Families of Drug Users, which was reviewed in March 1999. This research will further the development of the Family Impact Survey; a comprehensive assessment tool that measures the special problems faced by family member and significant others (FSOs) of drug abusers. The instrument addresses drug and alcohol use of family members and seven problem areas: Emotional, Relationship, Lifestyle, Legal, Financial, Health, and Physical Abuse. While research has documented increased prevalence of illness and increased domestic violence among FSOs of drug users, most studies have focused on psychological and interpersonal functioning of the family members of alcoholics. Systematic research exploring multiple aspects of the problems faced by FSOs of variety of drug users is virtually nonexistent, despite acknowledgment in both professional and lay literature that drug addiction affects the entire family. One factor hindering a comprehensive approach to the problems faced these FSOs is the lack of a multidimensional instrument to assess the wide range of problems they face. The Family Impact Survey collects standard, comprehensive, clinically pertinent information about the wide variety, of problems that beset families of drug abusers. This research will utilize a broad clinical sample to establish the interrater agreement and test-retest reliability of the instrument, develop standardized scores for different areas of the instrument, conduct psychometric/statistical analyses to refine the areas, establish internal consistency, and determine inter-correlation of problem area scores. The work proposed does not complete all the steps necessary for establishing a psychometrically sound instrument. Later studies will address issues of instrument validity and will examine whether the psychometric properties initially established here are maintained with a much large, representatively sampled population. Further development of this instrument is an important step in better understanding the impact of drug abuse on families, informing clinical assessment and treatment planning facilitating clinical research, and developing health policy for drug abuse treatment and for individuals dealing with the stress of a close relationship with a drug user. In addition, it could be a useful outcome measure in drug abuse treatment, providing information about improvements and cost-offsets that extend beyond the drug abuser to his or her family. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ANTECEDENTS OF DRUG ABUSE AND DEPENDENCE Principal Investigator & Institution: Fothergill, Kate E. Health Policy and Management; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218
14 Drug Abuse
Timing: Fiscal Year 2001; Project Start 16-SEP-2001 Summary: (Provided by Applicant) Research on drug use has sought to understand the individual, social, and environmental influences on drug use initiation, continuation, and abuse and dependence. Although researchers have identified many predictors of drug use initiation, less has been learned about the antecedents of drug abuse and dependence. The overall goal of the proposed study is to examine individual, social, and contextual factors in childhood and adolescence that distinguish adults with substance abuse problems from those without such problems. More specifically, the study will use data from a 25-year epidemiological, longitudinal study of a cohort (n= 1240) from Woodlawn, an African American community in Chicago. The cohort was assessed in first grade (age 6), in adolescence (ages 15-17), and in adulthood (ages 32-33), with 84 percent of the original cohort included in the adult phase. The study will examine the impact of first grade aggressive behavior, adolescent social bonds and drug use, and neighborhood on drug abuse and dependence in adulthood. The data includes self reports, teacher and psychologist ratings, and mothers? reports; census data will be used to examine neighborhood effects. The use of hierarchical regression analyses and multilevel analyses will allow for examination of both the direct and indirect effects of these factors on adult drug abuse and dependence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANTIBODY MEDICATIONS FOR (+) METH DEPENDENCE Principal Investigator & Institution: Mcmillan, Donald; Chairman & Wilbur D. Mill's Professor; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, AR 72205 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2006 Summary: Methamphetamine [(+)]methamphetamine, or (+)METH] has been a serious drug problem in the United States since the middle 1980s. It is by far the most prevalent synthetic controlled substance clandestine manufactured in the United States and it is abused throughout the world. Although there has been good success in the development of therapeutic drugs to treat some types of drug abuse, at this time there is no pharmacological treatment of (+)METH abuse that has clinical acceptance. This project will use antibody-based therapies as "pharmacological antagonists" of (+)METH abuse. (+)METH abuse will be studied using two animal models, drug selfadministration and drug discrimination. Drug self-administration is generally considered to be a model of the reinforcing properties of (+)METH and drug discrimination is considered to be a model of some of the subjective effects of (+)METH and drug discrimination is considered to be a model of some of the subjective effects of (+)METH that presumably contribute to its abuse. Anti-(+)METH antibodies will be screened for their ability to reduce (+)METH self-administration and to block the discriminative stimulus effects of (+)METH in rats. The most promising antibodies will be subjected to more rigorous testing to determine dose-response relationships, duration of action, specificity for blocking the effects of other (+)METH-like drugs, ability to prevent relapse to (+) METH abuse, and interaction with behavioral treatments for (+)METH abuse. Experiments on the effects of the most promising anti-(+)METH antibody on (+)METH self administration will be repeated in squirrel monkeys to develop a preclinical data base for the testing of these antibodies as pharmacotherapy for (+)METH abuse in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ANXIOLYTIC EFFECTS AND ABUSE OF BZ RECEPTOR LIGANDS Principal Investigator & Institution: Rowlett, James K. Assistant Professor; Psychiatry; Harvard University (Medical School) Medical School Campus Boston, MA 02115 Timing: Fiscal Year 2001; Project Start 15-JUN-1998; Project End 31-MAY-2003 Summary: (Applicant's Abstract) Benzodiazepines (BZs) are widely prescribed for the management of anxiety and sleep disorders, but their clinical usefulness is constrained by a significant potential for abuse and dependence. Considerable research is now focused on elucidating the mechanisms of action underlying the behavioral effects of BZs and related drugs, with the goal of increasing clinical utility and reducing abuse liability. Our proposed research will specifically evaluate the role of BZ receptor selectivity and intrinsic efficacy as determinants of the therapeutic vs. abuse -related effects of this important class of drugs. BZ ligands differing in receptor selectivity and/or agonist efficacy will be used as probes to characterize mechanisms of action in nonhuman primate models predictive of anxiolytic activity, subjective effects, and abuse liability. Anxiolytic activity will be evaluated in rhesus monkeys using conflict procedures in which food-maintained behavior is concurrently suppressed by response produced presentations of an aversive stimulus. Subjective effects will be evaluated in monkeys trained to discriminate the conventional BZ agonist triazolam or the BZ 1selective agonist zolpidem from vehicle. Abuse potential will be evaluated using fixedand progressive-ratio schedules of i.v. drug self-administration. Quantitative pharmacological tools including isobolographic analysis and in vivo apparent pA2 analysis will be used in conjunction with drug interaction studies to dissociate effects due to receptor selectivity and agonist efficacy. Identification of compounds that are effective anxiolytics lacking abuse potential in our studies will provide needed information for developing safer and more broadly effective anti-anxiety medications, as well as compounds that may be beneficial in the pharmacological management of BZ dependence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ASSESSING THE ROLE OF COGNITIVE/BEHAVIORAL SKILLS ON ATOD USE Principal Investigator & Institution: Schinke, Steven P. Professor; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2001 Summary: This application proposes a 5-year investigation designed to identify cognitive-behavioral mediating mechanisms related to the efficacy of a broad-spectrum, competence enhancement and drug abuse prevention intervention called Life Skills Training (LST). The proposed study will utilize data from a recently funded schoolbased drug abuse and violence project with inner-city minority students. The proposed study would expand the ongoing project by adding the assessment of cognitivebehavioral skills for a subsample of treatment and control students (n=500 per group). The LST intervention includes problem-specific material concerning drug abuse and violence prevention as well as generic cognitive-behavioral skills. New observational measures of cognitive-behavioral skills will be added to the existing battery of evaluation items. In addition to the observational study of 1,000 students, a substudy will be conducted on 200 adolescents selected from this group for a more in-depth analysis of family interactions and stress reactivity. The proposed study is divided into a 6-month developmental period, a 6-month pilot period, a 36-month intervention phase consisting of a large-scale randomized trial, and a 12-month data analysis/scientific
16 Drug Abuse
dissemination phase. Forty New York City schools (N=4,000) would be randomly assigned to treatment and control conditions. The treatment condition would receive a drug abuse and violence prevention intervention consisting of school and parent intervention components. A secondary objective will be to assess the role of cognitivebehavioral skills acquisition in the development of adolescent drug use and aggressive/violent behavior among non-treated controls. A final objective is to increase our understanding of family interactions and physiological processes and their role in the etiology and prevention od drug abuse. The study is significant because it would not only offer the potential of demonstrating the effectiveness of a promising intervention on two important public heath problems, but would also provide the opportunity to investigate linkages between these important problem behaviors' and cognitive-behavioral skills hypothesized to be associated with both drug use and aggression/violence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ASSESSMENT AND TREATMENT OF ADOLESCENT DRUG ABUSERS Principal Investigator & Institution: Winters, Ken C. Associate Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, MN 554552070 Timing: Fiscal Year 2001; Project Start 01-JUL-1990; Project End 30-APR-2004 Summary: (Applicant's Abstract) The majority of extant studies of the long-term consequences of adolescent drug abuse have been based on random samples drawn from the general population. Because these studies have low rates of clinical-level drug abusing adolescents, little is known about the long-term consequences of adolescent drug abuse. This revision of a continuation study of DA05104 proposes to focus on the description of the long-term outcomes, including drug abuse, patterns of relapse, and level of functioning in a young adult sample with a DSM-IV lifetime diagnosis of at least one substance use disorder. This target group will consist of 195 participants, aged 2023. A control sample of normal young adults (n-130) matched for age, ethnicity, and educational status will provide a comparison group. The following specific aims will be addressed: Aim 1: To describe the long-term (4 years) drug involvement severity and other psychosocial outcomes, including the comparison of the target (clinical) group and a control (normal) group. Such descriptions of a clinical drug-abusing adolescent sample, supplemented by a comparison to a matched control group, will provide invaluable contributions to the field regarding questions of the course of drug use and other problem areas from adolescence to young adulthood. Aim 2: To examine the relationship of prior drug involvement severity and psychosocial functioning to young adult outcomes in these domains. It is hypothesized that greater prior drug abuse and psychosocial risk will be associated with poorer psychosocial and health functioning (e.g., less educational attainment and more interpersonal problems), and more instances of continued drug abuse and co-morbid psychiatric disorders. Aim 3: To examine the relationship of prior drug involvement and psychosocial risk and developmental outcomes. It is hypothesized that greater prior drug use and psychosocial risk will be associated with poorer results on the developmental outcome measures. Aim 4: To evaluate the appropriateness of a model of post-treatment outcome adapted from the adult literature and alcohol adolescent literature to explain outcome patterns at year-1 and year-4. Aim 5: To describe the antecedents of drug use lapse and relapse in the young adult target sample at year 4. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies 17
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Project Title: BASIC SCIENCE TRAINING PROGRAM IN DRUG ABUSE Principal Investigator & Institution: Nestler, Eric J. Chairman; Psychiatry; University of Texas Sw Med Ctr/Dallas Dallas, TX 753909105 Timing: Fiscal Year 2003; Project Start 30-SEP-1992; Project End 30-JUN-2008 Summary: (provided by applicant): The objective of the Basic Science Training Program in Drug Abuse is the training of predoctoral and postdoctoral fellows in a broad range of biological research methods relevant to drug abuse and addiction. The training program fills an important need by increasing the number of basic science researchers in the field of drug abuse. A major strength of the training program is the multidisciplinary and proven basic research records of its training facility. The basic research is aimed at delineating the neurobiological mechanisms underlying drug addiction, with a purposeful endpoint being the development of new treatments for drug addiction that are designed to alter these neurobiological mechanisms. Our training program benefits greatly from the depth and breadth of the faculty's commitment to drug abuse research. There are active research programs, with strong grant support, at the molecular, biochemical, cellular, neuropharmacological, and behavioral levels in drug abuse with a primary focus on cocaine, and opiates. Other important strengths are the integration of the basic science training program with a well-established clinical program in drug abuse and the unique opportunity for the preclinical investigators to couple their work to direct clinical trials. The existence of a training program in biological psychiatry means that the drug abuse fellows are in a rich basic research environment with fellow trainees in broad areas of neuroscience. This proximity, along with several combined seminar activities, also has the added benefit of exposing a much larger number of trainees overall to drug abuse research. The existence of a clinical training program in drug abuse facilitates one of the central goals of the training program: to offer a unique opportunity for integrating basic research within a clinical context. In this model, the basic research is driven by identified clinical needs, with basic research findings then applied rapidly to ongoing clinical research programs and trials. Finally, drug abuse trainees benefit enormously from the outstanding basic molecular and cell biology training programs at UT Southwestern, which helps build our drug abuse research on the strongest molecular and cellular foundations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BEHAVIOR CONTROLLED BY DRUG INJECTIONS Principal Investigator & Institution: Spealman, Roger D. Professor of Psychobiology; Psychiatry; Harvard University (Medical School) Medical School Campus Boston, MA 02115 Timing: Fiscal Year 2001; Project Start 01-DEC-1977; Project End 31-DEC-2003 Summary: There is now compelling evidence for a functional link between cocaine's indirect dopamine (DA) agonist properties and its abuse-related effects in animals and humans. Based on such findings, several DA agonists and antagonists have been proposed as candidate medications to serve either as pharmacological replacements for cocaine or as functional cocaine antagonists. However, no broadly effective pharmacotherapy for cocaine abuse has yet been identified, prompting exploration of alternative treatment strategies. One such strategy involves the use of a relatively new class of DA drugs, the DA partial agonists. Because of their dual agonist-like and antagonist-like properties, DA partial agonists could have important therapeutic advantages over conventional DA antagonists or full agonists, along with less restrictive side-effects and low abuse liability. Research proposed in this application will establish
18 Drug Abuse
the agonist efficacy of selective DA partial agonists in vitro and in vivo and evaluate their potential utility for treating cocaine abuse and relapse in relevant non-human primate models. In vitro studies will determine the capacity of D/1 and D/2 partial agonists to either stimulate or inhibit adenylyl cyclase activity in squirrel monkey striatal tissue. Corresponding in vivo studies in the same species will: 1) characterize the agonist-like and antagonist-like behavioral effects of D/1 and D/2 partial agonists, 2) establish efficacy relationships by quantifying interactions of these drugs with selective DA antagonists and full agonists and 3) identify potential extrapyramidal and sedative side-effects. Evaluation of D/1 and D/2 partial agonists as pharmacotherapies for cocaine abuse will determine their capacity to modulate the effects of cocaine in: 1) monkeys trained to discriminate different doses of cocaine from vehicle, 2) monkeys trained to self- administer cocaine under a second-order schedule of i.v. drug injection, and 3) monkeys whose drug-seeking behavior is extinguished and subsequently reinstated by cocaine priming and cocaine paired stimuli. Additional studies will determine the selectivity of promising drugs to modulate cocaine-maintained versus food-maintained behavior and the degree to which the cocaine-modulating effect of these drugs are retained as the dose of cocaine is increased. The results will provide relevant information for establishing functional relationships between agonist efficacy and the cocaine-modulating effects of DA partial agonists and for identifying candidate medications to combat cocaine abuse and relapse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BEHAVIORAL ECONOMIC ANALYSIS OF POLYDRUG ABUSE Principal Investigator & Institution: Winger, Gail D. Senior Research Scientist; Pharmacology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2003; Project Start 10-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): Behavioral economic analysis of normalized demand functions is proving to be a useful way to quantify and compare drugs as reinforcers. Demand and response output functions generate two numbers, Pmax and Omax, both of which incorporate scheduled dose and response requirement variables, and likely reflect important aspects of the reinforcing effects of the drug. Because the reinforcing effects of drugs are probably related to their abuse liability in humans, these metrics may allow us to evaluate this aspect of the relative abuse liability of drugs more completely than we can do with most other procedures. The current proposal has as one of its aims the further use and development of the behavioral economic analysis of drugs as reinforcers in rhesus monkey models of i.v. drug-reinforced responding. In particular, the analyses will evaluate the relative reinforcing effects of a number of drugs of abuse using own-price elasticity of demand, will determine how the reinforcing effects of some drugs are modified when these drugs are combined with a second drug of abuse, and will measure demand functions when the animals can choose between two drug options using cross-price elasticity of demand. These latter two studies will provide information about types of polydrug use that are likely to occur commonly in human drug abusers, yet about which we have little data and few ways to study. The results should provide information about some of the behavioral and pharmacological mechanisms that lead people to take drugs simultaneously, or that direct their choice when more than one drug is available. We anticipate that these studies will help to identify and quantify important aspects of drug-seeking and drug-taking behavior and will put us in a better position to understand how these aspects control this behavior and what they might signify for intervention and treatment.
Studies 19
Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BEHAVIORAL ADMINISTRATION
PHARMACOLOGY
OF
DRUG
SELF
Principal Investigator & Institution: Woolverton, William L. Professor; Psychiatry and Human Behavior; University of Mississippi Medical Center 2500 N State St Jackson, MS 39216 Timing: Fiscal Year 2001; Project Start 01-APR-1991; Project End 31-AUG-2002 Summary: This RSDA renewal application is to support the career development of Dr. William Woolverton as research scientist in drug abuse. The candidate has a 25-year history of drug abuse research and has been funded continuously by NIDA for the past 14 years. His primary area of research is drug self administration with nonhuman primates as subjects. This model has played a central role in developing our understanding of drug taking. The PI proposes to extend this model using novel approaches to examine in detail the neurobiological and behavioral mechanisms that control drug taking by non-human primates, and, by extension, humans. Pharmacological studies consistently suggest the importance of CNS dopamine (DA) mechanisms in cocaine abuse. However, interpretation of those studies is ambiguous and the quantitative relationship between pharmacological mechanisms and reinforcing effect has not been established. The proposed research will examine that relationship by testing the hypothesis that relative intrinsic efficacy of a DA agonist determines its relative efficacy as a positive reinforcer. These studies will use agonists and antagonists for DA receptors and transporters ans correlate in vivo findings with in vitro results in rhesus monkey brain tissue. Behavioral mechanisms control drug abuse, as well. Since drugs are usually available to humans either simultaneously or sequentially with other reinforcers, an understanding of factors that control choice between drugs and other drug or non-drug reinforcers is important to a complete understanding drug abuse. The experiments described in the present proposal will examine the applicability to drug choice of models of choice that have evolved from the experimental analysis of behavior: matching and maximizing. Although these models have been shown to account for substantial amounts of data from experiments utilizing non-drug reinforcers, there has been little or no research designed to establish the generality of there models to drugs as reinforcers. This RSDA will allow the candidate to continue and enhance the development of his career as a drug abuse scientist. The research described in the present application will extend and refine the analysis of neurobiological and behavioral control of drug taking using the non- human primate model. In addition, it will have important implications for understanding basic mechanisms controlling drug abuse, for the development of treatment medications, and suggest behavioral approaches to modifying drug choice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BEHAVIORAL SCIENCES TRAINING IN DRUG ABUSE RESEARCH Principal Investigator & Institution: Johnson, Bruce D. Director; Medical and Health Research Associates Association of New York City New York, NY 10013 Timing: Fiscal Year 2001; Project Start 15-AUG-1984; Project End 30-JUN-2004 Summary: The Behavioral Sciences Training in Drug Abuse Research Program (BST) grew from 4 fellows in Year 1 (9/84) to 16 in Years 11-15. This application requests authorization to maintain the current levels of appointments (7 postdoctoral and 9 predoctoral trainees) and activities during each of Years 16-20. The program is
20 Drug Abuse
sponsored by three collaborating institutions, Medical and Health Research Association of New York City, Inc. (MHRA), the grant administrator, National Development and Research Institutes, Inc. (NDRI), the training site, and the School of Public Health (CSPH) at Columbia University, the university affiliate. Dr. Bruce D. Johnson directs a core faculty of 26 leading researchers from MHRA, NDRI, and CSPH, who provide highly structured and rigorous training at NDRI, one of the nation's largest centers for social science research on drug abuse, AIDS, and drug-related crime. The program has trained 94 postdoctoral and predoctoral fellows since 1984. The mission of the BST program is to prepare behavioral scientists, especially from minority backgrounds, for careers in drug abuse research and allied fields. This is accomplished by: (1) appointing promising scientists, half from minority backgrounds, for NIDA-approved traineeship; (2) providing fellows with advanced substantive and empirical training about drug abuse and HIV/AIDS; (3) mentoring and advising fellows; and (4) handling administrative matters and providing stipends. The program emphasizes advanced courses in drug abuse theory and research methods; HIV/AIDS; crime; criminology; and other drug- related topics; and proseminars about fellows' research, methodologies and professional practices and ethics. Trainees engage in direct participation in over 50 Federal grants/contracts supervised by Core faculty and in their own independent research. Core faculty mentor fellows, model professional careers, and facilitate job placement. The program's success is evident in the significant contributions of 78 graduates and 16 current fellows. Those who provided curriculum vitaes have collectively published 24 books, 200 journal articles, and 50 book chapters, and made over 350 conference presentations. BST trainees have also received support from 24 NIH grants, and 38 grants from non-NIH sources. Eight have become Principle Investigators of nine NIH-funded projects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIOBEHAVIORAL STUDIES OF SUBSTANCE ABUSE Principal Investigator & Institution: Mello, Nancy K. Professor; Mc Lean Hospital (Belmont, Ma) Belmont, MA 02478 Timing: Fiscal Year 2001; Project Start 01-JAN-1984; Project End 31-DEC-2003 Summary: This is a competing renewal application for a Senior Scientist Award (KO-5) to continue research on the biological and behavioral aspects of substance abuse. The proposed research is based on several awards currently funded by NIDA, NIH. I am Principal Investigator on three awards: (1) a cooperative agreement with NIDA designed to evaluate new strategies for cocaine treatment medications in basic preclinical and clinical studies (U19 - DA-11007); (2) an R01 award for pre-clinical studies of the interactions between cocaine and opioid drugs with different receptor selectivities (DA-02519) and (3) a contract concerned with the assessment of potential treatment medications in rhesus monkeys (DA7-8073). I am also Scientific Director of a NIDA Clinical Research Center (P50-DA 04059) involving multi-disciplinary studies of the biological and behavioral consequences of polydrug abuse in women. In addition, I am co-investigator on an R01 award designed to evaluate new medications for the treatment of psychostimulant abuse in clinical studies (DA-10757) and co-investigator on a NIDA training grant (DA- 07252). These interrelated clinical and preclinical multidisciplinary studies focus on two general research areas. One area is concerned with effects of abused substances on the endocrine system with special emphasis on the consequences of drug abuse on reproductive hormones in females as well as assessment of gender differences. The second area is concerned with the evaluation of new medications for drug abuse treatment in clinical studies and in primate models of drug self-
Studies 21
administration and drug discrimination. Proposed plans for professional growth include continued study of endocrinology, brain imaging and computer science as well as study of two new directions in our research program that involve collaborative studies in medicinal chemistry and immunology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BOSTON UNIVERSITY SOCIAL WORK MINORITY RESEARCH CENTER Principal Investigator & Institution: Delgado, Melvin; Professor of Social Work and Chair of Ma; None; Boston University Charles River Campus 881 Commonwealth Avenue Boston, MA 02215 Timing: Fiscal Year 2001; Project Start 25-SEP-1999; Project End 31-AUG-2003 Summary: The proposed Boston University School of Social Work, Minority Institutions' Drug Abuse Research Program (BUMIDARP) is designed to develop the capacity of the School of Social Work at Boston University's research infrastructure to conduct epidemiological drug abuse research in African-American and Hispanic populations. The aims of the BUMIDARP are to: (1) encourage faculty at the School of Social Work at Boston University and other schools of social work in the greater Boston area and nearby cities to develop epidemiological projects in the area of drug use and abuse in African-American and Hispanic communities in the greater Boston area; (2) provide research participation experiences for undergraduate and graduate students at Boston University's School of Social Work to encourage them to pursue careers in drug abuse research; 3) provide training to substance abuse service providers to more effectively document the substance abuse problems of African-Americans and Hispanics in the greater Boston area and demonstrate the need for substance abuse programs; 4) conduct two community-based ethnographic studies to document the problem of drug use among Puerto Rican and Dominican gangs in Lawrence, Massachusetts and the intergenerational transmission of drug use between African-American and Puerto Rican mothers and daughters; 5) develop and maintain a Web site that will serve as repository and disseminator and knowledge on epidemiological research with African-American and Hispanic populations for social workers and other professionals who conduct epidemiological research with African-American and Hispanics in the Boston area and nationally; and 6) develop and maintain a database on data files and a collection of publications on drug abuse research with African-American and Hispanic populations. The BUMIDARP is divided into two major components. The first component consists training program. This training program includes the following training activities: a summer faculty training program, a graduate student training program, a graduate lecture series program, an undergraduate biannual colloquims, a series of community workshops, and assistance and training of scientific and senior staff of the BUMIDARP. The second component consists of two research projects. The first project will identify and describe patterns of drug use and the structure of drug dealing in Puerto Rican and Dominican emerging gangs in Lawrence, Massachusetts. The second project will examine the intergenerational transmission of drug use between African-American and Puerto Rican mothers and daughters in the greater Boston area. The Principal Investigator will be managing, coordinating, and evaluating all the BUMIDARP training and research programs and projects. He will also be responsible for developing and maintaining a BUMIDARP Web site, a database of substance abuse data file, and a collection of publications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BUPRENORPHINE ABUSE BY HUMANS--LABORATORY STUDIES Principal Investigator & Institution: Comer, Sandra D. Associate Professor; New York State Psychiatric Institute 1051 Riverside Dr New York, NY 10032 Timing: Fiscal Year 2001; Project Start 01-FEB-1999; Project End 31-JAN-2003 Summary: Heroin use and treatment admissions for heroin dependence have been increasing steadily. Clearly, there is a need for new effective treatments for opioid dependence. Buprenorphine, a long-lasting, partial agonist at the mu subtype of opioid receptor, is one of the most promising new maintenance medications for heroin dependence. Buprenorphine's advantages are that: (1) only mild withdrawal effects develop upon discontinuation of use; (2) it may retain its therapeutic effectiveness when administered on an alternate-day, rather than a daily, schedule; and (3) it is generally well-accepted by patients. Despite these advantages, research indicates that buprenorphine may have abuse liability. Although it is commonly believed that the abuse potential of buprenorphine is low, numerous countries have reported illicit diversion of buprenorphine and a growing population of buprenorphine abusers. To date, no laboratory studies have evaluated the abuse liability of buprenorphine in humans using a drug self- administration protocol, in which research volunteers are given the opportunity to take drug under controlled conditions. We are proposing to evaluate the abuse potential of buprenorphine in the laboratory, incorporating selfadministration procedures with other measures of opioid effects. Physiological responses, subjects' verbal reports of drug effects, and learning and performance of a variety of computer tasks will also be measured. The studies will investigate the conditions under which buprenorphine may be self-administered in non- opioiddependent individuals with a history of opioid abuse, as well as in opioid individuals. The aims of the proposed studies are to: (1) determine the conditions under which buprenorphine will serve as a reinforcer; (2) evaluate the abuse liability of the buprenorphine/naloxone combination, which is currently being developed to reduce illicit diversion of buprenorphine; (3) compare the reinforcing effects of buprenorphine with methadone, which is currently the most widely used maintenance medication for heroin dependence; and (4) assess buprenorphine self- administration in participants maintained on different doses of morphine. This research will furnish useful information for clinicians treating heroin abusers, and importantly, will provide information about the effects of buprenorphine on multiple measures of human functioning, as well as actual buprenorphine use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CATALYTIC ANTIBODIES AS THERAPY FOR DRUG ADDICTION Principal Investigator & Institution: Janda, Kim D. Ely R. Callaway Professor of Chemistry; Scripps Research Institute 10550 N Torrey Pines Rd San Diego, CA 920371000 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 30-APR-2007 Summary: (provided by applicant): The problem of drug addiction continues to plague society. In particular, cocaine, amphetamines, and nicotine represent the major substances of abuse leading to dependence and significant behavior modification. A number of pharmacotherapies and psychosocial programs have been implemented over the years to aid in cessation, detoxification and relapse prevention with limited success. Cocaine abuse remains prevalent, people continue to smoke, a variety of amphetamines litter the recreational drug market, and the abuse of heroin is on the rise especially among adolescents, all with alarming statistics. In this regard, alternative therapies are
Studies 23
crucial, either as stand-alone treatments or to complement those already in existence, if progress is to be made in treating substance dependence. This proposal provides the foundation of an immunopharmacological therapy for drug addiction based on catalytic monoclonal antibodies (mAbs) that degrade drugs of abuse. The specific aims encompass 1) anti-cocaine catalytic mAb investigations in a rat locomotor model for testing efficacy, pharmacokinetics, and improvements in catalytic activity using cuttingedge recombinant DNA and structure-based strategies. Some mAbs nave been prepared and are ready for study. As improved catalysts become available from antibody engineering, they will be characterized and then tested in rats. 2) Synthesis of haptens to elicit catalytic mAbs specific for the degradation of amphetamines and nicotine. The novel hapten designs are derived using a "bait and switch" approach developed in our laboratory. Preliminary studies of mAbs against MDMA ("ecstasy") are in progress. Rationales are presented for the requirements of catalytic mAbs with regard to drug dependence in humans and their eventual realization as clinical therapeutics. Although the complete elimination of drug addiction may be an ideal, catalytic mAbs along with other pharmacological agents and counseling programs to alleviate addiction problems would prove beneficial for society. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CENTER FOR DRUG ABUSE RESEARCH Principal Investigator & Institution: Martin, Billy R. Louis/Ruth Harris Professor and Chair; Pharmacology and Toxicology; Virginia Commonwealth University Richmond, VA 232980568 Timing: Fiscal Year 2001; Project Start 30-SEP-1988; Project End 30-JUN-2006 Summary: For over two decades, investigators at Virginia Commonwealth University (VCU) have made significant contributions to our understanding of drugs of abuse. The interests of these researchers encompass drug synthesis and pharmacokinetic, neurochemical, neurochemical, molecular, behavioral and pharmacological characterization of most classes of abused drugs. While there have always been active collaborations among some of these investigators, the drug abuse research effort at VCU has been enhanced by the creation of the NIDA Center on Drug Abuse Research. The primary objective of the Center is to foster interdisciplinary research on drug abuse at VCU. The Center will continue to provide a mechanism for bringing together scientists from many different disciplines who have had the role for all drug abuse grants at VCU, which includes numerous R01's, NIDA contracts, a training grant, several development of young scientists in drug abuse research. Our success in stimulating collaborative research as well as research projects. The role of the Core is to provide program management and facilitate interaction and cooperation among the participants through its administrative, drug synthesis, shared instrumentation, mouse knock-out facility, and oocyte laboratory. In addition, a Small Grants Program provides a mechanism to attract new drug abuse problems by junior and senior scientists already associated with the Center. Of course, basic research will continue to be the primary focus of the Center. Three Projects are devoted to synthesis of nicotine analogs, pharmacological characterization of nicotine receptor subtypes, and preclinical and clinical studies on nicotine addiction. The remaining six projects address the mechanisms by which cannabinoids produce their acute transduction mechanisms that include both adenylyl cyclase and ion channels, and interactions between the opioid and cannabinoid systems. Finally, the roles of the endogenous nicotine and cannabinoids produce their acute and chronic effects. Efforts are directed toward understanding the nature of ligand-receptor interactions, signal transduction mechanisms that include both adenylyl cyclase and ion
24 Drug Abuse
channels, and interactions between the opioid and cannabinoid systems. Finally, the roles of the endogenous nicotine and cannabinoid systems in drug dependance, pain perception, convulsions and immune function are being examined in a systematic manner. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHILD MALTREATMENT AND LATER DRUG USE Principal Investigator & Institution: Hussey, Jon M. Maternal and Child Health; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, NC 27599 Timing: Fiscal Year 2003; Project Start 10-APR-2003; Project End 31-MAR-2005 Summary: (provided by applicant): The goal of this research is to further our understanding of the relationship between child maltreatment and subsequent drug use during adolescence and young adulthood. A wealth of correlational evidence suggests that an increased risk of drug use may be one of the most serious consequences of child maltreatment, but broad gaps in our knowledge remain. This study will extend our understanding of the maltreatment substance use association by employing a theorydriven design, attempting to identify key intervening mechanisms, including measures of the major forms of maltreatment and the major types of substances used, and by utilizing a large, nationally representative, and longitudinal data set. The specific aims of the study are to 1) provide detailed national estimates of adolescent and young adult drug use by childhood maltreatment status; 2) describe the natural history of drug use by childhood maltreatment status; and 3) test a conceptual model of maltreatment and substance use that identifies social ties to family, school, and peers as key intervening mechanisms. The data used to address these aims come from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative, probability-based survey of adolescents in grades 7-12 first interviewed in 1995 and then re-interviewed in 1996 and 2001. Self-reported measures of neglect, physical maltreatment, sexual abuse, and social service involvement experienced prior to the 6th grade are included on the Wave III instrument, when respondents will be 18-26 years old. The addition of these retrospective maltreatment reports, when combined with the wealth of repeated measures on drug use, social relationships, and other determinants of health behaviors found in Add Health, will create a new, unique, and valuable data source for examining this topic. The results from this project should inform drug abuse prevention and intervention programs, particularly those that specifically target victims of child abuse and neglect. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CHILDHOOD ETIOLOGIC DETERMINANTS OF ADOLESCENT DRUG USE Principal Investigator & Institution: Brook, Judith S. Professor; Community and Preventive Med; Mount Sinai School of Medicine of Nyu of New York University New York, NY 10029 Timing: Fiscal Year 2001; Project Start 15-MAR-1995; Project End 28-FEB-2005 Summary: The overall goals of this longitudinal study are to examine the etiologic determinants of young adult drug use/abuse and the consequences of use on the individual's functioning. The original sample in 1975 consisted of 976 mothers whose children's average age was 5 (T1). Subsequently, children and their mothers were interviewed when the children's average age was 13 (T2), 15 (T3), and 21 (T4). At T5,
Studies 25
only the youth (average age 26) was interviewed. A sixth data collection (T6) is proposed to accomplish the following: (1) to examine interrelations and interactions of personality, family, peer, and ecological factors (starting in early childhood) as they affect the course of drug use/abuse over time (i.e., onset, stability, and change); and (2) to study the consequences of long-term drug use of adult intra- and interpersonal functioning. As in the past, separate interviews with young adults will be conducted in their own homes by trained interviewers. Scales with adequate psychometric properties measuring the independence variables will be developed from the interview schedules. The primary analytic techniques will be causal analysis and/or hierarchial or logistic regression. The significance of this study lies in its longitudinal design with in-depth intra- and interpersonal data available at several crucial stages of development. These data allow us not only to examine the pathways to drug use/abuse from the very beginning but also to study the course of drug behavior over time, i.e., the factors related to the subject's becoming more (or less) involved in drug use/abuse over a span of years. Such knowledge will help pinpoint those adolescents/young adults at risk for increased drug involvement and will provide detailed and specific guidelines for prevention and treatment. Our longitudinal study of the consequences of drug use is unique in that the long-term effects of use can be evaluated to see if their impact is cumulative. Identification of childhood and adolescent factors that can mitigate or compensate for the impact of drug consequences on later functioning would provide additional aids for effective prevention and treatment efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL ADDICTION RESEARCH AND EDUCATION (CARE) PROGRAM Principal Investigator & Institution: Arnsten, Julia H. Associate Professor; Montefiore Medical Center (Bronx, Ny) Bronx, NY 104672490 Timing: Fiscal Year 2002; Project Start 25-SEP-2002; Project End 30-JUN-2006 Summary: (provided by applicant): In response to NIDA?s request for applications to support "Clinical Research Education Programs in Drug Abuse and Addiction," the Albert Einstein College of Medicine (AECOM) and its University Hospital, Montefiore Medical Center, propose to establish a research-oriented fellowship program for physicians interested in careers in drug abuse. This program (the Clinical Addiction Research-and Education, or CARE program) will be administered by AECOM?s Department of Psychiatry & Behavioral Sciences, and will draw additional NIDAfunded research faculty from AECOM?s Departments of Medicine, Family Medicine, and Epidemiology & Social Medicine, as well as from two local New York City research institutions: the Center for Urban Epidemiologic Studies at the New York Academy of Medicine (NYAM), and the Institute for Treatment and Services Research at the National Development and Research Institutes (NDRI). In addition to providing the training necessary to prepare physicians for independent careers as drug abuse researchers, CARE Program faculty will collaborate with key educational leaders at AECOM and Montefiore Medical Center to enhance evidence-based substance abuse training for residents in Internal Medicine, Family Medicine, Social Pediatrics, and Psychiatry. The specific aims of the CARE Program are: (1) To establish a researchintensive fellowship training program (the CARE Fellowship Program) for physicians who have completed residency training in Internal Medicine, Family Medicine, or Psychiatry, and are seeking careers that combine drug abuse research and clinical work with drug users; and (2) To expand the inpatient and outpatient training in substance abuse diagnosis and treatment received by Internal Medicine, Family Medicine, Social
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Pediatrics, and Psychiatry residents at Montefiore Medical Center (the CARE Resident Training Program). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL PROFESSIONALS
RESEARCH
EDUCATION
FOR
DRUG
ABUSE
Principal Investigator & Institution: Newton, Thomas F. Psychiatry & Biobehav Sciences; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-MAY-2007 Summary: (provided by applicant) In response to PA 99-093, the UCLA Integrated Substance Abuse Programs submits this application for funding of the Clinical Research Education for Drug Abuse Professionals training program. The program will develop professionals in health disciplines involving clinical research pertaining to the study of drug abuse and its treatment, starting in the first year with two M.D. or Ph.D.level trainees and expanding in future project years to three per year. This comprehensive education program will consist of a two-year period of coordinated clinical research training combining coursework, seminars, and practical experience. Trainees will acquire (1) a comprehensive education in a variety of disciplines, ranging from epidemiology of drug abuse to neurobiology of addiction and consequent effects on the brain; and (2) in-depth clinical research experience, with a focus on conduct of clinical trials research in both institutional and community-based settings. After the first three-quarters of the first year of the program, in which trainees gain knowledge in a core curriculum, trainees will spend the remainder of their time in "hands-on" clinical research at inpatient and outpatient sites. Given the applicant organization?s vast research portfolio, its history of research training, its distinguished academic affiliation, and its interrelated capacities in drug abuse research, clinical practice, and clinical training for specific projects, the proposed program will fill a pressing need for dedicated formal training of clinical researchers, setting the foundation for a highquality program that will continue to produce the drug abuse professionals required to investigate and address drug abuse and its consequences. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL RESEARCH ON DRUG ABUSE Principal Investigator & Institution: Strain, Eric C. Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 01-APR-1997; Project End 31-MAR-2002 Summary: (Applicant's Abstract) This is an application for a KO2 Independent Scientist Award (ISA) from the National Institute on Drug Abuse. The applicant is Eric Strain, a physician-researcher in the Department of Psychiatry at Johns Hopkins University School of Medicine. Dr. Strain has devoted his career to research on drug abuse and to treatment of substance abusing patients, with his primary interest focused upon the development of medications for the treatment of opioid and cocaine dependence. This work has included human laboratory studies as well as clinical trials testing the efficacy of medications for the treatment of substance abuse disorders. There are six short-term and two long-term career goals that will be accomplished through the support provided by this ISA. Short-term career goals are: 1) to conduct clinical pharmacology and treatment-evaluation research pertinent to the development of medications for the treatment of substance abuse disorders, 2) to study medication combinations being
Studies 27
developed for the treatment of substance abuse disorders, 3) to develop methodologies integrating pharmacotherapies with behavioral therapies in clinical trials of substance abuse treatments, 4) to study treatment approaches for patients with combined opioid and cocaine dependence, 5) to develop expertise in the development process of new medications for the treatment of substance abuse disorders, and 6) to regularly present results from studies at scientific meetings, in peer-reviewed journals, and to the treatment community. Achieving these short-term goals will contribute to accomplishing the first long-term goal, to become a recognized expert in drug abuse, its treatment, and research issues related to the study of substance abuse. In addition, a second long-term goal is to serve as a mentor to young scientists, and especially function as a role model for young physicians interested in pursuing a career in substance abuse research. The Research Plan included in this application provides illustrative investigations that provide a mechanism for achieving the career goals described. These studies examine the pharmacological effects of buprenorphine/naloxone combinations in human laboratory studies, and test a novel pharmacotherapy combined with a known and effective behavioral therapy in an outpatient clinical trial treating cocaine dependence. This research will be conducted through the Behavioral Pharmacology Research Unit (BPRU), a component of the Hopkins Department of Psychiatry. Dr. Strain has the strong support of the BPRU, the Department of Psychiatry, and the Hopkins School of Medicine, and this ISA provides a mechanism for ensuring the continuation of his highly productive career in substance abuse research. Thus, this ISA represents a good investment by NIDA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL TRIALS NETWORK MID-ATLANTIC COLLABORATIVE GROUP Principal Investigator & Institution: Stitzer, Maxine L. Professor of Behavioral Biology; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: This is a proposal to create a Mid-Atlantic regional node of the planned NIDA National Drug Abuse Treatment Clinical Trials Network. This Mid-Atlantic region incorporates Maryland, Virginia, and Washington, D.C., and involves a collaborative effort among major universities in the region (Johns Hopkins University School of Medicine, Virginia Commonwealth University, University of Maryland) and a diverse array of community drug abuse treatment programs. These community treatment programs provide clinical research access to a large population of drug abuse patients with great demographic, diagnostic, and syndromal diversity, as well as to treatment programs representing great diversity in the types, modalities, and focus of their treatment service delivery. These academic and community treatment programs have established strong collaborative relations and are jointly committed to systematic community-based research that will assess the effectiveness of different drug abuse treatments and services directly in community treatment programs, and that will assess and study factors related to adoption of improved treatments, as requested in the RFA. The academic centers have extensive experience and expertise in conducting and managing controlled clinical trials of drug abuse treatments, including both behavioral treatments and pharmacological treatments, as well as integrated behavioralpharmacological treatments, for a broad range of different types of substance use disorders (heroin, cocaine, sedatives, alcohol, tobacco). The centers also have extenisve experience and expertise in training, implementation, and assessment within
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community treatment programs. This collaborative group proposes to participate in the NIDA Clinical Trials Network, to conduct controlled trials of behavioral and/or pharmacological drug abuse treatments in community clinics, and to investigate the process of and influences on community clinic adoption of new treatments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL TRIALS NETWORK: NEW ENGLAND NODE Principal Investigator & Institution: Carroll, Kathleen M. Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: For too long, there have been substantial gaps between knowledge on effective treatments for drug abuse generated by clinical researchers and drug abuse treatment as practiced in community substance. The creation of enduring partnerships between researchers and community providers as envisioned by NIDA in creating the Clinical Trials Network represents a promising opportunity to improve the quality of drug abuse treatment in the United States and to generate important new knowledge about effective treatments applicable to diverse groups of drug abusers. We propose to utilize the Network as a platform on which to conduct an innovative series of Stage III research projects. The specific aims are: A. To develop an infrastructure for drug abuse treatment research through a partnership of the Yale Division of Substance Abuse and a network of community treatment programs (CTPs) in New England in order to (1) conduct clinical trials in a number of areas, including pharmacologic, behavioral, combined pharmacologic/behavioral practice, and technology transfer research and (2) work collaborative with other Nodes in the NIDA Clinical Trials Network. B. In collaboration with the Steering Committee of the Clinical Trials Network and NIDA, to develop and organizing framework for the Network, including policies on protocol development and review, publications and dissemination, quality control and data management, selection of assessment batteries and outcome measures, treatment development and therapist training, and clinical care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CLUB DRUG USE IN YOUNG, LOW INCOME WOMEN Principal Investigator & Institution: Wu, Helen Z. Obstetrics and Gynecology; University of Texas Medical Br Galveston 301 University Blvd Galveston, TX 77555 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 30-MAY-2003 Summary: (provided by the applicant): Current prevention and treatment programs for substance abuse are based primarily on data collected from men, even though women have different origins and patterns of substance abuse and are more vulnerable to its adverse consequences. Young, low-income women, in particular, have largely been excluded from drug abuse studies. Furthermore, racial/ethnic differences have not been investigated in this population. The proposed study will use both qualitative and quantitative methods to identify the natural history, patterns, risk factors, and ethnic/cultural differences in club drug use among young, low income women, under the guidance of theoretic models of the Social Cognitive Theory and stages of progression in substance use. A total of 600 women from three prominent racial/ethnic groups (200 non-Hispanic white, 200 Hispanics, and 200 African Americans) between 18 and 30 years of age will be recruited in the family planning clinics at the University of Texas Medical Branch. Data on history of club drug use will be collected among these young, low-income women. Correlates to club drug use will include: a) younger age (18-
Studies 29
24), b) favorable attitude towards club drugs; and c) multiple socio-environmental and psychobehavioral factors known to encourage drug use. In addition, the different clusters of correlates of club drug use will be assessed across ethnic groups. Our quantitative research (questionnaire survey) will provide information on whether the progress of club drug use follows patterns of other illicit drug use, while our qualitative research (face-to-face interviews) will assess the unique features of club drug use. The results will provide an understanding of the reasons behind club drug use in young, low-income women, and why some stop using, others continue, and some develop dependence. These data will also allow us to understand differences in club drug users based on ethnicity, which will ultimately lead to the design of culturally sensitive prevention strategies. These study methods and findings will be used to design a randomized controlled trial of these prevention strategies in our family I planning population of 27,000 patient visits annually. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CNS VIRAL INJURY AND VULNERABILITY TO OPIATE DRUG ABUSE Principal Investigator & Institution: Solbrig, Marylou V. Neurology; University of California Irvine Campus Dr Irvine, CA 92697 Timing: Fiscal Year 2001; Project Start 01-APR-1998; Project End 31-MAR-2003 Summary: Applicant's Abstract Acquired Immunodeficiency Syndrome (AIDS) and intravenous drug abuse are overlapping epidemics. The extent of overlap raises the possibility that vulnerability to opiate dependence may be directly or indirectly linked to virus-induced neurochemical and molecular changes in the CNS. The objective of this proposal is to study viral-induced changes in vulnerability to opiate reinforcement and dependence. Using a small animal model of a chronic viral encephalitis with neuropathologic similarities to human HIV neuropathology, the hypothesis that viralinduced changes in endogenous opioid expression are linked to behavioral effects on opiate reinforcement and dependence can be tested. An animal model of a persistent CNS viral infection based on experimental Borna disease virus infection of the rat will be developed then tested for 1) the reinforcing effects of opiates as measured by intravenous self-administration of heroin (Specific Aim 1) and 2) the dependenceinducing effects of opiates, as measured by the somatic signs of opiate withdrawal, and the affective (emotional) effects of opiate withdrawal as measured by place aversion (Specific Aim 2). The neural substrates for altered opiate sensitivity will be established by examination of opiate-rich structures using quantitative neuroanatomic techniques (Specific Aim 3). Finally, in vitro, the viral mechanisms for altered opioid expression will be investigated by examination of the effects of viral infection on transcriptionally active host cell proteins (Specific Aim 4). These studies will go far toward elucidating viralinduced neural mechanisms mediating opiate dependence. Knowledge of how viruses contribute to the development of vulnerability to opiate use will provide new insights into treatment and prevention of opiate abuse and drug abuse in general. The work proposed in this MCSDA application is designed to provide training in neuropharmacology, neurobehavior, virology, and molecular biology. The research program was developed with the assistance of George Koob (Ph.D.) of The Scripps Research Institute (TSRI) and W. Ian Lipkin (M.D.) of the University of California, Irvine (UCI). The research plan will allow for the development of new skills and techniques in several disciplines: the learning of methodologies utilizing animal models of drug abuse, plus molecular, cell culture and viral preparative techniques. Because of the scope and multidisciplinary nature of the proposal, the work will be conducted jointly at
30 Drug Abuse
TSRI and UCI. At the conclusion of the grant period, the requisite skills in behavioral pharmacology, neuropharmacology and molecular biology for continued work in the study and treatment of drug addiction will have been acquired by the candidate. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COGNITIVE MODELING OF RISKY DECISIONS IN SUBSTANCE USERS Principal Investigator & Institution: Stout, Julie C. Associate Professor; Psychology; Indiana University Bloomington P.O. Box 1847 Bloomington, IN 47402 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2005 Summary: (provided by applicant) Clinical neuroscientists have recently become interested in laboratory based simulated gambling tasks for investigating decision making deficits in drug abusers. Several studies have now shown that drug abusers perform poorly in these tasks compared to non abusers. These tasks have the potential to reveal interrelationships of several important factors, such as learning, responsivity to rewards and punishments, personality, and drug abuse profiles, which must be understood to enhance the treatment and prevention of drug abuse. Although useful for examining decision making in the laboratory, the behavior manifested in these tasks is multiply determined, making it impossible to isolate the component processes by simply quantifying the observable behaviors. For example, it is difficult to infer whether poor performance is related to insufficient attention to punishments, altered effects of rewards, inability to learn outcome contingencies, or simply reckless, random behavior in drug abusers. This is a translational research project in which mathematical models previously developed and tested in cognitive psychology will be applied to laboratory gambling tasks currently being used to study decision making in drug abusers. For the proposed project, formal models will be developed to reveal the critical processes that are intertwined and conflated within two gambling tasks. These models will provide a set of theoretically derived measures that describe and quantify basic cognitive processes that underlie the empirical data. We will use these new measures to determine the relative roles of learning, rewards, and punishments in the decision making behavior of drug abusers. Finally, we will determine the relationships between individual differences in drug abusers (i.e., type of drug abused, severity of current abuse, risk-seeking behavior traits) and the cognitive processes that underlie their decision making. The final product of this research will be an integration of our findings on decision making in drug abusers with available neuropsychological models of drug addiction. These theoretical analyses will permit a more direct evaluation of current neuropsychological theories by providing direct estimates of the mediating psychological constructs, thereby eliminating the need to making inferences from observable behavior to neurophysiology. Instead, it will finally be possible to specifically determine the implications of hypothesized neural systems for cognitive and motivational processes involved in drug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COGNITIVE NEUROPSYCHOLOGY OF HIV AND DRUG ABUSE Principal Investigator & Institution: Martin, Eileen M. Professor; Psychiatry; University of Illinois at Chicago 1737 West Polk Street Chicago, IL 60612 Timing: Fiscal Year 2001; Project Start 20-AUG-1999; Project End 31-JUL-2004 Summary: The long-term objectives of this research are to employ a cognitive neuropsychological model to conceptualize the effects of HIV and drug abuse on the
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brain and to relate these effects to critical behaviors in HIV-seropositive persons such as high risk sexual and injection practices. Evidence indicates that drug abuse and HIV infection cause dysfunction in overlapping frontal-subcortical brain regions and that careful study of specific cognitive functions mediated by different frontal-subcortical circuits will permit characterization of HIV-related cognitive impairment and its manifestation in persons who abuse drugs. This study will begin to evaluate the question of whether a history of drug abuse in the context of HIV infection will increase vulnerability to HIV-related cognitive deficits, a question with potential diagnostic and therapeutic implications. The specific aims of this investigation are to compare the performance of HIV-seropositive (HIV+) and HIV- seronegative (HIV-) with a current or past history of drug abuse on measures of decision-making, working memory, and response inhibition, "executive" functions dependent on the integrity of prefrontalsubcortical pathways and potential mechanisms of HIV- related cognitive dysfunction; to evaluate the relationship between parameters of drug abuse severity to deficits in executive function in HIV+ and HIV - drug users; to evaluate the presence and severity of executive deficits in HIV+ drug users at different stages of HIV disease; and to evaluate the relationships between executive functions and sexual and drug use-related risk behavior. The study will evaluate cognitive function in HIV+ and HIV- drug users employing state of the art computerized measure developed to model specific impairments associated with dysfunction of frontal-subcortical circuits. Data from the proposed study will advance knowledge of cognitive aspects of HIV-1 infection; the practical implications of how cognitive impairment associated with HIV influences behavior, and recent attempts to bridge the gap on how specific cognitive impairment can influence risk behavior Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COGNITIVE PROCESSES IN COCAINE AND POLYDRUG ABUSE Principal Investigator & Institution: Fillmore, Mark T. Assistant Professor; Psychology; University of Kentucky 109 Kinkead Hall Lexington, KY 40506 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: (provided by applicant) Cocaine abuse remains a serious public-health concern in the United States. The propensity to binge use cocaine, and to combine it with other abused drugs, such as alcohol, heighten the health risks associated with cocaine use. Cocaine can impair several cognitive and mental processes, including those that control behavior. Thus, it is important to understand how such disturbances also can reduce control over cocaine intake once cocaine use has begun. The proposed project aims to determine how an inability to control cocaine consumption is linked to cocaineinduced impairment of inhibitory and activiational processes involved in the self-control and regulation of behavior. The project will test acute and chronic cocaine effects in adult cocaine abusers. The research combines measures of cocaine effects on cognitive inhibitory processes with conventional indices of abuse potential, based on subjective rewarding effects of the drug and its ability to reinforce self-administration. Initial studies will determine dose-response functions of cocaine on inhibitory control, and compare effects of different routes of administration. Subsequent studies will determine how inhibitory processes contribute to abuse potential by testing the degree to which acute cocaine-induced impairment of inhibitory control contributes to cocaine selfadministration. The research also will determine how alcohol contributes to cocaine abuse potential by testing the degree to which its concomitant administration exacerbates cocaine-induced impairments of inhibitory control. Finally, the research will provide information on how long-term cocaine use could contribute to cognitive deficits
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that resemble attentional disorders, by producing a chronic deficit in basal levels of inhibitory control. The research has several long-term objectives. First, the findings and research strategies used to examine the role of cognitive mechanisms in cocaine abuse will allow the investigators to further develop and refine drug-testing protocols that measure the ability of medications to block the cognitive-impairing effects of cocaine which could play a role in its abuse potential. Second, the proposed research strategies and measures will provide initial methods and protocols for studying the combination of cocaine with other drugs of abuse that might also disrupt cognitive functions, such as opiates, which are also commonly co-administered with cocaine. Finally, the procedures for assessing inhibitory processes can be used to assess drug-free, basal levels of cognitive inhibitory functioning in drug abusers. Such studies would provide information on the degree to which these basic cognitive mechanisms play a role in the etiology of a general disinhibitory psychopathology which is considered to be a common phenotypic characteristic among drug abusers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COLLABORATIVE RESEARCH ON DRUG ABUSE Principal Investigator & Institution: Bentler, Peter M. Professor; Psychology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2001; Project Start 29-JUN-1974; Project End 31-MAY-2002 Summary: The program project proposal represents an integrated attempt to apply "state-of-the-art" methodologies for theory testing with naturally occurring phenomena to the comparative assessment of theories for drug abuse antecedents and consequences. Many important questions regarding the etiology and consequences of drug use and abuse must be studied in naturally occurring contexts. Typical experimental methods that assign subjects randomly to conditions of drug use leading to various degrees of abuse are unethical. Animal models and biochemical methods also cannot address many important questions, such as the psychosocial, financial, and generally disruptive effects of drug use. Nonetheless, it is critical to compare and contrast theories that attempt to explain drug-taking etiologies and consequences. This program project consists of six interrelated research studies that develop, compare, and contrast numerous theoretical models in new and existing databases from psychology, epidemiology, psychiatry, education, and sociology, using modern multivariate psychometric/statistical methods to control for artifacts and competing hypotheses. Under the umbrella of the program project, these studies are both theory-driven and relevant to drug use, yet range from the development of new statistical methods to analyze drug abuse data, to a unique effort to study the dynamics of gang membership. The Models and Methods Project is extending the state-of-the-art in latent variable modeling to a variety of types of data. The Longitudinal Consequences Project tests theories of long-term consequences of drug use through a 20-year follow-up of a large sample of adolescents, and adds a community sample to cross-validate findings. The Collaborative Project works with investigators who have generated over a dozen valuable epidemiological and longitudinal datasets to answer a variety of questions about the etiology and consequences of drug use. The African-American Drug Abuse Project is a longitudinal study contrasting those adolescents at high risk for drug use and abuse with others in their community. The Memory and Cognitive Processes in Drug Abuse Project uses contemporary psychological theories on memory and cognition to improve and test theories of drug use. The Computer Intensive Hypothesis Testing Project uses computer simulation to provide near-exact test performance for standard statistics that behave badly on drug abuse data. The Core Project integrates all
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components, hosts visiting scholars, and provides free computer access to national drug abuse researchers. It also proposes to provide opportunities for minority high school and undergraduate students to participate in some of its work. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONFERENCE--COLLEGE ON PROBLEMS OF DRUG DEPENDENCE Principal Investigator & Institution: Adler, Martin; Professor; College on Problems of Drug Dependence Drug Dependence Philadelphia, PA 19140 Timing: Fiscal Year 2001; Project Start 01-JUN-2000; Project End 31-MAY-2005 Summary: The College on Problems of Drug Dependence (CPDD) is the oldest standing scientific organization devoted to research on drug abuse. It will hold its 62nd Annual Scientific Meeting at the Caribe Hilton Hotel in San Juan, Puerto Rico, from June 17 through June 22, 2000. The goal of the annual meeting is to bring together the outstanding scientists in the field of drug abuse to present their work and discuss the latest findings in all facets of the field including molecular biology, genetics, medicinal chemistry, pharmacology, behavior, neuroimmunology, treatment, prevention, and epidemiology. Papers include reports about all drug classes involved in drug abuse including opioids, cocaine, methamphetamine, cannabis, nicotine, inhalants, hallucinogens, and sedative-hypnotics. No other meeting covers the breadth of research in the drug abuse field. There will be 5 days of scientific sessions which will be made up of volunteer oral presentations, poster sessions, and 12-16 timely symposia. Special attention is given to the needs of women, young scientists, trainees, students, and underrepresented populations in drug abuse research, and planned discussions and gettogethers are a vital part of the meeting. There will be a good balance of all fields and topics representing the drug abuse research community. To insure a proper balance and up-to-date topics, final choices from the symposia submitted by scientists in the field will not be made by the Program Committee of CPDD until the fall of 1999. Symposia topics are solicited from all members and all interested scientists by calling for submissions on our website, in our Newsline publication, in our journal Drug and Alcohol Dependence, and in announcements made at the annual meeting. Once the symposia have been chosen, submitted abstracts will be divided into poster and oral sessions in such a way that that there is a balance among of the various research facets of the drug abuse field. Plenary and award lectures as well as several satellite meetings and specialty workshops will complete the program. As has been done for many years, the Proceedings will be published as an archival NIDA monograph and will be mailed to all meeting registrants and to all NIDA grantees. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CORE--INTERVENTIONS Principal Investigator & Institution: Mccoy, H V.; University of Miami Box 016159 Miami, FL 33101 Timing: Fiscal Year 2001; Project Start 29-SEP-2000; Project End 28-SEP-2005 Summary: The overall goal of the University of Miami CDAAR is to move the elimination of health disparities by enhancing behavioral, basic, clinical, epidemiological, prevention, and applied research on drug abuse and HIV infection and other co-occurring illnesses, through the support of shared center resources. The CDAAR's theme, "Eliminating Health Disparities for Drug Users in the HIV/AIDS Epidemic" is an ideal focus for the Interventions Core. The Interventions Core will support the overall goal of the CDAAR by facilitating the interaction of psychological,
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sociological, behavioral, and clinical sciences among affiliated University of Miami investigators, to develop, implement and evaluate multi- factorial interventions of relevance to the drug abuse and HIV/AIDS research arena. The use of this core by CDAAR members will enhance their work in HIV/AIDS and drug abuse through the utilization of new procedures they have not capitalized on before, with the ambition of advancing knowledge in the area of interventions focusing on narrowing the health disparities gap for chronic drug users. The Core, led by Dr. H. Virginia McCoy will foster the combination of clinical, basic and behavioral science to produce collaborative, transdisciplinary research in behavioral and clinical interventions. Within this context, the Intervention Core will accomplish the following aims: (1) foster synergy among intervention scientists, (2) enhance coordination and collaboration of interventionspecific research; (3) support emerging research opportunities through the development of an Intervention Mentor/Partner program; and (4) promote economy of scale by sharing intervention resources. There has never been a greater need to increase knowledge in drug abuse and its relationship to the HIV/AIDS epidemic. This need is underscored by the growing health disparities between chronic drug users and other populations within the HIV/AIDS epidemic. Built upon 25 years of interdisciplinary activity in drug users and other populations within the HIV/AIDS epidemic. Built upon 25 years of interdisciplinary ability in drug abuse research, the UM CDAAR Interventions Core will become a national model of collaborative intervention research and a resource for researchers at other institutions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CORE--TRAINING Principal Investigator & Institution: Johnson, C Anderson. Sidney Garfield Professor of Preventive; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, CA 90033 Timing: Fiscal Year 2002; Project Start 01-NOV-2002; Project End 31-OCT-2007 Summary: (provided by applicant): Drug abuse is a complex problem. To create effective prevention programs, research ranging from biological to social must be considered and integrated. Unfortunately, most prior prevention research has lacked adequate structural opportunities and knowledge of the appropriate skills necessary to carry out this goal effectively. With a diverse group of investigators from otherwise distinct research areas, the training program will promote transdisciplinary (TD) research. Mechanisms to foster integration will occur at all stages of the research process from conceptualization of the research problem to the reporting of research findings. In addition, a process of self-study will be built into the program so that trainees together with faculty will develop the skills necessary for collaboration across disciplines. Because our research is focused on sociodemographically diverse populations, a cultural competency component for faculty, students, postdocs and researchers, is also central to the training core. The specific aims of this training core are to: (1) recruit, train, and mentor new researchers in TD drug prevention research, (2) recruit, train, and mentor established researchers from relevant academic disciplines in the skills, techniques, and practice of TD drug abuse prevention research, (3) fund innovative pilot studies that provide opportunities to bridge disciplines and techniques from basic research and other relevant disciplines to advance the science of drug abuse prevention, (4) build upon and modify the highly successful and firmly established research training program in cancer prevention research in order to further develop applications for TD drug abuse prevention training. Structural opportunities, incentives and skill building will be realized through the identification of academically diverse collaborative faculty,
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student, postdoc research teams; research assistant and fellowship support for TD research interactions; developmental research awards for cross-disciplinary collaborations; statistical support from the training core. A seminars series, work in progress meetings, core readings, and discussion groups will focus on skill building and critical thinking about conducting effective and culturally competent TD research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COST AND ADHERENCE IN DRUG ABUSE TREATMENT Principal Investigator & Institution: Stoller, Kenneth B. Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): This is a proposal for a Mentored Patient-Oriented Research Career Development Award (K23). A team of highly accomplished and diverse mentors, all full professors at Johns Hopkins, has committed to support the proposed work to facilitate my transition to an independent patient-oriented drug abuse treatment researcher. Their records of productive research and experience in mentoring junior faculty are extensive and their respective areas of expertise are complementary and central to the content of this proposal (involving drug abuse treatment, cost/costbenefit analysis, and adherence to treatment services). Dr. Eric Strain is a psychiatrist highly recognized for his research involving clinical pharmacology and drug abuse treatment-evaluation. Dr. Robert Brooner is a widely respected clinician and researcher with particular interest in novel treatment models utilizing behavioral enhancements. Dr. David Salkever is a highly recognized leader on the cost/cost-benefits of medical care. This proposal consist of three highly related components of my career development plan which will be enabled by this award: 1) enhance my knowledge and expertise in medical economics, cost/cost-benefit methodologies, general clinical trials methodology and analyses; 2) design, conduct, analyses and publication of the results of four studies involving cost and cost benefit of varying treatment models and interventions and on improving adherence to drug abuse treatment plans; and 3) use of this experience and data to inform the development and submission of future R01 or similar grant mechanisms to extend my work in these areas. The joint focus on the cost/cost-benefits of treatment and adherence to treatment services springs from their interdependence. For example, poor adherence effectively increases the cost of services actually delivered to patients in a treatment program, while good adherence can reduce those costs. My proposed research will therefore evaluate the cost and cost-benefit of drug abuse treatment services and both interventions and service models designed to improve patient adherence. It is hypothesized that significant interactions exist between drug abuse treatment interventions, patient adherence and treatment outcome and cost. This work will require completion of a series of academic courses on medical economics, cost-effectiveness and cost-benefit analyses and the completion of four studies. The first two studies evaluate cost and cost-benefit of a novel Motivated Stepped Care (MSC) treatment system for patients receiving either methadone or LAAM. The third study compares treatment costs and cost-benefit for combinations of MSC and voucher-based incentive to reduce drug use. The fourth study examines the effectiveness of a "significant other" intervention in improving rates of follow-up care after discharge from an inpatient unit. The results of this work will be used to inform the development of a new R01 type application to extend my work to a series of controlled evaluations of services and service models to improve patient adherence and maximize the cost effectiveness of treatment services. This accomplishment will document my transition to
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the status of an independent patient-oriented researcher and recognized expert in the field of drug abuse treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COURSE OF PROBLEMS IN ADOLESCENT DRUG TREATMENT INTAKES Principal Investigator & Institution: Weisner, Constance M. Professor; Langley Porter Psychiatric Institute; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2003; Project Start 25-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): This proposal responds to NIDA's Program Announcement, PA-01-097, of 5/21/01, on Drug Abuse Health Services Research. It examines the 3- and 5-year course of problems in an "intent to treat" sample of 400 adolescent intakes in four managed care substance abuse treatment sites, and assesses the relationship of substance abuse problems and treatment to medical utilization and cost. Baseline, 6- and 12-month follow-up data have been collected. The proposed study builds on the longitudinal and treatment outcome literature on adolescent substance abuse, and identifies the determinants of 5-year time paths of substance use patterns and problems. Time paths, or "trajectories" of substance use are of both theoretical and applied relevance to the adolescent drug treatment field, where substance abuse problems are increasingly viewed as chronic and relapsing, and at the same time, many individuals "mature out" of problems. Analyses draw on latent curve analysis techniques to compare the shape of trajectories of substance use and their determinants. We examine the influences that demographic characteristics, problem severity (i.e., substance use type and severity, medical and psychiatric comorbidities, social problems, and life stressors), treatment (i.e., starting treatment and length of stay of index treatment, and readmissions), and "extra-treatment" (e.g., peer influences, family functioning, twelve-step participation) factors have on the 5-year course of problems. Another important contribution of the proposed study to the longitudinal literature on adolescent substance abuse is the examination of co-morbid medical conditions, and their relationship to the course of adolescent substance abuse. We have also interviewed a parent at each wave of the study, and we examine collateral reports and validity of self-report through drug testing. The HMO has on-going computerized data on the dates and length of stay of treatment episodes and all psychiatric and medical services received, as well as their costs. We collect self-report data from teens and parents on treatment and medical service utilization not covered by the health plan. We follow adolescents for 5 years during the crucial "becoming young adult" period when many individuals "mature out" of problems, which allows us to examine the individual, environmental, and service factors that underlie this process, for those who succeed and those who do not. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CRACK COCAINE AND HEALTH SERVICES USE IN RURAL OHIO Principal Investigator & Institution: Siegal, Harvey A. Professor; Community Health; Wright State University Colonel Glenn Hwy Dayton, OH 45435 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant) This application responds to two program announcements: 1) "Drug Abuse Health Services Research" (PA-94-047) and "Drug and Alcohol Use in Rural America" (PA-95-060). In this 5-year project, Wright State
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University proposes to conduct health services research among rural crack users in four nonmetropolitan counties in west-central Ohio. Focusing on crack-cocaine abuse, this research will provide the field with descriptive and analytic data relating aspects of rural life with the phenomena of drug abuse and health service use. The overall goal of this proposal is to recruit 225 active crack users and interview them every six months over a three-year period. A natural history design will be used to examine rural crack user's substance abuse practices, health care needs, barriers to obtaining care, and service utilization patterns over time. Participants will be recruited using a modified version of chain-referral sampling, called Respondent-Driven Sampling. The Specific Aims are to: 1. Identify and describe key dimensions of rural crack abuse and health service utilization using ethnographic methods. 2. Describe the characteristics of 225 active crack-cocaine users recruited from four rural counties in west-central Ohio. 3. Identify the factors that predict changes in crack and other substance abuse among rural crack abusers over a three-year period. 4. Describe the barriers to obtaining substance abuse treatment among rural crack abusers and identify the correlates of the barriers. 5. Identify the factors that predict rural crack smoker's use of drug abuse treatment services over a three-year period. 6. Identify the factors that predict rural crack smoker's use of general and mental health services over a three-year period. 7. Describe and analyze the similarities and differences between the new sample of 225 rural crack users and our established sample of 430 urban crack smokers using crosssectional and longitudinal data. The scientific value of the proposed research is found in its potential to broaden and deepen our understanding of drug abusers and health seeking behaviors in rural areas. Finally, the data provided by this study will help policy makers plan prevention activities and develop a treatment response for drug abusers in rural areas. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CRH ANTAGONISTS FOR TREATMENT OF DRUG ABUSE Principal Investigator & Institution: Woods, James H. Professor; Pharmacology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-JUL-2006 Summary: (provided by applicant): A role for stress and CRH activation in acquisition, maintenance, and reinstatement of drug abuse is becoming more established. CRH antagonists are therefore of considerable interest as potential pharmacotherapies for drug abuse, both when it occurs alone, and when it is modified by stressful stimuli. Until recently, there were no significantly active CRH antagonists available for study. With the recent synthesis of small molecule antagonists and of novel, potent peptide antagonists, the means to probe these questions are much more available, and the research and therapeutic potential much more exciting. The purpose of this proposal is to characterize one new small molecule CRH1 receptor antagonist, antalarmin, one "ultra-new" small molecule CRH1 receptor antagonist, R 121919 and one new peptide CRH1/CRH2 receptor antagonist, astressin B. These characterizations will be done in rats using five measures of stress: i.v. administration of CRH, i.v. administration of the CRH R1 agonist EG12114, footshock, social defeat, and food deprivation. Initially, the effect of each stressor on ACTH and corticosterone levels will be determined. Then the ability of the antagonists to block the stress-induced increases in ACTH and corticosterone levels will be measured and the duration of this antagonism recorded. The antagonists will next be tested for their ability to modify rates and patterns of food, cocaine and remifentanil self-administration in unstressed rats. The effects of some of
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the stressors on rates and pattern of food and drug self-administration will be evaluated using a schedule of reinforcement that is resistant to the direct effects of the reinforcers, and the ability of each of the antagonists to modify stress-induced alterations in drug intake will be determined. Finally, the ability of the stressors to reinstate extinguished responding for food and drug will be determined and the effects of the antagonists on this effect of stress evaluated. These experiments are designed to characterize the CRH antagonists, and then to test their ability to modify drug self-administration, either as it is modified by stress, or in the absence of overt stress, and their ability to modify stressinduced reinstatement. This may provide information about the etiology of drug abuse, as well as data on the potential treatment of drug abuse in normal, or particularly, in stressed individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CT CLIMICAL JUSTICE-DATS RESEARCH INITIATIVE Principal Investigator & Institution: Frisman, Linda K. Director, Research Division; Ct St Dept of Mh and Addiction Services Health and Addiction Services Hartford, CT 06105 Timing: Fiscal Year 2002; Project Start 25-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Arrest and incarceration provide motivation for drug treatment not otherwise present in the community. Yet some persons with addictive disorders do not avail themselves of treatment, or leave treatment prematurely, or do not sustain long-term benefit from treatment. Recent evidence suggests that programs and services that better integrate the treatment community with the criminal justice system are likely to yield better clinical outcomes. The Connecticut Criminal Justice Drug Abuse Treatment Service (CT CJ-DATS) Initiative will create a partnership to empirically test integrated services and treatment in Connecticut, where the judicial and correction systems are state-operated, and interagency relationships have been developing for several years. The initiative will be overseen by a state-level steering committee composed of high-level state and community agency managers, and a research team including expertise in behavioral health, economics, and criminal justice, and with experience in multi-site collaborative research. We propose two examples of studies that could be led by the CT CJ-DATS team. First, for women offenders with co-occurring trauma and drug disorders, we propose a randomized controlled trial comparing a novel group treatment approach of substance abuse and trauma treatment called TARGET, compared to substance abuse treatment alone. We hypothesize that integrated treatment for trauma and drug abuse will improve outcomes with regard to substance abuse and criminal behavior. Second, for drug dependent or drug abusing defendants referred by the court system, including probation officers, we propose to test a model treatment called Network Support, which would emphasize the development of a positive social support network. Four conditions will be compared: (1) substance abuse treatment alone; (2) substance abuse treatment with contingency management; (3) substance abuse treatment with network support; and (4) substance abuse treatment with network support and contingency management. We hypothesize that using both network support and contingency management will result in the best outcomes with respect to reduced drug use and continuous abstinence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DEFINING FATHERHOOD AMONG DRUG DEPENDENT MEN Principal Investigator & Institution: Witte, Susan S. None; Columbia Univ New York Morningside 1210 Amsterdam Ave, Mc 2205 New York, NY 10027
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Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2005 Summary: (provided by applicant): The proposed R03 (PA 99-113) is designed to examine parenting attitudes and behaviors among African American and Latino fathers attending methadone maintenance treatment programs (MMTPs), and to explore how parenting attitudes and behaviors are affected by a father's current and past experiences with drug use and intimate partner violence (IPV). Substance use and parenting literature indicate that drug use compromises positive fathering and can constitute barriers to healthy father-child relationships. In addition, studies on IPV have revealed a significant problem among men being treated for drug abuse, and an overlap of IPV and child abuse occurring in families. However, to date, surprisingly few efforts have been made to study the role of fathers in violent families and no studies have examined how fathering attitudes and behaviors are affected by IPV among drug-dependent men. Concurrently, there is substantial and growing evidence suggesting that fathers have positive influences on their children, and that fathering may have positive effects on the well being of men in general. In light of research indicating that positive father effects may be countered by IPV and child abuse, promoting positive father-child relationships among violent men is extremely complex. Building on findings generated from ongoing NIDA studies, and guided by social learning theory and an ecological framework, the study will collect contextual narratives on the experience of fatherhood among 72 African American and Latino men in a New York City-based MMTP through focus groups and in-depth interviews. Through a contextually rich, in-depth understanding of the complex dynamics of these relationships afforded through qualitative inquiry, we aim to further inform and enhance paternal support interventions and services to promote healthy father-child involvement. The findings will also inform an R01 application aimed at the development and efficacy testing (using quantitative methods) of a parenting support intervention provided in drug treatment settings for a random sample of drug-dependent fathers and their families. Dr. Susan Witte will conduct the study under the guidance of Dr. Nabila EI-Bassel of the Social Intervention Group (SIG) at the Columbia University School of Social Work, and in consultation with Drs. Suniya Luthar and Peter Steinglass. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DETERMINANTS OF DRUG EFFECTS ON DRUG MAINTAINED BEHAVIOR Principal Investigator & Institution: Goeders, Nicholas E. Professor; Pharmacology and Therapeutics; Louisiana State Univ Hsc Shreveport P. O. Box 33932 Shreveport, LA 71103 Timing: Fiscal Year 2001; Project Start 01-JUL-1998; Project End 31-MAY-2003 Summary: (Adapted From The Applicant's Abstract): Substance abuse is a serious threat to society for which effective therapies are sought. Since no single effective treatment for substance abuse has been identified, current strategies seek to combine behavioral and pharmacological therapies. Successful pharmaceutical therapies include the agonist-based maintenance therapies: methadone (for heroin abuse) and nicotine patches (for tobacco abuse). Despite a profound understanding of the pharmacological actions of these drugs, the basis for their therapeutic effects remain unclear. In addition, no effective treatment has been found for cocaine abuse. Behavioral data from animal models may improve methods for developing these medications. Drugs that can decrease drug self-administration without having effects on other behaviors may be potential candidates. We recently developed a promising series of findings on the treatment of cocaine-maintained responding with the selective dopamine (DA) reuptake
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inhibitor GBR 12909. Acute administration abolished cocaine-maintained responding, while having no effect on food-maintained responding. Repeated administration sustained this effect, and a single injection of a long-acting decanoate formulation decreased cocaine-maintained responding for almost thirty days, while having little or no effect on food-maintained responding. While the behavioral effects of GBR 12909 and its decanoate appear very promising, their physiological effects may warrant further study. For example, cocaine has cardiovascular effects, and the potential of these drugs for interaction with this effect should be explored. Lastly, the effects of agonist-based treatments are likely to depend upon both specific pharmacological actions and behavioral factors. Our collaborators continue to modify the GBR series to improve its pharmacology and we also propose testing additional drugs as potential adjuvants to improve the effects of GBR analogs. The specific aims of this grant are to 1) further evaluate the effects of an ultra long-acting formulation of GBR 12909 alone and in combination with other drugs, 2) assess the behavioral effects of novel GBR 12909 analogs, with the aim of identifying improved decanoate candidates, and 3) assess the effects of GBR 12909 analogs and GBR 12909 decanoate alone, and in combination with cocaine, on cardiovascular functioning. These studies are designed to extend the agonist-based approach to the development of potential medications for the treatment of cocaine abuse and further our understanding of the behavioral pharmacology of the self-administration of cocaine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEVELOPMENT OF DRUG ABUSE&DELINQUENCY IN ADHD ADOLESCENT Principal Investigator & Institution: Williams, Andy; Psychology; State University of New York at Buffalo 402 Crofts Hall Buffalo, NY 14260 Timing: Fiscal Year 2001; Project Start 15-MAR-2001 Summary: Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with significantly impairing levels of over activity, impulsivity, and inattention, which can deleteriously affect social and academic domains of functioning. Although the extant evidence is abundant regarding the short-term impairments associated with ADHD, the evidence is mixed regarding the predictive risk for drug abuse and juvenile delinquency/adult criminality associated with ADHD. The proposed research is aimed toward understanding the risks and impairments associated with ADHD alone and when co-morbid for CD and non- ADHD comparisons. The specific aims of the proposed research are 1) to gauge the hypothesized differential risk for children with ADHD alone and co-morbid with CD in key domains (e.g., alcohol and other drug use, delinquency), 2) to identify subsets of children (e.g., ADHD subtypes, groups based upon demographic factors and parental factors) that may be at higher risk drug abuse and juvenile delinquency/adult criminality. Current information regarding drug abuse and delinquent and criminal offenses will be gathered from a sample of 500 ADHD children who attended a summer camp for treatment of disruptive behavior disorders when they were between the ages of 6-12 years of a comparison sample of 200 nonADHD adolescents matched for age, gender, and SES. The ADHD sample will be divided into three developmental stages: early adolescence, mid-to-late adolescence and young adulthood. Because of the large sample size and the availability of diagnostic information gathered while the sample was of elementary school ages, this proposed research will be of especially important in 1) clarifying the conflicting evidence regarding risk for alcohol and other drug abuse and juvenile delinquency/adult criminality associated with ADHD and CD independently and co-morbidity, and 2)
Studies 41
identifying other demographic and parental factors that may increase children's risk for drug abuse and juvenile delinquency/adult criminality above and beyond the risk associated with ADHD and CD independently and co-morbidity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEVELOPMENT OF DRUG USE AND ABUSE IN ADHD ADOLESCENTS Principal Investigator & Institution: Pelham, William E. Professor; Psychology; State University of New York at Buffalo 402 Crofts Hall Buffalo, NY 14260 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: This application expands upon an ongoing study (R01AA11873) to examine the onset and development of alcohol abuse in 500 adolescents previously diagnosed with Attention Deficit Hyperactivity Disorder ADHD). The proposed study requests a modest amount of additional funding to add measures of licit and illicit drug use and abuse (self-report, parent report, biological assessment) and assessment of additional drug-relevant domains such as subdiagnostic symptoms of abuse, family history of drug abuse, and expectancies for drug effects. Participants will be 500 adolescents, 74 percent of whom had comorbid oppositional defiant (44 percent) or conduct (30 percent) disorder, who were previously diagnosed with ADHD at the Western Psychiatric Institute and Clinic Summer Treatment Program for ADHD. These adolescents, who will be interviewed annually for four years, will range in age from 12 to 26 at initial follow-up contact, representing a wide range of developmental stages that represent different levels of risk for the development of drug abuse. This cohort-sequential design will permit us to evaluate drug use, abuse, and its emergence over time in ADHD children across three developmental periods. The proposed study will also enable comparison of ADHD adolescents' drug use to 200 non-ADHD demographically similar comparison adolescents who will be followed for the same time period. This data set will be unique in several ways, allowing the investigators to address questions regarding ADHD risk for drug use and abuse with much greater scope and precision than previous investigations. Unique advantages of this study include: (1) the sample size will be four times that of the largest existing follow-up study, affording subgrouping on the ADHD sample on key risk factors (e.g., conduct disorder, academic functioning, parental drug and alcohol use), (2) the wide age range of our sample compared to previous studies will yield information both on development of drug use (younger adolescents), as well as on routine drug use and abuse (older subjects) in the same study; (3) drug use and abuse assessment will be far more comprehensive than in previous studies, (4) the clinic-referred sample has a wealth of standardized, objective information on the children and their family functioning at initial contact during childhood not available in previous studies, affording differentiation between childhood and adolescent functioning in our models; and (5) assessment will include comprehensive evaluation of a number of domains in the probands and their families that may explain or escalate ADHD children's risk for later drug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PROGRAMS
DIFFERENTIAL
EFFECTIVENESS
IN
DRUG
PREVENTION
Principal Investigator & Institution: Herting, Jerald R. Psychosocial & Community Hlth; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 30-APR-2004
42 Drug Abuse
Summary: (provided by the applicant) The purpose of this proposal is to investigate the components of an effective, indicated drug abuse prevention program for high risk youth and directly address the National Institute on Drug Abuse's call for a new generation of drug abuse prevention studies. The proposal takes advantage of a just completed replication study of the Reconnecting Youth (RY) indicated prevention program funded by the Department of Education (DOE # S184F970055). This DOE study provides a sample of 890 at-risk youth who were randomly assigned to either a control condition or to the RY prevention program. The study has been rigorously implemented and has extensive baseline and longitudinal measures for participants, including post-program and a 5 month follow-up; extensive process evaluation data measures the implementation of the RY program across 41 group-based interventions. A long-term follow-up, at approximately 30 months, is proposed to evaluate the long-term efficacy of the RY program, and to provide for a detailed quantitative analysis of the theoretical underpinnings of the intervention. The latter directly addresses how the specified intervention components act to achieve the desired outcomes (reduced drug involvement and increased mood management and school performance). Analyses also provide detailed evaluation of how characteristics of the RY intervention mechanisms and group characteristics influence the experimental outcomes. Finally, a detailed quantitative and qualitative analysis, based on a re-sampling of 100 individuals for indepth interviews, explores categories of youth who were successful or who failed to achieve the desired outcomes, particularly with respect to drug involvement. The study should inform the specificity and efficacy of the RY intervention and promote, more generally, prevention sciences' ability to understand what components of intervention strategies are successful in obtaining reductions in drug involvement and related cooccurring problem behaviors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DIFFUSION OF PROJECT TOWARDS NO DRUG ABUSE (TND) Principal Investigator & Institution: Rohrbach, Louise A. Preventive Medicine; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, CA 90033 Timing: Fiscal Year 2003; Project Start 10-SEP-2003; Project End 31-MAY-2008 Summary: (provided by applicant): As a result of decades of research, numerous schoolbased drug abuse prevention programs have been demonstrated to be effective in reducing drug use among adolescents. However, to date the public health impact of these programs has been limited. The majority of the nation's schools are not using evidence-based drug abuse prevention programs. The question of how to best bridge the gap between research on prevention programs and practice in schools has received limited scientific attention, and there is an urgent need for studies that evaluate strategies designed to increase the adoption, implementation, and maintenance of evidence-based programs. This study will evaluate a comprehensive training and consultation approach to increase implementation and maintenance of Project Towards No Drug Use (TND), an evidence-based drug abuse prevention program for high school students. Project TND has shown positive one-year outcomes over three experimental replication trials, in regular and continuation (high-risk) high school settings, and is considered a model or exemplary program by NIDA, CSAP, and Health Canada, as well as several state and local agencies. Schools within a national sample of school districts that have recently adopted (purchased) Project TND will be randomly assigned to one of three conditions: (1) a standard TND training condition, in which teachers will receive a pre-implementation training workshop only; (2) a comprehensive Implementation Support condition in which teachers will receive the standard pre-implementation
Studies 43
training workshop, plus web-based interactive feedback, on-site peer coaching, and offsite technical assistance, and school and school district administrators will receive consultation and technical assistance to assist them in developing organizational capacity for program maintenance; and (3) a delayed intervention control condition. We will determine the relative effectiveness of the two interventions on fidelity of program implementation and program maintenance. We will also examine the effects of the two intervention groups, relative to the control group, on student use of tobacco, alcohol, marijuana, and other drugs. We hypothesize that both of the training conditions will result in greater reductions in student drug use relative to the delayed-intervention control condition. Furthermore, the comprehensive-implementation support condition will produce greater fidelity of implementation, program maintenance, and reductions in student drug use relative to the teacher training workshop-only condition. The goal of this research is to develop and evaluate a prototype for a training system that can be used to facilitate rapid research-to practice technology transfer of evidence-based substance abuse prevention programs, thereby increasing the public health impact of these programs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG ABUSE AND AIDS RESEARCH CENTER AT U. MIAMI Principal Investigator & Institution: Mccoy, Clyde B. Professor; None; University of Miami Box 016159 Miami, FL 33101 Timing: Fiscal Year 2001; Project Start 20-SEP-2001; Project End 31-AUG-2004 Summary: The overall goal of the UM-CDAAR is to move toward the elimination of health disparities by enhancing behavioral, clinical, basic, epidemiological, prevention, and applied research on drug abuse and HIV/AIDS infection and other co-occurring illnesses, through the support of shared resources. Our application proposes to build a research center of national importance on the foundation of an experienced group of HIV/AIDS and drug abuse researchers who have worked together for the past quarter of a century. The creation of the UM-CDAAR will enable us to formalize these working relationships and to expand this collaboration to over 40 HIV/AIDS and/or drug abuse investigators to enhance their individually funded projects as well as foster programmatic coherence, synergy and integration locally, nationally and internationally. Collectively, this group has co-authored over 1000 publications and has worked together on more than 50 federally funded grants. The five UM- CDAAR cores were selected by a needs assessment process conducted with currently funded HIV/AIDS and drug abuse investigators. Cores were selected that support the aims of the individual grants and provide shared resources that would contribute toward costeffectiveness and quality control in resource utilization. These cores include (a) Administrative Core; (b) Developmental Core; (c) Biostatistics, Data Management and Information Technology Core; (d) Interventions ore; and (e) Transdisciplinary Methods Core. Core Leaders and Co-Leaders were selected based on knowledge, experience, and representation of the many different HIV/AIDS and drug abuse research areas at the University of Miami. All CDAAR core leaders have an outstanding record of HIV/AIDS and drug abuse research based on current NIH funding and peer-reviewed publications. Evidence of senior leadership and administrative excellence is demonstrated by the inclusion of five current department chairs in the CDAAR leadership. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
44 Drug Abuse
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Project Title: DRUG ABUSE LIABILITY & SENSATION SEEKING Principal Investigator & Institution: Kelly, Thomas H.; University of Kentucky 109 Kinkead Hall Lexington, KY 40506 Timing: Fiscal Year 2001; Project Start 30-SEP-1992; Project End 31-MAR-2006 Summary: (provided by applicant) This grant proposes five years of research to continue an ongoing investigation of sensation seeking status as a potential predictor of drug abuse in young adults. Prior epidemiological research has established a link between sensation-seeking (or novelty-seeking) behavior and drug abuse in humans. Research with rat models further suggests that novelty-seeking behavior is predictive of individual differences in dopamine function and in the reinforcing and other behavioral effects of drugs of abuse. Our ongoing studies have confirmed the predictive association between sensation-seeking status and individual differences in the behavioral effects of drugs with abuse liability in young adults. Reliable and substantial group differences on the sensation-seeking factor were insured as a result of the availability of the Lexington Longitudinal Database for recruitment of study participants. Currently, studies of the reinforcing, discriminative and other behavioral effects of d-amphetamine and diazepam are ongoing. We propose to continue these investigations and to extend this work to include other drugs with high abuse liability (marijuana, nicotine, alcohol, methylphenidate). In addition, the potential use of high sensation activities to modulate the behavioral effects of d-amphetamine will be investigated as a potential prevention intervention. Finally, since high- and low-sensation seekers have been shown to differ along a number of clinically important dimensions, we will begin investigations of the interrelationships among these dimensions by evaluating the extent to which predicts individual sensitivity to the behavioral effects of drugs with abuse liability. The wealth of data available in the Lexington Longitudinal Database (e.g., peer associations, school performance, prior drug use, family status, other intrapersonal factors) will also be available to examine individual differences in behavioral response to drugs with abuse liability, in addition to sensation seeking status. These studies will have important implications for understanding individual differences in risk for drug abuse, and may help to guide future prevention interventions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DRUG ABUSE PREVENTION - A LIFECOURSE PERSPECTIVE Principal Investigator & Institution: Bardo, Michael T. Professor; Center for Prevention Research; University of Kentucky 109 Kinkead Hall Lexington, KY 40506 Timing: Fiscal Year 2003; Project Start 30-SEP-1992; Project End 31-AUG-2006 Summary: (provided by applicant) The Center for Prevention Research at the University of Kentucky is distinguished by thematic integration around the construct of novelty/sensation (N/S) seeking. Over the past 12 years, we have evaluated N/S seeking behavior at a number of complementary levels of analysis and have made considerable progress in our understanding of the onset and development of drug abuse, and in applying this information to the development of more focused and effective prevention efforts. Our work has clearly benefited from the strong interdisciplinary collaboration among distinct yet complementary laboratories, both within the Center and with other ongoing projects on the University of Kentucky campus. The three specific aims of the Center Core are (1) Scientific: To generate and publish high quality prevention science that is recognized as state-of-the-art research across relevant disciplines; (2) Organizational: To provide an intellectually stimulating, creative, and productive environment in which research questions and issues are
Studies 45
examined from a multilevel, interdisciplinary perspective; and (3) Leadership: To serve as a resource, advocate and leader for drug abuse and prevention science, in part by training the next generation of drug abuse prevention researchers. The substantive theme that consistently links scientists and research projects together in our Center is a broad and in-depth focus on N/S seeking behavior in the onset and development of drug abuse, and in applying this information for the development of more focused and effective prevention efforts. The three projects proposed in the current application continue and extend the Center?s on-going evaluations of the effects of N/S seeking on drug use and abuse. (1) Animal Laboratory: Individual Differences in Drug Response: An Animal Model (Mike Bardo, PI). This project will use an animal model to study the relationship between N/S seeking and amphetamine reward; the guiding hypothesis is that novelty, similar to stimulant drugs of abuse, activates the mesolimbic dopamine reward system. (2) Human Laboratory: Drug Abuse Liability and Sensation Seeking Status (Tom Kelly, PI). This project will expand the research team?s prior work on N/S seeking as a moderator of the relationship between drug dose and the discriminative, reinforcing and other behavioral effects and abuse liability of marijuana, nicotine, alcohol and methylphenidate. (3) Community Laboratory: Comprehensive Drug Prevention for Youth (Dick Clayton, PI). This project will continue a long-standing Center tradition of evaluations of school-based, curriculum-driven prevention programs with the evaluation of a comprehensive prevention program featuring both universal and selective high sensation value components. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG APPLICATION
ABUSE
PREVENTION:
COMPUTER
TECHNOLOGY
Principal Investigator & Institution: Bickel, Warren K. Professor of Psychiatry and Psychology a; Health Sim, Inc. Burlington, VT 05401 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 31-AUG-2003 Summary: Recent evidence indicates that drug use is increasing among adolescents, which may lead to a plethora of negative outcomes during these formative years. The aim of this proposal is to develop and evaluate an interactive, computer-based Drug Abuse Prevention Multimedia program for adolescents that incorporates the effective components of both drug abuse prevention science and informational technology. The program's curriculum incorporates the components of primary prevention efforts shown to be efficacious in preventing initiation to drug use and is presented in the context of both Computer Assisted Instruction and video- based simulation technologies. This program may promote the increased adoption of effective prevention science, as it is designed to be efficacious, cost-effective, easily exportable and able to applied with fidelity. In Phase I, we demonstrated the program's scientific, technical and commercial merit and feasibility by developing several sections of the program asking youth to systematically evaluate these sections and revising the sections based on student feedback. In Phase II, we will complete development of the program and conduct a controlled trial evaluating the efficacy of the program in increasing knowledge about drug abuse prevention, retarding initiation of drug-taking, and in affecting a range of variables associated with adolescent drug use. PROPOSED COMMERCIAL APPLICATION: An effective multimedia drug abuse prevention program would be a valuable resource to the public school system, - as it would enable them to markedly reduce the expense of their drug abuse prevention programs while permitting the adoption of effective methods of preventing the initiation of drug use among middle school-aged adolescents.
46 Drug Abuse
Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG ADULTHOOD II
ABUSE
PREVENTION--ADOLESCENCE
&
EARLY
Principal Investigator & Institution: Pentz, Mary A. Professor; Preventive Medicine; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, CA 90033 Timing: Fiscal Year 2001; Project Start 15-JUN-1996; Project End 30-JUN-2002 Summary: (Applicant's Abstract) Few longitudinal studies exist that evaluate changes in predictors of drug abuse or prevention program effects over multiple risk periods or that systematically address risk factors, program effects, and program effect mediators in the same study. The specific objectives of this longitudinal etiology and prevention study are to evaluate: (1) long-term effects of an earlier community-based prevention program for adolescents on reducing drug abuse and related problem behaviors (drunk driving, social dysfunction, job and school drop-out, unprotected sex) and on increasing participation in prevention and health promotion activities in adulthood (healthy lifestyle choices); (2) changes in mediators of early drug use risk, particularly mediators targeted by the earlier community program; and (3) changes in the strength and pattern of personal, social, and environmental drug abuse predictors as individuals move through four potential risk periods (early adolescence, adolescence, onset and end of early adulthood). Two expanded panels of adolescents will be tracked through early adulthood, half of whom were previously assigned to a control group or a group that received a comprehensive community-based intervention that included school, parent, community organization, health policy change, and mass media program components, beginning in middle school. Three additional waves of survey and archival data on two panels of individuals from Kansas City and Indianapolis (75% white, 23% AfricanAmerican, 2% Other; 51% female; 63.2% low SES; 23.5% inner city; N=2646) will be collected. Merged with up to nine previously collected waves of data, this proposed study will include subjects spanning the ages 12-29. Panels represent an overall 17% oversample compared to previous waves to enable stratified tests of drug use development and program effects by ethnicity. Based on 1993-94 data, 25.0% reside outside of the original study area,.4% have died,.7% are in prison, 2.5% needed treatment for drug abuse, and 4.4% were in trouble with police over a drug related problem. Hierarchical regression, growth curve, and structural equation analyses will be compared for their ability to predict drug abuse development and program effects with models that include personal, social, and environmental influences. The proposed study is important because it encompasses four potential periods of drug use risk (early adolescence, adolescence, onset of early adulthood, end of early adulthood--ages 12-29); includes multiple waves of data on two diverse populations; is large enough to enable test replication across sites and population sub-groups; incorporates and compares sophisticated analytical techniques to evaluate models of drug use and program effects; and represents the most long-term study of drug abuse prevention program effects in the U.S. Results should inform at least two important questions relevant to drug abuse prevention: whether a drug prevention program aimed at adolescents has the capacity to affect drug abuse, problem behaviors, and healthy lifestyle choices, and whether patterns of risk factors change over different periods, which would suggest that prevention efforts may require a different emphasis depending on age/stage of risk implemented. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DRUG ABUSE RESEARCH CENTER IN MOLECULAR AND CELL BIOLOGY Principal Investigator & Institution: Loh, Horace H. Frederick Stark Professor and Head; Pharmacology; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, MN 554552070 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 30-JUN-2003 Summary: In order to synchronize the two exiting program project grants, e propose to establish a Drug Abuse Research Center in Basic Molecular and Cell Biology at University of Minnesota which utilizes the expertise of the core faculty in the Department of Pharmacology and more effective promotes service and interaction with other drug abuse researchers in this community. During the past 8 years, we have proven that two P01 grants have worked successfully and coherently as a single program, with Horace H. Loh as the P.I. Thus, in the current proposal, we have combined various components from these two program projects to establish the proposed Drug Abuse Research Center. The main objectives of the proposed center are: (a) foster interdisciplinary approaches in drug abuse research among the investigators; (b) to serve as an "activity" center to coordinate and to promote all academic and scholarly activities in drug abuse research in the Minneapolis metropolitan area; (c) to serve as a national resource for molecular and cellular studies in the mechanisms of drug abuse either by providing expertise, reagents, clonal cell lines or transgenic/knockout animals to the drug abuse community locally and nationally; and (d) to serve as training center for young scientists here in Minnesota. Within the proposed center, there will be an Administration Core, a Molecular/Cellular and Genetic Core, an Antibodies Production Core and a Bioimaging Core which will support the activities of the scientific components. There are total 8 scientific components with 5 components which deal directly with the different aspects of the drug opiate, while the other three deals with other drugs of abuse, marijuana, nicotine and caffeine. All these 8 components deal with the investigation of the basic molecular and cell biological mechanisms of these drugs of abuse. The different approaches used: transgenic animals, molecular biological mutational analysis of proteins and genes, second messengers regulations, electrophysiological measurements and transcription control studies will provide a fertile ground for training of young scientists, interaction among investigators nd developing resource for the drug abuse research community locally and nationally. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DRUG ABUSE RESEARCH SCHOLARS PROGRAM IN PSYCHIATRY Principal Investigator & Institution: Mirin, Steven M. Senior Consultant; American Psychiatric Association 1400 K St Nw Washington, DC 20005 Timing: Fiscal Year 2001; Project Start 01-APR-1998; Project End 31-MAR-2003 Summary: (Applicant's Abstract) This proposal is submitted in response to the NIDA request for applications for the Institutional Mentored Career Scientists Development program, for the establishment of a Drug Abuse Research Scholars Program in Psychiatry. The overall intent is to develop a cadre of psychiatrist-investigators to effectively study and develop new treatments, and conduct research on the organization and outcomes of services for individuals with drug abuse and dependence. The primary specific aims of this proposal are to identify current and potential junior faculty psychiatrists (with special emphasis on ethnic racial minorities and women) who are especially promising candidates for successful careers in drug abuse research; provide intensive mentored training and research development support for six Drug Abuse
48 Drug Abuse
Research Scholars to be proficient in designing, implementing, analyzing and publishing results from original research projects and, ultimately, to successfully obtain independent funding. The secondary aims are to provide ongoing research career enrichment and support to these individuals and meld them into a cohesive and collegial group of future leaders; link existing resources (both within and across academic institutions) in psychiatric research generally, and drug abuse and health services research specifically; establish a high level consortium of the leadership of the principal academic organizations and academic departments in psychiatry and related fields, organized and energized to expand the number of talented young academic psychiatrists entering drug abuse research careers. Inadequate numbers of young physicians are being drawn to and remaining in careers in biomedical research in general(1,2,3) and drug abuse research careers(4) in particular. The intersection of psychiatric investigators with interests and subsequent careers in drug abuse clinical or health services research is vanishingly small.(5) The DARSPP will establish a broad national consortium of organizations and academic institutions involved in psychiatric, drug abuse, and health services research. The consortium, along with other recruitment strategies will form the basis for identifying promising potential research scholars, connect them with appropriate mentors and host institutions and assist them in applying for the program. With the assistance of an advisory committee consisting of national experts in drug abuse and health services research, the program will select four scholars in the first year (and two in the second). Over the length of the grant, the scholars will undertake a detailed and carefully structured specialized research career development program, under the guidance of an experienced mentor in a research intensive host institution. A core enrichment program, including annual retreats, with a specific curricula and ongoing collegial efforts involving leading drug abuse and health services researchers would augment host institution resources. A multilevel evaluation component with a capacity for early trouble shooting and self-correction is incorporated into the program. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG ABUSE RESEARCH TRAINING PROGRAM Principal Investigator & Institution: Mendelson, Jack H. Professor; Mc Lean Hospital (Belmont, Ma) Belmont, MA 02478 Timing: Fiscal Year 2002; Project Start 01-SEP-1991; Project End 30-JUN-2006 Summary: (provided by applicant) This is a competing continuation application for a NIDA Drug Abuse Research Training Program conducted at the Alcohol and Drug Abuse Research Center, McLean Hospital and Harvard Medical School. A multidisciplinary clinical and preclinical training program is offered to postdoctoral fellows who have been awarded an M.D., Ph.D., M.D.-Ph.D., or D.V.M. The faculty includes scientists trained in Pharmacology, Neurology, Internal Medicine, Neurobiology, Medicinal Chemistry, Psychiatry and Psychology with active research programs that involve brain imaging, neuroendocrinology, pharmacology, behavioral science, genetics, neuroscience and medicinal chemistry. The 12 member faculty has academic appointments as Assistant, Associate and full Professor or Lecturer at the Harvard Medical School. Trainees have an opportunity to participate in clinical research on drug abuse treatment, clinical laboratory evaluations of novel medications, the acute and chronic biomedical effects of abused drugs on neuroendocrine and immune function, and brain function using functional magnetic resonance imaging. Basic science fellows can receive training in medicinal chemistry, brain imaging techniques, drug selfadministration and drug discrimination procedures, analysis of analgesic efficacy, and
Studies 49
neuroendocrinology. Fellows can participate in studies of the pharmacological characterization of novel opioid and dopaminergic compounds, the evaluation of candidate treatment medications and analgesics, the effects of abused drugs on the hypothalamic-pituitary-adrenal and the hypothalamic-pituitary-gonadal axis, and the modulation of the endocrine and behavioral effects of drugs by the hormonal milieu. This Center has had a long-standing interest in the role of gender and neuroendocrine hormones in the effects of abused drugs. This research program is especially concerned with issues related to drug abuse problems in women. Trainees initially participate in one or more ongoing research projects with their mentors. Then trainees design an independent research project, compatible with the overall research goals of the program. The trainee's formal protocol is reviewed by mentors and by external scientific advisors. These trainee pilot projects are intended to form the basis for a research application, and the overall goal of the program is to train young scientists to conduct independent research on drug abuse. Trainees are taught about ethical issues that affect research and learn about IRB and IACUC procedures. Trainees take courses, participate in a journal club, attend lectures and scientific meetings and present research findings. Each trainee's program is individually tailored to meet his/her training objectives. Fifteen of our recent trainees have independent research grants and/or junior faculty positions, and two will serve as mentors for the proposed renewal of this training program. Research reports by trainees have been published in outstanding biomedical journals including the Journal of Pharmacology and Experimental Therapeutics, JAMA, Magnetic Resonance in Medicine, Journal of Nuclear Medicine, Neuropsychopharmacology, Nature Neuroscience, Biological Psychiatry and Psychopharmacology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LINKAGES
DRUG
ABUSE
TREATMENT
EMERGENCY
DEPARTMENT
Principal Investigator & Institution: Sorensen, James L. Professor of Psychiatry; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2002 Summary: (Applicant?s Abstract) Drug abusers with complex problems have frequent contact with medical emergency departments. Emergency departments can assist patients in accessing drug abuse treatment and linking with less acute care. This randomized trial will test the effects of two linkage strategies: (1) transitional case management; and (2) vouchers for free methadone treatment --- with opioid-dependent injection drug users recruited from the emergency department of a public general hospital. The primary aims are to test the effects of the interventions on: (1) enrolling participants in drug abuse treatment; (2) enrolling participants in medical and social services; (3) improving opioid use outcomes; and (4) changing participants? pattern of utilization of acute health services. Participants will be opioid-dependent injection drug users recruited at a hospital-based emergency department, randomly assigned in a twoby-two factorial design to receive: (1) transitional case management, (2) vouchers for free methadone treatment, (3) case management and vouchers, or (4) usual care (brief contact and referral). Case management will have a cognitive behavioral focus. Assessments will occur before randomization and follow-up assessments at 6, 12 and 18 months. Primary hypotheses will test the effects of: (1) vouchers on enrollment in drug abuse treatment; (2) case management on enrollment in other services; (3) the combination of vouchers and case management in reducing opioid use; and (4) case management on the cost of health care used by the participants. To identify predictors of participation and retention, the study will gather information about the treatment
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process and prepare treatment manuals that can be used in other settings. The treatment research effort will assess innovative models linking health care with drug abuse treatment. It contributes to cross-component TRC studies, including self-referral versus voucher-referral with Dr. Batki, nicotine dependence with Dr. Hall, and measurement of process variables with Dr. Havassy. It also contributes to collaborative studies described in the TRC core, including drug abuse treatment and statistical analyses, psychiatric and substance abuse comorbidity, and assessing the environments of opioid abusers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG ABUSE TREATMENT UNDER MANAGED CARE--ROLE OF PPOS Principal Investigator & Institution: Horgan, Constance M. Director of Research; None; Brandeis University 415 South Street Waltham, MA 024549110 Timing: Fiscal Year 2002; Project Start 30-SEP-1997; Project End 31-AUG-2004 Summary: (Applicant's Abstract) The main objective of this study is to understand how drug abuse services are provided in preferred provider organizations (PPOs) and to model decisions to provide these services internally or through a carve-out contract with a specialty vendor. The specific aims for this study include the following: 1. Describe the provision of drug abuse services in PPOs in terms of several factors, including overall plan and market characteristics, and characteristics of the drug abuse services themselves in terms of contracting with vendors, treatment approaches, payment methods and risk sharing, utilization management, provider selection, entry into treatment, benefit design, and quality assurance. 2. Document how the provision of drug abuse services in PPOs changes over time and explore what factors influence these changes. 3. Model why some PPOs provide drug abuse services internally within the plan and other PPOs choose to carve-out drug abuse services to be delivered by a specialty managed behavioral health care organization. To examine questions related to these three specific aims, we will conduct an initial telephone survey and another survey approximately three years later of 240 PPOs in 30 market areas. We will collaborate with the longitudinal, nationally representative Community Tracking Study (CTS) conducted by the Center for Studying Health System Change and funded by the Robert Wood Johnson Foundation. In 30 of the same market areas as CTS and in the year following their health plan survey, we will survey a sample of the same PPOs (stratified into two groups according to how they provide drug abuse services by maintaining a network directly or through contracts with a specialty vendor. Similarly, the second wave of our survey will coordinate and follow-up on the second wave of the CTS survey of health plans. The proposed study of drug abuse treatment services is the first to combine a national survey of PPOs within market areas with a prospective design that will allow us to track how the delivery of drug abuse services in PPOs evolves within the changing health care market. This study will provide systematic information on the nature and extent of these changes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DRUG ABUSE TREATMENT--PROCESS, OUTCOMES, & SOCIAL POLICY Principal Investigator & Institution: Anglin, M D. Associate Research Psychologist; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005
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Summary: (Applicant's Abstract) This proposal represents a competing continuation application for salary support in the form of the K05 Senior Scientist Award in order to sustain my professional development. During the period of support provided by the current K02 (NIDA Grant DA00146), my work has contributed to the understanding of drug abuse phenomena, including its etiology, epidemiology, treatment, and related issues. Findings have significantly influenced social policy as well as clinical and research practices. Furthered by K02/RSDA funding support, my career development has proceeded along an increasingly sophisticated course to the point that I have achieved considerable stature as a senior scientist in the field of drug abuse research. As demonstrated by over 150 publications in scholarly journals and by my principal role on numerous large research projects over the past three decades, my reputation among my peers and the accomplishments of a long, productive research career validate the renewal of continued support under the K05 Career Award funding mechanism. During the next five years of K05 support I will continue to foster the expansion of the UCLA Drug Abuse Research Center (DARC) as its Co-Director and will pursue scientific evaluation of interventions for drug abuse and associated drug policies; I will also continue as the Director of the NIDA-funded Research Training Program at DARC and will continue publishing articles, books, and monographs to disseminate the experience gained during my career. Furthermore, I will be broadening my professional scope by participating as co-Principal Investigator on the UCLA Node of the NIDA Clinical Trials Network. Ongoing and future efforts reflect my emphasis on increasing and refining the knowledge base regarding drug-related issues, ultimately toward the goal of providing reliable findings that policymakers, clinicians, and researchers can use to gain a greater understanding of drug phenomena and to better address associated problems. As the co-Director of DARC, I am academically affiliated and supported by the UCLA Neuropsychiatric Institute (NPI), organized within the Department of Psychiatry at the UCLA School of Medicine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG ABUSE, VIOLENCE, AND HIV/AIDS IN IMPOVERISHED WOMEN Principal Investigator & Institution: Wenzel, Suzanne L. Senior Behavioral Scientist; Rand Corporation 1700 Main St Santa Monica, CA 90401 Timing: Fiscal Year 2001; Project Start 25-DEC-1999; Project End 31-JAN-2004 Summary: (Adapted from Applicant's Abstract): Drug abuse, HIV/AIDS, and violence are all critical public health problems in the lives of impoverished housed and homeless women. However, the relationships among drug abuse, other behaviors that place women at risk for HIV.AIDS (i.e., unprotected sex and sharing of needles and works), and violence (i.e., physical and sexual victimization) remain unclear. Further, there is a lack of research on the impact these interrelated problems have on health outcomes (i.e., physical health and injuries, service utilization, and psychological distress) for homeless and low-income housed women. The goal of this study is to examine the linkages among drug abuse, other HIV risk behaviors, and violence, and to determine their impacts on key health outcomes (physical health and injuries, service utilization, and psychological distress) among homeless and low-income housed women in Los Angeles County. In this natural history study, 840 primarily African-American, Latina, and Caucasian women between the ages of 18 and 62 residing in randomly selected homeless shelters and low-income housing units will be administered structured interviews and will undergo physical health assessments at baseline and at 12-month follow-up. For a sub-sample of 20% of the women, hair samples will be collected to
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validate self-reported drug use. In-depth interviews (30 with homeless women, 30 with low-income housed women) will precede structured interviews and physical health assessments to ensure inclusion of important measurement domains and validity of instruments, particularly those addressing victimization. Focus groups (2 with homeless women, 2 with housed women, 2 with community experts, and 2 with policy makers) will be conducted at the end of the study to help us frame results in terms of feasible community and policy interventions for homeless and low-income housed women. The specific aims of this study are: 1) determine correlates of, and examine linkages between, drug abuse, HIV risk behaviors, and victimization among low-income housed and homeless women, 2) prospectively determine the impact that drug abuse, HIV risk behaviors, and victimization have upon key health outcomes (physical health and injuries, service utilization, and psychological distress), 3) document low-income housed and homeless women's understanding of and experiences with victimization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG ABUSE: EPIDEMIOLOGY, TREATMENT PROCESS, & OUTCOMES Principal Investigator & Institution: Hser, Yih-Ing; Adjunct Professor; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2001; Project Start 01-SEP-1989; Project End 31-JUL-2004 Summary: Building upon work accomplished in the current award, the applicant will continue her professional work by conducting six convergent research studies examining drug use epidemiology and evaluating treatment interventions for drug abuse and dependence. These projects are (1) Natural history of narcotics addiction: a 33-year follow-up study, (2) Treatment utilization and effectiveness study, (3) Tobacco use and cessation study, (4) Drug treatment process study, (5) Drug abuse treatment outcome study (DATOS), and (6) Persistent effects of treatment studies (PETS). Projects 1 to 4 were initiated in the current award period and provide data for more in- depth analyzes in the renewal period. Projects 5 and 6 are ongoing national studies that will provide further data for analysis. A special emphasis is on the examination of implications of research findings pertinent to the development of improvement treatment strategies and relevant social policies. The applicant will continue her professional development applying innovative statistical methodologies to drug abuse data in support of her substantive work. The applicant's supporting institution is an organized research unit, the Neuropsychiatric Institute (NPI), within the Department of Psychiatry, School of Medicine, UCLA. Affiliated with the NPI is the UCLA Drug Abuse Research Center, which has been conducting research in drug abuse epidemiology, the natural history of narcotics addiction, treatment evaluation, and social policy over the past 20 years. In this setting, the applicant will conduct the proposed research wand will receive additional training in clinical aspects of drug abuse treatment and in the implementation of treatment services. Furthermore, the applicant's considerable psychosocial research complementing the Institute's biobehavioral perspective. The applicant also expects to grow professionally as Associate Director of the UCLA Drug Abuse Research Center. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DRUG ABUSE: HIV/AIDS & SOCIAL CONSEQUENCES Principal Investigator & Institution: Zlotnik, Joan L.; Institute for Advancement/Social Wrk Res Social Work Research Washington, DC 20002
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Timing: Fiscal Year 2003; Project Start 05-APR-2003; Project End 31-MAR-2004 Summary: (provided by applicant): The Institute for the Advancement of Social Work Research in partnership with the Society for Social Work and Research is proposing a symposium on Drug Abuse: HIV/AIDS and Social Consequences. The purpose of the symposium is to disseminate the latest research findings on drug abuse and HIV/AIDS and to develop social work researchers' capacity in prevention and intervention research on these interactive issues. It will endeavor to enhance social work research through disseminating information to social work doctoral students and faculty on the latest science in drug abuse and HIV/AIDS prevention and intervention research. The symposium will be held on January 17, in conjunction with the 2003 Society for Social Work and Research conference that is scheduled for January 16-19 at the Hilton Hotel Towers in Washington, DC. The proposed symposium will include the following 3 sessions: 1) A presentation discussing key advances in drug abuse and HIV/AIDS prevention and intervention research, which will include protective factors, resiliency, and implications for future social work research; 2) An interdisciplinary presentation addressing research and dissemination methodologies, including methodological issues and innovations in drug abuse and HIV/AIDS research; and 3) A session discussing important directions in community-based research and communities as units of analysis, including culture and context in relation to health disparity concerns, as well as ways to integrate research and practice. The presenters will be interdisciplinary researchers who have been funded by the National Institute on Drug Abuse and who are conducting research in key areas of drug abuse and HIV/AIDS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG COURT OFFENDERS IN OUTPATIENT TREATMENT Principal Investigator & Institution: Pottieger, Anne E. None; University of Delaware Newark, DE 19716 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAY-2004 Summary: The overall goal of the project is increased understanding of the influence that drug courts have in motivating treatment retention and post-treatment success when they divert or sentence offenders to outpatient substance abuse treatment. The specific aims are: (1) assessment of 12-month and 24-month post-treatment outcomes for drug court offenders sent to outpatient substance abuse treatment, by examining multiple outcome indicators for diverted and sentenced drug court offenders as well as comparable volunteer treatment clients; (2) examination of the impact of drug court sentencing on retention in outpatient substance abuse treatment; and (3) analysis of variations in treatment treatment motivations, program retention, and post-treatment outcomes for drug court offenders sent to outpatient substance abuse treatment, through hypothesis testing and exploratory study of how those variations are related to addiction careers, treatment careers, and concurrent life problems. In a proposed 5-year study, the project will interview 720 adult offenders sent to outpatient substance abuse treatment by the Delaware Drug Court in Wilmington (New Castle County): 180 offenders referred to each of three programs: diversion to drug education, diversion to outpatient therapy, and sentencing to intensive outpatient treatment. A fourth sample will be 180 volunteer clients with similar drug and crime backgrounds who are also in intensive outpatient treatment at the same treatment agency. Treatment program data will be used to indicate retention, treatment motivation at entry, and substance use before treatment. Treatment outcome indicators for 12 and 24 months after leaving treatment will be official arrest data, urine tests for drug use, and self-reported substance use, crime, employment, family relationships, and health. Analysis will
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include both hypothesis testing and exploratory analysis, combining outcome assessment of outpatient programs for drug court offenders with specification, testing, and exploration of a theory about how treatment effects are modified by addiction career stages and consequent life problems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG COURTS AND MEDICAID MANAGED BEHAVIORAL HEALTH CARE Principal Investigator & Institution: Mcfarland, Bentson H. Associate Professor; Psychiatry; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2003 Summary: (Applicant's Abstract) Drug courts have increased rapidly in recent years, as have evaluations of their impact on criminal activity. On the other hand, little is known about the substance abuse treatment services provided to drug court participants. As noted in a recent National Institute on Drug Abuse Request for Applications, this lack of information is especially striking since "drug abuse treatment in general is undergoing change related to managed care." While drug court programs facilitate (indeed mandate) access to and participation in treatment services, managed care may restrict (or at least alter) provision of drug abuse treatment services. Little if anything is known about the interaction between drug courts and managed care. This issue is of particular interest to Medicaid clients since most states have adopted or are planning to implement managed care for publicly funded drug abuse treatment programs. This revised longitudinal cohort study (application number R01 DA 13091) will describe substance abuse treatment services for drug court participants and comparison group offenders in Oregon (which has one of the country's oldest drug court programs). Oregon made a dramatic alteration to its public substance abuse treatment programs in 1995 when fee for service Medicaid was replaced by managed care (i.e., capitation). This project will examine cohorts of offenders prior to Medicaid managed care and after managed care had been implemented. Drug court participants will be compared with similar offenders who were eligible for but did not participate in drug court (chiefly due to lack of drug court capacity). Medicaid clients will be compared with non-Medicaid offenders. The chief outcome measure will be re-arrest rates. Process measures will include the modality and extent of drug abuse treatment services (as well as information gleaned from chart review). The results will be important for justice system and Medicaid policy makers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DRUG EFFECTS ON BEHAVIOR--WORKPLACE IMPLICATIONS Principal Investigator & Institution: Hart, Carl L.; New York State Psychiatric Institute 1051 Riverside Dr New York, NY 10032 Timing: Fiscal Year 2001; Project Start 01-AUG-1983; Project End 31-JUL-2003 Summary: (Applicant's Abstract) Drug use by the workforce has the potential to impact significantly on workplace productivity and safety, yet few data are available from studies simulating workplace conditions. Our residential laboratory provides a unique opportunity to investigate drug effects on multiple aspects of human behavior under conditions that closely approximate the environmental context and daily schedule of the workplace. This proposal continues research investigating drug effects on human performance and social behavior, and the relationship between workplace demands and drug-taking behavior. We have demonstrated that the workplace-relevant behaviors
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under observation (e.g., learning and performance of a variety of work tasks, social behavior, food, tobacco, and caffeine consumption, and participants' verbal reports of drug effects) are differentially sensitive to a variety of pharmacological agents. Three important aspects of these behaviors will be addressed: 1 ) the acute and repeated dose effects of several potentially problematic drugs on behaviors required for workplace productivity and safety; 2) the residual (next day), or "hangover," effects of drug use during non-work time; and 3) workplace performance and drug use following shift change. We will evaluate the effects and likelihood of abuse of smoked marijuana, oral THC (dronabinol), oral methamphetamine, and zolpidem on workplace-relevant behavior. The marijuana-dronabinol studies are timely and important in light of the current changes in marijuana laws in California and Arizona, as well as the sharp increase in marijuana use by the cohort about to enter the workforce. Studying the effects of methamphetamine is particularly relevant given the rapid increase in methamphetamine abuse in the U.S. In addition, we will evaluate the effects of changing work shifts on workplace-relevant behaviors in the presence and absence of drugs that might be used to alleviate the disruptive effects of such shift changes (e.g., sedatives or stimulants). The data collected will be of public health importance, informing both the public and the business communities as well as public policy directed at reducing drug use by the workforce. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG REDUCTION INTERVENTION FOR NEEDLE EXCHANGE CLIENTS Principal Investigator & Institution: Gogineni, Aruna; Assistant Professor; Ctr for Alcohol & Addict Studs; Brown University Providence, RI 02912 Timing: Fiscal Year 2001; Project Start 25-SEP-2001; Project End 31-AUG-2005 Summary: (Applicant's Abstract) Injection drug users are at risk for a variety of problems such as HIV infection, hepatitis B and C, endocarditis, trauma, legal and work difficulties and family dysfunction. The objective of this research is to investigate ways to effectively reduce drug use among needle exchange program users, whose attendance at such services may signal the beginnings of risk reduction and a desire to escape drug use. In the past two decades brief interventions have proven to be promising in reducing substance abuse in a variety of settings. Recent developments in treatments for substance abuse underscore the primacy of utilizing motivation-based approaches. However, few studies have examined the likelihood that using a brief motivation based intervention with drug users enrolled in needle exchange programs may improve drug use outcomes. Intensifying brief intervention by adding a booster session might further enhance efficacy. The long-term objective of this programmatic body of treatment outcome research is to provide effective brief interventions for adult substance abusers. The specific aims of this proposal are to investigate the extent to which a Motivational Interview with a booster session is effective in reducing drug use among injection drug users enrolled in needle exchange programs as compared to an Attention Placebo Control (AQ condition in a 2-group design. Patients will be followed at 1-and 6 months after the baseline intervention, with self-reports confirmed by urine screens and reports of family or friends. Primary outcome variables include total number of drug use days and number of days in treatment. It is hypothesized that groups receiving MI will show lower levels of drug using days and more days of substance abuse treatment and that 2) the relationship between MI and the outcome variables will vary as a function of the patient's degree of readiness to change. This study will extend previous research by evaluating the use of MI with individuals who are needle exchange participants. The
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development of effective interventions for a population with poor linkage to primary care, an enormous burden of illness, and high HIV transmission risk should reduce the chronicity of drug use and enhance days in drug treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUG USE LIABILITY: INVESTIGATING COMPETING MODELS Principal Investigator & Institution: Ridenour, Ty A. Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 16-AUG-2000; Project End 31-JUL-2005 Summary: This Mentored Research Scientist Development Award (K01) application requests support for five years to investigate how risk and protective factors combine to put pre-teens at some overall drug use liability level. Many risk and protective factors pertaining to drug use, and dependence have been identified, however, few studies have investigated the association between risk factors among children prior to their first ingestion of drugs and later drug use, abuse, and dependence. Even fewer studies have examined how the various risk and protective factors combine to put individuals at some overall risk for (liability to) substance use. Under the mentorship of experts in psychopathological assessment, this study would a) develop a computer-administered instrument titled the Assessment of Liability and EXposure to Substance Use (ALEXSU) and b) prospectively test competing models of drug misuse liability. The ALEXSU would a) not require minimum reading or writing levels, b) be computerized because computer- based assessments of drug abuse generate increased reporting of substance use (Reich, et al., 1995; Turner, et al., 1998), and c) be enhanced with developmentally appropriate and culturally neutral graphics. The research plan proposes to a) develop the ALEXSU from existing measures designed for older individuals, b) investigate the ALEXSU's one-week test-retest reliability among 9 to 12 year old children, c) investigate how well ALEXSU scores predict stages of use and drug-related psychiatric symptoms for a variety of legal and illicit substances two years later and d) test three competing models of drug use liability against each other against a model that combines them, and against a simple summation score of the number of risk factors that participants report. Samples represent high- and low-risk populations. Small-scale validity studies of the ALEXSU will be conducted. Competing liability models will be compared in terms of how accurately they predict three drug use variables (having tried a drug, stage of drug use, and having an abuse or dependence symptom) at the two-year follow-up. The execution of the proposed research plan, formal coursework, and mentoring from the Sponsor and Co-Preceptors will facilitate the Applicant's a) transition in scientific focus to substance use, abuse, and dependence; b) acquisition of advanced analytical skills regarding substance use assessment and d) a platform from which to pursue a career of independently funded substance use research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DRUG USE--GENERATIONAL TRANSMISSION IN MINORITY YOUTH Principal Investigator & Institution: Rosenberg, Gary; Community and Preventive Med; Mount Sinai School of Medicine of Nyu of New York University New York, NY 10029 Timing: Fiscal Year 2001; Project Start 15-APR-1999; Project End 31-MAR-2004 Summary: The purpose of this project is to study the transmission across three generations of the childhood precursors of drug use/drug abuse. This longitudinal study began in 1990 (T1) when first generation (G1) mothers and second generation (G2)
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adolescents were assessed. Data were obtained on cultural and family context, parent child-rearing, and personality/behavioral variables. Five years later (T2), the G2 adolescents were reassessed. At the T2 data collection, the original T1 measures were repeated, and additional data were gathered from both mother and child on cultural influences, personality/behavior, parent- child relations, peer drug use and self drug use. The T1-T2 data established that adolescent factors do influence later drug use; we now propose to further investigate these influences by studying the G3 offspring of the G2 original study adolescents. The G3 child will be evaluated at age 7-12 in terms of childhood precursors of later drug use/drug abuse. We will then trace the intra- and intergenerational pathways (T1-T3) to determine how drug-prone characteristics are transmitted. The hypothesized pathway, based on our Family Interactional Model, is that cultural factors and parent personality risk characteristics (e.g. unconventionality, poor control of emotions) lead to parent-child mutual detachment (e.g., less warmth, more conflict). This then leads to the development in the child of risks for drug use/drug abuse. We hypothesize that this pathway, already shown in the G1 parent and G2 child, will be repeated for the G2 child (now a parent) and his/her offspring. Also of interest is our examination of risk (drug-conducive) and protective (nondrug-conducive) intra- and intergenerational interactions as they affect G3 child outcome. The sample size for the study is 325 7-12-year-olds and their parents. T3 data will be collected using self-report. The analytic techniques will include structural equation and hierarchical regression. The significance of the study lies in its delineation of generational factors implicated in the development of childhood precursors of drug use/drug abuse. (By focusing on ways to improve the psychosocial environment of the young child at risk, one can not only lesser the likelihood of later drug use, but also effect changes that "break the chain" of generational risk transmission.) Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DRUGS OF ABUSE AND GENETICS ON IMPULSIVE CHOICE Principal Investigator & Institution: Anderson, Karen G.; University of Mississippi Medical Center 2500 N State St Jackson, MS 39216 Timing: Fiscal Year 2002; Project Start 16-SEP-2002; Project End 31-AUG-2007 Summary: GRANT=6673577;P20RR Many psychiatric disorders, including drug abuse, are characterized by behavior that is deemed "impulsive." Impulsivity is often defined as the choice for a small, immediate outcome or reinforcer over a larger, more delayed outcome, the self-controlled choice. Impulsive choices may be a result of the value of the larger reinforcer being discounted due to the delay to its presentation. Drug abusers have been shown to discount the value of delayed outcomes to a greater extent than non-drug abusers. However, it is not clear whether delay discounting and/or impulsive choice is an acute drug effect, a consequence of long-term drug exposure, or a preexisting component of an individual's behavioral repertoire determined by behavioral history and/or genetics. The present proposal is designed to begin to address these issues by the investigation of acute and chronic effects of drugs of abuse on impulsive choice in an animal model using two different rat strains, Lewis and Fischer 344, that differ in potentially relevant neurochemical and behavioral measures. The research has three Specific Aims that are addressed in three series of experiments. Specific Aim 1 is to investigate acute effects of drugs of abuse on impulsive choice in the two rat strains, which are expected to differ in their impulsive choices. Specific Aim 2 is to examine effects of repeated administration (long-term exp0osure) of drugs of abuse on impulsive choice in the two rat stains. Specific Aim 3 will enable us to better understand issues surrounding neurochemical bases of impulsivity and drug effects on impulsive choice.
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Within this aim is included investigations effects of selective serotonin and dopamine receptor ligands on impulsive choice modified by drugs of abuse. Also included is examination of differential brain neurochemistry between the two rat strains and how any difference in neurochemistry is related to impulsive choice and drug effects on that choice. Differential and systematic findings in impulsive choice and drug effects will lay the foundation for further studies into understanding the role of neurochemistry and genetics into delay discounting and impulsive choice. The proposed research will contribute to the understanding of the neurobehavioral biology of delay discounting and impulsive choice and effects of drugs of abuse. Ultimately, this work may have relevance to, including understanding and treatment of, many psychiatric disorders characterized by impulsive behavior, e.g., drug abuse, gambling, violence, attentiondeficit hyperactivity disorder (ADHD). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DYNAMIC MODELS OF ADOLESCENT DRUG USE PREVENTION Principal Investigator & Institution: Scheier, Lawrence M. Adjunct Associate Professor; Counseling; University of Nevada Las Vegas 4505 S Maryland Pky Las Vegas, NV 89154 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 30-MAY-2003 Summary: (provided by the applicant) This two-year investigation is designed to increase our understanding of the precise etiologic and developmental processes that influence adolescent alcohol and other drug use. The proposed study significantly extends a program of prospective research to determine the efficacy of Life Skills Training (LST), a school-based, competence enhancement, drug abuse prevention program targeted to middle school populations. Secondary analyses will be conducted using data from three randomized, school-based, prevention trials including a study of primarily white middle-class youth (N=5800), one containing predominantly Hispanic youth (N=3500) and a third comprised mainly of black inner-city youth (N=5900). Evidence has been obtained from each sample regarding the efficacy of the LST intervention in reducing cigarette, alcohol, and marijuana use with follow-up assessments conducted anywhere from three to six or more years following implementation. An essential next step is to conduct manipulation checks to determine if the reductions in drug use are brought about in the manner hypothesized and whether a multi-component intervention strategy is essential to achieve this goal. The study will specifically focus on determining the relative efficacy of three theoretically driven prevention approaches including: social skills/social competence, personal skills and self-management, and normative education (including strategies to alter cognitions regarding the social acceptability of drug use and information regarding the harmful effects of drug use). A primary analytic focus includes the use of structural equation modeling to test mediation as well as hierarchical linear modeling to control for potential clustering effects that arise from randomization of schools to experimental conditions. An important feature of this research is the use of multiple datasets that share a common assessment of key psychosocial risk mechanisms involved in the etiology of adolescent drug use and the ability to test alternative risk mechanisms that may operate specifically in ethnic minority populations. This study has the potential of informing prevention science with regard efficacious intervention strategies that extend to a wide range of ethnic groups during the critical and formative years of adolescence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECTS OF COCAINE ON THE DEVELOPING NUCLEUS ACCUMBENS Principal Investigator & Institution: Kirstein, Cheryl L. Director, Cognitive and Neurosciences; Pharmacology and Therapeutics; University of South Florida 4202 E Fowler Ave Tampa, FL 33620 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-JUL-2006 Summary: (provided by applicant): The role of the mesolimbic dopamine (DA) pathway (specifically the nucleus accumbens septi. NAcc) in reward has been well-documented in adult animals. Drugs of abuse, such as cocaine increase DA levels in the NAcc of adult rats. Similarly, in many studies drug "expectancy" or anticipation has been shown to increase accumbal DA in the adult. As a result, several studies have implicated this pathway as a neural substrate mediating drug abuse. In humans, drug abuse is often established in adolescence not adulthood: this is especially true of cocaine, Unfortunately, few studies have examined changes in the NAcc in response to cocaine during adolescence. Studying the functional responsiveness of this reward system and the effects of cocaine during adolescence is critical. The data show that drug use begins around adolescence and continues into adulthood. Moreover, development of the brain is still ongoing during this period, and the DA system may be critically altered by cocaine exposure. To this end, we modified and adapted the in vivo microdialysis procedure to enable us to effectively and reliably recover DA from the NAcc of young rats. The dialysis procedure allows measurement of the neurochemical changes resulting from cocaine. The present studies propose to use microdialysis to examine the effects of acute, repeated or "expected" cocaine on the NAcc in preadolescent (postnatal day 25; PND 25), periadolescent (PND 35, 45) and adult (PND 60) animals. Additionally, behavioral studies will assess responsiveness to cocaine using a conditioned place preference (CPP) paradigm and novelty-seeking behavior to assess age-related vulnerability to cocaine's effects. Finally, we propose to examine the effects of repeated cocaine at these critical ages on functioning of the adult DA system. The principal goals of the proposed studies are to: first, determine the effects of acute, repeated or "expected" cocaine on mesolimbic DA in PND 25, 35, 45 and 60 rats; second, establish CPP across age; third, measure novelty-seeking differences across age and DA activity in high vs. low responders and finally, determine effects of cocaine exposure during critical periods of adolescence on later DA responsiveness. It is our basic hypothesis that periadolescent animals are unique in their response to cocaine and that repeated administration during this time might down-regulate the basal functioning of this developing system but increase responsiveness to subsequent drug administration and therefore drive repeated drug use. The proposed studies will allow us to examine the underlying mechanism of cocaine's effects in adolescence which is critical in order to understand how these processes control the initiation and maintenance of cocaine abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ENHANCED LINKAGE OF DRUG ABUSERS TO PRIMARY MEDICAL CARE Principal Investigator & Institution: Samet, Jeffrey H. Professor of Medicine; Boston Medical Center Gambro Bldg, 2Nd Fl, 660 Harrison Ave, Ste a Boston, MA 02118 Timing: Fiscal Year 2001; Project Start 30-SEP-1996; Project End 30-JUN-2003 Summary: (Applicant's Abstract) Drug abusers suffer significant health consequences, yet are difficult to engage in primary medical care. Consequently, they miss potential
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preventive health care, behavioral counseling, and treatment for illnesses. Drug abuse treatment is an opportunity to link to primary medical care. Linkage of ongoing, continuous, and comprehensive primary medical care to addiction care may result in reduced drug abuse severity, improved medical outcomes, decreased high risk behaviors, and more appropriate utilization of addiction and medical treatment. To test these hypotheses, a cohort of 380 individuals undergoing detoxification from heroin or cocaine will be identified and followed for two years. The cohort will be randomized into two groups. The standard care group will be informed about available primary care. The intervention group will attend the Health Evaluation and Linkage to Primary Care (HELP) Clinic based at the detoxification unit, which will include a comprehensive medical, substance abuse, and social service assessment, a personalized referral to a specific primary care physician at a site where patients are seen regardless of ability to pay, and nurse contacts to remind them of primary care appointments. This novel clinic is a model-based intervention designed to promote linkage to primary medical care. If effective, this model could be adopted at other detoxification units. As part of a baseline research interview, all patients will be assessed regarding substance abuse severity (Addiction Severity Index), motivation for behavioral change (SOCRATES-D), health status (EuroQol and the SF-36 Health Status Survey), history of HIV risk behaviors, and health services utilization. The subjects will participate in research interviews at 1, 6, 12, 18, and 24 months after enrollment. The linkage outcome measure will be attendance at a visit to a primary care physician within six months of detoxification. To assess the impact of this linkage with and receipt of primary medical care, other primary outcomes include dimensions of addiction severity (ASI drug subscore and days abstinent in past month), health (having had an HIV test and health status scores), behavioral outcomes (condom use and needle sharing), and health utilization (primary medical care vs emergency department visits and drug detoxification vs substance abuse treatment). It is expected that subjects randomized to the HELP clinic will attend more first and subsequent visits with a primary care physician. It is hypothesized that the resultant linkage with primary medical care will result over two years in improved addiction, medical, and behavioral outcomes with more appropriate utilization of health services. By establishing the HELP Clinic, encouraging and facilitating linkage to primary care, and rigorously assessing patient outcomes over two years, both 1) the efficacy of a specific innovative strategy for linking patients in drug abuse treatment with primary medical care, and 2) the benefits of linking drug abusing patients with primary medical care will be determined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ENHANCING HEALTH CARE OF DRUG USERS WITH HIV Principal Investigator & Institution: Mccance-Katz, Elinore F. Associate Professor; Psychiatry and Behavioral Scis; Yeshiva University 500 W 185Th St New York, NY 10033 Timing: Fiscal Year 2001; Project Start 05-APR-2001; Project End 31-MAR-2006 Summary: (provided by applicant) This application is an extensive revision of the K02 application which had been entitled "HIV disease and Drug Abuse: Medications Development." This resubmission expands upon the career development plan to describe related grants and collaborations that link drug abuse, infectious disease with a principal emphasis on HIV disease, and epidemiology using the human laboratory as a tool to explore research questions that span these areas. As a result the resubmission has been retitled "The Human Laboratory: Enhancing Health Care of Drug Users with HIV." This K02 is built around RO1 grant DA13004 "Opiolds and HIV Medications: Interactions in Drug Abusers" (PI: E. McCance-Katz). The aim of this project is to
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enhance the care of patients with HIV disease and opiold dependence by using the human laboratory setting to identify significant drug interactions between opioids and antiretroviral medications. These findings will assist clinicians by identifying drug combinations likely to have substantial interactions that can lead to non-adherence, by assisting with the process of matching patients to treatments, and may improve adherence with decreased medical complications of AIDS as well as reduced transmission of the virus. Related collaborative efforts are a key component of the career development plan and include a study of directly observed HAART therapy in methadone maintained individuals (PI: E. McCance-Katz, M. Gourevitch, J. Arnsten), determination of methadone and antiretroviral drug concentrations and correlation with HIV therapeutics adherence (PI: J. Amsten, E. Schoenbaum), determination of HAART effectiveness in late stage HIV in drug users (PI: D. Vlahov, B. Greenberg), and methadone maintenance in primary care settings (PI: S. Magura). Additional prongs of the career development plan include didactics specifically aimed at enhancing knowledge and ability to contribute to these projects. Molecular pharmacology, epidemiology, and research ethics courses are proposed as is substantial time meeting with other experts and mentors including T. Kosten, R. Schottenfeld, P. Jatlow, G. Friedland, P. Rainey, E. Morse, and M. Fischman. This revised application also includes a career development path in teaching and mentoring trainees with an interest in drug abuse research. The Albert Einstein College of Medicine and the surrounding, New York City and New Haven areas provide an ideal environment for continuing progression as an independent clinical researcher in drug abuse and HIV disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ENHANCING HEALTH OUTCOMES AMONG HIV+ SUBSTANCE ABUSERS Principal Investigator & Institution: Altice, Frederick L. Associate Professor of Medicine; Internal Medicine; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): This application is for a Mid-Career Investigator Award in Patient-Oriented Research (K24). Through this award, my goals are to increase: 1) my productivity in patient-oriented research; 2) increase mentorship of beginning investigators; and 3) awareness of the interface between substance abuse and infectious diseases. My research to date has broadly involved epidemiological, health services outcomes and intervention studies involving drug users with or at risk for HIV. My focus has involved interventions targeting out-of-treatment drug users - primarily in community and correctional settings. These settings are complementary as HIV+ drug users (HIDUs) filter between these two domains, both of which offer unique opportunities for intervention. Specifically, I am now developing NIDA-funded programs of directly observed therapy (DOT) for HIV treatment in correctional, community and the transition between these settings. This research uses a randomized controlled trial design with biological (HIV-1 RNA, CD4 count, HIV-1 genotypic resistance), behavioral (adherence, HIV quality of life, self-efficacy) and health services (entry into and retention in drug treatment, use health care services) outcomes. Similar to drug treatment and correctional systems, DOT provides a structure for adherence to antiretroviral therapy (ART). Without strict adherence, HIDUs will experience poor health outcomes, increased infectivity to others by inadequately suppressed HIV-1 RNA levels and develop resistance to HIV medications that can then be transmitted to others. Therefore, development and evaluation of such programs may impact on the
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organization of and health care delivery for HIDUs. The K24 mechanism is ideally suited for my career development. In addition to being committed to increase my level of mentorship, I have a long-standing history of external funding to provide a research infrastructure for beginning investigators. I work within an exceptional institution with expertise in the areas of substance abuse, infectious diseases, and HIVIAIDS, from which qualified candidates can be recruited. I have a commitment from the institution to reduce my clinical and administrative duties so that I can focus on scholarly research and mentorship. I have effectively mentored a small number of beginning investigators who have moved on to independent careers. Lastly, I have long-term goals of developing a novel institutional training program in the interface between substance abuse and infectious diseases. Therefore, if allowed the opportunity to decrease my current clinical and administrative responsibilities, I am likely to be able to achieve my short- and long-term career development goals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EVALUATION OF SOBER LIVING HOUSES Principal Investigator & Institution: Polcin, Douglas L.; Haight Ashbury Drug Detox & Rehab Center and Rehabilitation Center San Francisco, CA 94117 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 30-JUN-2008 Summary: (provided by applicant): Numerous studies have documented how characteristics of the social environment are related to alcohol consumption and the types of problems associated with alcohol dependence. Studies have also shown that the characteristics of clients' living situations are factors associated with treatment outcome. Sober living houses provide individuals with an alcohol and drug free living environment who attempting to establish or maintain sobriety. They have been used as aftercare placements for clients completing residential treatment, places for clients to live while attending outpatient treatment, or as referral sources for individuals in the criminal justice system. However, the research on sober living houses has been limited and no research has tracked measures of resident functioning over time. The primary aim of this study is to investigate longitudinal outcomes of individuals in sober living residences. Data will be collected during in-person interviews at entry into the residence, and 6-month, 12-month, and 18-month follow-up time points. Effectiveness will be measured in terms of 6-month measure of alcohol and drug use, criminal justice involvement, housing stability, employment, and Addiction Severity Index composite scores. Pre-post comparisons will be made for the overall sample as well as three subgroups of residents: those who completed residential treatment, those who are attending outpatient treatment with no residential treatment the past year, and those who were referred from the criminal justice system. The study also will assess whether demographic characteristics, psychopathology, motivation for change, involvement in formal treatment, a ratio of adjunctive services received to services desired, or various social support measures predict outcome. Finally, comparisons will be made between individuals residing in sober living houses and a group of individuals referred to sober living residences who left within the first week. This research will provide a longitudinal description of how well residents in sober living houses function in a variety of areas. It will also describe the mix of formal treatment and informal social support activities that these individuals utilize, and will correlate these activities with outcome. Finally, it will demonstrate whether sober living residents have better outcomes than a comparison group of similar individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EXPANDING COMPUTER-BASED DRUG ABUSE PREVENTION Principal Investigator & Institution: Marsch, Lisa A. Research Assistant Professor; Healthsim, Inc. 187 St. Paul St, Ste 3 B-1 Burlington, VT 05401 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2004 Summary: (provided by investigator): Recent evidence indicates that drug use is highly prevalent among children and adolescents, and initiation of drug use is often occurring at very early ages. These findings underscore the need to initiate age appropriate prevention efforts with youth at an early age in elementary school and continue these interventions throughout middle school and later years. We previously developed and evaluated an interactive, computer-based drug abuse prevention multimedia program for middle school-aged youth that incorporates effective components of both drug abuse prevention science and educational technologies This computer-based program was designed to promote the increased adoption of effective prevention science, and was shown to be efficacious, easily exportable and able to be applied with fidelity. In the present application, we propose to develop and evaluate a similar computer-based prevention program specifically for elementary school-aged children. This program will extend effective prevention science to this age group, while addressing many of the challenges associated with the current delivery of evidence-based prevention programs to this population In determining the scientific, technical and commercial merit and feasibility of the program, various program modules will be 1) developed, 2) subsequently assessed by the target population and 3) revised as necessary during Phase I. An effective multimedia drug abuse prevention learning environment, which provides integration between state-of-the-art computer technology and behavioral science research, may be of substantial benefit in providing drug abuse prevention education to elementary school children within the public school system. Such a program will deliver evidence-based prevention interventions in a manner that is considerably more cost-effective and comprehensive than the labor-intensive, schoolbased, prevention interventions that have been demonstrated to be efficacious in preventing the initiation of drug use among this age group. Even if a computer-based drug abuse prevention program is shown to be at least as effective as traditional prevention efforts, and not necessarily more effective, it would likely still be a valuable resource to the educational system, as it would enable educators to markedly reduce the expense of their drug abuse prevention programs, while permitting the adoption of effective methods of drug abuse prevention among elementary school-aged children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EXPLORING DRUG ABUSE THROUGH THE SCIENCE OF EPIDEMIOLOGY Principal Investigator & Institution: Kaelin, Mark A. Health Professions/Physical Education/Recreation/Leisure Studies; Montclair State University Upper Montclair, NJ 07043 Timing: Fiscal Year 2003; Project Start 17-SEP-2003; Project End 31-JUL-2007 Summary: (provided by applicant): We will develop, evaluate, and disseminate a curriculum that will explore drug abuse issues relevant to high school students through the science of epidemiology. The curriculum, called Exploring Drug Abuse Through the Science of Epidemiology, will prepare students to make personal and collective, evidence-based decisions about drug abuse. This exploration of drug abuse issues will be structured according to a concept map for the discipline of epidemiology and the National Science Education Standards' fundamental abilities in Science as Inquiry. The
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lessons will be created and refined in partnership with an Advisory Board consisting of high school science teachers, drug educators and counselors, epidemiologists, and college professors. As part of lesson development, the Principal Investigator and high school teachers who are members of the Advisory Board will pilot-test the prototype lessons in their high school classes. The prototypes will be refined based on this experience and the advice of the Advisory Board. The prototype lessons will then be field-tested by a Field Testing Team consisting of science teachers from twenty high school members of the New Jersey Network for Educational Renewal. These twenty schools will be randomly assigned to be either experimental or control schools. Teachers from the Field Testing Team's ten experimental schools will be trained to teach the lessons and will implement them in their classes. The impact of the curriculum will be tested by assessing students' knowledge of drug abuse and epidemiology, as well as, their fundamental abilities in Science as Inquiry and scientific literacy. Several evaluations will use controlled, pre-test/post-test comparisons. The prototype lessons will be refined further based on the Field- Testing Team's experiences and on students' assessments and feedback. With Centers for Disease Control and Prevention approval, the Exploring Drug Abuse Through the science of Epidemiology web site will be linked with the CDC EXCITE web site (Excellence in Curriculum Integration through Teaching Epidemiology). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EXTENDING GROWTH MIXTURE MODELS TO THE STUDY OF DRUG USE Principal Investigator & Institution: Bauer, Daniel J. Sociology; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, NC 27599 Timing: Fiscal Year 2002; Project Start 01-DEC-2001 Summary: The proposed project is designed to clarify, expand upon, and apply growth mixture modeling as it relates to understanding developmental pathways that lead to adolescent drug abuse and dependence. Growth mixture modeling techniques are recently emerging quantitative methods that permit investigators to identify discrete developmental patterns of change over time. These new methods hold great promise for the social sciences, arid especially for the study of pathways of drug use, because they enable investigators to construct taxonomies of normal and maladaptive developmental patterns. Each developmental pathway of risk may have a unique etiology or special portent for later psychopathology. Because little is known about these emergent methods, the primary goal of this proposal is to review and evaluate growth mixture models for their relevance to research in developmental psychopathology and drug abuse. The project is organized around three specific aims. Aim 1 is to review and contrast two recently developed growth mixture modeling techniques relative to one another and to more traditional analytic models. Aim 2 is to examine the behavior of growth mixture models with data simulated to reflect variations and conditions that would commonly be encountered in applied research on drug use and abuse. The results from Aims 1 and 2 will be applied in Aim 3, which provides a pedagogical demonstration of growth mixture modeling with real world data by testing the specific hypothesis that particular developmental pathways of antisocial behavior will predict adolescent drug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FACTORS INFLUENCING COCAINE USE IN HUMANS Principal Investigator & Institution: Higgins, Stephen T. Professor; Psychiatry; University of Vermont & St Agric College 340 Waterman Building Burlington, VT 05405 Timing: Fiscal Year 2001; Project Start 01-FEB-1993; Project End 30-JUN-2002 Summary: This is a continuation application for a project examining the influence of other drug use on human cocaine use using a laboratory model. The prior project focused on the influence of non-prescription drug use (i.e., alcohol, caffeine, marijuana, and nicotine) and the proposed project will focus on the influence of prescription drug use (i.e., psychomotor stimulants, sedative hypnotics, and opioid analgesics). Understanding the influence of such other drug use on the probability of cocaine use is essential to the development of effective clinical strategies for managing polydrug abuse in cocaine treatment clinics, and could also prove useful to the development of effective pharmacotherapies for cocaine abuse. Laboratory models are important due to the rigorous experimental control they afford and their lower costs compared to clinical trials. In our laboratory model, volunteers participate in a series of experimental sessions in which they make exclusive choices between doses of intranasal cocaine and varying amounts of money. In studies completed to date (l) cocaine use varied as an orderly function of monetary value, demonstrating experimental control over drug use; (2) acute alcohol, but not caffeine, pretreatment increased preference for cocaine over the alternative monetary option, suggesting the model has pharmacological sensitivity and selectivity; and (3) these laboratory findings were concordant with evidence from clinic studies with cocaine-dependent patients, supporting the generalizability of these observations to treatment settings. Six studies are proposed for the next funding period. All examine the acute effects of prescription drugs that are commonly used and abused by cocaine abusers. The specific drugs proposed for study are damphetamine, methylphenidate, pentobarbital, triazolam, codeine, and buprenorphine. These studies wTh provide important new information on (l) how use of these drugs alters preference for cocaine versus alternative, non-drug reinforcers, (2) possible differences between drugs in how they affect cocaine use, and (3) the utility of laboratory models for addressing clinically important issues. Additionally, by examining non-prescription (prior application) and prescription (this application) drugs, this project will contribute a comprehensive experimental analysis of the influence of commonly used drugs on human cocaine use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FAMILIES AS PARTNERS IN HOMELESS DRUG ABUSE SERVICES Principal Investigator & Institution: Polgar, Michael F. None; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 05-AUG-2001; Project End 31-JUL-2003 Summary: (provided by applicant) Homeless adults have disproportionate rates of drug use disorders, especially those dually diagnosed with other mental disorders. Drug use disorders are significantly associated with homelessness, early onset of homelessness, protracted homelessness, and housing instability. However, the homeless population does not fully utilize drug abuse treatment. Previous research has identified family involvement as an important predictor of treatment outcomes and housing among homeless populations. A variety of educational group intervention models for families have demonstrated effectiveness. An experienced, multidisciplinary research team in social science and medicine will develop a family-based intervention against drug abuse, pilot this intervention, and develop methods that can be used to evaluate the
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success of this intervention. This project strives to apply research to practice in order to reduce and reverse adverse consequences of drug abuse and homelessness. The proposed intervention, empowering families as partners against drug abuse, is based on responsive educational groups for relatives of persons who are homeless and abusing drugs. This project will develop educational groups for 25 family pairs, one homeless person meeting diagnostic criteria for drug abuse disorder and one close relative, helping families engage their drug abusing relatives in treatment and recovery. This project will test methods for assessing intervention outcomes, surveying both homeless individuals and their relatives before and after they attend multifamily groups. For homeless drug abusers, this project will measure primary outcomes, including severity of drug use disorder, housing status, and use of health and social services. For relatives, this project will measure secondary problems related to drug abuse, including family burdens, social support, social costs, health and social service use. This study will contribute to our knowledge of recovery from drug abuse in homeless populations, which can be improved by a strong and supported family. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FAMILY INTERVENTION FOR CHILDREN AND CRACK-USING MOTHERS Principal Investigator & Institution: Lam, Wendy K.; Research Triangle Institute Box 12194, 3040 Cornwallis Rd Research Triangle Park, NC 27709 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): This developmental (R21) study will address an unmet need among preteen youths and their African-American mothers who abuse crack cocaine. The strong link between adolescent substance use and high-risk sexual behaviors makes adolescent children of African-American drug abusers one of the highest risk groups for substance abuse and HIV. The social contexts of maternal drug use and its associations with potentially neglectful and aggressive parenting may lead to poor child outcomes through negative influence on family dynamics. Research shows that family factors influence substance use, HIV-related risk, and protective factors in the long term. Short-term effects of substance use and HIV risk-reduction interventions with youth may diminish over time because of the lack of family or parent involvement. Selective family-skills interventions that target drug-using mothers, their preadolescent children, and their dyadic interactions may be a more-durable approach to prevent youth drug abuse and HIV risk factors through adolescence and adulthood. To break potential intergenerational patterns of drug use and HIV risk among families with maternal drug use, there is a critical need to identify risks and protective mechanisms operating for the children of these families, and to adapt and test a family-skills intervention that targets these factors among youths at an especially vulnerable stage of pre-adolescence. Because target mothers and children are hard to reach and retain in interventions, the proposed study will be conducted in two phases: formative and experimental. The formative phase will adapt and refine recruitment and retention strategies and the intervention with community input; the experimental phase will examine the outcomes of the adapted family-skills intervention delivered in a multicomponent format (maternal, youth, and mother-child sessions) to prevent drug abuse and HIV among children (aged 10 to 14 years) of African-American mothers who abuse crack and are not in treatment. The specific aims of the proposed developmental study are as follows: Specific Aims: Formative Phase. Aim 1) To develop and refine effective strategies to reach, recruit, and retain African-American mothers who use crack and their children (aged 10 to 14 years) in a multicomponent family-skills intervention
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to prevent youth drug abuse and HIV. Aim 2) To revise, adapt, and tailor relevant family interventions to reduce risk factors for substance abuse and prevent HIV among the targeted preteen children (aged 10 to 14 years) of African-American mothers who use crack and are not in treatment. Specific Aims: Experimental Phase. Aim 3) To describe individual, maternal, and familial risk and protective factors in children (aged 10 to 14 years) of African-American mothers who use crack and are not in treatment. Aim 4) To examine the outcomes (family environment, youth social skills and problem behaviors, substance use, and sexual risk) of a family-skills intervention adapted for drug abuse and HIV prevention among African-American mothers who use crack and their children relative to a no-intervention control group at 3- and 6-month follow-ups. Aim 5) To explore mediating (e.g., maternal and adolescent self-efficacy, perceived risk, and maternal drug use) and moderating factors (youth age, gender, school performance, religiosity) of intervention effectiveness on substance use, sexual intentions and risk behaviors among children of African-American mothers who use crack and are not in treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FAMILY, DRUG USE, AND DISPARITIES IN ADVERSE OUTCOMES Principal Investigator & Institution: Klepinger, Daniel H.; Battelle Centers/Pub Hlth Res & Evaluatn Health Research & Evaluation Seattle, WA 98105 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 29-FEB-2004 Summary: (provided by applicant) Although drug use has declined substantially over the past two decades, it remains a serious problem in the U.S., as almost twelve percent of the population still used illicit drugs during the past year. Moreover, prevalence rates for most groups have remained fairly stable over the past few years, and appear to be rising for young adults. Minority groups, tend to be over-represented among those who suffer from the adverse health and social consequences associated with drug use, although they report similar or lower levels of drug use, and differences in socioeconomic status does not fully account for the differences in the adverse health and social outcomes. Much prior research has focused on the short-term effects of adolescent drug abuse rather than on the possible long-term effects of drug abuse, and has not devoted enough attention to the importance of childhood living arrangements and sibling behavior. There are important racial and ethnic differences in patterns of drug use and these family factors, and these differences may help account for observed racial and ethnic differences in the adverse health and social associated with drug abuse. The proposed study will use the National Longitudinal Survey of Youth, a large nationally representative longitudinal data set that has followed respondents for 18 years, to examine the timing pattern of the effects of drug use to determine whether detrimental effects of drug abuse only appear when there is persistent or long-term drug use. The proposed study will also examine whether the types of drugs used and their intensity of use matter. The NLSY also contains detailed information on childhood living arrangements and on older siblings' adverse health and social outcomes, including drug use, and the proposed research will employ these data to examine how these family factors are associated with drug use and adverse health and social outcomes. Throughout the proposed analysis, we will examine the extent to which family factors account for observed racial and ethnic differences in drug use, how differences in these factors and drug use account for differences in adverse outcomes, and estimate how the effects of each of these factors vary by race and ethnicity. We will also test and control for possible unobserved factors and reciprocal effects that may bias empirical estimates. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FEASIBILITY OF BIOLOGICAL MEASUREMENT IN DRUG SURVEYS Principal Investigator & Institution: Fendrich, Michael; Associate Professor; Psychiatry; University of Illinois at Chicago 1737 West Polk Street Chicago, IL 60612 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2003 Summary: (Adapted from the Applicant's Abstract): This work will facilitate more effective drug abuse prevention and treatment efforts on a societal level by enhancing the accuracy of drug abuse measurement. Specifically, this study will provide definitive answers regarding the viability of incorporating biological measurement of drug use in the context of general population household surveys on drug abuse. The proposed study will evaluate the feasibility and utility of three different types of biological measurement procedures (hair, saliva, and urine testing) to be used as an adjunct to a household survey on drug abuse. This study will compare the relative acceptability of the different biological test methods among survey participants through household surveys of 600 randomly selected subjects residing in the City of Chicago. By randomly assigning subjects to either a high or low incentive drug test condition, this study will evaluate the role of alternative incentive strategies on participation in biological measurement. Through quantitative and qualitative analyses, this study will assess the myriad of subject, interview condition, and procedural variables associated with drug test participation in household surveys. This study will examine impact of prior exposure to drug testing and perceptions about drug testing accuracy on willingness to participate in biological measurement. The study will also gain an understanding of adult willingness to provide consent for similar drug testing in children. Alternative statistical procedures for constructing prevalence estimators from multiple biological measures will be explored. Results derived from biological assessments will be compared with responses to questions about drug use provided in an Audio Computer Assisted Self Interview that precedes the biological assessment. Taking into account factors influencing drug test participation, these comparisons will be used to evaluate the extent of underreporting of drug use in the general population. Subject and drug use variables associated with drug use underreporting will be fully analyzed. The utility of hair testing will be further evaluated by examining whether a new confirmation process (negative ion screening) yields increased sensitivity for detecting marijuana metabolites. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FEMALE DRUG ABUSE SCIENCE CURRICULUM Principal Investigator & Institution: Leukefeld, Carl G. Professor; None; University of Kentucky 109 Kinkead Hall Lexington, KY 40506 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 31-AUG-2002 Summary: (Applicant's Abstract) Attracting young people into scientific careers in drug abuse, is a goal of the National Institute on Drug Abuse (NIDA, 1993). The under representation of females in the scientific community underscores the need to encourage more females to pursue scientific careers (Yentsch & Sinderman, 1992), and in drug abuse research (NIDA, 1993). Based upon involvement with research projects in rural areas, and experiences with Appalachian youth, there is modest interest in scientific careers among these youth, and most frequently no knowledge of, or interest in, drug abuse research among females. The overall aim of this revised project is to develop, implement, and refine a curriculum manual -- Female Drug Abuse Science Curriculum (F-DASC) -- which targets Appalachian high school females to increase their scientific, technological, and interpersonal skills in order to facilitate their entry into drug abuse
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research. The specific aims for this project are: (1) To develop and implement the curriculum to increase the scientific, technological, and interpersonal skills of Appalachian high school females in the area of drug abuse research; (2) To provide female scientific mentors and community mentors to serve as role models; (3) To increase the scientific, technological, and interpersonal skills of Appalachian women in order to enhance their awareness of, interest in, and likelihood of entering scientific careers in the areas of drug abuse research; and (4) To refine the curriculum and develop a manual for replication. Fifty young women will participate in the intensive three year F-DASC experience. Scientific and community mentoring on-going throughout each year is coupled with a four week campus summer curriculum. The approach, based on the literature and the experience of the University of Kentucky Center for Science and Health Careers makes science exciting and offers rewards to maintain interest in research with increased skills to pursue careers in drug abuse research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FLORIDA NODE OF THE DRUG ABUSE CLINICAL TRIALS NETWORK Principal Investigator & Institution: Szapocznik, Jose; Professor and Director; Psychiatry and Behavioral Scis; University of Miami Box 016159 Miami, FL 33101 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: This is a proposal to establish the Florida Regional Node of the National Drug Abuse Treatment Clinical Trials Network (CTN). Four major research centers at the University of Miami have joined to provide the Regional Research and Training Center (RRTC) with their considerable clinical trials, multi-site, and drug abuse treatment expertise: Center for Family Studies, Comprehensive Drug Research Center, Center for Treatment Research on Adolescent Drug Abuse, and Behavioral Medicine Research Center. The Community Treatment Programs (CTPs) elected are among the largest and most respected in the State, representing the north(Gateway in Jacksonville), central (PAR in Tampa; Center for Drug Free Living in Orlando) and south (The Village in Miami; Spectrum in Broward County) pats of the State. They offer exceptional diversity of treatment modalities, ethnic profiles, and drug abusing and addicted populations. In the first year, The Florida Node has the capacity of serving up to 20,000 drug abusing and addicted patients. The Florida Node Steering Committee includes the leaders of the 5 CTPs, the P.I., and the Co-P.I/Operations Director. Each of the other teams also include RRTC and CTP representation: Clinical Trials Training and Implementation Monitoring, Concept Development, and Biostatistics/Data Management. In this partnership both the RRTC and the CTPs are eager to learn from each other, and eager to learn about efficacious treatment models that can be transported from other nodes to Florida's treatment programs. The Florida Node RRTC has developed and published efficacious family- based treatment models and brings considerable strength in family-based interventions with drug abusing populations (adolescent drug abusers, drug addicted new mothers, HIV+ women using drugs intermittently) and with HIV+ populations (HIV transmission prevention, family ecological therapy to improve individual and family functioning). The Node's interests in these areas range from transportability of interventions to statistical methodological issues in aggregating family data in longitudinal designs. Particular challenges to the work of the Florida Node include communication and collaboration across geographic distance. Facilitators include eagerness to provide quality services, interest in using outcome data to update state treatment funding policies, recognition of a zeitgeist in the
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state and the nation of accountability, and prior collaboration among the CTP under the New Century Institute umbrella to promote the group's treatment and research competence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FOOD INTAKE, SENSITIZATION AND RELAPSE TO DRUGSEEKING Principal Investigator & Institution: Gosnell, Blake A. Director of Basic Research; Neuropsychiatric Research Institute Fargo, ND 58103 Timing: Fiscal Year 2002; Project Start 12-JUL-2002; Project End 30-JUN-2006 Summary: (provided by applicant): Several types of studies suggest a partial overlap between the neural mechanisms mediating drug reward and those mediating food reward. This overlap holds forth the intriguing possibility that dietary manipulations may be useful as adjuncts to approaches for prevention and treatment of drug abuse. Currently, there is a lack of information about the influence of dietary factors on two processes that are thought to be important factors in drug abuse: sensitization and relapse. The animal studies described in this proposal will address these issues. Experiments in Part 1 will determine whether intermittent pre-exposure to sucrose will produce or facilitate sensitization to the locomotor activating effects of cocaine. To this end, rats will be given 1 of 3 different schedules of pre-exposure to sucrose, and the response to an initial and to repeated injections of cocaine will be measured. Experiments in Part 2 will examine whether intermittent pre-exposure to sucrose will produce sensitization to the reinforcing effects of cocaine, as measured by differences in the rate of acquisition and dose-response relationships in the intravenous selfadministration model. Experiments in Part 3 will examine whether brief exposure to sucrose will cause a reinstatement to cocaine seeking in rats that have undergone extinction of self-administration behavior. The effect of sucrose on reinstatement caused by priming infusions of cocaine will also be examined. It is hypothesized that preexposure to sucrose will, under some conditions, produce a sensitization to the locomotor and/or reinforcing effects of cocaine. It also is hypothesized that sucrose intake will cause some degree of reinstatement of drug seeking, and that the presence of this palatable food will influence the effect of a priming infusion on drug seeking. To determine the food-specificity of any observed effects, follow-up experiments will be conducted with pre-exposure to dietary fat. An investigation of the impact of dietary factors on the processes of sensitization and reinstatement will provide a better understanding of the contribution of disordered eating patterns to the initiation, maintenance or relapse to human drug abuse. Ultimately, improved nutritional counseling and/or manipulations of dietary factors may be helpful in efforts to prevent or treat drug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FUNCTIONAL MRI OF HUMAN DRUG ABUSE Principal Investigator & Institution: Risinger, Robert C. Assistant Professor; Psychiatry and Behavioral Med; Medical College of Wisconsin Po Box26509 Milwaukee, WI 532264801 Timing: Fiscal Year 2002; Project Start 30-SEP-1994; Project End 31-MAR-2005 Summary: Cocaine and nicotine abuse remain serious problems in society, with high recidivism rates. When self administered by humans, abused drugs exert powerful, direct pharmacological actions within localized brain regions and circuits, while also
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interacting with specific cognitive systems. The overall goals of this project are to employ fMRI to define those neuronal systems in the human CNS mediating the actions of these two very addictive agents and to determine how cocaine and nicotine interact with specific cognitive and affective processes. The interplay between where cocaine acts in the human brain and how these circuits overlap with nicotine and other abused agents is poorly understood. Additionally, almost nothing is known regarding their neural pharmacokinetic and pharmacodynamic properties and neurochemical sites and mechanisms of action in humans. Specific Aim I of this proposal addresses these pharmacological issues. However, human drug abuse is not simply explained by where a drug acts in the brain. While the powerful reinforcing and, in the case of cocaine, euphorigenic properties of these drugs are important in drug-seeking and drug-taking behavior, drug administration also engages a complex, poorly understood sequence of behavioral alterations that, taken together, perpetuate drug taking behavior. Specific Aim 2 addresses the effects of cocaine and nicotine on cognitive and affective processes. Since cocaine addicts report selective recall of the high over the crash and exhibit considerable difficulty controlling impulses to use and appropriately weighing risks of use. Therefore, it is hypothesized that acute cocaine will enhance sustained attention and recall for events occurring under the influence of the drug and that corresponding alterations in fMRI activation in attentional networks (frontal, parietal, thalamic) and in memory circuits (hippocampus) will be seen. It is further hypothesized that acute cocaine will impair inhibitory control, concept formation and attention switching with corresponding alterations in specific frontal lobe activation. Finally, we will examine the interaction between acute cocaine administration and affective state to test the hypothesis that the reinforcing properties of the drug are enhanced during times of negative affect and cocaine craving. A better understanding of these processes may lead to better behavioral and/or pharmacological therapeutic interventions for cocaine abuse and recidivism and identify a likely cognitive profile resulting from prolonged abuse to help identify those most at risk for dependence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FUNCTIONAL NEUROIMAGING OF DRUG ABUSE Principal Investigator & Institution: Levin, Jonathan M.; Mc Lean Hospital (Belmont, Ma) Belmont, MA 02478 Timing: Fiscal Year 2001; Project Start 10-MAY-1997; Project End 30-APR-2003 Summary: (Applicant's Abstract) This application is in response to PA-95-053 for the Mentored Clinical Scientist Development Award. This award will allow the candidate, a neurologist with additional training in functional neuroimaging and public health, to become expert in the neuroscience of drug abuse and ultimately become an independent investigator. The immediate goal of the candidate is to acquire training in the experimental methodology of applied clinical drug abuse research. Specifically, the candidate hopes to augment neuroimaging skills with a more complete understanding of the neurobiology, neuropharmacology, physiology, and behavioral aspects of addiction and problems in drug abuse. The mentor, Dr. Jack Mendelson, is a unique resource for guiding the candidate in this development program. Besides Dr. Mendelson, the program utilizes the expertise of several preceptors with different skills pertinent to the goals of this application, including neuroimaging (Drs. Renshaw and Cohen), the neuropharmacology of drug abuse (Dr. Lukas), and statistical analysis of functional imaging datasets (Dr. Lange). The research plan that complements this development program focuses on cocaine, a tremendously addictive drug that is neurologically damaging and neuroscientifically intriguing. The research plan details
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the application of two fMRI techniques, dynamic susceptibility contrast (DSC) and blood oxygenation level dependent (BOLD) imaging, to assess cocaine's acute and chronic effects on brain hemodynamics and function. These techniques are extremely well-suited to the study of drug effect on brain function due to their extraordinary spatial and temporal resolution, ease of repetition, and minimal invasiveness. The specific aims of the research plan are to assess 1) the acute effect of cocaine injection on global and regional relative cerebral blood volume (relCBV) in recreational cocaine users 2) the acute effect of cocaine on brain functional activation, both generally as well within dopaminergic projection areas likely to underlie cocaine's reinforcing effect and 3) the effects of chronic cocaine abuse on global and regional relCBV at rest and in response to cocaine-related cues. The candidate's institution is very committed to both his development and drug abuse research, and has guaranteed the resources necessary to accomplish these objectives. Importantly, this award will allow the candidate to utilize and contribute to existing, funded drug abuse research at the same institution, and will provide a secure salary commitment so that the candidate can devote the next five years to training in applied clinical drug abuse research. It is expected that the results of these investigations will provide important new insights into understanding cocaine's effect on brain hemodynamics and function, which ultimately promises greater understanding of the neural systems subserving euphoria and addiction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENDER DIFFERENCES IN HEALTH SERVICES UTILIZATION Principal Investigator & Institution: Vaughan Sarrazin, Mary S. School of Social Work; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2003 Summary: (Applicant Abstract) Dr. Vaughan is submitting this application as a new, less experienced investigator. Dr. Vaughan has several years of health services research experience, and this is her first submission as principal investigator for a NIH grant. This study proposes to describe gender differences in the need for, utilization of, and access to health and social services prior to drug abuse treatment. Specific attention will also be given to differences across ethnic minorities within gender. Clients will be recruited and interviewed at intake at a central referral center for drug treatment. More specifically, this study has the following aims: 1. To compare characteristics of male and female adult drug abusers. Clients interviewed will be assessed at treatment intake on the following characteristics: drug/alcohol use history, physical health, mental health, family and social relationships, legal involvement, and financial resources. 2. To evaluate differences in the utilization of health and social services prior to referral to drug treatment, for male and female adult clients. Where possible, comparisons within gender will be made between clients of different races. 3. To evaluate gender differences in access to health services, including drug abuse treatment. If clients do not receive necessary services, we will determine the barriers to obtaining services, including drug abuse treatment. A major outcome of this study will be identification of services used frequently prior to referral to substance abuse treatment. This information has enormous potential to assist outreach and prevention efforts by identifying likely environments in which drug abusers may be found. One of the most difficult aspects of treatment is identifying substance abusing women and drawing them into care. Research is needed to examine how women in treatment came to be there and identify differences among sub-populations of women in the route by which they entered treatment. There is relatively little awareness among health care professional regarding sex-based differences in physiology and cultural environment. Such factors as sexual
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abuse, depression, poverty, single parenthood, under-employment, and self-esteem may affect males and females differently, leading to greater risk of drug abuse for females than males. Identification of these risks, service utilization associated with these risks, and barriers to services may assist early identification of women at risk for drug abuse. This research will also enhance the understanding of barriers to drug treatment for women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENE-ENVIRONMENT INTERACTION IN ETIOLOGY OF DRUG ABUSE Principal Investigator & Institution: Cadoret, Remi J. Professor; Psychiatry; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2001; Project Start 01-AUG-1989; Project End 30-MAR-2004 Summary: The purpose of this study is to elucidate through an adoption paradigm the role of genetic and environmental risk factors in the etiology of drug abuse. Past work on this project has established the roles of genetic factors for antisocial personality and environmental factors as determinants of adult drug abuse/dependency. During this competitive renewal we propose to study the effects of genetic factors for antisocial personality and a variety of environmental factors for their influence on the life course of drug abuse. This will be done by personal interviews of the 743 adoptee subjects (381 male and 362 female) who have been part of the Iowa Adoption Studies. These studies have been ongoing since 1974 so that proposed follow-up subject interviews will be given 10-25 years after the initial interview (all were initially interviewed as adults 18-50 years of age). Retrospective information will be gathered about the subject's lifetime experience with drugs and other substances of abuse. Having a previous interview will allow for determination of reliability of recall for a number of items in the lifetime drug experience, e.g., age at first use or age at first problem. The age spread of subjects will allow for control of secular changes which are important in altering trends in drug use behavior. Focus of the analysis will be upon the behavioral trajectory from biologic background of antisocial personality, through adoptee aggressivity and conduct disorder to adult drug use and comorbid antisocial personality. This is an important pathway leading to substance abuse as evidenced by the large number of antisocials in the country's correctional systems who are incarcerated for drug-related crimes. Study variables have been selected on the basis of their demonstrated importance in drug abuse in our preliminary studies, their potential clinical significance, and their ability to illuminate the personal dynamics which lead to important changes in drug taking behavior, such as cessation of abuse. Information from this proposed study could lead to changes in drug prevention methods as well as indicate long term prognosis for this sizable population. Analysis will involve a number of multivariate techniques including Cox's curve fitting, logistic regression correlating long term behaviors with genetic and environmental factors while controlling for confounds. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HAIR ANALYSIS TO MONITOR DRUG ABUSE TREATMENTS Principal Investigator & Institution: Wilkins, Diana G. Assistant Director; Pharmacology and Toxicology; University of Utah 200 S University St Salt Lake City, UT 84112 Timing: Fiscal Year 2001; Project Start 30-SEP-1994; Project End 31-AUG-2004 Summary: (Applicant's Abstract) Improved methods to monitor treatment compliance and efficacy is an important goal of drug-abuse treatment programs and clinical trials
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for new treatment regimens. Monitoring drug use during pregnancy is also an important clinical goal. Compared to urine, plasma and blood, hair may provide a longer window to monitor for drugs and other compounds due to its slow growth and possible permanent retention of drugs. The presence of certain drugs and their metabolites has been demonstrated in human hair at times when plasma and urine drug concentrations are not measurable. The goal of this project is to acquire knowledge regarding the suitability of quantitative, segmental human hair analysis for determination of drug exposure in clinical settings. Specific marker substances will be used to establish reference points (with respect to time) in human hair. To achieve these objectives, the following specific aims are proposed: (1) To develop quantitative analytical methods for hair utilizing LC/MS/MS. Ultra-sensitive and specific procedures using liquid chromatography and tandem mass spectrometry will be developed for the combined detection and quantitation of a treatment drug (buprenorphine, 1-alpha-acetylmethadol, or methadone), drugs of abuse (morphine, heroin) and marker substances (phenazopyridine or ofloxacin) in hair. Also, specific and selective decontamination procedures will be developed to minimize the potential bias of environmental contamination of hair for drugs of interest and to maximize the reliability of measured quantitative drug concentrations. (2) To determine if quantitative analysis of hair can be used to evaluate recidivism and treatment compliance. Administration of a marker substance such as phenazopyridine or ofloxacin will be used to establish reference points in human hair between which drug use and treatment compliance or recidivism in clinical drug-abuse studies can be measured. We will also determine if quantitative measures of drug concentrations in hair are dependent upon the dose and route of drug administration. (3) To determine if quantitative analysis of hair can be used to evaluate fetal drug exposure in pregnant women receiving drug treatment. Specifically, we will determine if there is a relationship between maternal exposure to a treatment drug (methadone) during pregnancy and neonatal hair concentrations of methadone at birth. Preliminary data presented demonstrate that we are able to perform all aspects of this proposal and that we will clearly be able to progress from analytical methods development, to decontamination studies, to in vivo human and animal studies of marker substance incorporation into hair, and to studies of fetal drug exposure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HBCU RESEARCH SCIENTIST AWARD Principal Investigator & Institution: Browne, Dorothy C. Senior Scientist; None; Morgan State University 1700 E Cold Spring Ln Baltimore, MD 21251 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 31-AUG-2003 Summary: (Applicant's Abstract) The overall goal of this grant application is to promote a research program at Morgan State University designed to investigate drug abuse and disorders associated with drug use. Established drug abuse investigators will be recruited to Morgan State University and provided support, equipment and resources necessary to conduct research into drug abuse and related disorders. Current Morgan State University faculty will be provided professional development activities allowing them to develop and/or expand their capabilities to conduct research into drug abuse and related disorders. Additionally, research training for students will occur once the research infrastructure has developed to accommodate them. Training for research into drug abuse and related disorders will begin at the undergraduate level and eventually extend into master and doctoral levels; these training programs will be designed to encourage and direct minority students into careers investigating drug abuse and
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related disorders. This proposed research program will focus on the cultural, social class and gender variations in risk and protective factors pertaining to drug abuse and disorders associated with drug use and will become an integral part of the current Morgan State University Prevention Science Program. The proposed program will be administered in two Phases. Phase 1 will focus on identifying and hiring a senior level research scientist under the guidance of a HBCU Scientific Advisory Committee. As Principal Investigator in Phase 2, the senior level research scientist will build the necessary research infrastructure at Morgan State University and conduct state-of-theart research into drug abuse and associated disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HBCU RESEARCH SCIENTIST AWARD Principal Investigator & Institution: Sanders-Phillips, Kathy; None; Howard University 2400 6Th St Nw Washington, DC 20059 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 30-APR-2005 Summary: (Applicant's Abstract) The School of Education at Howard University is seeking to recruit a senior researcher, Dr. Faye Z. Belgrave, to serve as a Category I HBCU Research Scientist. It is our intent to recruit a candidate who is qualified to serve in a full-time faculty position in the School of Education and the Graduate School of Arts and Sciences in Phase II of the project. Howard University is the only comprehensive Historically Black University in the United States. Howard offers doctoral, graduate and undergraduate degrees in the biomedical and social sciences. The Medical, Dental, Nursing and Law Schools offer advanced degrees in their respective disciplines. In May 1998, of the 72 Ph.D. and 104 M.D. degrees conferred in a variety of disciplines, 5 were related to research in drug abuse. The HBCU Research Scientist's work at the University will: 1) stimulate the development of drug abuse research programs at the University; 2) assist Howard in strengthening its readiness to administer conduct drug abuse programs; 3) augment human resources within the University of drug abuse research; 4) build research capacity at Howard and facilitate relationships with other research institutions in drug abuse research capacity; and 5) enhance the career of the recruited scientist as well as Howard University faculty and students. The Principal Investigator of this project is the Interim Dean of the School of Education. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HIV RISK REDUCTION AND DRUG ABUSE TREATMENT IN MALAYSIA Principal Investigator & Institution: Schottenfeld, Richard S. Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2005 Summary: (provided by applicant): Combining drug abuse and HIV risk reduction counseling with opioid agonist maintenance treatment (OMT) or antagonist maintenance treatment with naltrexone (NMT) is effective for reducing illicit drug use and preventing HIV transmission associated with heroin dependence, but support for NMT remains tenuous and OMT is not currently available in many Western Pacific countries (e.g., Malaysia, Indonesia and Singapore) where heroin addiction and HIV infection are epidemic and closely linked with injection drug use (IDU) and high-risk sexual behaviors among addicts. Promising results of NMT in Malaysia have created interest in evaluating OMT using buprenorphine (BMT) and comparing the efficacy of counseling alone and counseling combined with BMT or NMT. We are proposing a 24-
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week, randomized double blind clinical trial to evaluate the efficacy for maintaining abstinence and reducing HIV risk behaviors of manual-guided, HIV risk reduction and drug counseling (DC-HIV) alone or when combined with BMT or NMT for recently detoxified and currently abstinent heroin dependent patients (N=l80) in Malaysia (Specific Aim 1). The study will allow evaluation of 3 hypotheses: DC-HIV plus naltrexone is superior to DC-HIV alone; DC-HIV plus buprenorphine is superior to DCHIV alone; and DC-HIV plus naltrexone is superior to DC-HIV plus buprenorphine. Primary outcome measures, assessed by 3x/wk urine toxicology testing and self-report, include resumption of heroin use, 1 or 3 weeks continuous relapse and reductions in HIV risk behaviors. The project will also evaluate the characteristics of treatmentseeking heroin addicts in Malaysia (including specific risk behaviors and patterns of HIV risk behaviors; prevalence of psychiatric and other medical comorbidity; and patterns of social, family, vocational, and criminal activity and service needs--Specific Aim 2). This data will be used to revise the DC-HIV manual to address the specific circumstances and risk behaviors of Malaysian heroin addicts. Finally, the project will also provide clinical training for health professionals and training and mentoring in drug abuse treatment and HIV prevention research to clinical researchers who will continue development, implementation, evaluation and dissemination of HIV prevention and drug abuse treatment approaches in Malaysia after the project ends (Specific Aim 3). The results of the study will inform government policy and support for HIV prevention and drug abuse treatment efforts in Malaysia and possibly also in other Western Pacific countries. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HIV RISKS AND TRANSITIONS TO INJECTION AMONG NONIDUS Principal Investigator & Institution: Colon, Hector M. None; Universidad Central Del Caribe Bayamon, PR 009606032 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 30-JUN-2006 Summary: (provided by applicant): New cohorts of non-injection drug users (non-IDUs) are at substantial risk of transitioning to injection and of becoming infected with HIV, HBV, and HCV. Moreover, several studies have reported unexpectedly high rates of infection with HCV among individuals reporting no history of drug injection. Other possible routes of transmission of HCV among non-IDUs, such as sexual transmission or the shared use of non-injection drug equipment are still unclear. Puerto Rican drug users have consistently been found to have greater overall HIV risk than drug users of other ethnic/racial backgrounds. Moreover, there is evidence suggesting that Puerto Rican non-IDUs are more likely to make the transition to drug injection and, once injecting, to become infected with HIV and HCV than their counterparts of other ethnic/racial groups. Therefore, the need to increase our understanding of the factors that can account for greater risk among Puerto Rican non-IDUs and new injectors is critical. We propose a prospective cohort study of 720 non-IDUs in Puerto Rico designed to examine transitions to injection, the sexual risk behaviors of non-IDUs, and the risk factors of infection of non-IDUs who transition to injection and those who do not. The sample will be recruited from street settings and will consist of heroin sniffers and crack smokers 18 to 25 years old who have never injected drugs. Participants will be followedup during a period of two years and re-assessed four times at six-month intervals. Ethnographic/qualitative and quantitative methods and procedures will be utilized. The proposed study is grounded conceptually in several theories and research approaches from which three domains of variables have been derived: 1) Social
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relationships and social contexts, 2) personality traits, attitudes and beliefs, and 3) drug behaviors and disorders. The data will be analyzed with bivariate analyses and multivariate modeling, including multiple logistic regression, Cox proportional hazards regression, and generalized estimation equations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HIV, DRUGS & SEXUAL IDENTITY IN YOUNG PUERTO RICAN MSM Principal Investigator & Institution: Finlinson, H A. None; Universidad Central Del Caribe Bayamon, PR 009606032 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 30-JUN-2004 Summary: (provided by applicant): Recent studies underscore the need for a more complete understanding of processes of minority sexual identity formation, and the ways in which high risk drug-related and sexual behaviors of lesbian, gay and bisexual individuals are located in these processes. The proposed exploratory study uses anthropological methods to elucidate relationships between early life experiences, the development of minority sexual identity, and high-risk sexual and drug-related behaviors in a sample of young Puerto Rican men who have sex with men (MSM). Specific aims are: (1) to describe the process of sexual identity formation and its place in the social, economic, and cultural ecology experienced by young, economically disadvantaged, Puerto Rican MSM who use heroin and/or cocaine. (2) To elucidate relationships between minority sexual identity formation and early life experiences, including experiences related to: (a) development of ethnic identity, (b) verbal, physical, and sexual abuse, (c) relations with peers, especially those who self-identify as homosexual or are engaged in sexual questioning. (3) To describe past and present drug use/abuse and sexual behaviors, and associated HIV risks, in the context of minority sexual identity development. (4) To examine participants' experiences with HIV/STI and drug prevention and treatment services in relation to minority sexual identity formation. This study will gather retrospective and current information through ethnographic observations and three-session, in-depth qualitative interviews conducted with each of thirty Puerto Rican MSM, age 18-24, who reside in government subsidized housing in San Juan and use heroin and/or cocaine. Findings from the study will contribute to the design and implementation of more effective interventions for young, street-based MSM drug users and MSM clients of drug treatment services. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HOMELESS CONSEQUENCES
DRUG
ABUSE--SERVICE
USE,
COSTS,
Principal Investigator & Institution: North, Carol S. Professor; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 01-JUN-1998; Project End 31-MAY-2003 Summary: (Applicant's Abstract) While the prevalence of drug abuse in the homeless population is substantial, little is known about their patterns of service utilization and the types of services used (drug abuse, housing, or substitute services), or about the outcomes resulting from these services. To address this gap, this project proposes to study a random sample of 400 homeless adult men and women over two years to identify predictors of service use and status changes in the drug abusing homeless population. Building on more than a quarter of a century of combined experience in research and service provision for the homeless population this team will test a
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theoretical model that predicts Service Use, Needs, Costs, and cOnsequences for the Drug Abusing homeless population (SUNCODA). The opportunity to follow a non-drug abusing homeless population comparison group will provide evidence about the impact of drug use disorders on homelessness in terms of relationships between service utilization patterns and status change (consequences). Obtaining organizational, financing, and management structure data from relevant service agencies to this population will provide the opportunity to investigate how structural characteristics of services predict actual service use by drug abusing compared to non-drug abusing homeless individuals. Finally, this study will compare costs associated with treatment of drug abusing and non-drug abusing subjects. The proposed project is particularly significant in that it directly addresses well-documented gaps in the literature on service utilization, changes in status, and costs in the drug abusing homeless population. Results from this project will have significant impact on public policy, including guidance of allocation of resources for effective service provision and informing future discussions of treatment alternatives for this particularly difficult population. The sample will be randomly selected from a variety of public settings, including overnight shelters, day centers, and specialized rehabilitation programs for homeless people, as well as from street locations. All subjects will be interviewed at baseline and at one-year intervals with an instrument adapted for this study collecting diagnostic, personal history, sociodemographic, and status data (modified for each wave). Subjects will be asked to submit a urine screen at all three waves of data collection. All subjects will be asked to provide access to their medical, psychiatric, and substance abuse records so that agencies can provide information on type and extent of service use over time. In addition, subjects will participate in quarterly reports to detail changes in functioning an service use over time. Exhaustive tracking methods will be utilized to maximize subject retention. Structural characteristics (organizational, management, and financing) data will be collected from service agencies at baseline to examine their impact on service use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HUMAN BEHAVIORAL PHARMACOLOGY OF SUBSTANCE ABUSE Principal Investigator & Institution: Bigelow, George E. Professor and Director; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 01-FEB-1981; Project End 30-JUN-2006 Summary: (provided by applicant) This is a proposal to renew an ongoing and successful postdoctoral clinical research training program on the human behavioral pharmacology of substance abuse. Ten training positions are proposed, all at the postdoctoral level. Training duration is two years. The goal is to produce experts in various aspects of substance abuse, psychopharmacology, and treatment who go on to succeed as independent clinical researchers, scientists, academicians, and administrators in drug abuse and related fields. Major themes of the research training are: (a) Clinical pharmacology of drug abuse and of medications for treating drug abuse; (b) Behavioral and pharmacological treatments for drug abuse, and their integration; and (c) Psychiatric comorbidity and behavioral assessment of drug abusers. Training consists primarily of conducting supervised clinical research in collaboration with training faculty and analyzing and publishing the results of that research. In addition, trainees present reports at major scientific meetings and participate in an organized program of educational seminars designed to provide both breadth and depth to their knowledge and skills relevant to drug abuse and clinical research. The training program site is a
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multifaceted drug abuse clinical research program - the Behavioral Pharmacology Research Unit - plus other affiliated drug abuse treatment and research programs at the same campus. Research training will be provided in the following specific areas: clinical pharmacology of drugs of abuse; medications development research; cognitive and behavioral toxicity of drugs of abuse; abuse liability assessment; behavioral treatment of drug abuse; pharmacological treatment of drug abuse; integration of behavioral and pharmacological treatments; psychiatric comorbidity; behavioral assessment; HIV risk behavior assessment; clinical trials research methods and management; addiction and pregnancy; and women?s health issues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HUMAN POLYDRUG USE: AND ECONOMIC ANALYSIS Principal Investigator & Institution: Spiga, Ralph; Psychological Studies in Educ; Temple University 406 Usb, 083-45 Philadelphia, PA 19122 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2003 Summary: Polydrug abuse is a common pattern of drug abuse which involves simultaneous or sequential use of multiple drugs. From an economic perspective drugs are commodities, the drug user is a consumer, drugs of abuse have a price, and drug consumption varies with price. Thus, behavioral economic concepts such as unit price, elasticity, and demand may be useful in determining drug use patterns in polydrug environments. These studies will (1) investigate human drug choices in a controlled polydrug laboratory environment and (2) determine whether behavioral economic concepts describe the observed patterns of drug consumption. In each study participants will be randomly assigned to GROUP 1: PRIMARY DRUG VS VEHICLE ALTERNATIVE or GROUP 2: PRIMARY DRUG VS DRUG ALTERNATIVE. Participants in GROUP 1 will have the option of procuring small doses of drug or vehicle by pressing a button. Their counterparts in GROUP 2 will have the option of procuring either of two concurrently available drugs. STUDY 1 will examine methadone consumption when vehicle (GROUP 1) or ethanol (GROUP 2) are concurrently available. STUDY 2 will examine methadone consumption when vehicle and hydromorphone are the concurrent drug alternatives. STUDY 3 will examine intranasal cocaine consumption when vehicle or oral cocaine are the concurrent drug alternatives. STUDY 4 will examine intranasal cocaine consumption when vehicle or ethanol are the concurrent drug alternatives. Price for procuring drug will be increased systematically for participants in both experimental groups. This permits determination of demand curves, elasticity of demand, and cross-price elasticity. Demand will be assessed by observing the effect of price increases of primary drug on primary drug consumption when vehicle is concurrently available (GROUP 1). Elasticity will be assessed by comparing primary drug consumption across price in the presence vehicle or alternative drug (comparison of GROUP 1 and 2). Cross-price elasticity will be assessed by observing the effects of primary drug price on consumption of alternative drug (GROUP 2). These studies will collect economic data on polydrug abuse, test behavioral economic concepts of drug choice, and extend economic principles to the understanding and control of polydrug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HYPOTHALAMIC FEEDING PEPTIDES AND DRUG ADDICTION Principal Investigator & Institution: Dileone, Ralph J.; University of Texas Sw Med Ctr/Dallas Dallas, TX 753909105
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Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2008 Summary: Project 3 focuses on the role of three hypothalamic neuropeptides in drug addiction. The peptides, melanocyte-stimulating hormone (MSH), melaninconcentrating hormone (MCH), and orexin (also known as hypocretin), have all been implicated in the control of feeding. Hypothalamic neurons expressing these peptides project to the nucleus accumbens (NAc), a brain region important for the rewarding actions of drugs of abuse. In addition, orexin-containing neurons project to the ventral tegmental area (VTA), also important for drug reward, and to the locus coeruleus (LC), which is implicated in physical opiate dependence and withdrawal. In addition, both MCH and orexin are expressed in the lateral hypothalamus (LH), a brain region known to be important in reward. We hypothesize that the molecular and neuronal pathways defined by these peptides and their receptors may play an important role in regulating an individual's responses to many types of rewards, including drugs of abuse. Preliminary data support this hypothesis, as exposure to drugs of abuse modifies the expression of the peptides or their receptors in the hypothalamus or NAc. Moreover, modulation of these pathways via pharmacological or genetic tools alters drug responses. Specifically, MSH acts via its receptor (MC4-R), enriched in the NAc, to sensitize an animal to the behavioral effects of drugs, and chronic drug exposure increases MC4-R expression in this brain region. Likewise, MCH acts via its receptor (MCH-R), also enriched in the NAc, apparently to also sensitize an animal to the behavioral effects of drugs, although drug exposure downregulates MCH-R expression in the NAc. Orexin is required for normal opiate withdrawal behaviors, and its expression is induced during withdrawal. These data provide the first glimpse into a series of novel hypothalamic circuits that appear to be highly relevant to the molecular neurobiology of drug addiction. Both genetic and pharmacological tools will be used to further elucidate the role of these peptide pathways in drug addiction. Regulation of peptide expression via transcription factors, including CREB, will also be explored. Novel transgenic mouse lines will be generated to specifically test the role of peptide signaling in the NAc and elsewhere in modulating neuronal and behavioral responses to drugs of abuse. Molecular mechanisms of action of the peptides will be investigated by better defining their target neurons in the NAc, VTA, and LC, and characterizing the signaling pathways through which the peptides produce their effects. Together, these highly integrated studies will shed new light on neural and functional connections between the hypothalamus and the brain's reward circuitry and other drug-responsive brain regions, and define the contribution of these connections to drug abuse and addiction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMMUNOTHERAPY FOR DRUG ABUSE Principal Investigator & Institution: Owens, S. Michael. Professor & Director; Pharmacology and Toxicology; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, AR 72205 Timing: Fiscal Year 2001; Project Start 01-MAR-1992; Project End 30-JUN-2003 Summary: The long-term objective of this project is to develop short- and long-acting antibody-based medications for the treatment of drug abuse. Medications are badly needed since repeated use of these drugs can lead to toxicity, psychosis, violent behavior and addiction. These new medications could be used in an emergency room setting for rapidly reversing a drug overdose or in a treatment plan for a recovering addict. Although the long-term goal is to learn how to best use antibody-based "pharmacokinetic antagonists" for treating a wide range of drugs, the main focus of this
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project will be on phencyclidine (PCP). The experiments in this proposal are designed to systematically test the hypothesis that anti-PCP IgG monoclonal antibodies (MAb) and their antigen binding fragments (Fab) could be used to treat the medical problems associated with PCP abuse. The first studies will address the biopharmaceutical and clinical strategies for anti-PCP Fab treatment of PCP overdose in dogs. In the second studies, mouse MAb with a wide range of affinity constants (from about 1-300 nM) will be generated for use as potential long-acting antagonists of repeated PCP use. These antibody medications will then be used in rats to test our hypothesis that careful selection of antibody affinity can lead to an optimal balance between drug association with the antibody (to block drug effects), and drug dissociation from the antibody (to allow regeneration of antibody binding capacity). Combined pharmacokinetic and pharmacodynamic analysis of these experiments will allow us to design better clinical strategies for using antibody-based medications. In the final series of experiments, we will study the rates of partitioning into, and out of, the rodent brain without and with treatment with our antibody-based medications. These data will help to determine the ability of the MAb to redistribute the drug and the rate at which drugs of abuse enter and leave the brain. These integrated studies of pharmacokinetic, behavioral and central nervous system changes before and after antibody-based therapy will serve as a prototypic model that can be applied to treatment of drugs of abuse in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMPACT OF STATE CONTINUUM OF CARE MANDATES Principal Investigator & Institution: Lennox, Richard D. Chief Scientist; Piedmont Research Institute 976 Airport Rd, Ste 100 Chapel Hill, NC 27514 Timing: Fiscal Year 2001; Project Start 10-MAR-1999; Project End 28-FEB-2002 Summary: Responding to an increasing demand for better accountability of drug abuse treatment funds, the State of Illinois mandated a continuum of care model to assure that clients obtain the appropriate drug abuse treatment for their specific level of need. Issued in 1995, the mandate required that as a condition of funding, providers in the public drug abuse system use a set of standardized patient placement criteria for establishing appropriate care. From a managed care perspective, the use of the continuum of care and the patient placement criteria, should provide more appropriate management of health care resources care and more effective drug treatment. This study conducts an aggregate analysis of the Illinois public drug treatment system by examining the impact of the mandates on aspects of the treatment provided and on the cost the State of Illinois plays for treatment. Using a time-series analysis to examine aggregate trends before and after the mandate and an analysis of co-variance of clientlevel data to control for client-mix differences across the series, we test the impact of the mandates on the Illinois drug treatment system. Data for the study are extracted from a computerized record used by the Department of Alcoholism and Substance Abuse to administer drug treatment funds. Data representing seven years of services and nearly 2,500,000 are expected to provide extremely stable parameter estimates as well as generalizability across treatment systems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IMPACT/HIV INTERVENTION/ADOLESCENT MALES LEAVING JAIL Principal Investigator & Institution: Freudenberg, Nicholas; Professor and Director; Urban Public Health; Hunter College 695 Park Ave New York, NY 10021
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Timing: Fiscal Year 2002; Project Start 05-APR-2002; Project End 31-MAR-2006 Summary: (provided by applicant) The purpose of this randomized controlled study is to evaluate the impact of an intensive 30-hour post-release intervention versus a single jail-based discharge planning session in reducing drug use and drug selling, HIV and STI risk behavior, and rearrest among a population of jailed male adolescents. We are currently completing a randomized trial of a one-year post-release case management intervention for male adolescents. Our experience suggests that a shorter, more intensive intervention may achieve higher retention rates and effectively protect adolescents from returning to drug use, crime or HIV risk behavior in the hours, days, and weeks after they are released from jail. Whether a brief intervention in the two weeks after release from jail is more effective than a single jail-based discharge planning session is an open question. We propose to recruit in the New York City jail over four years 600 male adolescents from Manhattan and the Bronx with a history of substance abuse problems or drug selling, conduct an intake assessment, and then randomize individuals to receive either jail services only or jail and intensive community services. The specific aim of this study is to test the hypothesis that incarcerated male adolescents aged 16 to 18 who receive a jail and community intervention that includes at least 12 hours of jail services and 30 hours of community services in the two weeks after release will be more likely than a randomly assigned comparable group that receives only a discharge planning session in jail to demonstrate at 12 months post-release an increase in involvement in drug treatment, education and employment; and, reductions in the frequency and amount of alcohol and illicit drug use; lower rates of HIV risk behavior; lower rates of involvement in drug sales; and of rearrest. A secondary aim of this study is to compare patterns of drug use and HIV risk behavior among male and female incarcerated adolescents. To achieve this aim we will recruit 240 adolescent females who will complete an intake assessment and receive a jail-based discharge planning session. This sub-study will also be used to tailor the intervention tested in this proposal for adolescent females. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMPORTANCE OF SLEEP & GENOTYPE IN DRUG ABUSE STUDIES Principal Investigator & Institution: Dugovic, Christine; None; Northwestern University Office of Sponsored Programs Chicago, IL 60611 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): It has been well established that both genetic background and the environment can have pronounced effects on how mice respond to drugs of abuse, including both psychostimulants and the opiates. In particular, different strains of mice respond differentially to drug treatment, and acut7e sleep deprivation alters the response to a number of drugs of abuse. However, essentially nothing is known about how the genetic background affects the response to drugs of abuse in animals with disrupted sleep. Examining the effects of sleep disruption on the response to drugs of abuse in mice with different genetic backgrounds is particularly important since one of the hallmarks of substance abuse in humans is disrupted sleep. Poor sleep, whether due to genetic or environmental causes, may in itself predispose one to abuse and drug addiction. One of the overall objectives of the proposed studies is to determine if the effects of acute sleep deprivation on the response to drugs of abuse in mice is dependent on genetic background. Since very little is known about the effects of chronic sleep loss on the response to drugs of abuse, a second overall objective will address this question and determine if the genetic background influences the effects of chronic partial sleep deprivation on the response to drugs of abuse. Six different strains
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of mice will be used to test hypotheses. that genetic differences in either sensitivity or sensitization of the locomotor response to either cocaine or morphine are affected by either acute or chronic partial sleep deprivation. The completion of the proposed studies is expected to not only lead to a better understanding of how genetic differences predispose mice to be more or less responsive to cocaine and/or morphine under both baseline and sleep deprivation conditions, but also will provide new insights for optimizing the genetic animal models to be used for ultimately elucidating the genetic, neurochemical and biochemical mechanisms underlying the actions of drugs of abuse. The use of these genetic animal models is expected to lead to new genetic and pharmacological strategies for the treatment of drug abuse and addiction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMPROVING HEALTH CARE UTILIZATION IN HIV+ DRUG USERS Principal Investigator & Institution: Gebo, Kelly A. Medicine; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2006 Summary: Dr. Gebo is a Robert Wood Johnson Clinical Scholar and will be an infectious disease fellow at the Johns Hopkins University (2000-01). She has spent the past two years conducting epidemiologic and health services outcomes research for individuals with HIV, many of whom are drug users. Through this award, Dr. Gebo would like to conduct health services research on the interaction of drug abuse and HIV infection, as a faculty member in Infectious Diseases at Johns Hopkins. She will have the mentorship of Drs. Richard Moore and Neil Powe, experts in HIV epidemiologic and health services research, as well as the collaboration of Drs. Mary McCaul and Barbara Turner, established researchers in drug abuse and HIV health services utilization of drug users. To complement her research, Dr. Gebo will complete courses in the School of Public Health in substance abuse, ethics, and advanced biostatistics and health services research methods. Protease inhibitors were shown to decrease morbidity and mortality in HIV+ patients. In pilot data, Dr. Gebo found that hospitalization rates in our HIV+ patients decreased significantly between 1995 and 1997; however, this trend was markedly attenuated in patients with a history of illicit drug use. Illicit drug use is strongly associated with hospitalization among HIV+ patients, even after adjustment for antiretroviral use. To explore this, Dr. Gebo will perform a cohort study on patients followed in the Johns Hopkins HIV clinic where she will examine hospitalization and outpatient care utilization rates, in a time-series analysis, between 1998 and 2001. She will also conduct a cross-sectional study of patients enrolled in the Johns Hopkins HIV Clinic in 2001 to examine the adequacy of preventive care utilization. After assessing utilization patterns, she will conduct an intervention of intensive case management in substance abusing patients to increase substance abuse treatment and decrease substance use. Finally, she will conduct a cost-effectiveness analysis of the intervention. The goals of the award are to identify areas of over and under utilization of health care by HIV+ patients, and to increase completion of substance abuse treatment referrals and decrease overall substance use in HIV+ drug users. The combination of research utilizing existing data sources, as well as intervention planning and primary data collection, the excellent mentorship of senior scientists, the coursework available, and the supportive environment of the Johns Hopkins University will provide Dr. Gebo the skills she needs to develop into an independent clinician researcher in HIV epidemiologic and health services research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: INCENTIVE PROPERTIES OF ABUSED DRUGS Principal Investigator & Institution: Weiss, Stanley J. Psychology; American University Massachusetts & Nebraska Aves Nw Washington, DC 20016 Timing: Fiscal Year 2002; Project Start 01-SEP-1996; Project End 31-JUL-2007 Summary: (provided by applicant): There is a developing consensus that environmental stimuli associated with the drug-taking experience can acquire the capacity to energize drug craving, seeking and consumption. The PI has developed a "stimuluscompounding" model of drug abuse that elucidates how multiple drug-associated stimuli interact to motivate drug-related behavior. Research stimulated by this model has revealed that simply exposing rats to certain combinations of drug-related cues can override the mechanisms that normally regulate drug-intake, causing them to double their intake of cocaine or heroin and triple their rates of drug seeking. The human drug abuse environment is rife with cues that could have analogous effects. Thus, environmentally induced enhancement of drug intake may be one factor responsible for the spiraling escalation and "uncontrollability" of drug use often seen in addicted individuals. In the proposed research, we will continue to investigate the excitatory conditions that determine how long this escalation is sustained. However, the proposed research will primarily explore methods by which drug taking can be reduced. Conditioned inhibitors are stimuli that signal drug absence and may thereby attenuate or even eliminate the incentive motivation that chives drug-related behavior. The systematic investigation of conditioned inhibition within the context of drug selfadministration will be the major new objective of this program and should provide information relevant to the treatment of drug abuse. Strategies will be compared to determine the most effective means of counteracting a history of excitatory drug-related conditioning. When the program is completed, we should have a better understanding of: (1) how conditioned inhibitors can attenuate the motivation to abuse drugs, (2) how the motivational effects of multiple drug-related stimuli might lead to persistent, uncontrollable escalation of drug use, and (3) how drug and non-drug reinforcement processes are related. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: INHALANT USE/DEPENDENCE: INCIDENCE AND COMORBIDITY Principal Investigator & Institution: Wu, Li-Tzy T.; Research Triangle Institute Box 12194, 3040 Cornwallis Rd Research Triangle Park, NC 27709 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2006 Summary: (provided by applicant): This proposal seeks support for research on the epidemiology of inhalant use and dependence, including incidence, determinants, comorbidity, and substance abuse service utilization in nationally representative samples of household residents. The proposed research focuses on the extent and magnitude of inhalant use/dependence among school dropouts, females of childbearing ages, ethnic minority groups, and children of drug-using parents. Analyses will be performed on public use data files from multiple waves of recent National Household Surveys on Drug Abuse and the National Comorbidity Survey. Inhalant abuse has been described as one of the most pervasive yet least recognized drug problems, particularly among adolescents. Current knowledge about inhalant use is based primarily on the prevalence of inhalant "use." This proposed study addresses the following specific aims (1) to examine the incidence and determinants of inhalant initiation, (2) to determine the pattern and determinants of inhalant use/dependence among youths, school dropouts, females of childbearing ages, ethnic minority groups, and children of drug users, (3) to
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identify subgroup variation in the developmental sequence of inhalant use to other illicit drug use (females, ethnic minority groups, and multiple or early-onset drug users), (4) to explore the natural course of inhalant dependence, subtypes of inhalant users, and symptom profiles of inhalant dependence, and (5) to examine comorbidity and substance abuse service utilization. The proposed analysis will provide estimates of incidence trends and the characteristics related to onset of inhalant use. The pattern and magnitude of inhalant use/dependence by special subgroups will be examined so that their needs for prevention or substance abuse services can be better served. Subgroups of inhalant users vulnerable for psychopathology and underserved users will also be identified. The information generated will be vital to policy makers in predicting the potential burden of inhalant use problems and planning service delivery. Gaps in our knowledge of the natural course of inhalant use will be specified for future research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTERACTIVE MOTIVATIONAL MEDIA FOR PERINATAL DRUG ABUSE Principal Investigator & Institution: Ondersma, Steven J. Assistant Professor; None; Wayne State University 656 W. Kirby Detroit, MI 48202 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant) The health-related, social, and financial costs of drug abuse are well known; these costs are only multiplied when perinatal drug use also places an infant at risk, both prenatally and postnatally. A wide range of relevant programs exist, but are not able to either (a) reach all women who are in need of treatment, or (b) engage and retain many of those they do identify and intend to treat. However, combining techniques from brief motivational interventions and interactive computer-based models may prove effective--particularly when applied in a primary care setting, allowing an extremely high proportion of at-risk women to be intervened upon. The goal of this exploratory/developmental proposal is to develop a low-cost, highly adaptable brief motivational intervention for perinatal drug abuse via embedding motivational principles in a self-contained interactive computer system. The Motivation Enhancement System (MES) will utilize a touch-screen, audio enhancement, and an interactive narrator to guide women in the immediate postpartum period through evaluation (thus facilitating self-report) and a one-time motivational intervention. A taxi voucher will be provided to further facilitate entry into treatment, and multiple tailored self-help mailings will be issued following discharge. If validated, this intervention could offer a highly cost-effective, replicable, and prescriptive method for increasing self-change and treatment involvement in drug abusers. Following development of the MES, a preliminary pilot phase will study the use of the MES with postpartum drug-using women and make necessary modifications, using data from participant debriefings and a single-case research design. After optimization of the MES, a clinical trial will randomly assign 120 postpartum drug-using women into treatment or assessment only conditions, with a 3-month blinded follow up to evaluate intervention effects on drug use, readiness to change, and consequences of drug use. Toxicological and self-report measures, as well as objective analysis of infant development, will be utilized. Participants will be lower socioeconomic status urban women recruited from WSU's Hutzel Hospital, where universal meconium screening has revealed a 44 percent rate of prenatal drug exposure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: INTERDISCIPLINARY TRAINING IN DRUG ABUSE RESEARCH Principal Investigator & Institution: Sealfon, Stuart C. Professor; Pharmacology; Mount Sinai School of Medicine of Nyu of New York University New York, NY 10029 Timing: Fiscal Year 2001; Project Start 01-DEC-1979; Project End 30-JUN-2006 Summary: (provided by applicant) This is a competitive renewal for the 21st to 25th years of an interdisciplinary postdoctoral program providing training in basic and clinical research in the pharmacology, physiology and neurobiology of drug abuse. This training program has a long and distinguished history. The Mount Sinai School of Medicine has always been a major and vibrant research center. We have recently undergone a dramatic growth in physical facilities and research programs. The training program has been revised to maintain its historical strengths and to take advantage of these new physical, educational, programmatic and intellectual resources of the school. The goals of our program are 1. Attract the finest young biomedical and clinical researchers to careers in drug abuse research. 2. Encourage faculty to pursue research relevant to drug abuse. 3. Train fellows in cutting-edge drug abuse research. 4. Facilitate the career development of trainees. To achieve these goals we have developed an extensive recruitment program, a rich training curriculum and a strong mentoring and tracking structure. We have endeavored to design a program that will train researchers who will provide significant advances in the basic understanding and treatment of this important social and medical problem. Towards that end, we have revised our steering committee and faculty so that they are now composed of both basic and clinical researchers and we have revised our program to provide both basic science and clinical training for both scientists and physicians. We offer either basic science or clinical research training for 6 postdoctoral trainees. In addition to the laboratory environment and mentor, the training program includes courses in Research in Drug Abuse and Responsible Conduct in Research, a Drug Abuse Colloquium/Journal Club, a Drug Abuse Visiting Scholar and Seminar program, an annual Training Program Retreat, mentoring by a secondary advisor and Trainee Advisory Committee, participation in courses and presentations at the medical school, and travel to national meetings. We have assembled a world-class, broad-based interdisciplinary training faculty. The institution provides a fertile environment for this training program as well as specific resources to enhance this important educational endeavor. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: INTERVENTIONS FOR HIV-POSITIVE DRUG ABUSERS Principal Investigator & Institution: Avants, S K. Psychiatry; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 31-AUG-2007 Summary: (Provided by Applicant): The goals of this application for an Independent Scientist Award (K02) are consistent with the strategic plan of the CDC for reducing HIV transmission in the years 2001 to 2006 through the development, evaluation, and dissemination of interventions targeted toward those persons already infected with HIV. HIV-infected drug users represent a major vector of HIV transmission not only through sharing of drug paraphernalia and unsafe sexual practices, but also in the context of nonadherence to HAART regimens, which can result in the emergence and transmission of medication-resistant strains of HIV. Interventions targeting this patient population would therefore have both individual and societal benefits. Communitybased substance abuse treatment programs have the potential to be highly instrumental in this regard. However, access to scientifically-evaluated, yet "user-friendly," manual-
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guided interventions, together with comprehensive training on their provision, remains limited. The need exists for timely dissemination of results of research-based interventions for HIV-positive drug users to community settings in a format that is practical for use by clinicians in the field. This K02 application is being submitted subsequent to completion of a K21 award which permitted the applicant to become an independent researcher committed to addressing these issues. Goals are: (1) Intervention development. Develop interventions specifically targeting inner-city HIVpositive injection drug users to (a) reduce high risk behavior; (b) increase medication adherence, and (c) improve quality of life. (2) Intervention evaluation: Rigorously evaluate these interventions in randomized clinical trials that include cost analyses to ensure that these interventions are cost effective as well as clinically efficacious. (3) Technology transfer: Bring research findings to clinical practice by ensuring timely dissemination of efficacious and cost-effective treatments to community-based programs -- by publishing and disseminating treatment protocols in ready-to-use manuals, and by designing and implementing comprehensive training programs for front-line clinical staff using state-of-the-art technology in electronic and print communications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ISSUES IN GAMBLING AND COMORBID DRUG ABUSE Principal Investigator & Institution: Cunningham-Williams, Renee M. Research Assistant Professor; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 16-AUG-2000; Project End 31-JUL-2005 Summary: This NIDA Mentored Research Scientist Award (K01) provides the foundation for Dr. Renee Cunningham-Wliliams career and research development. Drs. Linda Cottler, Wilson Compton, and Edward Spitznagel, Jr. will provide substantive training to enhance the Applicant's expertise in drug abuse research, behavioral drug pharmacology and clinical issues, and statistics. With this award, the Applicant will be able to apply expertise in these areas to a research project that addresses nosological issues in one of the fastest growing problems co-morbid with drug abuse-pathological gambling. The proposed research project will provide baseline psychometric data on an expanded module of the Diagnostic Interview Schedule (i.e., GAM-IV), designed to evaluate pathological gambling among youth and adults. By doing so, methodological foundations will be established for the PI's future research effort-an epidemiologic study of personal and environmental factors that are associated with co-morbid condition of pathological gambling and drug abuse among persons age 15 and older. Specifically, the Applicant will be able to build upon her previous mental health training and research as well as newly acquired knowledge in drug abuse and problem gambling to conduct a project that has the following seven specific aims: (1) To test the feasibility and acceptability of the new GAM-IV among adults and adolescents recruited from the community and from drug treatment settings; (2) To establish 1-week test-retest reliability estimates of the GAM-IV and to assess its reliability in males vs. females, underage (15-20 year olds) vs. Iegal age gamblers (21-70 year olds), African-Americans vs. Caucasians, urban vs. suburban residents, and persons with comorbid psychiatric and substance abuse problems vs. persons without such problems; (3)To assess concordance by comparing the GAM-IV to the most widely used research tool for predicting problem gambling-The South Oaks Gambling Screen (SOGS); (4) To evaluate any reasons for low reliability by asking respondents at the end of the retest interview to explain discrepancies between responses given to GAM-IV items at the first and second interviews; (5) To assess concordance rates between self-reports of gambling and
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collateral informant reports; (6) To improve the GAM-IV based on the results of the data derived from the proposed study; (7) To provide a foundation for launching an independent behavioral science research career by providing important psychometric data for a larger epidemiologic study of the prevalence of gambling and the personal and environmental factors that may predispose or protect underage and legal age gamblers from developing co-morbid pathological gambling problems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LABORATORY MODEL FOR HEROIN ABUSE MEDICATIONS Principal Investigator & Institution: Fischman, Marian W. Professor of Behavioral Biology; New York State Psychiatric Institute 1051 Riverside Dr New York, NY 10032 Timing: Fiscal Year 2001 Summary: Heroin use and treatment admissions for heroin dependence have been increasing steadily over the past several years. Clearly, there is a need for new effective treatments for opioid dependence. Although methadone, levo alpha-acetylmethadol (LAAM), and naltrexone are currently approved for the treatment of opioid dependence, many problems are associated with their use such as patient noncompliance, continued opioid use during treatment, and high relapse rates during withdrawal from treatment. Several possible causes for these problems have been suggested but insufficient research has been conducted to evaluate the effects of these medications on ongoing human behavior in a research laboratory setting. In the proposed research, participants residing in a controlled setting will be given the opportunity to work for heroin and money. These studies will examine the multiplicity of ways in which several current and proposed medications affect heroin consumption, performance, mood, physiological measures, and participants' verbal reports of drug effects. The model thus developed will be used to evaluate potential new medications for opioid abuse as they are developed and before they are put into large multi-center trials. The specific aims of the proposal are to evaluate: l) the effects of the combination tablet containing buprenorphine and naloxone; 2) the time course and efficacy of a depot formulation of naltrexone; 3) the ability of oral naltrexone maintenance to induce supersensitivity to the effects of heroin; and 4) the effects of memantine and dextromethorphan, which are low-affinity N-methyl-D-aspartate receptor antagonists. Several of these medications will also be evaluated in another project as adjunct medications for the treatment of withdrawal during detoxification from heroin. Together, data from these projects should shed light on the effects of these medications on a broad range of heroin's effects, from actual heroin taking to detoxification from heroin. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: LATINO MINORITY DRUG ABUSE RESEARCH PROGRAM Principal Investigator & Institution: De La Rosa, Mario R. Associate Professor; School of Social Work; Florida International University Division of Sponsored Research and Training Miami, FL 33199 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2008 Summary: (provided by applicant) The purpose of this five year research application is to develop the research infrastructure of Florida International University (FIU) to conduct epidemiological research on the extent and nature of drug among Latino persons of Cuban, Dominican, Puerto Rican, Colombian, Honduran, and Nicaraguan descent. FIU is ideally suited for the development of such a program of research because
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it has one of the largest concentrations of Latino faculty and students from the above Latino subgroups of any institution of higher learning in the mainland United States (Hispanic Association of College and Universities, 1999). More specifically, we expect to accomplish this aim through: 1) Involving a group of FIU faculty members, primarily from the College of Health and Urban Affairs, the Departments of Sociology and Anthropology, and Psychology, and the Centers for Latin American and Caribbean studies at FIU in a two year advanced drug abuse epidemiological research training program leading to a competitive research grant on the epidemiology of drug abuse in Latino populations in the Miami-Dade area. 2) Increasing the number of graduate students involved in the conduct of epidemiologic drug abuse research with Latino populations in the Miami-Dade area by providing basic epidemiological research training to graduate students at FIU. 3) Supporting research development activities for faculty involved in the conduct of drug abuse research with Latino populations in the Miami-Dade area through ongoing funded drug abuse studies or the two pilot studies (women and violence) proposed by the Latino MDARP. And 4) Increasing FIU infrastructure to conduct epidemiological research on the extent and nature of drug abuse among Latino populations in the Miami-Dade area by conducting two pilot studies directly linked to the training activities of the Latino MDARP. One of the pilot studies will be a community-based epidemiological study that will document the problem of drug-related violence in Latino populations in the Miami-Dade area. The second pilot study will focus on investigating the inter-generational transmission of drug use between Cuban mothers and daughters in the Miami-Dade area. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LINKAGE TO HEALTH SERVICES IN DRUG ABUSE TREATMENT Principal Investigator & Institution: Friedmann, Peter D. Associate Professor; Rhode Island Hospital (Providence, Ri) Providence, RI 02903 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2003 Summary: (Applicant's Abstract) Drug abuse and dependence produces harm in multiple areas of the lives of addicted people, but empirical support for the provision of supplemental medical and psychosocial services in drug abuse treatment to address these multidimensional life problems is equivocal. Thus, the Specific Aims of this proposal are: 1. To examine the effects of organizational linkage mechanisms to health services on drug abuse treatment patients' health, social and substance use outcomes. 2. To assess whether drug abuse treatment programs that match comprehensive supplemental service delivery to patients' problems, produce better problem-specific, and health, social, and substance use outcomes. To accomplish these aims, this project will use mixed-effects regression modeling techniques in secondary, cross-level analyses of data from the National Treatment Improvement Evaluation Study (NTIES). NTIES was a national, longitudinal evaluation of drug abuse treatment that included 6593 patients in 78 programs. Linkage types (on-site delivery, case management and referral, and referral alone) will be examined as mechanisms to increase the certainty of health service delivery in the organizational context. We hypothesize that patients in programs with stronger linkages will have greater service utilization, and better physical and mental health, social adjustment, and drug use outcomes than patients in programs with weaker linkages. This project will also assess whether the extent to which the program matches services to patients' multidimensional problems improves their health-related, social, and drug use outcomes. We hypothesize that patients in programs with more comprehensive problem-service matching will have better problem-specific and overall outcomes. The research team has extensive experience with studies of supplemental
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service delivery in drug abuse treatment programs, with substance abuse health services research, and with the NTIES data. This work will improve our understanding of linkage mechanisms and of problem-service matching, and quantify the extent to which medical and psychosocial services are important components of effective drug abuse treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MDMA/CLUB DRUG USE & STD/HIV SEX RISK BEHAVIOR IN OHIO Principal Investigator & Institution: Carlson, Robert G. Professor; Community Health; Wright State University Colonel Glenn Hwy Dayton, OH 45435 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2006 Summary: In response to increases in the use of methylenedioxymethamphetamine (MDMA) and other "club drugs" among young people, the National Institute on Drug Abuse issued a "Club Drug" Alert in December, 1999, to warn the nation of the dangers associated with these drugs. Despite our knowledge of the risks associated with club drug use, little is known about the people who use these substances, including initiation patterns, substance abuse practices, health problems related to drug abuse, perceived need for health services, or HIV/STD sex risk behaviors. The overall objective of this proposal is to produce a longitudinal epidemiologic study of MDMA and other club drug users that is informed by ethnographic research. Using a natural history research design, 480 active MDMA users recruited in Columbus, Ohio, will complete a structured assessment every six months for three years. The Specific Aims are to: 1. Describe key dimensions in club drug use and risky sexual practices among young adults in Columbus, Ohio, using ethnographic/qualitative methods; 2. Describe the characteristics of 480 active MDMA users recruited in Columbus, Ohio, and conduct preliminary analyses focusing on substance abuse practices, sex risk behaviors, and psychological problems; 3. Describe and analyze changes in MDMA use and the relationship between MDMA and other drug use practices among 480 young adults over a three-year period; 4. Determine the incidence of substance abuse-related problems and resulting health service utilization over three years; 5. Identify the factors that predict risky sexual behaviors among 480 MDMA users over a three-year period; and 6. Describe the club drug use practices of 40 minors in recovery using qualitative methods and identify the complications of conducting research with active club drug users under 18. The proposed research is significant because little is known about club drug users or the nature and extent of risky sexual behaviors among this population. It is innovative because the use of ethnographic and quantitative methods will provide a well-rounded epidemiologic understanding of how club drug use and sex risk behaviors interface over time among young people in the Midwest. The results can inform future sex risk-reduction interventions as well as club drug prevention and treatment initiatives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MENTORING IN DRUG ABUSE NEUROIMAGING Principal Investigator & Institution: Renshaw, Perry F. Director; Mc Lean Hospital (Belmont, Ma) Belmont, MA 02478 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2007 Summary: This is an application for a Midcareer Investigator Award in PatientOriented Research (K24) grant. The applicant is a psychiatrist/biophysicist who directs
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the McLean Hospital Brain Imaging Center (BIC). The BIC is an extremely active and productive research center with a major research interest in the development and rapid application of promising new magnetic resonance techniques for better understanding the acute and chronic effects of drugs of abuse on the brain. During the last 12 months, a total of 650 NIDA-funded research scans were completed by BIC investigators. The PI has been a NIDA-funded investigator since 1994 and he currently provides mentoring for 13 talented scientists, five of whom have NIH-funded Mentored Career Development Awards. This application is a request for five years of funding to relieve the candidate of a significant amount of administrative responsibility so that he can devote a greater effort to conducting research, growing professionally, and fostering the careers of the next generation of clinician scientists in the unique field of brain imaging and drug abuse. Funding of this K24 proposal, which will support 50% of the candidate's effort, would allow the PI to focus his research on a select group of the candidate's funded drug abuse research projects, to spend more time working with young investigators, and to obtain additional training in the areas of biomedical engineering, computing, and statistics. McLean Hospital has committed to hiring an administrator for the BIC to reduce the candidate's administrative responsibilities and to hire two additional faculty members to take over the candidate's responsibilities for research studies which do not involve drug abuse. In addition to the mentoring and training activities supported by the K24 award, the PI proposes to devote the remaining 50% of his effort to NBA-funded research grants on which he is PI: Magnetic Resonance, EEG, and Behavior After Cocaine (DA09448); High Field MR Research in Drug Abuse: A Bioengineering Partnership (DA14178); and on which he is Col: MR Spectroscopic Imaging During Methadone Maintenance (DA11321); and Medication Development for Cocaine Abuse: CDP-choline (DA11098). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: METHAMPHETAMINE, ENVIRONMENTAL COMPLEXITY, AND BEHAVIOR Principal Investigator & Institution: Brakke, Karen E.; Spelman College 350 Spelman Ln Sw Atlanta, GA 30314 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-DEC-2005 Summary: (Applicant?s Abstract): The abuse of methamphetamine is rising rapidly in the United States (National Institute on Drug Abuse, 1999) and the drug has been identified as a target for increased investigation by the National Institute on Drug Abuse (NIDA) (Mathias, 1998). Because of the potentially serious implications of chronic methamphetamine use for both the adult abuser and infants exposed prenatally, it is imperative that animal models be developed in which the parameters of methamphetamine abuse and its prevention and treatment can be explored. Determining the interactions between experiential and drug stimuli as they affect the behavior of other species is a critical link in understanding similar processes in humans. In this series of proposed studies, the behavior of methamphetamine-exposed LongEvans hooded rats reared in an enriched, complex environment will be compared to that of rats reared in a restricted, standard laboratory environment as well as to non-exposed control animals. Also, rats that have been prenatally exposed to methamphetamine will be simi1arly assessed to determine whether sensitivity to environmental enrichment can exert "retroactive" effects as well by modifying the effects of drugs administered during the prenatal period. Drug effects will be tested across a variety of tasks (open field activity patterns, acoustic startle, Hampton Court maze). Each task taps into a different aspect of behavior (affect, activity, and complex cognition) that has been linked with
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methamphetamine-associated deficits. Taken together, the data from all of the studies should provide a portrait of the nature of the behavioral disruptions induced by methamphetamine, the effects of differential early rearing, and the interaction between these two factors. Particular relevance of this study exists for the application of early intervention strategies to children and adults who have been exposed to drugs of abuse, in that this series of studies win help delineate the range of behaviors affected by rearing environment and drug administration, and will determine the impact of enrichment on prenatal drug exposure versus that experienced after birth. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MIDARP AT HUNTER COLLEGE Principal Investigator & Institution: Barr, Gordon A. Professor of Psychology; Psychology; Hunter College 695 Park Ave New York, NY 10021 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: Hunter College of the City University of New York has a traditionally high (greater than 50 percent) minority population. It is our goal to develop a program at Hunter that draws on existing strengths to broaden and encourage drug abuse research at Hunter. This program for studies on drug abuse will encompass research on the molecular, cellular, and behavioral level in response to different drugs of abuse. It will include active research faculty, graduate and undergraduate research students, and technical support personnel in the Psychology and Biology Departments, who share an interest in understanding addiction as a brain disease or who want to move their research efforts in that direction. The aims of proposal are to enhance the research infrastructure of Hunter to facilitate our efforts in drug abuse research, develop individual projects within our departments within this area of research, and to stimulate the interest of other faculty and our students, both at the undergraduate and graduate levels, in research on drug abuse. An integral goal of this center is to facilitate the career development of minority undergraduate and graduate students who will become the independent scientists of the future. The specific projects proposed include: 1) Mechanism of sensitization to methamphetamine; 2) Neurobiology of drug addiction and impulsive behavior; 3) Interactions between stress and psychostimulant drugs in behavioral sensitivity and memory; and 4) Effects of the estrous cycle and gender differences in cocaine-induced alterations in the CNS. The PI, who is not submitting a research project is an established drug abuse research and will serve as advisor on these projects and mentor to the junior scientists. Three of the five of us are Hispanic scientists and the two non- minority scientists have a long history of training minority scholars and are part of the administration of the COR, MARC and MBRS grants. Three of the five work in areas consistent with the NIDA mission and the other two are moving in that direction. Finally, two of us are senior scientists with over 25 years of research experience each and will serve as mentors to the more junior faculty of this group, especially the two faculty who have joined Hunter this year. The mechanisms for this mentoring are built into the collaborations that we have and the program itself. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MIDARP AT XAVIER UNIVERSITY OF LOUISIANA Principal Investigator & Institution: Komiskey, Harold L. Div/Basic Pharmaceutical Scis; Xavier University of Louisiana Box 121-C New Orleans, LA 70125 Timing: Fiscal Year 2001; Project Start 14-AUG-1992; Project End 31-MAY-2003
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Summary: The present application proposes research projects that will enhance the ability of our institution to conduct drug abuse research. The objectives of this proposal are: 1) To strengthen the institutional infrastructure to encourage and foster increased research activity in drug abuse, 2) To enhance the capability of faculty and staff to perform research to facilitate independent drug abuse research careers, and 3) To involve outstanding students in research in order to encourage them to pursue careers in drug abuse research. Four pilot projects and seven individual research subprojects are proposed. The pilot projects and individual research subprojects focus on analytical analysis and development of new drug products for disease states related to drugs of abuse. The three-dimensional structure and electronic character of cocaine analogs and dopamine transporter ligands will be determined, Slow release drug delivery systems will be developed for treating drug addictions. For example, a biodegradable microcapsules containing buprenorphine will be developed and evaluated for release characteristics. In addition, a biodegradable microcapsule drug delivery system releasing a catalytic antibody to cocaine will be evaluated and optimized for preventing the effects of cocaine in rodents. The in vivo and in vitro cannabinoid metabolism, using highly sensitive and specific analytical cocaine in rodents. The in vivo and in vitro cannabinoid metabolism, using highly sensitive and specific analytical methodology will be studied using high performance liquid chromatography coupled to a tandem mass spectrometer. The influence of nicotine and morphine on a rodent model of diabetes mellitus. The design, synthesis and in vivo evaluation of novel anionic chemical delivery conjugates of selected AIDS drugs and addiction treatment drugs to the brain will be investigated. Novel anti-Pneumocystis carinii drugs with not only less toxicity, but neuroprotective action, will be synthesized to enable improved drug therapy of stimulant-abusing AIDS patients. The limited equipment requested will not only enable the proposed research to be carried out, but will strengthen the institutional infrastructure. Finally, this revised continuation application will increase the number of outstanding students conducting drug abuse research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MODELS FOR THE PREVENTION AND TREATMENT OF DRUG ABUSE Principal Investigator & Institution: Carroll, Marilyn E. Professor of Psychiatry and Neuroscience; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, MN 554552070 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (Provided by Applicant): The overall objective of this K05 application is to obtain salary support that will release time from teaching and administrative duties that are not directly related to research. This would effectively increase time allocated to research from the current 40 percent to 75-90 percent. An overview of the candidate?s 27 year background in drug abuse research is provided including a list of publications, presentations, a citation analysis, a record of research funding, mentorship of students, science advocacy and other educational activities. A section on career goals describes short- and long-term plans that will be implemented when more time is released for research, specific activities (including collaborations) that are planned to sustain outstanding research performance, how past and future goals are blended, the likelihood of continuing successful contributions, and plans to obtain and provide instruction on the responsible conduct of science. The research plan consists of continuing 2 R01 projects that have been funded by NIDA for over 20 years and beginning a third project, a new R01 that is under review. The first grant is a nonhuman
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primate model to study factors that affect the vulnerability to drug abuse (e.g., sex, hormonal status, duration of expsoure) and behavioral and pharmacological treatments that reduce drug abuse. Behavioral economic analyses that maximize treatment effects will be a procedural focus at the proposed experiments. The overall hypothesis for this series of experiments is that vulnerability factors such as sex and duration of exposure to drug self-administration will predict greater reinforcing efficacy. With respect to treatment effects, it is hypothesized that females will show a greater suppression of drug self-administration than males. The second grant to be conducted in rats, concerns genetic and other biological determinants of drug abuse such as other excessive behaviors (e.g., exercise and consumption of nondrug substances), sex, and hormonal status. These factors will be compared during critical transition phases of addiction; acquisition and reinstatement of drug seeking after drug access has been terminated. This research is based on the hypothesis that a predisposition (individual differences) for excessive behavior directed toward novel stimuli increases vulnerability to drug abuse, and that rats showing greater vulnerability to drug abuse will be more susceptible to treatment. The third grant, also to be conducted in rats, is focused on factors underlying escalation of drug abuse. The overall hypothesis is that if rats are given the opportunity to engage in excessive behavior directed toward nondrug substances (e.g. sucrose) or events (e.g., wheel running), they will show crosssensitization to drug seeking behavior as measured by models of acquisition, escalation, regulation/dysregulation and reinstatement. There will be comparisons across species, gender, several drugs of abuse, routes of administration, and phases of the addiction process. The results should allow for identification of biological, behavioral and environmental factors that lead to recognition of individuals who are at risk for drug abuse, and the experimental interventions used with these models will inform prevention and treatment strategies for humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOLECULAR COMPONENTS UNDERLYING DRUG ABUSE Principal Investigator & Institution: Chavkin, Charles; Professor of Pharmacology; Pharmacology; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 31-MAY-2007 Summary: (provided by applicant) This NIDA P50 Center would foster research interactions, promote exchange of ideas and technology and enhance the training environment in ways that will strongly advance drug abuse research at the University of Washington and will generate resources that will be made widely available. The Center would bring together a group of established investigators to focus on developing mouse models to resolve the molecular components underlying, drug abuse. Three projects within the Center address related questions: molecular mechanisms underlying opiate tolerance (Chavkin), molecular mechanisms underlying cannabinoid tolerance (Mackie), the specific role of protein kinase A in drug preference and sensitivity to amphetamine and cocaine (McKnight). These projects focus on the molecular basis of animal behavior controlled by drugs of abuse, and the design of the Center includes extensive collaborative interactions between these related projects. The Center would support core facilities required for efficient resource utilization and technique transfer within the projects: 1) a Mouse Genetics Core (Binion/McKnight) would facilitate the generation of new strains having tissue-specific, inducible mutations in key components of the animal?s response to opioid, cocaine and cannabinoid drugs; 2) the Behavioral Core (Bernstein & External Advisors) would standardize the analysis of drug effects and drug tolerance; and 3) the Anatomy Core (Westenbroek) would perform a generalized
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neuroanatomical characterization and maintain access to a confocal microscope facility. The third element of the Center is a Pilot Project component that initially would bring a distinguished scientist (Palmiter) into the drug abuse field, potentially bring other outstanding scientists (Catterall, Storm) into drug abuse research, and would help junior faculty (Stella, Brot) develop research programs in this area. All of the individuals listed would actively participate in regular progress meetings, training sessions, journal club and seminar programs, and Center retreats. The Center would expand the educational and training activities of an existing, NIDA Institutional training grant on the molecular pharmacology of abused drugs. Our prime motivation for establishing this Center is to enhance the intellectual, educational, and developmental interactions that would stimulate and expand drug abuse research. Synergy within the proposed Center would be derived from the transfer of ideas, techniques, expertise, perspective and mice between members of the group. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MORRIS BROWN COLLEGE DRUG ABUSE DEVELOPMENT PROGRAM Principal Investigator & Institution: Stahl, Jeanne M. Psychology; Morris Brown College 643 Martin Luther King Dr Nw Atlanta, GA 30314 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAR-2006 Summary: (Applicant?s Abstract): There is a serious shortage of minority researchers involved in drug abuse research. Building on the strengths of existing faculty in the Atlanta University Center?s consortium of Historically Black Colleges and Universities (HBCUs), and following Morris Brown College?s "Learning Tree" model of comprehensive education for pre-college, in-college, and post-baccalaureate students, a program has been designed to do the following: (1) to strengthen the infrastructure that supports research on these campuses; (2) to create a "cluster" of drug abuse researchers on campus and, thus, to broaden the base of scientific knowledge in the area of drug abuse research; (3) to further increase drug abuse research on the Atlanta University Center campuses by encouraging local graduate students to carry out drug abuse research dissertations on these campuses; (4) to involve faculty in research development activities that will strengthen their capability to carry out cutting edge research; and (5) to provide research participation experiences for high school, undergraduate, and graduate students that will encourage them to pursue post-graduate studies and careers in drug abuse research. To our existing cluster of animal research projects on drug tolerance and drug discrimination, we propose to add several human projects on drug abuse prevention and treatment. This will serve to "broaden the scientific knowledge base in those areas where minority institutions may have particular interest, knowledge, and commitment" and, we believe, will enhance the attractiveness of drug abuse research for our students and faculty. We feel that a community of faculty and student researchers on the Atlanta University Center campuses will serve to strengthen faculty research and inspire additional faculty, staff, and students to become involved in drug abuse research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MOTIVATIONAL PROBATIONERS
ENHANCEMENT
FOR
DRUG
COURT
Principal Investigator & Institution: Kinlock, Timothy W.; Friends Research Institute, Inc. Box 10676, 505 Baltimore Ave Baltimore, MD 21285
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Timing: Fiscal Year 2001; Project Start 20-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant) This is a health services research study of a brief motivational intervention designed to increase the engagement and retention of probationers under drug court supervision who are entering outpatient drug-free treatment. Motivational enhancements are especially needed 'in criminal Justice settings 'in which offenders typically lack sufficient 'internal motivation to recognize, let alone reduce, their drug abuse. Enhancing client motivation to engage and remain in treatment may be particularly relevant for drug court programs because these programs tend to have greater levels of structure, control, and supervision than other criminaljustice based drug abuse treatment initiatives. Addressing this issue, the Social Research Center of Friends Research Institute, in cooperation with the Maryland Division of Parole and Probation, plans to examine the effectiveness of a motivational intervention designed to facilitate readiness for, and 'involvement in, outpatient drug-free treatment. Motivational Interviewing (MI; Miller, 1983), previously found efficacious 'in the treatment of individuals with alcohol abuse or dependence, will be adapted for use with drug-abusing probationers referred to outpatient drug abuse treatment by the Baltimore City Drug Treatment Courts. Prior to outpatient treatment entry, 300 probationers will be randomly assigned to either: 1) a two-session MI *intervention; or 2) a two-session drug abuse education program designed as an attention control. Measures will be obtained at baseline, 1-month post-baseline, end of outpatient drug-free treatment, and 6- and 12- months post-treatment completion. These measures will assess: the extent and quality of outpatient treatment engagement; retention 'in the drug court program; drug abuse (urinalysis and self-report); HIV-risk behaviors; criminal activity (self-report and official record data); psychological functioning; and employment. The proposed research will also identify probationer characteristics that predict: favorable response to motivational interviewing; compliance with treatment and the drug court program; and change over time in probationer behavior and functioning. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MR TECHNIQUES FOR DRUG ABUSE AND HIV BRAIN RESEARCH Principal Investigator & Institution: Ernst, Thomas; Director of Medical Physics; Brookhaven Science Assoc-Brookhaven Lab Brookhaven National Lab Upton, NY 11973 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-MAY-2008 Summary: (provided by applicant): This is a new application for a K02 Independent Scientist Award. The PI, Dr. Thomas Ernst, is the Director of Medical Physics at the Brookhaven National Laboratory (BNL). Dr. Ernst is an MR physicist with extensive experience in the development of neuroimaging techniques, and has been involved with the application of these exciting neuroimaiging techniques to neuropsychiatric disorders, particularly drug abuse and HIV, for over a decade. Dr. Ernst is PI on one NIH-funded research project (from NIMH), one large DOE-funded program project on biomedical engineering, and co-PI on two additional R01 grants (one from NIDA, and one from NINDS). The K02 award would allow Dr. Ernst to reduce his administrative duties, and re-focus his research on advancing MR techniques for translational research into drug abuse and HIV brain disease. Specifically, Dr. Ernst would spend 30% on methodological developments (10% directly on the MRI scanner), 20% on clinical projects, 10% on educational activities, and 15% on mentoring, for a total of 75% protected research time. The specific Methodological Aims of the proposed research are: 1. To introduce event-related fMRI designs to the study of drug abuse and HIV brain disease, and 2. to apply structural equation modeling (SEM) to the analysis of fMRI data in drug abusers and HIV-positive subjects. These technical advances will make it
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possible to address the following Clinical Aim: 3. To determine the effects of drug abuse and HIV infection, alone or in combination, on the connectivity of the working-memory network in the brain. The educational activities will be based on the strong collaborations with outstanding scientists and physicians at BNL and SUNY-SB, reading scientific literature, attending local seminars and scientific meetings, as well as participating in advanced educational courses at meetings. Another important part of Dr. Ernst's effort would be mentoring. Over the past decade, Dr. Ernst has mentored 18 young scientists. Eight of the past mentees now have faculty-positions, ten are working in drug abuse and HIV research, and six are currently supported or have applied for funding by NIDA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MULTIETHNIC DRUG ABUSE PREVENTION AMONG NEW YORK YOUTH Principal Investigator & Institution: Botvin, Gilbert J. Associate Professor; Public Health; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2001; Project Start 30-SEP-1991; Project End 31-JUL-2003 Summary: Cornell University Medical College, in collaboration with Columbia University School of Social Work and Teachers College, Columbia University, proposes to continue a MULTI-ETHNIC DRUG ABUSE PREVENTION CENTER 9MDAPRC). This application has grown out of a longstanding collaborative relationship between the investigators representing the participating institutions and their recognized need for feasible and eficacious interventions designed to prevent drug abuse and reduce avoidable morbidity and mortality in minority populations. The theme of the proposed Center will be "multi-ethnic drug abuse prevention over the life span." The structure of the Center will consist of two core divisions and four research projects. The functions of Core 1 will include administration, training, dissemination, and community liaisons. Core 2 will deal with data management and evaluation. The work of the Center is conceptualized in stages, with the focus of work during the initial funding period on African-American and Hispanic-American adolescents. Moreover, during the proposed funding peirod, the research of the center will focus on further testing school-based interventions for inner-city minority youth with an emphasis on long-term effectiveness and two projects examining mediating mechanisms. A secondary focus will be on collecting etiologic data to help us better understand the causes of drug abuse and its developmental progression among minority youth. In addition to having implications for theory, this information is important because it will facilitate the further refinement of current prevention strategies and the development of new ones. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROBIOLOGICAL TECHNIQUES
BASES
OF
DRUG
ABUSE:
NOVEL
Principal Investigator & Institution: Lowen, Steven B.; Mc Lean Hospital (Belmont, Ma) Belmont, MA 02478 Timing: Fiscal Year 2003; Project Start 10-AUG-2003; Project End 30-APR-2008 Summary: (provided by applicant): This is a request for 5 years of funding through the "Mentored Quantitative Research Career Award" (K25) mechanism. The applicant, a biomedical/electrical engineer, proposes a comprehensive training/research program in drug abuse and brain imaging. The long term goal of the applicant is to become an independent and interdisciplinary investigator, skilled in the application of functional
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magnetic resonance imaging (fMRI) methods for the study of substance abuse research. The research component of the award will develop and improve fMRI techniques for the study of substance abuse and addiction in human subjects. Current fMRI technology suffers from three shortcomings which limit its usefulness in a drug-abuse context. First, stimuli for craving studies are limited to auditory and visual modalities, while odors are known to cause powerful emotional effects. Second, motion artifacts remain a serious problem in fMRI studies, especially for drug-dependent populations. No independent verification of motion currently exists, and motion compensation software is not reliable. Third, slowly varying physiological "noise" comprises the major signal component of fMRI data sets, often swamping the effect being measured. Current data analysis methods attempt to exclude this noise from analysis, but the noise remains a critical limitation of all current fMRI data analysis paradigms. Three separate technical development efforts are proposed. First, an odor delivery system, compatible with the high magnetic fields in the fMRI scanner, will be developed and reduced to practice. This system will enable fMRI studies of craving induced by odor, known to be a potent modality. Second, a motion analysis system will be used to obtain accurate measurements of subject motion during scans. After validation, software phantoms will be developed, and together with the motion analysis system will evaluate available motion analysis packages. Finally, motion data will be incorporated into scanner function, so that resulting fMRI data will be almost free of motion artifacts. Third, a wavelet-based fractal analysis of fMRI data will be developed. This method focuses on the slowly varying physiological "noise" which plagues other analysis techniques, turning a liability into an asset and our work shows that it readily highlights drug effects. The training plan will include coursework in neuroscience, pharmacology, and drug abuse; seminars in responsible conduct of research; laboratory rotations; grant writing experience; and regular meetings with the mentors. The timeline of the training will be matched to coincide with the progress of the research projects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROCOGNITIVE FUNCTION IN RUSSIAN HEROIN ADDICTS Principal Investigator & Institution: Fishbein, Diana H. Senior Research Scientist; Research Triangle Institute Box 12194, 3040 Cornwallis Rd Research Triangle Park, NC 27709 Timing: Fiscal Year 2003; Project Start 10-SEP-2003; Project End 30-APR-2006 Summary: (provided by applicant): Research on the neurocognitive consequences of chronic heroin use is sparse, despite the global existence of millions of addicts and young initiates. Most U.S. studies include polydrug abusers and are unable to precisely distinguish between neurocognitive consequences of specific drugs. This deficit is particularly true for heroin addiction, which is often also preceded by several years of extensive use of other drugs, confounding the ability to assess single drug effects. Thus, it is important to determine whether there are neurocognitive impairments associated specifically with heroin addiction that may differ from those associated with alcoholism or whether the same deficits are common to multiple drug users. To elucidate differential neurocognitive consequences of heroin use, it is necessary to identify a population with a dependency on only one drug. Most studies of drug effects on brain function also do not measure prefrontally modulated executive cognitive function (ECF) and focus largely on general neuropsychological function. Recent research using stateof-the-art cognitive instruments provides support for a relationship between specific dimensions of ECF and drug abuse propensity and persistence. ECF may predict relapse propensity, and intact function may be a prerequisite for favorable responses to
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treatment programs that require a certain level of cognitive processing. There is also insufficient research on gender disparities in the cognitive consequences of drug use, despite differences in historical patterns of use, neurologic drug effects, and involvement of contextual factors. ECF assessment of male and female heroin addicts entering treatment is useful for the evaluation of aspects of cognitive functioning that may be relevant for optimal therapeutic management and treatment planning. To evaluate differential relationships between ECF in heroin addicts versus alcoholics among these groups, the proposed study will focus on single drug users without extensive prior use of other drugs from an inpatient treatment facility in St. Petersburg, Russia. Two control groups will be included: polydrug abusers from the facility and a group of nondrug abusers from the community. Neurocognitive tests will be administered after detoxification. Mediating effects of personality traits on cognitive outcomes will further be assessed. This innovative design and unique sample population will generate findings critical to understanding differences in ECF among heroin addicts, alcoholics, and polydrug abusers, as well as differential gender effects. Because the nature and degree of recovery from drug abuse are likely a function of the type or pattern of neurocognitive impairment, differential drug effects must be considered. This study will significantly contribute to NIDA's goal to support international collaborative research to increase understanding of consequences of drug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROPEPTIDE RECEPTORS AND DRUGS OF ABUSE Principal Investigator & Institution: Duman, Ronald S. Professor; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2001 Summary: Opiates and psychostimulants exert complex effects on multiple brain regions to produce drug abuse behaviors. These effects occur at the molecular and cellular levels and include adaptations of the cAMP signal transduction pathway. The focus of this Project is to extend previous studies to identify and characterize neuropeptide receptor sites that are localized in brain regions influenced by drugs of abuse, and that modulate drug abuse responses. The melanocortin and corticotrophin releasing factor (CRF) receptors will be the focus of these studies. Melanocortins modulate the opiate and dopamine neurotransmitter systems, and CRF contributes to the anxiety and aversion that occurs during drug withdrawal. Studies are proposed to identify the specific melanocortin and CRF receptor subtypes that mediate these effects. This will include studies to examine the regulation of melanocortin and CRF receptors by chronic morphine and cocaine treatments, the molecular and cellular mechanisms that underlie this regulation, and the role of these receptors in drug abuse behaviors. These studies will include analysis of receptor mRNA and ligand binding in rat brain and analysis of receptor mRNA half-life, gene transcription rate, and receptor gene promoters in cultured cells. In addition, mutant knockout and transgenic mice will be used to further characterize the regulation and function of these receptors. Preliminary studies demonstrate the feasibility of the proposed experiments and provide direct evidence that thee receptors are involved in drug abuse behavior. The melanocortin 4 receptor (MC4-R), which has been cloned and characterized by this group, is the most abundant melanocortin receptor in brain. In addition, preliminary studies demonstrate that MC4-R, but not other melanocortin receptor subtypes, is enriched in the striatum and nucleus accumbens and that the expression of MC4-R in these regions is regulated by chronic morphine and cocaine treatments. Preliminary studies also demonstrate that
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expression of CRF-R1 in frontal cortex is regulated by opiate withdrawal, and that a selective nonpeptide CRF-R1 antagonist blocks opiate withdrawal behaviors. The proposed studies will further characterize these findings and could lead to the identification and novel receptor targets for the development of new therapeutic agents for drug craving and withdrawal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROPSYCHOPHARMACOLOGY TRAINING FOR DRUG ABUSE RESEARCH Principal Investigator & Institution: Vezina, Paul; Neurobiology/Pharmacology/Phys; University of Chicago 5801 S Ellis Ave Chicago, IL 60637 Timing: Fiscal Year 2002; Project Start 30-SEP-1991; Project End 30-JUN-2007 Summary: (Provided by Applicant): The overall objective of the Drug Abuse Research Training Program at The University of Chicago is to provide both pre- and postdoctoral trainees with comprehensive educational and research experiences that will enable them to pursue distinguished research careers in areas impacting drug abuse. Drug abuse poses a serious threat to the health and well being of both individuals and society. Mental status, physical health, social function and economic productivity are compromised. Such factors can lead to an increase in crime and violence. To the credit of NIDA-sponsored research programs, considerable gains have been made over the last two decades. However, much more remains to be learned from the molecular to the social realm. Existing programs in the area of drug abuse are designed to acquire knowledge about the social, behavioral, neuropharmacological, molecular and genetic factors relevant to the abuse of drugs. The aim is to increase our understanding of the etiology of and our ability to intervene in the treatment and prevention of drug abuse. Specific strengths of this program relate to the neuropharmacology, psychopharmacology and molecular biology of drug abuse as well as the behavioral and subjective effects of drugs in humans. Several factors place the faculty submitting this application in an excellent position to continue to offer an outstanding training program. These factors include the strength of current interests and ongoing research into the problems of drug abuse, the diversity of approaches employed by individual faculty, the presence of a critical mass of creative scientists working on drug abuse related problems in a multidisciplinary setting as well as a curriculum that addresses the broad aspects of drug abuse ranging from the molecular bases of drug action to the consideration of ethical and social issues related to drug taking. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROSCIENCE OF DRUG ABUSE TRAINING PROGRAM Principal Investigator & Institution: Childers, Steven R. Professor; Physiology and Pharmacology; Wake Forest University Health Sciences Winston-Salem, NC 27157 Timing: Fiscal Year 2002; Project Start 30-SEP-1991; Project End 30-JUN-2006 Summary: (provided by applicant) One of the keys to understanding the actions of drugs of abuse is a systematic study of the neurobiological basis of drug abuse. To be effective, such studies must involve multi-disciplinary approaches at several different levels of brain function. This is the goal of the current application, which proposes to continue a successful NIDA training program, the Neuroscience of Drug Abuse Training Program at Wake Forest University School of Medicine. This program trains both predoctoral and postdoctoral students in a multi-disciplinary program in the neurobiology of drug abuse. The program consists of 16 faculty members of several
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Departments at Wake Forest, with a joint faculty member at North Carolina Central University, with research interests including molecular biology, receptor pharmacology, brain imaging techniques, electrophysiology, and behavioral analysis of drug selfadministration. The research of the faculty is supported by 45 funded grants, many of which are directly related to the field of substance abuse. A central focus of research for the training program is the NIDA-funded Center for the Neurobiological Investigation of Drug Abuse, which offers highly integrated collaborative research projects among a number of faculty. The program is organized around three principal areas of research: Molecular/Cellular Neurobiology, Neurobiological Systems, and Behavioral Neurobiology. The training program, offers a specific course in drug abuse related to each of these three areas. Predoctoral students have a choice of three different Ph.D. degree programs: Pharmacology, Physiology, and Neuroscience. Although each of these programs have their own requirements, specific drug abuse-related topics are integrated into the standard programs. The training program offers specific seminars and journal clubs for both predoctoral and postdoctoral trainees. The program also contains specialized components dealing with grant writing and ethics in scientific research. Recruitment of students will be aided by the fact that Neuroscience is one of the fastest growing disciplines in the biological sciences. In addition, recruitment of minority applicants will be a high priority, with a new interactive arrangement between Wake Forest University and North Carolina Central University. In summary, the Neuroscience of Drug Abuse Training Program not only offers students outstanding opportunities for education and research in the neurobiology of drug abuse, but is also a valuable resource for the field of drug abuse by providing trained young investigators capable of independent scientific careers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROSCIENCE TRAINING IN DRUG ABUSE Principal Investigator & Institution: Kuhn, Donald M. Professor; Psychiatry & Behav Neuroscis; Wayne State University 656 W. Kirby Detroit, MI 48202 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2005 Summary: (Applicant's Abstract) The broad, long term objective of this training program in drug abuse is to prepare a cadre of developing young scientists who will specialize in drug abuse research in their future careers and, thereby, contribute to national research priorities in the biomedical and behavioral neurosciences. The current program will train two predoctoral and two postdoctoral fellows per year in its inaugural 5 year period. The training program will be based within an established PhD program in Cellular and Clinical Neurobiology (CCN) in the Department of Psychiatry and Behavioral Neurosciences at Wayne State University. This program and department have actively recruited a faculty, that specializes in drug abuse research and treatment, and is in a strong position to use this expertise to train pre and postdoctoral fellows in all facets of drug abuse research. All faculty on this training grant serve as faculty in the CCN PhD program, all didactic and research courses are established, a seminar series and Chair's Grand Round are ongoing, and pre-/post-doctoral fellow recruitment and training have matured to the point that a specialized program in drug abuse will integrate seamlessly with current training activities in our department. A comprehensive program of instruction in neurobiology, emphasizing the development of research capabilities in pharmacological, molecular/cellular biological, clinical, and behavioral aspects of substance abuse will lead to the PhD degree for predoctoral trainees. Postdoctoral trainees will be involved in an intensive program of research in the field of drug abuse which will foster the refinement of their investigational skills,
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and stress further development of their oral and written communication skills. The Program Director will administer this training program with the advice and consent of an Executive Committee. The participating faculty is composed of 16 productive scientists and clinicians, with 8 serving as Training Faculty and 8 serving as Resource Faculty. The combination of an established research training curriculum in neurobiology and a faculty with demonstrated, long-term commitment to the field of drug abuse research, will lead to a cohesive training program specializing in drug abuse, and will produce young scientists who will be among those who dedicate their future careers to the study of drug abuse and addiction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NIDA DRUG ABUSE RESEARCH COLLABORATION Principal Investigator & Institution: Howlett, Allyn C. Director of Neuroscience/Drug Abuse Rese; None; North Carolina Central University 160 Alexander-Dunn Bidg. Durham, NC 27707 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 30-JUN-2005 Summary: (Applicant's Abstract) North Carolina Central University is responding to the NIH-National Institute on Drug Abuse and Office of Research on Minority Health initiative entitled HBCU Research Scientist Award. The proposed NCCU drug abuse research program in collaboration with Wake Forest University School of Medicine, will focus on molecular mechanisms of drug-cell interaction, seeking to understand the molecular correlates of addictive behavior. The program will be housed in the new Biomedical/Biotechnology Research Institute. Working with NIDA and ORMH, NCCU will address the program goals and support the growth and development of drug abuse research by: assembling a panel of scientists external to NCCU that could serve as a drug abuse research advisory committee: identifying and recruiting an experienced individual generally recognized as an accomplished drug abuse research scientist: establishing formal linkages with scientists at the drug abuse research center located at Wake Forest University School Medicine, located approximately 110 miles from NCCU: cost effective assembly and training of a high quality team of scientists to conduct drug abuse research at NCCU: and serving as a catalyst to enhance public awareness, particularly among the minority community, of the behavioral and public health consequences of drug addiction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: OPIOID RECEPTORS ON LYMPHOCYTES AND BRAIN Principal Investigator & Institution: Bidlack, Jean M. Professor; PharmacologyPhysiology; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2003; Project Start 01-FEB-1998; Project End 31-JAN-2008 Summary: (provided by applicant): This K05 Senior Scientist Award is to support Dr. Jean M. Bidlack's research activities. The specific aim of this award is to provide Dr. Bidlack with some release time from grant writing, teaching and administrative responsibilities to cover her salary. This award will allow her to devote the majority of her time to research and the training of graduate students and postdoctoral fellows. Training activities will be supported by a NIDA Training Grant (T32 DA07232). Dr. Bidlack will expand her research background and expertise in studying the expression and regulation of opioid receptors on immune cells. Also, she will investigate whether a chemokine receptor expressed on human herpes virus -6 and -7 binds opioids, and if opioids alter chemokine activation of the receptor. This chemokine receptor, U51, shares
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considerable amino acid sequence homology and similarity with the kappa opioid receptor. In addition, ongoing studies directed at medications development for the treatment of heroin and cocaine abuse will continue. The working hypothesis for which we have produced experimental support is that compounds, which release dopamine from the nucleus accumbens, promote drug-seeking behavior and those, which prevent release of this transmitter, prevent drug-seeking behavior. It is known that kappa agonists and mu antagonists inhibit dopamine release in the nucleus accumbens. Studies are further defining properties of select compounds that make some ? agonists with varying activity at mu receptors better at reducing cocaine self-administration in nonhuman primates than other compounds. In collaboration with chemists and behaviorists, we are evaluated new opioids as potential pharmacotherapeutics for treating drug abuse. The goals of these three independent projects will be accomplished within the framework of two R01 grants, a R21 grant, and three subcontracts from NIDA. Collectively, these projects will provide new information on the localization and function of the multiple opioid receptors on immune cells and on the human herpes viruses -6 and -7. Also, they will advance efforts in developing drugs to treat cocaine and heroin abuse. The present proposal is being requested in order to provide the candidate with stability of support, which is necessary for her continued commitment to research in the field of drug abuse and to ensure her sustained high level of productivity as both a senior scientist, and as a mentor for trainees, who will be the next generation of drug abuse researchers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OPIOIDS IN CANCER PAIN & DRUG ABUSE--OPTIMIZING THERAPY Principal Investigator & Institution: Kharasch, Evan D. Professor; Anesthesiology; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2001; Project Start 01-MAY-1999; Project End 31-MAR-2004 Summary: The overall long-term objective of this proposal is to develop a patientoriented research program in opioid pharmacology, specifically directed towards the therapy of cancer pain and of substance abuse. A principal component of this program will be the development of beginning clinical investigators. The specific research objectives are to 1) expand existing research which investigates mechanisms of variability in human opioid disposition, pharmacodynamics and clinical efficacy, and endeavors to optimize opioid therapy of cancer pain and of substance abuse, 2) facilitate program expansion into underutilized therapies such as nonsteroidal antiinflammatory drugs and emerging issues such as outpatient postoperative pain therapy, and 3) mentor beginning clinician-scientists in patient-oriented research, utilizing the above framework to spawn independent research programs. A critical focus will be interfacing in vitro and in vivo aspects of human drug disposition and efficacy, and translating recent explosive discoveries in basic enzymology and pharmacogenetics of drug disposition into clinical strategies for optimized therapy. Oral and parenteral opioids ar the primary therapy for opiate addiction and cancer pain. Methadone maintenance is the cornerstone of opiate abuse therapy, a vital and effective strategy for HIV/AIDS risk reduction, and is widely used for cancer pain treatment. lalpha-acetylmethadol (LAAM) is the first new opioid in three decades approved for opiate abuse. Oral transmucosal fentanyl (OTFC) is the first drug ever specifically developed for treating breakthrough cancer pain. All these opioids are characterized by extreme, unexplained, and unpredictable interindividual variability in their pharmacokinetics, causing inadequate pain treatment, opioid abstinence syndrome,
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treatment failures, and frequent unwanted side effects. Unexplained age- and genderdependent variabilities also prevail. These opioids are metabolized by cytochrome P450 in the intestine and liver. The mechanisms of individual and age-dependent variability in the metabolism of these opioids are, however, unknown. Indeed, little is known about the P450s responsible for human clinical metabolism of OTFC, LAAM and methadone (and its individual enantiomers, which have divergent efficacies), and the factors affecting these P450s. Consequences for clinical drug effect are similarly unknown. Experiments in vitro will use human liver and intestinal microsomes to identify relevant P450 isoforms and probe enantiomeric and drug-drug interactions, while complementary in vivo clinical investigations will verify these identifications and establish the influence of age, gender, and diet on opioid disposition and pharmacologic effects. Successful identification of the P450s and factors affecting metabolism, clearance, blood concentrations, and clinical effects of OTFC, LAAM and methadone will improve the clinical outcome and reduce the costs of opiate addiction and cancer pain treatment, and provide insights into age-, gender-, and environmentally-dependent changes in drug disposition. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ORGANIZATIONAL CULTURE & QUALITY OF DRUG ABUSE TREATMENT Principal Investigator & Institution: Mael, Fred A.; American Institutes for Research 3333 K St Nw Washington, DC 20007 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-MAY-2006 Summary: (provided by applicant): Aims: Organizational culture (OC) affects morale and service quality in a wide range of professions. Despite interest by NIDA and practitioners, the impact of OC on performance of drug abuse treatment providers has not been examined systematically. This study's primary goal is to better measure quality of care and OC in the drug treatment arena, determine how OC impacts on quality of care and employee morale, and provide guidance on improving a facility's OC. We propose to accomplish this by: developing behaviorally-anchored rating scales (BARS) for staff to evaluate the dimensions of quality care in drug abuse treatment settings; devising a measure of the OC dimensions likely to promote quality care and employee morale; accessing administrative outcome measures of quality; examining the relationship between OC and both quality care and employee morale in the treatment setting; and conducting a benchmarking study addressing ways in which a facility's OC might be improved, thereby effecting change in treatment quality. Methods: The study population will be drug abuse treatment staff in three California counties. The research plan includes a survey of treatment staff to examine the relationship of OC with staffrated quality of care, administrative outcome measures, and employee morale; a comparison of culture and morale with outcomes-based measures of treatment quality, a benchmarking study to determine how best to change and improve OC in treatment settings; and feedback and dissemination. The Critical Incident Technique will be used to develop BARS covering the key dimensions of quality care in a drug abuse treatment setting; measures of OC, related perceptual/affective variables, and employee morale will be used or adapted. The relationship between these variables will be empirically examined. Qualitative methods will be used to identify exemplary methods of effecting cultural change in treatment settings; multimedia dissemination will occur. Implications: This investigation will make a number of contributions to the field. These include informing practitioners and researchers about the role that OC plays in quality care and employee morale; informing them how to make positive changes in a facility's
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OC; and development of tools that can be used for program evaluation and performance management in substance abuse treatment settings. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OUTCOMES FOR DRUG ABUSERS CHILDREN--MULTISITE STUDY Principal Investigator & Institution: Stanger, Catherine; Psychiatry; University of Vermont & St Agric College 340 Waterman Building Burlington, VT 05405 Timing: Fiscal Year 2001; Project Start 05-JUN-1998; Project End 31-MAY-2003 Summary: (Applicant's Abstract) This proposed FIRST project will continue Dr. Stanger's programmatic research on children of drug abusers. The purpose of this study is to identify predictors of adolescent drug use and its correlates among children of dug abusers. Previous research has shown that children of parents receiving treatment for drug abuse are at greater risk for behavioral/emotional problems than matched comparison groups. In particular, children of drug abusers are at risk for conduct problems that are associated with early and persistent drug use. However, not all children of drug abusers show behavioral/emotional problems at the time of their parent's treatment for drug abuse. This project aims to identify risk and protective factors for the onset an persistence of drug use among children of drug abusers. Candidate predictors will include severity of parental drug abuse, family environment and parenting, child behavioral/emotional problems and deviant attitudes, peer influences, and demographic variables. We will assess children's behavioral/emotional problems, drug use, and antisocial behavior via standardized rating forms from: (1) a parent or parent figure who is receiving treatment for drug abuse; (2) a second parent figure in the home; 93) the child's teacher and (4) children age 11 years and older. Study sites included Burlington, VT, Houston, Philadelphia, New York, and Denver. This study will extend and expand findings from Dr. Stanger's NIDA small grant project. Advances in this First proposal includes assessing the children directly, assessing important mediators and moderators of parental drug abuse on children's problems, assessing drug abuse and delinquency outcomes, and assessing similar constructs at both Time 1 and Time 2. The project includes three components: (1) in Years 1-5, we will do a cross-sectional assessment of 2-18-year-old children of drug abusers; (2) in Years 2 through 5, we will do a prospective 1-year follow-up of children aged 11-18 years; and (3) in Year 1, we will do longitudinal follow-up of all children aged 1-18 years from Dr. Stanger's NIDA small grant project who were originally assessed in 1995 and 1996. Findings will be used to develop preventative interventions for children. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PATHWAYS TO HIGH RISK DRUG ABUSE AMONG URBAN YOUTH Principal Investigator & Institution: Schensul, Jean J. Executive Director; Institute for Community Research 2 Hartford Sq W, Ste 100 Hartford, CT 06106 Timing: Fiscal Year 2001; Project Start 01-APR-1998; Project End 31-MAR-2003 Summary: (Applicant's Abstract) The purpose of this four-year study, entitled "Pathways to High-Risk Drug Abuse Among Urban Youth," is to identify critical factors responsible for the transition from gateway poly-drug use (defined as use of alcohol/marijuana and one other drug in the past month) to "hard" drug use (defined here as weekly heroin and/or cocaine sniffing, smoking, or injection) and the associated health risks among multiethnic inner city mature minors and young adults (ages 16-24). The study is important because the transition to hard drug use and associated exposure
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to HIV is known to occur during this time and because preventing the transition will simultaneously reduce the risk of HIV infection in this age cohort. Both national and local studies, including those conducted by the Institute for Community Research and the Hispanic Health Council in Hartford with two populations (in-school youth at risk for substance abuse and other risks; and injection drug and crack cocaine users), have not yet reached very high risk youth in the target age group, especially in smaller urban areas. The study combines a longitudinal epidemiologic approach to understanding the natural history of progression to hard drug use, with network ethnography to examine the role of social networks in influencing drug use transitions. The aims of the study are to: a) conduct exploratory ethnographic research to identify drug use histories and contexts; validate and pilot epidemiological and network instruments; and identify index individuals for network study in target neighborhoods (Stage 1, Year 1); b) conduct a panel study with 400 high risk youth at two points in time 18 months apart to identify the relative contributions of individual vulnerability and personal and macronetwork characteristics to the transition from gateway polydrug use to cocaine/heroin use (Stage 2, Months 13-40); c) use the results to promote focus group discussions around appropriate approaches to outreach and intervention with hidden populations of high risk youth (Stage 3, Months 41-45); and d) generate a manual outlining ethical approaches to ethnoepidemiological research with mature minors and young adults involved in dangerous or illegal activity, through annual ethics symposia and collection and coding of observations, interviews and discussion. Results will be used to frame strategies for preventing hard drug use and HIV transmission in the target population and for advancing the discussion of ethical issues in multi- method drug and AIDS research with mature minors and young adults. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PET IMAGING AND COCAINE NEUROPHARMACOLOGY Principal Investigator & Institution: Howell, Leonard L. Research Associate Professor; Behavioral Biology; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 15-AUG-1997; Project End 31-MAY-2006 Summary: (provided by applicant): The proposed research will utilize a nonhuman primate model to characterize the effectiveness of selective dopa-mine transporter (DAT) inhibitors to reduce cocaine use. A second-order schedule of I.V. drug selfadministration in rhesus monkeys will characterize changes in drug-maintained behavior following pretreatment with DAT inhibitors (Specific Aim 1). In addition, DAT inhibitors will be substituted for cocaine to assess their abuse liability. Positron emission tomography (PET) neuroimaging techniques will quantify DAT occupancy following drug pretreatments shown to be effective in reducing cocaine use (Specific Aim 2). It is hypothesized that DAT occupancy will be a direct function of drug dose, and that a minimum threshold of DAT occupancy will be required for effectiveness in reducing cocaine use. In vivo microdialysis will quantify drug-induced changes in extracellular dopamine associated with different levels of DAT occupancy (Specific Aim 3). It is hypothesized that doses of DAT inhibitors that effectively reduce cocaine use will produce significant elevations in extracellular dopamine. While the behavioral effects of cocaine have been attributed primarily to an interaction with the dopa-minergic system, evidence indicates that serotonin is an important modulator of the behavioral effects of cocaine. Accordingly, studies will manipulate serotonin activity pharrnacologically to assess changes in the effectiveness of DAT inhibitors to reduce cocaine use (Specific Aim 4). It is hypothesized that co-administration of selective serotonin reuptake inhibitors (SSRI) will lower the effective dose required for DAT inhibitors to decrease cocaine self-
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administration. A final objective is to continue the development and implementation of cocaine self-administration protocols during dynamic neuroimaging of regional cerebral blood flow (rCBF) as a model of brain activation (Specific Aim 5). The direct pharrnacological effects of cocaine on rCBF will be compared to those induced by environmental stimuli associated with cocaine self-administration. It is hypothesized that the pattern of brain activation will differ significantly under the two conditions. Collectively, the proposed research will provide an innovative preclinical model to evaluate the use of selective DAT inhibitors as pharmacotherapies for cocaine abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHARMACOLOGICAL AND BEHAVIORAL INDICES OF DRUG ABUSE Principal Investigator & Institution: Lukas, Scott E. Professor of Psychiatry (Pharmacology); Mc Lean Hospital (Belmont, Ma) Belmont, MA 02478 Timing: Fiscal Year 2002; Project Start 01-AUG-1997; Project End 31-AUG-2007 Summary: (provided by applicant): This is a request to continue a K05 Senior Scientist Award to permit the candidate to continue his career development in drug abuse research. During the past 15 years as a K02/K05 awardee the candidate has spent 8085% of his time engaged in drug abuse research. His overall research goals employ multidisciplinary approaches to study the neurobiological bases of reinforcement, polydrug abuse, sex-related differences and novel pharmacotherapies for drug and alcohol abuse. The research plan is based on three currently funded R01 grants and a likely T32 Training grant on which the candidate is the Principal Investigator. The Career Development plan for the next five years will include 1) conducting research and acquiring new skills (80%), 2) mentoring (10%), 3) CPDD (5%), 4) Responsible Conduct of Research (5%). Currently funded projects are well stocked with a variety of brain imaging protocols to enhance the value of the information learned from the studies. Such ventures require a great deal of collaboration with other scientists at McLean. Mentoring the next generation of scientists is aimed primarily at the K23/K25 level but if the candidate's T32 is awarded he will take on postdoctoral trainees as well. The College on Problems of Drug Dependence (CPDD) is the major scientific organization dedicated to the study of drug abuse and as Chair of the Program Committee (and now candidate for president-elect) the candidate will continue to play a major role in the future development of the field. As Chair of McLean's IRB the candidate is responsible for monitoring the ethical conduct of all human research protocols at the hospital. Further, the candidate directs a monthly seminar series on the Responsible Conduct of Research for postdoctoral fellows, K-awardees, junior scientists and senior scientists. The candidate has made a strong commitment to drug abuse research and actively collaborates with junior and senior scientists to conduct the variety of protocols. Over the next five years he will study the effects of drug-related cues on brain function of adolescents and adults using brain electrical activity and fMRI, evaluate nicotine patches and citicoline as novel pharmacotherapies for cocaine abuse, and evaluate the utility of a Chinese herbal medicine, kudzu, as a possible treatment for alcohol abuse. The present application is being sought to provide the candidate with continued stability of support essential for his sustained commitment to research in the field of drug abuse and to ensure his continued level of productivity not only as a senior scientist, but as a mentor for the next generation of drug abuse scientists. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ADDICTION
PHARMACOLOGICAL
SUBSTRATES
OF
AMPHETAMINE
Principal Investigator & Institution: Brauer, Lisa H.; Duke University Durham, NC 27706 Timing: Fiscal Year 2001 Summary: Purpose and Methods: The goals of this ongoing study are 1) to evaluate the role of dopamine (DA) in the subjective and behavioral effects of d-amphetamine in normal volunteers and 2) to explore the effects of the combined administration of a DA agonist and antagonist in blocking amphetamine reward. Studies with laboratory animals have demonstrated a role for DA in mediating the rewarding effects of amphetamine but studies with humans have provided inconsistent results. We are exploring the role of DA by comparing the subjective and behavioral effects of amphetamine after pretreatment with placebo, a DA agonist and a DA antagonist. We also aim to determine the extent to which combined pretreatment with a DA agonist and antagonist produces greated reduction of amphetamine's effects than either treatment alone, in an effort to extend previous findings in cigarette smokers. The study is conducted according to a 2 (Agonist: d-amphetamine [AMP] or placebo [PLAC]) x 2 (Antagonist: haloperidol [HAL] or PLAC) x 2 (Challenge drug: AMP or PLAC) mixed within- and between subjects design. The pretreatment drugs are within- subjects manipulations, whereas the challenge drug condition varies between subjects. All drugs are administered under double-blind conditions, with the order of conditions counterbalanced across subjects. We hypothesize that both haloperidol and damphetamine will attenuate subjective (e.g., euphorigenic) responses to the challenge dose of d-amphetamine, but that combined pretreatment with haloperidol and damphetamine will attenuate responses to the challenge dose to a significantly greater extent. Furthermore, we expect the combined pretreatment condition to produce a better side effects protocol than either pretreatment drug alone. Results: Preliminary data from 25 subjects supports our hypotheses. For example, pretreatment with both amphetamine and haloperidol attenuated euphorigenic responses to d- amphetamine; combined pretreatment attenuated responses to a greater extent than either pretreatment alone. Moreover, amphetamine and haloperidol offset the side effects of each other. For instance, haloperidol produced a slight decrement in psychomotor performance, which was reversed by the addition of amphetamine. These preliminary results suggest that this treatment approach should be studied further. Significance and future plans: Studies with laboratory animals have consistently demonstrated a role for dopamine (DA) in the effects of amphetamine related to its abuse, but to date no dopaminergic agents have proven effective in treating stimulant abuse. The lack of efficacy of dopaminergic agents may relate to differences in the role of DA in animals as compared to humans, or to limitations in the doses of the treatment drugs that can be tested. This study will directly address both issues. We will determine whether the effects of a dopaminergic agonist and antagonist on responses to amphetamine in humans suggest a significant role for DA in humans. In addition, we will explore the effects of an agonist/antagonist combination on responses to amphetamine. To date, DA agonists and antagonists have not been well tolerated at the doses required for treatment of stimulant addiction; DA agonists can produce unpleasant side effects and may have abuse potential of their own, and DA antagonists are aversive and can produce long lasting and permanent motor side effects after prolonged use. Based on previous work with nicotinic agonist/antagonist combinations and smoking cessation, the combined drug treatment would be expected to have less abuse liability and to produce fewer side effects than either drug alone, and should block the positive rewarding effects (e.g., euphoria) of d-amphetamine. The potential usefulness of this treatment approach for
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stimulant drug abuse cannot be underestimated since no effective treatments are available at this time. If the results of this study are promising, future studies will explore the effects of these and other dopaminergic treatments and combinations in both normal volunteers and in patients with diagnoses of stimulant abuse and/or dependence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHARMACOLOGY AND NEUROSCIENCE OF DRUG ABUSE Principal Investigator & Institution: Inturrisi, Charles E. Professor; Pharmacology; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2002; Project Start 30-SEP-1991; Project End 30-JUN-2007 Summary: (Provided by Applicant): This application provides pre and postdoctoral training in Drug Abuse Research with a multidisciplinary and triinstitutional faculty that is proficient in the Molecular, Structural, Biochemical, Behavioral and Clinical aspects of Drug Abuse Research. The faculty includes members from the Departments of Pharmacology, Neuroscience, Biochemistry and Public Health at Weill Medical College of Cornell University and from the Memorial Sloan-Kettering Cancer Center (MSKCC) and the Rockefeller University (RU). Faculty research interests include: the phenotypic consequences for pain states, opioid tolerance, reward, anxiety or gaseous anesthetic action of the mutation or deletion of opioid, glutamatergic, GABA or serotonergic receptors, the role soluble and transmembrane adenylyl cyclases in opioid signal transduction, in vivo receptor and drug imaging techniques, anatomical and ultrastructure characterization of the dopaminergic, glutamatergic and opioid peptides systems as they relate to the effects of drugs of abuse, the biological basis of opioid, cocaine and alcohol tolerance and dependency, maternal-fetal pharmacodynamics of drugs of abuse, drug abuse prevention research and the clinical pharmacokinetics and pharmacodynamics of opioid and nonopioid analgesics. Predoctoral trainees will have a choice of a major concentration in either Pharmacology or Neuroscience. In addition to lectures and seminars devoted to topics in drug abuse, both the 5 pre and the 5 postdoctoral trainees will attend a biweekly Pain Conference at MSKCC where patient presentations are followed by a discussion with a multidisciplinary Pain Research Team of pain management, drug abuse and related issues. The program provides training in study design, biostatistics and the ethics of scientific research. Special programs are available to identify minority trainees. The Pharmacology-Neuroscience Drug Abuse Training Program provides an opportunity for young investigators to participate in basic and clinical research in drug abuse. An important aspect of this program is that the trainees will have the opportunity to learn directly about the clinical issues and opportunities in drug abuse research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PILOT--DRUG RETENTION PROJECT
COURT
TREATMENT
ENGAGEMENT
AND
Principal Investigator & Institution: Ashford, Jose B.; Arizona State University P.O. Box 873503 Tempe, AZ 852873503 Timing: Fiscal Year 2002; Project Start 01-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant) The major goals of this project are to develop culturally relevant, valid screening and assessment tools for the diverse populations of the Southwest who are ordered into drug treatment by drug courts, and to examine preliminary hypotheses concerning the determinants of client engagement and retention
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in court mandated drug treatment services. This pilot will also enable the Team Leader (Jose B. Ashford) and senior researchers from the Arizona State University Multidisciplinary Research Initiative on Conflict and its Management (MRIC), and other SIRC Mentorship and Methodology researchers to work with junior social work faculty members with related research interests. These include developing treatment engagement and retention technologies for dually diagnosed individuals (Layne Stromwall) and low income mothers with substance abuse problems (Nancy Larson), and examining the resiliency effects of social networks for Latino youth and families experiencing co-morbidity of mental illness and drug abuse in mandated treatment (Jane Holschuh). The objectives for achieving these pilot aims are: Client engagement and retention Evaluate the suitability of existing measures of "readiness to change" for use with parents in Family Dependency Drug Courts, applying the resiliency to risk ecological approach and testing for cultural competency. The project will begin by studying treatment engagement and retention issues germane to family/juvenile drug courts. Here we will explore the applicability of competing theories in the social science literature about what predicts parental engagement and compliance with treatment in a Family Dependency Drug Court. Faculty expertise and development Foster interdisciplinary dialog between social work researchers, practitioners, and senior investigators in economics, justice studies, law, psychology, and sociology about measuring parental attitudes germane to assessing treatment engagement and compliance issues among families in the Southwest region. Link the project?s interdisciplinary research team with senior substance abuse researchers and members of the SIRC methodology/mentorship core (e.g. Jennie Kronenfeld and Verna Keith) and court-based social workers. Receive consultation from leading experts on measuring cooperation and compliance with the decisions of authorities/institutions from a culturally competent approach (e.g., Robert Cialdini and Tom Tyler). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PK-PD MODELS: THE ROLE OF METABOLITES IN DRUG ACTION Principal Investigator & Institution: Hendrickson, Howard P. Pharmacology and Toxicology; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, AR 72205 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2005 Summary: The long-term goal of this Mentored Quantitative Research Career Award (K25) is to compliment the career preparation of the PI, an analytical chemist, with the training and research experience he needs to become a successful, independent researcher in drug abuse. This will be accomplished through a program of training and research in the pharmacology of drug abuse, focusing on the advanced areas of pharmacokinetics and behavioral pharmacology. In the final phase of this career development plan these diverse research areas will be integrated and used to conduct studies employing pharmacokinetic- pharmacodynamic (PK-PD) modeling. The mentor and co-mentor are both drug-abuse researchers with extensive research experience in these areas. The aims of the research-training proposal are to investigate the pharmacology of dextromethorphan with regard to its actions as a drug of abuse. Dextromethorphan, a common component of cold and cough remedies, is an increasingly abused club drug ("robo") among youth, often masquerading as more popular drugs such as MDMA ("ecstasy") or gamma-hydroxybutyrate ("GHB"). The applicant will investigate the role of dextrorphan, the primary active metabolite of dextromethorphan, as the agent responsible for the phencyclidine-like actions of dextromethorphan. Because dextromethorphan is extensively metabolized to
Studies 111
dextrorphan in the liver, first-pass effects play a significant role in its metabolism. To test the hypothesis that oral and intravenous administration of dextromethorphan will produce unique behavioral-time profiles, dose-response and time-course studies of spontaneous locomotor activity will be studied in rats. Concurrently, serum concentration-time profiles of dextromethorphan and metabolites will be determined. PK-PD modeling of response-time and concentration-time profiles will be used to determine in vivo pharmacodynamic parameters such as, intrinsic efficacy, estimated drug-receptor binding, and drug concentration at the effect site. This approach should provide evidence about whether dextromethorphan or dextrorphan, or both, are primarily responsible for the actions sought by abusers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: POSTNATAL STRESS--HPA AXIS AND VULNERABILITY TO DRUG USE Principal Investigator & Institution: Vazquez, Delia M. Associate Professor; Pediatrics & Communicable Dis; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2001; Project Start 15-MAY-1998; Project End 30-APR-2003 Summary: (Applicant's Abstract) There is evidence for a relationship between development, the biology of stress, growth retardation and substance abuse. In humans, psychosocial stressors, such as child abuse and neglect, can cause growth failure and are also risk factors for subsequent drug use and dependence. A common neurobiological substrate for stress, growth failure and drug use, is the limbichypothalami-pituitary-adrenal (LHPA) axis, a system that can be altered in a significant and long term manner during development (e.g., by maternal deprivation). The focus of this proposal is to understand the role of critical developmental periods which, when altered, lead to growth retardation and vulnerability to drug abuse, using the rat as an animal model. It proposes to study how the LHPA axis changes as a function of early developmental events and exposure to repeated stress, and how these factors contribute to individual differences in stress responsiveness and individual vulnerability to drug use. We shall concentrate our efforts on a particular stage of the rodent's development, the first 2 weeks of life, when activation and termination of stress can be altered in opposite directions depending on the timing of stressors. We shall focus on the hypothalamus and hippocampus, because these structures are likely to exert important neural control upon the LHPA axis, the growth hormone axis and the circuits which mediate behavioral sensitization to amphetamine and drug seeking behavior. Thus, we shall explore these issues via four interrelated sets of studies: 1) In a series of developmental studies, we shall examine the neuronal bases of the stress hyporesponsiveness (SHRP) in the rat and the mechanisms associated with the emergence into stress responsiveness; 2) We shall look at the consequences of early stress (maternal deprivation at specified times in life) on growth parameters, on the duration of the SHRP, and on stress responsiveness as an adult, focusing on related changes in the brain elements of the LHPA and the endocrine response to novelty; 3) In studies focusing on amphetamine behavior sensitization, we shall examine if the individual differences in stress responsiveness predispose to drug seeking behavior. 4) Finally, we will attempt to revert the long term negative effects of maternal deprivation by blocking the LHPA response to stress during early life. In summary, we shall study how events taking place during development may impact on growth and drug use. These studies should further our general understanding of the developmental biology of
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stress responsiveness and individual vulnerability to drug use and increase our knowledge of a key aspect of drug abuse biology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PREVENTING DRUG ABUSE--PARENTS AND YOUTH IN SCHOOLS Principal Investigator & Institution: Eggert, Leona L. Spence Endowed Professor; Psychosocial & Community Hlth; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2001; Project Start 15-JUN-1996; Project End 31-MAY-2004 Summary: Parents And Youth with Schools (PAYS) is an indicated drug abuse prevention program for high-risk youth. It is designed to address one of society's most disturbing trends: the co-occurrence of drug use/abuse, aggression, and depression among youth who are at risk for dropping out of high school. Project PAYS is a response to NIDA's recent calls for drug abuse prevention programs through family intervention (PA 96-013) and school-based indicated prevention program for high-risk youth. Initial funding was granted for a 2-year pilot study (1996-98) of the parent intervention component of PAYS. The impressive recruitment and retention rates lend support to our preliminary findings and suggest both the feasibility and acceptability of the program. These results in combination with expected changes in mediators call for the implementation of a full prevention trial of PAYS. Project PAYS augments the efficacious school-based Reconnecting Youth (Ry) program for potential high school dropouts with an innovative parent components. Parents As Partners (PAP) includes home visits and parent group meetings to foster parenting skills and support strategies directed at re-establishing the youth-parent-school bond. Both components are delivered over a full school year, providing an intensive, sustained 'dose" of social network support and life skill training. This approach is designed to reduce known risk factors and enhance protective, mediating factors within individual, family, school and peer contexts. The proposed study is a randomized trial. A 4-group factorial design with 5 repeated measures over 1.5 years is planned. It is hypothesized that the PAYS program will be significantly more effective than RY or PAP alone in reducing high-risk youths' drug involvement, school dropout and aggression/depression. Moreover, all three program conditions- PAYS, RY and PAP-compared to controls will show significantly greater reductions in the 4 outcomes and 4 mediators. The sample will consist of 760 high-risk youth in grades 10-12. The measurement model permits sophisticated assessments of individual students' antecedent, mediating and outcome dimensions, as well as corroborating evidence form parents and teachers. Process measures will assess the full implementation of the parent and school programs including measures of exposure, participation, receptivity and implementation fidelity. Latent growth models will be used to examine variance/co-variance structures and changes in outcomes and to test the hypothesized mediating intervention effects. The proposed analytic strategies permit exploration of key prevention research questions including the identification and outcome evaluation of youth with discrete risk vulnerability (including risk factor interactions) as well as the differential effects of gender. The proposed study is both innovative and significant. It has implications for both theory-testing and prevention science implications. This research should markedly increase our understanding of how family-focused preventive interventions with high-risk youth work to stem the progression of co-occurring drug involvement, aggression, depression and school deviance. Comparing the parent and school components of PAYS furthers our understanding of the relative gains associated with each program component. 1) parent and youth combined, 2) high-risk youth alone, and 3) parents alone. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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•
Project Title: PREVIOUS PERSPECTIVES
AMERICAN
DRUG
EXPERIENCE
&
FUTURE
Principal Investigator & Institution: Musto, David F. Professor of Child Psychiatry And; Child Study Center; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2001; Project Start 15-SEP-1994; Project End 30-APR-2005 Summary: (Applicant's Abstract) This is a request for a competing continuation of the applicant's Senior Scientist Award (K05 DA00219) to allow him to continue work in pursuit of his long-term goal of analyzing the historical record on drug abuse in the United States and, where appropriate, using this material to contribute a balanced historical perspective to the ongoing debate on national drug policy. His specific research aim is a study of women and drug abuse in the United States (this project will be supported by NIDA grant RO1 DA 11413-01 A1). A clearer perspective on our assumptions about drug abuse, morality, disease, and women's roles over time and what their principal manifestations in health policy and law have been provides us with a broader view of our experiences and a wider choice of policy alternatives. The methods to be employed are traditional historical research in published and archival records. The applicant in conjunction with the researchers under his direction will produce a volume of analysis and a CD-ROM collection of historical documents. Two related major projects are also nearing completion, namely a volume of analysis and documentary CD-ROM on federal drug policy between 1964 and 1980 (funded by the Robert Wood Johnson Foundation) and a study of the decline phase of drug abuse in the United States 1920-50 (NIDA grant R01 DA 09564). Along with this research, the Senior Scientist Award would permit substantial contributions to science education, collaboration with scientific investigators, and mentoring of students and others interested in the history of substance abuse. The Yale School of Medicine, with its strong History of Medicine program and Historical Library, the Yale Child Study Center and School of Epidemiology and Public Health, with their focus on substance abuse issues, and the clinical and research facilities of the Psychiatry Department's Substance Abuse Treatment Center provide a unique institutional environment that allows the applicant to pursue his historical work while remaining fully abreast of important contemporary issues in the field of drug dependence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROJECT TOWARDS NO DRUG ABUSE COMPONENTS ANALYSIS Principal Investigator & Institution: Sussman, Steven Y. Professor; Preventive Medicine; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, CA 90033 Timing: Fiscal Year 2001; Project Start 15-SEP-2000; Project End 31-AUG-2004 Summary: (Applicant's Abstract) This proposal is a response to RFA 00-004, "The Next Generation of Drug Abuse Prevention Research." We propose to examine the relative importance of the two theoretical content components of the school-based Project Towards No Drug Abuse (TND) curricula in effecting drug abuse prevention effects on tobacco, alcohol, marijuana and hard drug use (cognitive perception versus behavioral skills, versus their combination). Project TND is an empirically validated indicated drug abuse prevention program, which has shown positive one-year outcomes over three experimental replication trials. Instruction will be provided by both experienced project staff health educators and school teachers recently trained in the program as a means of examining implementer characteristics. The impact of the program content and implementer characteristics will be examined in two cohorts of youth varying in
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contextually defined risk, in a randomized experimental design. Project and school staffdelivered classroom programs will be implemented in 12 high schools and compared to 4 standard care (control) condition schools, in a seven-condition randomized design replicated across two school contexts (traditional and alternative high schools, 32 schools total). We will assess student drug use behavior at baseline (pretest), post program (immediate post-test), and 1-year follow-up. We will apply a series of sophisticated models to analyze the collected data for potential experimental, mediational and moderational effects as specified by hypotheses generated from the underlying theoretical base. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PUERTO RICO DRUG ABUSE RESEARCH DEVELOPMENT PROGRAM Principal Investigator & Institution: Robles, Rafaela R. Senior Scientist; None; Universidad Central Del Caribe Bayamon, PR 009606032 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2005 Summary: The Universidad Central de Caribe (UCC) School of Medicine in Bayamon, Puerto Rico, seeks support for a Minority Drug Abuse Research Development Program in response to the National Institute on Drug Abuse (NIDA) Initiative for Minority Institutions (MIDARDP, PD No. PAR 98-0001). The proposed Puerto Rico Drug Abuse Research Development Program (PRDARDP) will focus on developing an infrastructure, and the necessary environment and resources, at the UCC School of Medicine to train Puerto Rican (Latino) researchers in understanding drug abuse and its medical, social and psychological consequences, with particular emphasis on HIV/AIDS. During the first five years, the proposed PRDARDP will focus on training program participants from the biomedical and behavioral sciences, following a general theme: The medical, social and psychological consequences of drug abuse, with a focus on the HIV/AIDS epidemic. Our initial focus will be with the outcomes of drug abuse, not its antecedents. The individual research projects proposed in the PRDARDP will address three critical issues of this theme: HIV risk behaviors; effects of drug use on the immunology system and patterns of health care among HIV seronegative and seropositive drug abusers. The structure of the PRDARDP comprises three cores: Administrative, Research and Methodology, and Training cores. The training curriculum is extensive in content and structure, addressing the different components of the drug abuse and HIV/AIDS research fields. Our goal is to have the PRDARDP evolve into a training resource for Puerto Ricans and other Latinos in the US as well as in the South and Central America. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RANDOMIZED CLINICAL TRIAL OF JUVENILE DRUG COURT AND MST Principal Investigator & Institution: Henggeler, Scott W. Professor and Director; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, SC 29425 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: (Applicant Abstract) The timing of the RFA "Research on Drug Courts" provides an extraordinary opportunity to conduct a rigorous randomized trial to determine (a) whether a juvenile drug court improves clinical and cost-related outcomes when compared with available community services, and (b) whether the integration of
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an intensive evidenced-based treatment model enhances the possibly favorable outcomes of juvenile drug court. A unique opportunity to address these issues has been presented because NIAAA is about to fund (see Appendix A) a study titled "MST with Alcohol Abusing Delinquents: Outcomes and Cost." The soon-to-be-funded study is a randomized trial that compares multisystemic therapy (MST, Henggeler et al., 1998) enhanced with key aspects of the community reinforcement approach (CRA; Budney & Higgins, 1998) versus current community services for alcohol abusing or dependent juvenile offenders. In Charleston, current community services for substance abusing youths identified in the juvenile justice system now consist of drug court and mandated treatment with a state provider of substance abuse services (i.e., facility-based group counseling). The present application proposes to include two additional comparison conditions-conditions that will address critical gaps in the juvenile drug court literature per the present RFA as well as enhance the contributions of the NLAAA-funded study. The two new conditions are Community Services without Drug Court and MST without the CRA enhancement. Hence, if the present application is funded, the four treatment conditions would include: 1. Community Services without Drug Court (CS), (requested from NIDA) 2. Drug Court with Community Services (DC+CS), (funded by NIAAA) 3. Drug Court with MST (MST), (requested from NIDA) 4. Drug Court with MST enhanced with CRA ~IST+CRA), (funded by NL\AA) This application proposes a 4 (treatment condition: CS, DC+CS, MST, MST+CRA) x 4 (time: pretreatment [T1], 4 months [T2], 12 months [T3], 18 months [T4]) design, in which 288 juvenile offenders who meet DSM-IV criteria for substance abuse or dependence and their families will be randomly assigned to conditions. A comprehensive multimethod, multisource evaluation will address the following aims: Aim 1. To evaluate treatment effects on adolescent alcohol and drug use, criminal activity, and mental health functioning; as well as on family relations, peer relations, and school attendance. Aim 2. To track adolescent substance abuse and mental health service utilization, juvenile justice involvement, and out-of-home placements and their associated costs across the treatment conditions for 18 months post recruitment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REDUCING YOUTH DRUG RELATED HIV/STD RISK IN THAILAND Principal Investigator & Institution: Celentano, David D. Professor; Epidemiology; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): Methamphetamine (MA), a central nervous system stimulant, has become the leading drug of abuse in Thailand over the past three years. The United Nations' Drug Control Program reported that the most significant increase of illicit drug use worldwide in the1990s was in the consumption of amphetamine-type stimulants (ATS). The WHO estimates more than 35 million regular users of MA worldwide, making it the second most commonly used illicit drug after marijuana. With recent drought and subsequent reduced poppy production in Burma, the Burmese military junta in power has responded to declining foreign reserves by encouraging the production and shipment of massive quantities of methamphetamine into Thailand during the past two years. These mobile factories are very difficult to locate and the MA tablets are easily concealed and smuggled, resulting in easy access and low price in Thailand. There are a range of social and medical consequences of MA abuse: poor performance in schools among students; anxiety; convulsion; brain damage; MA psychosis, characterized by violent behavior, repetitive activity, memory loss and paranoia; and acquiring HIV and other blood-borne infections from administering MA
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by injection. In Thailand, youth are the leading age group initiating MA use. A recent Thai national survey estimated that 12.4 percent of students between 12 and 20 years used illicit drugs in 1999, of whom 57 percent reportedly have used MA. Thus, there is a compelling public health need to address the issue of MA abuse among adolescents and young adults in northern Thailand. Preventing escalation of drug use practices, particularly with respect to route of drug administration, may prove effective in preventing the spread of HIV among those who have not yet begun injecting; HIV prevalence among injectors in northern Thailand is currently over 30 percent. In response to this public health emergency, we are proposing a randomized, controlled peer-outreach intervention trial targeting methamphetamine users (n=258) and their drug and sexual networks (n=1032) in northern Thailand. We will adapt Latkin's intervention that has been demonstrated effective in the USA in reducing HIV-related risk behaviors among IDUs. The primary study endpoint would be reduction in transition to injection drug use among MA users who currently deny any history of injection. The primary objective of this RCT is to assess the efficacy of a peer educator intervention versus HIV voluntary counseling and testing (VCT) on transition to injection drug use among MA users and their peer networks. The intervention addresses reduction of HIV risk behaviors. A series of behavioral measures for HIV risk, level of MA abuse (including overdose and psychiatric morbidity) and injection use among the index and network members will be used to evaluate the efficacy of the intervention. Secondary objectives include: (1) To compare the incidence of sexually transmitted infections (C trachomatis, N gonorrhea, and, for women, T vaginalis) and Hepatitis C Virus in each study condition; (2) To compare changes in HIV and sexual risk behaviors in each study condition for index participants and network members; and (3) To compare perceived changes in substance use network norms for drug and sexual risk practices in each study condition. This study builds on an active NIDA study (DA11133) of our Thai collaboration, is an appropriate extension of our work on HIV and drug use epidemiology and is responsive to a public health problem of central concern to our host country. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESEARCH ON TREATMENT AND PREVENTION OF IV DRUG ABUSE Principal Investigator & Institution: O'brien, Charles P. Prof/Vice Chair of Psychiatry; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, PA 19104 Timing: Fiscal Year 2001; Project Start 30-SEP-1992; Project End 30-JUN-2002 Summary: This research Center was originally funded in 1987. The Center funding provided support for a Core Unit to coordinate Center activities and initiate new projects using flexible funding for pilot projects. Specific research projects were also funded within the Center. The "center concept" has functioned very well in that the Center funding has been used to stimulate growth and productivity. Not only have the specific projects been completed, but new projects which began as pilot projects were completed and others were developed into new grant applications. The educational program has grown and there now is an institutional fellowship program that has attracted high quality applicants including a high proportion of physicians. An Institutional Physician Scientist Development program has just been awarded for new faculty level development. A 21 hour required course on substance abuse for medical students has been instituted. A Treatment Research Unit has been created that has expanded our research population to the non-veteran community. We have just been awarded an Instrument Development Center that will coordinate with this Research
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Center to facilitate the development of new clinical research instruments. A Scientific Advisory Board was formed and it has met annually since the founding of the Center. Over the past five years, the Center staff have published 145 research reports, 79 reviews and 2 books. Studies completed by Center staff have been utilized by policy markers in Congressional testimony. These include a controlled study of the effects of three levels of psychosocial intervention in combination with methadone treatment, a longitudinal study of HIV conversion rates in opiate addicts in and out of treatment, a study of the efficacy of inpatient and outpatient rehabilitation for cocaine dependence and a controlled study of the effects of naltrexone treatment on reincarceration rate for Federal probationers. The present application is for an additional five years of funding. In addition to continuing the Core Unit at approximately the same level, we are requesting funding for new projects that will address current problems of intravenous drug abuse. The first section addresses the biological basis of relapse to drug dependence. The first utilizes new brain imaging techniques in human subjects to extend our prior findings concerning conditioning in cocaine dependence. The second combines microdialysis and behavioral techniques in an animal model of cocaine dependence. The third project continues our work on endogenous opioids in a series of proposed studies of tolerance and dependence using animal models and isolated cells and in studies of human opiate addicts at specific stages of the addiction cycle. Section 2 consists of three projects dealing with relapse to drug dependence. The first compares levels of psychosocial intervention in combination with medication for the treatment of cocaine dependence. The second compares two types of aftercare over 24 months of followup for the treatment of cocaine dependence. The third study examines the relationship between psychopathology and treatment response in women substance abusers over a two year followup period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESEARCH PROGRAM ON DRUG ABUSE INTERVENTIONS Principal Investigator & Institution: Neff, James A. Professor and Director; Ctr for Social Work Research; University of Texas Austin 101 E. 27Th/Po Box 7726 Austin, TX 78712 Timing: Fiscal Year 2001; Project Start 15-SEP-2001; Project End 31-AUG-2006 Summary: The Center for Social Work Research (CSWR) in the School of Social Work (SSW) at The University of Texas at Austin (UT) proposes a Social Work Research Development Program (SWRDP) focusing on ethnicity and psychosocial factors as they relate to strategies for improving drug abuse prevention and treatment (including treatment readiness/engagement, utilization, retention, and outcomes) for African Americans and Mexican Americans. The CSWR at UT proposes to build an infrastructure for drug abuse research in the SSW and to increase participation of UT social work faculty in interdisciplinary drug abuse research to improve the quality of interventions aimed at reducing drug abuse and addiction in the US, especially among African American and Mexican American children, adults, and families. The proposed SWRDP will consist of an administrative core designed to facilitate federally funded research and a research core designed to focus on ethnic and psychosocial factors that increase treatment utilization, retention, and outcomes. Two pilot projects on these topics are proposed to begin during year 1. Strategies to leverage current strengths of the CSWR and fill gaps in infrastructure for an enduring program of interdisciplinary drug abuse research include establishing a Multi-disciplinary Research Advisory Board, a Multi-disciplinary Steering Committee, and a Community/Consumer Liaison Committee; sponsoring a three-hour, bi- weekly training seminar on attract talented doctoral students; building on the relationships already established with community-
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based treatment providers and other institutions involved in drug abuse research (e.g., the Waggoner Addiction Research Center); establishing a small grant mechanism to support pilot projects; and building on resources within the Diversity Institute and other local groups dedicated to cultural competence in research and practice. The SWRDP responds to the need for a rigorous, interdisciplinary program of culturally sophisticated drug abuse intervention and services, research based from the social work perspective. Using the Transtheoretical Stages of Change and a ecological model, the proposed research will recognize the complex interactions among social systems including clients and their families, service providers, and service organizations, and the need for culturally relevant approaches to prevention and treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESEARCH SYNTHESIS TO ASSESS COMMUNITY DRUG PREVENTION Principal Investigator & Institution: Hallfors, Denise D. Research Associate Professor; Maternal and Child Health; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, NC 27599 Timing: Fiscal Year 2001; Project Start 15-DEC-1996; Project End 30-NOV-2002 Summary: (Applicant's Abstract) The proposed research seeks to develop methodological techniques and assess the impact of community drug programs on youth. Substantial research documents the extent of drug use among adolescents, but there is little research linking the reduction of drug problems with community interventions. Surveys of alcohol and drug use are routinely conducted by virtually every state and many local communities. Yet these represent a virtually untapped source for understanding the impact of prevention efforts. The present research proposes to develop a systematic research synthesis of extant school survey data from at least 42 communities in 10 states. The synthesis is designed to assess the effectiveness of comprehensive community-based prevention programs on drug use and attitudes among junior high and high school students. Prevention strategies in two national demonstration programs will be studied: Fighting Back, which is funded by the Robert Wood Johnson Foundation, and the Community Partnership Program, funded by the Center for Substance Abuse Prevention. School survey data from 21 treatment sites and 21 matched control sites will be meta-analyzed to calculate effect sizes and assess the impact of programs in youth drug use. Specific aims of the project are: 1) To develop a typology of community-based drug abuse prevention programs in order to test systematically their impact on youth; 2) To collect data from state- and locallysponsored school-based surveys and develop dependent variables for meta-analysis; 3) To conduct a research synthesis and assess the impact of community programs, controlling for concurrent school-based prevention programs. The use of drugs has profound negative health consequences and is associated with traffic accidents, criminal activity, infant morbidity; and the spread of HIV. It is particularly devastating for youth: the three leading causes of death for 15-24 year old are unintentional injuries, suicide, and homicide, each of which is associated with the use of drugs. Hundreds of communities have formed coalitions in an attempt to prevent these problems. Information gained from this study will be important in understanding what types of strategies are effective. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RESEARCH INTERVENTION
TRAINING
IN
ADOLESCENT
DRUG
ABUSE
Principal Investigator & Institution: Liddle, Howard A. Professor & Director; Psychiatry and Behavioral Scis; University of Miami Box 016159 Miami, FL 33101 Timing: Fiscal Year 2001; Project Start 01-JUL-1994; Project End 30-JUN-2004 Summary: Drug abuse treatment research generally and adolescent drug abuse treatment research in particular have progressed to a new developmental stage with higher scientific and clinical standards. Predoctoral and postdoctoral training programs are necessary to keep pace with the rapidly advances and challenges. This is a competitive renewal of a training program focusing on adolescent program abuse treatment research. We propose to continue our postdoctoral training program in order to prepare promising scientists to conduct psychosocial treatment research on adolescent drug abuse. The continuation of this program aims to produce a new generation of research scientists who possess the requisite conceptual, methodological and clinical skills to conduct the rigorous research necessary to test a broad range of psychosocial interventions for adolescent drug abuse. We have conducted a postdoctoral research training program since 1994 with training sites at the University of Miami and the University of Utah. We request continuation of this postdoctoral training and propose to expand our research training efforts to include a predoctoral training program. The proposed research training program will be comprised of 4 predoctoral and 9 postdoctoral trainees. The research training infrastructure of the proposed program is the newly funded University of Miami Center for Treatment Research on Adolescent Drug Abuse (CTRADA) [P-50 DA11328-01). There are 10 program faculty with considerable collaborative and research training experience. The postdoctoral program has 4 key components: core seminar, supplementary coursework, collaborative work with primary research mentor, and clinical supervision. The predoctoral program has 3 key components: coursework, research tutorial, and participation in Universitywide seminars and colloquia. The proposed program is designed to create a set of collaborative teaching and learning experiences that will not only advance research skills but also will spark an enduring commitment to an important area within the drug abuse field-adolescent drug treatment research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESEARCH TRAINING IN DRUG ABUSE BEHAVIOR Principal Investigator & Institution: Garrity, Thomas F. Behavioral Science; University of Kentucky 109 Kinkead Hall Lexington, KY 40506 Timing: Fiscal Year 2003; Project Start 01-AUG-1998; Project End 30-JUN-2008 Summary: (provided by applicant): This training program co-directed by Thomas Garrity and Carl Leukefeld proposes to support three pre- and three postdoctoral trainees with a training faculty of 21 drawn from seven different academic and research units of the University. The environment is rich with opportunities for biobehavioral research in facilities such as the Center on Drug and Alcohol Research, the Center for Prevention Research, and the Residential Research Facility. Trainees will be housed in offices of the Department of Behavioral Science and the Center on Drug and Alcohol Research with 24-hour/day access to laboratories and computer facilities; some trainees will have additional work space in the project areas of their faculty supervisors. This program is designed to prepare trainees to assume research responsibilities in academic, and other scientific organizations concerned with drug abuse and the behavioral aspects of health and medical care. Postdoctoral fellows will either have a doctorate in a
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behavioral science discipline and will be preparing for a research role in the drug abuse field, or they will be health professionals who are seeking a behavioral science research orientation in drug abuse. Predoctoral trainees will concentrate in behavioral science aspects of drug abuse as part of their program for a doctorate in a biobehavioral science discipline. Basic elements of the program include (I) research training designed to provide experience in utilizing the basic building blocks of research laboratory methods, case study, experimental design, development and pretesting of instruments, data analysis) and independent research competence; (2) a multidisciplinary orientation which takes students beyond their basic discipline and provides exposure to key theoretical concepts and methodological issues of the related biobehavioral sciences along wish a biobehavioral conceptualization; (3) a program of enculturation and orientation to drug abuse, health and mental health settings; (4) opportunities to explore drug abuse topics from a medical behavioral perspective through courses offered by training faculty; and (5) opportunities for independent research around relevant questions in drug abuse behavior that can constitute significant learning experiences for postdoctoral fellows and a dissertation project for predoctoral trainees. The program for postdoctoral fellows will be individually geared to the Objectives of the fellows and will build on their previous knowledge and experience. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RISK-FOCUSED PREVENTION DRUG ABUSE IN AGGRESSIVE YOUTH Principal Investigator & Institution: August, Gerald J. Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, MN 554552070 Timing: Fiscal Year 2001; Project Start 01-MAR-1998; Project End 28-FEB-2003 Summary: (Applicant's Abstract) The project aims to alter the developmental path of children at risk for drug abuse. A prospective, longitudinal design is used to map the development of individual and contextual mediators of drug abuse in children with early-onset aggressive behavior and residence in urban, economically disadvantaged neighborhoods. A randomized experiment is nested within this design to evaluate the differential and incremental effects of three increasingly intensive intervention models compared to a no-intervention control condition. The intervention models are: Level 1, a School-Based Academic Competence Enhancement Program, Level 2, the School-Based Program + a Family-Focused Behavioral Skills Enhancement Program, and Level 3, the School-Based Program + the Family-Focused Program + Proactive Case Management Program (FLEX). The aim of preventing drug abuse will be achieved by the amelioration of early risk factors linked to later drug abuse outcomes and the enhancement of protective factors that buffer young people against health compromising influences. The sample will include Caucasian (40%) and African American (60%) children identified by th presence of cross-setting aggressive behavior during kindergarten or first grade years (high risk subjects). The intervention models are informed by social-development, social-learning, and competence enhancemen theories and as such target child adjustment (academic achievement/bonding, selfregulatory behaviors, and social skills and parent/family process (discipline methods, involvement with child, and parent psychological well-being) that are predictive of drug abuse development. The research plan is to test an "additive strength" approach, beginning with a single component, school-based program which provides a natural setting for behavioral modification, social skills training, an activities that support learning and promote positive bonding to school. The school program provides year round coverage with an intensive 8-week Summer Program (Pelham's Summer
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Treatment Program, 1996) and a regular school year program for maintenance and generalization. To this we add a family-focused program which strengthens the family's roll in the positive socialization of the child. The family-focused program features interactive videotape modeling technique provided by Webster-Stratton (1996). Last, we add a flexibly tailored case management program which facilitates family access to health care services and community resources based on an individualized assessment of need. A multitrait multimethod approach is used to assess the convergent, discriminant and construct validity of our theoretical model. Mixed effects random regression models are used to analyze intervention effects with clustered data. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SERVICE USE BY MEN ON METHADONE COMMITING PARTNER ABUSE Principal Investigator & Institution: Wu, Elwin; None; Columbia Univ New York Morningside 1210 Amsterdam Ave, Mc 2205 New York, NY 10027 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant): In response to NIDA PA-01-097, this application details an R03 project that focuses on the service utilization of formal healthcare, mental health, and social services for men on methadone who perpetrate intimate partner violence (IPV). The proposed study will examine barriers and enhancers of service utilization among male methadone maintenance treatment program (MMTP) clients who perpetrate IPV. Drug-involved men who perpetrate IPV lie at the heart of two critical public health issues, drug abuse and IPV, that exact enormous financial and societal costs. Perpetrators of IPV represent a significant proportion of drug-involved men that may have a greater number and/or unique spectrum of service needs that differ from non-violent, drug-involved men and that remain unmet due to lack of service utilization. These needs extend beyond drug abuse and IPV to include mental and physical health and other social service needs. Most of the prior studies with perpetrators of IPV have been carried out with samples obtained from batterers intervention programs. Thus, service utilization among a more general population of men who perpetrate IPV remains unexplored. The proposed research will build upon findings from the Men's Health Project (MHP), an ongoing NIDA-funded study (PI: ElBassel) to examine over time the relationships among drug abuse, IPV, and HIV-related risks among a random sample of 355 men attending MMTPs in New York City (NYC). We propose to extend the MHP by reinterviewing MHP participants who perpetrated IPV to study factors that impact their service utilization, an area not addressed in the parent study. The proposed study also includes a qualitative inquiry with MMTP service providers to understand MMTP service providers' perspectives on factors that impede or promote service utilization among their male clients who perpetrate IPV, as well as identify potential targets of change in the MMTP service delivery system. Aims, hypotheses, and measurements in the proposed study are guided by the Network Episode Model, which conceptualizes utilization of formal services as a series of behaviors influenced by individual/social context, social network, and service system factors. This study will provide pilot findings for the development of an R01 study testing the efficacy of an intervention designed to increase service utilization among men attending MMTPs who perpetrate IPV. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SERVICES RESEARCH: PSYCHIATRIC COMORBIDITY IN DRUG ABUSE Principal Investigator & Institution: Brooner, Robert K. Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2003; Project Start 05-MAY-2003; Project End 30-APR-2008 Summary: (provided by applicant): Drug abuse treatment that incorporates adequate doses of daily methadone and weekly counseling is usually effective in managing the pervasive and devastating symptoms of opioid dependence (e.g., Simpson & Sells, 1990). Over two-decades of treatment research has also shown that the presence of a comorbid psychiatric disorder adversely impacts the overall effectiveness of this treatment modality, at least for many of these unfortunate patients (King et al., 2001; Rounsaville et al., 1986). Interventions with much hope of resolving this serious health problem must ultimately change the fact that most of these patients fail to receive any psychiatric care -- even when referred to general psychiatric settings outside of the drug abuse program. The extremely poor patient adherence to psychiatric care is a major health services problem that reaches across patients, programs and countries (e.g., Thompson et al., 2000). One promising approach to reducing the poor adherence that exposes these drug abusers to unnecessarily high levels of morbidity from untreated psychiatric disorders is a fully integrated service delivery approach. Using an integrated model of care, drug abusers with a comorbid disorder could be offered a broad range of standard psychiatric services with the drug abuse program. While practitioners and researchers extol the virtues of integrated systems of drug abuse and psychiatric care, amazingly few controlled studies have been done to evaluate the efficacy of this approach (e.g., Drake et al., 1996, Ley et al., 2001). More importantly, most of these studies were conducted in general psychiatric versus drug abuse programs, and the small number done in drug abuse settings did not use random assignment to evaluate the influence of on- versus off-site services on adherence or outcomes; and all but one of these studies (Saxon et al., 1995) offered a very narrow range of services. The proposed work will be the first known randomized evaluation of the effectiveness of an integrated drug abuse and standard psychiatric treatment approach delivered a drug abuse program. Study participants will be 396 opioid abusers with a current psychiatric disorder; all will be new admissions to the Addiction Services Treatment program (ATS). Using a two-group factorial design, participants will be randomly assigned to either the Integrated Substance Abuse and Psychiatric Care condition (ISAP-Integrated) or the Parallel Substance Abuse and Psychiatric Care condition (PSAP-Parallel). Participants in the ISAP condition will be offered standard psychiatric care in the ATS program; those assigned to the PSAP condition will be offered care in the Community Psychiatry Program (CPP), located on the same campus. The scope and amount of standard psychiatric services will be the same across treatment sites (ATS and CPP); all drug abuse services will be provided in the ATS program. Participants will be evaluated over a 12- month period and compared on a range of adherence and outcome measures: rates of initial engagement in psychiatric care and overall adherence to psychiatric services (therapy sessions and prescribed medications), adherence to scheduled drug abuse treatment services, and a range of objective and self-reported psychiatric and drug abuse treatment outcomes, including utilization rates of high cost intensive ambulatory psychiatric care, acute inpatient psychiatric hospitalization, and emergency room visits for psychiatric or drug abuse problems. This study will produce both timely and scientifically rigorous health services research data on the effectiveness of integrated psychiatric and drug abuse treatment in a drug abuse program; data from this study will inform and guide the treatment field and both local and national health
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care discussions and decisions that will impact the organization and funding of drug abuse and mental health services. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SES DISPARITIES IN ILLEGAL DRUG USE AND TREATMENT Principal Investigator & Institution: Miech, Richard A. Mental Hygiene; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (Provided by Applicant): The principal investigator seeks a career award to extend his research on socioeconomic status (SES) and health to the fields of illegal drug use and illegal drug use treatment. The training proposed in this application will allow the P.I. to use available data to address research questions that will serve as groundwork for an independent research program, which will examine dynamic links between social conditions and illegal drug use and treatment. Several mentors with complementary skills will advise the candidate. Co-sponsor Dr. James Anthony, will advise the candidate's training in the area of illegal drug use epidemiology. Co-sponsor Dr. Wallace Mandell will advise the candidate's training in the area of community drug abuse treatment programs. An advisory board on minority health, consisting of Drs. William Vega, Dorothy Browne, and Thomas LaVeist, will provide feedback on the research projects of this proposal. In addition, Dr. Jerome Jaffee will provide assistance on pharmacological programs for drug abusers, and Drs. Kung-Yee Liang and Howard Chilcoat will provide assistance on methodology. The candidate also proposes to enroll in formal coursework to complement his training. These courses include the classes that are part of Dr. Jim Anthony's NIDA-sponsored training program in illegal drug use epidemiology, as well as the classes that are part of Dr. Wallace Mandell's Hubert Humphrey training program in illegal drug use treatment programs. The candidate proposes to enroll in these courses in the first year of project, and over the following three years he proposes to fulfill the requirements for a Master's Degree in Public Health. These courses will improve the candidate's skills by exposing him to the public health methods and theoretical frameworks currently in use in the field. The training and research of this project will provide the groundwork for the candidate's long-tern goal to better identify and understand the processes linking social structure and drug use/treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SOUTHWEST INTERDISCIPLINARY RESEARCH CONSORTIUM (SIRC) Principal Investigator & Institution: Marsiglia, Flavio F. Associate Professor; School of Social Work; Arizona State University P.O. Box 873503 Tempe, AZ 852873503 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2007 Summary: (provided by applicant) The purpose of the Southwest Interdisciplinary Research Consortium (SIRC) is to conduct multi-disciplinary community-based social work research on family and youth drug use prevention and services under two priority areas: 1) culturally-grounded drug use prevention, and 2) culturally responsive and resiliency-focused drug abuse services research. Our focus is the relationship between drug use and the strengths, competencies, and other protective factors buffering against drug use and risk processes of families and youth. We are also concerned with variations within the diverse communities of the Southwest in the relationship between drug use and ethnic, gender, developmental, geographic, and other social identity
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variables. We developed the structure of SIRC to be inclusive of and responsive to the research needs and priorities identified by community-based social workers, and to work in partnership with them throughout the research, dissemination, and skill building processes in a reciprocal manner. The consortium strengthens the institutional infrastructure of the School of Social Work by enhancing the capacity of its faculty members and social workers in the community to design, develop and implement drug abuse prevention and services research in partnership with the social work community outside the university and with colleagues from other disciplines within the University. This public health initiative follows the health promotion and disease prevention objectives of Healthy People 2000 (priority areas: 3, 4, 6, and 8) and the "Initiative on Race and Health" of Healthy People 2010. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STARNET--RESEARCH EXPERIENCES FOR STUDENTS AND TEACHERS Principal Investigator & Institution: Nickerson, Deborah A. Associate Professor; Molecular Biotechnology; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: (Applicant's Abstract) The abuse of psychoactive drugs, particularly tobacco and alcohol, is a major health problem in the United States, affecting people of all ages, both directly and through their contact with family members or friends who have a drug addiction. StarNet (Student- Scientist-Teacher Authentic Research Network) will involve high school biology teachers and their students in the state of' Washington and across the country in the excitement of scientific research and provide relevant resources for teaching about drug abuse research. Specifically, StarNet program will: I. Enable high school students and their teachers to participate in authentic research projects focused on unraveling the biology of drug abuse. Building on the existing efforts of the High School Human Genome, we will involve high school students and their teachers in Washington and throughout the country in sequencing human genes related to drug abuse. We will also place six teachers per year in university labs focused on drug abuse research. 2. Foster teaching about drug abuse research by compiling and disseminating information about material and human resources for teaching about the biology of drug abuse. We will identify outstanding resources for teaching about drug abuse research, including written materials, videos, and other outreach programs. Information about resources will be made available through our program web site. 3. Develop a model for dissemination of the project and support its integration into several key partner sites throughout the USA. We have already identified several partnerships that are committed to participating in this program, including the Spokane School District (WA), Gene Connection (San Mateo County) and the Bay Area Biotechnology Education Consortium (BABEC) (CA), Virginia Polytechnic Institute and State University (VA), University of Chicago and the Chicago Museum of Science and Technology (IL). In Years 3 and 4, we will incorporate two additional partners (not yet identified). 4. Promote the growth of a supportive community of learners around this topic. To meet this goal we will build on the efforts of established outreach programs in our community (e.g. Making Connections: Expanding our Web and Addiction and the Brain: Beyond Saying No) to identify professionals in the area of drug abuse and connect them to teachers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: STUDENT ATHLETE DRUG SURVEILLANCE TRIAL Principal Investigator & Institution: Goldberg, Linn; Medicine; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2001; Project Start 05-AUG-1999; Project End 31-JUL-2004 Summary: This proposal is designed to address the increase in drug use among adolescent athletes by studying a school-based version of the random, no-advance warning drug testing program used by the United States Olympic Committee (USOC). High school athletes are a large group, comprising 50 percent of their school's enrollment. They have a high rate of substance abuse behaviors similar to the general school population, and an even higher use of 'ergrogenic' (athletic enhancing) drugs. Recognizing the high rate of substance abuse among young athletes and their 'role model' effect on other students, the U.S. Supreme Court recently upheld an Oregon School Districts' policy to randomly drug test students engaged in school-sponsored sports. Drug testing has the potential to deter adolescent substance abuse. It is genderneutral, without ethnic bias and provides a potentially powerful environmental influence. However, despite its legality and theorized effectiveness, schools are implementing drug surveillance without the benefit of randomized, prospective efficacy research. Focusing on adolescent athletes provides a unique opportunity to study the prevention effect of drug testing. All sports teams in 24 schools who agree to implement mandatory testing as school policy but have never implemented this policy, will be randomly assigned by school, to three years of either: 1) random, no-advance warning drug testing or 2) a 3-year control period without testing. Selection of students for drug testing will be random, with no exclusions for having been previously tested. State-ofthe-art testing will include physician specimen collectors under the direction of research physicians (PI and Co-I) who are Certified USOC Drug Surveillance Crew Chiefs with specimen analysis at the UCLA Olympic Laboratory using the most accurate analytical techniques to minimize false negative (reducing policy integrity) and false positive (mislabling students) results. Confidential questionnaires will be completed by studentathletes twice yearly to assess risk and protective factors for drug use and asess selfreported substance abuse. The role model effect of the surveillance program on nonathletes' drug use will be assessed twice yearly by anonymous survey. We will determine the effect of drug testing policy on: 1) adolescent drug use mediators, 2) actual drug use behaviors of student-athletes and their non-athlete peers, and 3) potential gender and demographic differences. Reliability of subjective questionnaire responses will be assessed by comparisons with objective drug test results. Study findings will assist school districts and education agencies evaluate, guide, and implement future drug prevention policy decisions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SUBSTANCE DEPENDENCE/ABUSE IN THE U.S.POPULATION Principal Investigator & Institution: Kandel, Denise B. Professor of Public Health in Psychiatry; Psychiatry; Columbia University Health Sciences New York, NY 10032 Timing: Fiscal Year 2001; Project Start 30-SEP-1994; Project End 31-JAN-2005 Summary: The National Household Survey on Drug Abuse (NHSDA) represents a major effort to monitor drug use in the population on an annual basis. In addition to patterns of drug use of legal and illegal drugs, information is also collected about symptoms of drug dependence. Except for the work conducted by our research group, the data on dependence symptoms have been little analyzed. This competing continuation proposal requests 31/2 years of support to carry out further analyses of
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multiple waves of the NHSDA to investigate selected issues related to substance dependence on four drug classes: marijuana, cocaine, cigarettes and alcohol. During the prior six years of support, we developed proxy DSM-lV definitions of substance dependence and investigated extent of drug dependence in the population in different sex, and racial/ethnic groups, the relationships of dependence to extent of use among adolescents and adults, comorbidity of psychiatric disorders, drug and mental health treatment among adults, and parental-child similarity on marijuana use and smoking. In this next period, four issues will continue to be investigated: (1) the relationship between dependence and progression along the developmental sequence of involvement in drugs; (2) the extent of familial similarity on drug behavior between parents and adolescents, siblings and spouses; (3) the comorbidity of use and dependence with selected psychiatric disorders among adolescents; (4) the natural history of nicotine dependence. Analyses will be conducted for age, sex and ethnic specific groups, and will be based on the 1999, 2000 and 2001 surveys (N=66,70670,000). The samples are almost evenly divided among 3 age groups, 12-17, 18-25 and 26 years old and over. Each survey will provide a large number of nationally representative familial dyads, about 6,000 parent-child, 4,400 sibling, and 500 marital pairs. The very large national samples of youths and minorities, the inclusion of data on nicotine, and the availability of familial dyads make possible age, gender and racial/ethnic-specific analyses, comparisons across drugs, and analyses of intra intergenerational similarity on drug use in the NHSDA rarely feasible in any other study. The research will extend our understanding of the extent of serious drug use in the nation, the etiology of substance dependence, the extent of treatment needs, the transmission of drug use across and within generations, and racial/ethnic differences in patterns of use, dependence, comorbidity and familial similarity in the population. Such questions by and large have not been treated in the epidemiological literature on drug use in the general population, which has focused almost exclusively on frequency measures of drug use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SYSTEM TO TEST MEDICATIONS DEVELOPED TO TREAT DRUG ABUSE Principal Investigator & Institution: Campbell, James S.; Biographics, Inc. 2000 W 1St St, Ste 406 Winston-Salem, NC 27104 Timing: Fiscal Year 2001; Project Start 01-SEP-1998; Project End 31-MAY-2003 Summary: (Applicant's Abstract): The goal of this project is to create a system to test potential therapeutic medications for substance abuse. Information on the neurophysiology of the sites of drug action in the brain reward circuitry in animal models is critical for understanding the process of addiction in brain and clarifying modes of therapeutic intervention designed to block the craving and negative brain affect and mood characteristics of the addiction process. The new technology will build on significant new advances in fabrication of recording probes, which have recently made possible the recording of impulse trains from large populations of single neurons in animal models of addiction to drugs. One goal is to produce an advanced real time software module for the Windows 2000 operating system capable of controlling multiple behavioral chambers for testing potential medications for substance abuse. A further aim will be to create a relational database for organizing the control of experiments and accumulating all relevant experimental data. A Website interface with JAVA- language active-server applications will enable access to data in real time at remote sites on the Internet. An existing software and hardware system for capturing data from multiple
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spike trains will be significantly enhanced, redesigned, and greatly reduced in cost to allow automated sorting and time stamping of waveforms from large populations of neurons in the mesolimbic "brain reward system" during drug self administration behavior. The goal is to allow neuron population recording to be achieved routinely during studies of behavioral actions of candidate drug medications. Technology developed will be used applications throughout basic and clinical neurophysiology, including real time control of prosthetic robotics devices. This project will lead to establishment of new procedures urgently needed for evaluating efficacy and mode of action of therapeutic drugs for substance abuse. PROPOSED COMMERCIAL APPLICATION: This multichannel software/hardware data acquisition system will allow a new mode of testing of potential medication for substance abuse. The system is equally adapted to a wide range off application in clinical neuroscience and physiological study. The ability to acquire multichannel neuron activity is managed by a real time software module that is readily adapted to robotic control of prosthetic devices. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE BEHAVIORAL PHARMACOLOGY OF PHENCYCLIDINE Principal Investigator & Institution: Balster, Robert L. Professor; Pharmacology and Toxicology; Virginia Commonwealth University Richmond, VA 232980568 Timing: Fiscal Year 2001; Project Start 01-APR-1976; Project End 31-MAR-2005 Summary: (Adapted from the Investigator's Abstract) The abuse of phencyclidine (PCP) and ketamine remain important public health problems, yet relatively less basic scientific information is available on this class of drugs than some other, more widely studied, abused drugs. One goal of our research is to continue to advance our understanding of the pharmacology of this class of PCP-like drugs. In previous years of this project, we have shown that PCP-like drugs functioned as antagonists of the Nmethyl-D-aspartate (NMDA) subtype of glutamate receptor to produce behavioral effects in animals that are relevant to their abuse potential. NMDA antagonists are possible treatments for drug tolerance and dependence. Other important indications for NMDA antagonists include use for treatment of epilepsy, head injury and stroke, anxiety and panic disorders and pain. Thus, another significant goal of our work is to provide scientific information that can lead to the development of medications that have diminished capacity for PCP-like psychological effects and abuse liability. Our strategy for doing this is to compare the behavioral pharmacology of NMDA antagonists that act at various sites on the NMDA receptor complex, including PCP-site channel blockers which vary in affinity and other important characteristics, competitive antagonists, glycine-site antagonists, polyamine-site antagonists as well as NMDA receptor subtype selective agents using well validated animal testing procedures in rats and rhesus monkeys. These types of drugs will be compared using 1) Drug discrimination in rats and rhesus monkeys using NMDA antagonists as training drugs, 2) Drug vs. drug discrimination in rats and rhesus monkeys to further differentiate similar drug effects identified in drug vs. no-drug discrimination, 3) Intravenous drug self-administration in rhesus monkeys, 4) Drug discrimination in rats using novel GABAergic drugs, 5) Tests for anti-anxiety effects using a multiple drug discrimination-punished responding schedule in rats, and 6) Tests for effects on the efficacy of intravenous cocaine reinforcement in rhesus monkeys using a procedure which will also allow assessment of effects on conditioned reinforcement which might be involved in cocaine craving. This latter study is part of a planned continued collaboration with scientists at the Pavlov Medical University in St. Petersburg supported under a Fogerty Center grant tied to this
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project. Finally, the hypothesis that subtypes of NMDA receptors comprised of NR2A subunits are important for mediating PCP discrimination will be tested using antisense procedures directed to knocking down the expression of this and other subunits. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE ECONOMICS OF POLYDRUG ABUSE Principal Investigator & Institution: Meisch, Richard A. Professor; Psychiatry and Behavioral Scis; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, TX 77225 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2003 Summary: (Applicant's Abstract) This new application concerns the use of behavioral economics to analyze polydrug abuse. Two groups of 5 rhesus monkeys will be used in parallel studies of polydrug abuse. One group of monkeys will have access to methamphetamine and the other group will have access to methadone. The delivery of drugs will be contingent upon the completion of fixed-ratio schedules. Under a fixedratio schedule delivery of the reinforcer is contingent upon making a fixed-number of responses. In the present application completion of fixed-ratio schedules will result in the delivery of 0.67 ml of liquid. Depending upon the experimental conditions, the liquid will be water or a solution of drug. Two liquid delivery systems will be present thereby giving the monkey a choice between liquids. In Study 1, either a solution of methamphetamine vs. water, or a solution of methadone vs. water will be present. The concentration of the drug solutions will be varied and also the number of response (i.e. fixed-ratio size) required per liquid delivery will also be systematically changed. The results will be plotted in terms of the drug amount consumed at different prices (i.e combinations of fixed-ratio size and drug concentration). In the next set of studies a series of drug pairs will be analyzed as the price for one drug is changed to different values and the price of the other drug is held constant. In these studies the monkeys will have the option of taking two drugs or just one drug or neither. The focus is on the interactions between intake of drug and their prices. The overall aim is to determine what combinations of drugs are taken when the cost of each drug is varied. The results will demonstrate a systematic and quantitative strategy for the analysis of polydrug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE ROLE OF EXECUTIVE FUNCTIONS IN COCAINE ABUSE Principal Investigator & Institution: Garavan, Hugh P. Psychiatry and Behavioral Med; Medical College of Wisconsin Po Box26509 Milwaukee, WI 532264801 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 30-JUN-2005 Summary: (provided by applicant) Cocaine abuse continues to be a substantial medical and social problem in the USA and elsewhere. Despite increasing knowledge of the pharmacological basis of cocaine's effects and of the environmental and socioeconomic factors in drug abuse, relatively little attention has been given to the cognitive factors that are involved in addiction. It is proposed that a substantial cognitive component of human addiction is a dysexecutive loss of control, that is, an inability to control one's own behavior in light of the strong motivation to consume drug. It is hypothesized that these executive processes are compromised in cocaine users which facilitates the continuation of the drug habit and are also compromised acutely following cocaine administration, which facilitates the duration of a particular drug binge. To address these issues, a series of studies are proposed that will examine those aspects of the executive control of behavior that are considered most germane to drug addiction using
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tasks that selectively isolate the executive function of interest to minimize the contribution of non-executive processes to task performance. As well as addressing the basic cognitive phenomena, these studies will also address the neuroanatomical substrates of these (dys)functions using functional MRI. Aims of this research include determining if cocaine users are impaired in executive control of behavior relative to drug-naive controls and if cocaine users are acutely impaired following a cocaine administration relative to their own baseline. Aspects of executive control will include the ability to (a) switch focal attention from one item of thought (i.e., a currently active working memory representation) to another item; (b) exercise control over strong prepotent urges; and (c) maintain endogenously driven attention. A further aim is to understand the neurobiological changes that occur in the onset of automaticity and how this may relate to drug addiction. Habit based behavior can be described as the loss of executive control as certain behaviors become automatized and fall under exogenously cued control. The neuroanatomy of this transition from controlled to automatic behavior and how it features in the onset of drug addiction is not well understood and has implications for how drug use tends to evolve into habitual behavior over which the drug user may feel and appear powerless. It is proposed to characterize the basic mechanisms of this transition and to assess the cocaine user's ability to re-establish executive control over what have become automatic processes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THERAPEUTIC POTENTIAL OF KAPPA-OPIOIDS AGAINST COCAINE Principal Investigator & Institution: Walsh, Sharon L. Associate Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 30-SEP-1996; Project End 31-JUL-2003 Summary: (Applicant's Abstract) While recent epidemiological studies suggest that the prevalence of illicit cocaine use has plateaued over the past few years, cocaine abuse continues to pose a significant public health problem in the United States. Despite a vigorous research effort directed towards developing an effective medication, no pharmacotherapies to date have well demonstrated clinical efficacy against cocaine abuse. This project proposes to evaluate the potential efficacy of kappa-opioid compounds to alter the euphorigenic effects of cocaine and to reduce cocaine use. There is a substantial amount of preclinical evidence which suggests that compounds with kappa-opioid activity can decrease the neurochemical, behavioral, and reinforcing effects of cocaine. A series of four controlled laboratory studies are proposed that will systematically evaluate the safety and efficacy of two kappa agonists in humans when given alone and in combination with cocaine. Enadoline, a novel agent which acts selectively at kappa sites as a full agonist, and butorphanol, an agent with mixed opioid activity which acts as a partial agonist at kappa sites, will be tested. An initial withinsubject dose-ranging study will evaluate and compare the safety and pharmacodynamic profiles of enadoline and butorphanol over a range of doses. The second study will evaluate and compare the effects of enadoline and butorphanol when administered under acute dosing conditions in combination with cocaine in an effort to determine the safety of concomitant administration of these agents. This within-subject study will also assess the ability of enadoline and butorphanol to alter the subjective response to intravenous cocaine and cocaine self-administration, as an index of their potential efficacy for reducing cocaine use. The third and fourth studies will evaluate the safety of chronic treatment with enadoline and butorphanol, respectively, characterize the tolerance that develops following chronic administration of these drugs, and evaluate
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their ability to alter cocaine self-administration and the pharmacodynamic effects of cocaine during chronic dosing. These studies will contribute importantly to our understanding of the interaction between cocaine and kappa opioids in humans and will systematically evaluate this class of drugs for their potential efficacy against cocaine abuse. These studies are relevant to the treatment of cocaine abuse and may lead to the development of an effective pharmacotherapy, thereby, reducing the HIV and other health risks associated with cocaine abuse and intravenous drug abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRAINING PROGRAM IN NEUROBIOLOGY OF DRUG ABUSE Principal Investigator & Institution: Kuhar, Michael J. Candler Professor of Pharmacology; Pharmacology; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2003; Project Start 07-JUL-2003; Project End 30-JUN-2008 Summary: (provided by applicant): This new Training Program in the Neurobiology of Drug Abuse focuses on brain mechanisms of drug use/abuse/dependence. The Program is interdisciplinary and offers training in gene expression, gene profiling, drug receptors, signal transduction, neurotransmitters and neuroanatomy of reward/reinforcement, animal models, behavioral effects of drugs, medications development, and brain imaging in animals and humans. The goal is to produce scientists who have a depth of expertise in their respective approach and a breadth of expertise in the neurobiology of drug abuse. In addition to an emphasis on technical research skills, this program will develop written and oral communications skills, the ability to critically assess papers, data and applications, familiarity with grant/contract/application writing, ethical awareness and knowledge of the cutting edge research problems and questions in the field of drug abuse. "Hands-on" research, courses, journal clubs and meetings comprise the training. The Training Faculty derives from five departments and has a record of outstanding achievements. The core of the Faculty consists of long-standing NIDA-funded investigators, as well as other strong investigators whose work intersects the Drug Abuse area and who have a strong interest in expanding their work more formally in drug abuse. The Faculty includes experienced Full and Associate Professors as well a,' more junior investigators who add substantial expertise and who are committed to developing a program in Drug Abuse research. The Program is designed to support four predoctoral fellows after they have completed their Doctoral Qualifying exams, usually at the end of their second year. In addition, it is designed to support six postdoctoral fellows. The duration of support for any given trainee will vary from one year (the minimum) to three years (rarely, and the maximum) so that many trainees will have the opportunity for support. A large percentage of our previous trainees have desirable positions and have been very productive. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TRAUMA AND ADDICTED FEMALE OFFENDERS TREATMENT OUTCOME Principal Investigator & Institution: Budney, Susan E. Psychiatry; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2003 Summary: (provided by the applicant) This study examines the frequency and severity of interpersonal violence, substance addiction, Posttraumatic stress disorder (PTSD) and
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trauma-related symptoms, and their impact on treatment outcome among female offenders in an Alternative to Incarceration (ATI) program. There is evidence that interpersonal violence can lead to substance addiction and criminal behavior. Females are more likely than males to be victims of interpersonal violence, and to develop traumatic reactions. Substance abuse comorbidity with posttraumatic stress disorder has been associated with poorer treatment outcomes for substance abusing women. A large concentration of woman offenders have reported histories of interpersonal violence and drug addiction, however, methodology assessing these variables has been unsophisticated and probably underestimate rates. In addition, the impact of trauma upon drug treatment outcome is little understood and has never been studied for this population. This is an urgent need as failure in these programs means not only relapse into substance abuse, but also a return to criminal behaviors so often partnered with it. This study will achieve three aims 1) to systematically and comprehensively assess the prevalence and severity of a history of interpersonal violence and substance use among drug addicted women in an ATI drug treatment program, 2) to measure the current frequency and severity of posttraumatic stress disorder, dissociation, affect dysregulatin and interpersonal dysfunction within this same population, and 3) to assess the potential contribution of interpersonal violence history, trauma symptom, and substance abuse upon treatment outcome. Treatment outcome variables include drop out, substance relapse, criminal recidivism, and achievement of work and/or education goals. Fifty (50) women participating in an ATI drug treatment program will undergo approximately 5 hours of interviewing to assess the above interpersonal violence/substance abuse history and clinical symptoms. Outcome data will be collected through staff reports and chart documentation. The long-term goal is to use information from this study to develop an integrated treatment to serve the multiple needs of female offenders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRAUMA AND PTSD IN SUBSTANCE ABUSE TREATMENT Principal Investigator & Institution: Peirce, Jessica M. Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2003; Project Start 10-SEP-2003; Project End 30-APR-2008 Summary: (provided by applicant): This proposal is a NIH-NIDA application for a Mentored Patient-Oriented Research Career Development Award (K23) for Jessica Peirce, Ph.D. The proposed work will take place in an impressive academic and clinical environment and the excellent mentoring team will be led by Dr. R. K. Brooner, a widely-respected clinician and drug abuse treatment researcher. His expertise in psychiatric comorbidity, associations between comorbidity and drug abuse treatment and in the development of novel treatment approaches is exceptionally well-suited to my career goals. The co-mentors provide critical scope and depth to the team. Dr. Stitzer is an internationally recognized expert in the behavioral treatment of drug abuse and an accomplished writer and research mentor. Dr. Svikis is a respected drug abuse researcher with an expertise in the assessment and treatment of women. The career development plan involves three integrated and temporally overlapping areas of work. Component one involves completion of an organized series of JHU academic courses on the development and conduct of clinical trials involving human subjects. The second component involves implementation and conduct of three studies of drug abusers. These studies address four interrelated questions on psychiatric comorbidity, drug abuse treatment-seeking and drug abuse treatment response in women versus men: 1) what are the best strategies for assessing trauma exposure and Posttraumatic Stress
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Disorder (PTSD)?; 2) what is the role of trauma and PTSD in treatment-seeking?; 3) what is the role of trauma and PTSD in response to routine drug abuse treatment?; and 4) how do gender and gender-related characteristics relate to trauma and PTSD and to drug abuse treatment-seeking and response? Study 1 evaluates two procedures for assessing traumatic event exposure and PTSD, both of which are used clinically but have not been systematically studied. Study 2 evaluates the effect of previous and ongoing traumatic event exposure and PTSD on drug abuse treatment-seeking. Study 3 evaluates the impact of prior and ongoing traumatic event exposure and PTSD on response to routine drug abuse treatment interventions. Interactions with gender and gender specific characteristics will be systematically investigated in each study. The third component will be marked by the submission of an R01 or similar type of grant to evaluate interventions to reduce the negative impact of pre-treatment and in-treatment characteristics in women and men and improve treatment-seeking and drug abuse treatment response. Accomplishing these three goals will document my progression to an independent patient-oriented researcher and recognized expert in the assessment and treatment of drug abusing women and men with PTSD and other comorbid disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATING ADDICTIONS OF SERIOUSLY MENTALLY ILL ADULTS Principal Investigator & Institution: Havassy, Barbara E. Director; University of California San Francisco 500 Parnassus Ave San Francisco, CA 94122 Timing: Fiscal Year 2002 Summary: (Applicant?s Abstract) The proposed randomized clinical trial is to test the effects of augmenting case managers? usual treatment of seriously mentally ill drug abusing patients by providing a distinctive intervention for drug abuse. The treatment, Behavioral Treatment for Substance Abuse in Schizophrenia--BTSAS (Bellack, Gearon, Everist, Alexander, 1998), is a six month intervention, provided in group format, designed to teach basic skills to facilitate reduction in drug use, to cope with stress, and to heighten awareness of negative consequences of substance abuse including increased risk of exposure to HIV. BTSAS (BT) is a promising, behavioral skills training treatment, developed under a NIDA treatment development grant DA09406 (Bellack) that has the advantage of a comprehensive and explicit manual to guide provision of treatment and training of therapists. The study will extend an established line of inquiry concerning effective treatments for drug-dependent seriously mentally ill adults. It is consistent with the focus of the TRC on treatment for complex drug-abusing patients, in clinical settings that have not typically provided specialized treatment for drug abuse and congruent with the TRC?s orientation towards cognitive behaviorally based interventions. The study will assess the effectiveness of adding BT to case management as usual and will test whether BT: (1) can be successfully exported to clinical case management settings; (2) can effect reduction in drug use and in the practice of AIDS risk behaviors; and (3) is associated with alterations of service utilization patterns that reflect a reduction in crisis treatment episodes and in treatment costs. Furthermore, the study will test whether BT: (4) is associated with improved quality of life; and (5) will have differential effects for participants who are cocaine-dependent. Primary hypotheses concern psychosocial and service utilization outcomes, and BT treatment processes. Secondary hypotheses concern status of cocaine-dependent participants relative to other study participants. This study is enhanced by Dr. Bellack?s consultation and by being integral to the scientific endeavors of the TRC. The collaborative style of the TRC will inform development of a smoking treatment intervention to be piloted in collaboration with Dr. Hall and the development of process measures with Dr. Sorensen
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to study case management for drug abusers. Core support for hypotheses testing and economic analyses will ensure the methods applied here will be among the most powerful. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATMENT MOTIVATION IN DRUG USERS Principal Investigator & Institution: Longshore, Douglas Y. Senior Behavioral Scientist; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAY-2004 Summary: It is commonly believed that treatment success depends in part on the client's motivation during a given episode of treatment and over the course of the treatment career. But client motivation has shown only modest predictive value in drug treatment research, and the concept of treatment motivation is not yet well understood with regard to drug users. We believe its relevance and meaning will become more clear if three issues are pursued. First, the predictive strength of treatment motivation may vary in relation to drug users' treatment careers or other characteristics. Second, treatment motivation and external pressure for treatment, e.g., legal coercion, may have important interactive effects. Third, stage-of-change research has identified cognitive variables that appear to be important correlates of recovery from smoking and alcohol abuse-with and without formal treatment. Similar research on the stages and correlates of change in drug users may help us understand why some who want to stop using drugs decide to seek treatment while others try to quit on their own. This project consists of three complementary studies. Study A will explore the psychometrics of treatment motivation measures as a function of drug users' treatment careers and other characteristics. For this study we will conduct extensive analyses of in-house datasets. Study B will use focus-group methods to better understand aspects of treatment motivation that remain unclear in Study A and will use survey methods to test revised treatment motivation measures, if needed, as well as measures of other cognitive variables. Study C will test the predictive value of treatment motivation. Specific aims are: (1) Evaluate the psychometrics of treatment motivation measures in relation to drug users' treatment careers and other characteristics; (2) Examine the relationship between treatment motivation and stages of behavior change among drug users; (3) Examine cognitive variables (processes of change, abstinence self-efficacy, temptation to use drugs, attitudes toward quitting drug use, external pressure for treatment, expected benefit of treatment, and moral beliefs) that may underlie treatment motivation and stage of change among drug users; and (4) Assess the predictive value of treatment motivation in relation to users' treatment careers, primary drug, race/ethnicity, external pressure for treatment, stage of change, and other cognitive variables. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TREATMENT OF SUBSTANCE ABUSE AND PSYCHIATRIC COMORBIDITY Principal Investigator & Institution: Levin, Frances R. Q. J. Kennedy Associate Professor of Cli; Psychiatry; Columbia University Health Sciences New York, NY 10032 Timing: Fiscal Year 2001; Project Start 16-AUG-2000; Project End 31-JUL-2005 Summary: The overall aim of this proposal is to support the continuing development of the applicant as a research clinician and independent scientist in the field of drug abuse treatment. Two themes drive the applicant's work: 1) pharmacotherapies need to be
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developed that consider the heterogeneity of drug addicted samples and target specific subgroups, and 2) a better understanding of the biological and behavioral antecedents that contribute to drug abuse among certain vulnerable populations warrant investigation. Most medication development efforts to date have approached drug dependence as a unitary syndrome and have tested treatments in unselected samples. Many drug dependent individuals remain refractory or only partially responsive to this approach. Further, even among treatments with proven efficacy (e.g., methadone), certain subpopulations may do less well with these interventions and would benefit from a targeted intervention. During the proposed K02, the applicant will continue an ongoing line of inquiry by directing two studies to determine whether the identification and treatment of adult ADHD improves drug use outcome and psychopathology in opiate (DA-11444) and cocaine dependent (DA-11755) samples. Extending this approach to other comorbid disorders, the applicant will collaborate with junior investigators who are targeting ppharmacotherapies to nicotine- dependent schizophrenic patients, and marijuana and cocaine abusing individuals with schizophrenic and schizoaffective illness. Working with experienced investigators, the applicant plans to 1) use SPECT imaging to assess the neurobiologic dysfunction associated with ADHD and/or cocain abuse, and 2) better understand the sensitivity that vulnerable populations of women may have to alcohol and anxiolytic medications. Finally, the applicant will continue to contribute to a variety of educational activities and collaborate with young clinical investigators within the Division on Substance Abuse at Columbia University. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TRICITY STUDY OF CLUB DRUG USE, ABUSE AND DEPENDENCE Principal Investigator & Institution: Cottler, Linda B. Professor of Epidemiology in Psychiatry; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-JUL-2005 Summary: (provided by the applicant): Surveillance data from the field's best monitoring systems are detecting alarming increases in the rates of "club drug use" among young adults; yet, we know little about club drug abuse and dependence. Such information is essential to a relevant public health response. The proposed "Tri-City Study" will be the first study of the applicability, reliability and validity of abuse and dependence concepts as they apply to specific "club drugs." Specifically, a multisite study is proposed among 450 recent Ecstasy and other club drug users, 15 to 30 years of age, in areas indicated by NIDA's Community Epidemiology Workgroup (CEWG) as emerging or current areas of high risk -- St. Louis, Seattle and Miami -- to: 1) Describe the nature and extent of self-reported dependence on and abuse of Ecstasy, GHB, rohypnol and ketamine. This will be accomplished by determining whether "cookie cutter" diagnostic criteria used for other illicit drugs (such as described in DSM-IV, III-R, III, and ICD-10 and the Edwards-Gross Dependence Syndrome) are generalizable to individual club drugs, and to what extent users report the hallmark symptoms of dependence and abuse such as tolerance, withdrawal, craving, loss of control and social consequences; 2) a) Expand the Substance Abuse Module (SAM) to assess abuse of and dependence on specific club drugs and b) determine the psychometric properties (reliability and validity) of these disorders; 3) Understand the reasons for inconsistent answers and misunderstood questions; 4) Develop and test a Risk Behavior Assessment to facilitate the collection of risk factor data relevant to club drug use, abuse and dependence; 5) Conduct qualitative research on the unique contextual factors that relate to club drug use, in each site, to help inform revisions to the SAM and the RBA; 6)
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Disseminate the aggregate findings to the drug abuse field. Such efforts, considered mundane to many in the drug abuse field, are critical at this early stage of the club drug epidemic. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: UCLA DRUG ABUSE RESEARCH TRAINING CENTER Principal Investigator & Institution: Rawson, Richard R. None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2002; Project Start 01-SEP-1996; Project End 30-JUN-2006 Summary: This application seeks funding for the continuation and expansion of the UCLA Drug Abuse Research Training program (NIDA 1-T32-DA07272), which has grown to maturity since its inception in 1991 and its renewal and expansion in 1995. The numbers, credentials, and qualifications of the pool of applicants have steadily increased, with each new cohort possessing a range of skills that is broader than the previous cohort. The goals of the training program have been met in each year of the program and over the course of the program history. The interdisciplinary, comprehensive training environment sought in the original and renewal applications has steadily coalesced and will be even more thoroughly ingrained with the ongoing addition of more neuroscience-oriented faculty and neurobiological research training opportunities. These enhancements have been successfully integrated into the program, and training has been provided in virtually all areas of drug abuse research, ranging from neurobiology to social policy. The curriculum and the program ethos promote the interdisciplinary training of the fellows, representing a unique training ecology with many ongoing research projects offering fellows considerable opportunity to enhance and broaden their substantive knowledge of drug abuse research, expertise in research methodologies, and practical skills associated with successful scholarship. The informal linkage of UCLA drug abuse researchers created for the current training grant over the past decade served as a formative organizational structure for a much larger substance abuse research entity at UCLA; the amalgamation of affiliated substance abuse researchers at UCLA was formalized in November 1999 into a major institutional research center within the UCLA Department of Psychiatry and Biobehavioral Sciences. This center, the UCLA Integrated Substance Abuse Programs (ISAP), includes 48 M.D. and Ph.D. substance abuse researchers and a multi-site treatment service delivery capacity, making it one of the largest groups in the country specializing in the topic of substance abuse disorders. ISAP will serve as the new organizational home of the training grant continuation requested in this application. The continuation of the training program as the Drug Abuse Research Training Center will advance the field by developing the skills and acumen of the next generation of drug abuse researchers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: UTILIZATION AND COST OF HEALTH SERVICES BY CDUS Principal Investigator & Institution: Bradford, W. David. Associate Professor; Health Administration and Policy; Medical University of South Carolina 171 Ashley Ave Charleston, SC 29425 Timing: Fiscal Year 2003; Project Start 15-MAR-2002; Project End 29-FEB-2004 Summary: (provided by applicant) A conventional view in the U.S. is that, ceteris paribus, individuals with a behavioral health problem(s), such as drug addiction, consume excessive amounts of health care relative to individuals who do not have a behavioral health problem. Although little research has examined this issue employing
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quality data or contemporary statistical methods, a few recent studies have demonstrated that chronic drug users (i.e., weekly or more frequent use of illicit drugs during the previous year) generally consume more expensive health care (e.g., emergency room visits, inpatient hospital days), but less routine and preventative care (e.g., outpatient clinic and physician visits) (French, McGeary, et al., 2000; McGeary and French, 2000; French, et al., forthcoming). According to one study conducted on chronic drug users in Miami, Florida (French, McGeary, et al., 2000), the estimated differential in the cost of health services utilization may amount to over $1,000 per year. Given the need for current and nationally representative information on the type and cost of health services utilization by drug abusers, this research application will estimate differentials in utilization and cost of health services by chronic drug users relative to non-chronic drug users and non-drug users using the most recent public use file of the National Household Survey on Drug Abuse (i.e., 1999). The proposed secondary analysis study has important policy implications because little scientific information is available on the utilization and cost of health services by chronic drug users. Such information is crucial for policy makers, substance abuse program personnel, and health care providers as they consider and decide on addiction interventions. The research significance is also high because recent studies have used contemporary health services research methods to estimate the utilization and cost of health care for drug users. However, since these studies have analyzed regional data, it is important to determine whether the regional results are similar to estimates derived from national data. Finally, the examination of chronic drug users versus non-chronic drug users and all drug users contributes to the growing recognition among substance abuse researchers and treatment providers that drug users should not be treated as a 1 homogeneous group. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VIDEO-BASED TEACHER TRAINING IN DRUG PREVENTION Principal Investigator & Institution: Dusenbury, Linda A. Senior Researcher; Tanglewood Research, Inc. 7017 Albert Pick Rd, Ste D Greensboro, NC 27409 Timing: Fiscal Year 2003; Project Start 20-SEP-2000; Project End 31-MAR-2005 Summary: (provided by investigator): Research-based drug abuse prevention programs are now widely disseminated; however, adopting and implementing a research-based program does not, by itself, guarantee that desired outcomes will be achieved. Research on fidelity of implementation reveals that teachers are not sufficiently well trained in drug abuse prevention theory and practice. As a consequence, they experience difficulties even when implementing otherwise promising prevention programs. If the goals of drug abuse prevention are to be realized, teachers and other service providers need high-quality training. This project will produce a training program for prevention professionals. The goal of this program is to improve the integrity with which a wide variety of research-based prevention programs are implemented. This goal will be achieved through the creation of a high-quality media-enhanced program. Researchbased interventions each have unique characteristics; however, most share a common set of underlying concepts and methods. The research team will complete the development of six multimedia programs that address core concepts and methods of drug abuse prevention. They will also develop a manual for guiding the complete implementation of a teacher training course. The course will instruct and motivate teachers to use research-based prevention strategies effectively. As a result of this training, teachers are expected to make significant gains in understanding. Teachers are expected to implement research-based approaches to drug abuse prevention with
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greater competence and fidelity. The course will be tested in a randomized field trial. Two organizations that specialize in training will deliver the course to 120 teachers; 120 teachers in a comparison condition will receive training-as-usual. The field trial will test the ability of the package to change teachers' knowledge, beliefs and intentions. A substudy will examine changes in teaching practice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VISUALIZING ADDICTION: IMAGING FOR SECONDARY SCIENCE ED. Principal Investigator & Institution: Moore, Steven D.; Center for Image Processing in Education in Education Tucson, AZ 85712 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2003 Summary: The goal of the Science Education and Drug Abuse Partnership Award program (SEDAPA) at the National Institute on Drug Abuse (NIDA) is to ".support the development of model programs and materials that engage working scientists in enhancing public understanding of research related to drug abuse and encourage young people to enter careers in science, particularly drug abuse research" (NIDA 1993). SEDAPA directly supports NIDA's mission of improving drug abuse and addiction prevention, treatment and policy (NIDA 1998) and places the institute in a central role of educating youth about the risks and effects of using addictive substances. The Center for Image Processing in Education (CIPE) proposes to add to NIDA's offerings Visualizing Addiction, a set of supplementary instructional materials for science education in grades nine through twelve. Visualizing Addiction will involve students in active learning about neuroimaging science. This branch of addiction research is revolutionizing how scientists, medical practitioners, and social services professionals view addiction. Working in research teams, the students will simulate and replicate neuroimaging research conducted by NIDA-supported scientists. Because the students will be working with images derived from actual research subjects, the impact of the curriculum will be immediate and concrete. Visualizing Addiction will provide students with a way to renew their relationship with science, improve their science and technology literacy, alter their perceptions of drug use and abuse, and imagine themselves in careers as drug abuse researchers. The materials will be packaged in a notebook of ten lessons ready to implement in the classroom. A modular format will be developed so that the lessons may be used in a traditional biology class, a senior biology research class, or by health educators who wish to add neuroimaging science content to their curricular format. The lessons will be correlated with relevant education standards. A CD-ROM of digital images and software needed for the lessons will be included with each notebook CIPE's established dissemination system will provide nation-wide distribution of the materials via the Internet, national conferences, and telephone orders. Educators will be supported in the implementation of Visualizing Addiction by professional development workshops held at national meetings of science educators and at regional workshop sites. A comprehensive evaluation program will identify student outcomes gained from use of Visualizing Addiction in the classroom. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: YOUNG ADULTS AND DRUG USE: CAREERS AND FAMILIAR FACTORS Principal Investigator & Institution: Sterk, Claire E. Professor and Chair; None; Emory University 1784 North Decatur Road Atlanta, GA 30322
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Timing: Fiscal Year 2001; Project Start 05-AUG-1996; Project End 31-MAY-2005 Summary: This competing continuation application builds on our past research on multigenerational drug use among mothers and daughters by distinguishing between different stages of drug involvement, including resistance to involvement, initiation, continuation or discontinuation, escalation or resistance to escalation, dependence, cessation, and relapse. The approach will allow for the identification of factors which determine an individual's susceptibility and resistance at each stage of drug involvement from the users' perspective. The proposed research also builds on our past work by including of a nested-family approach, which will allow for an exploration of the family domain and gender. Finally, we will supplement the predominantly qualitative data collection with quantitative measures. The specific aims of the proposed study are: (1) to examine the developmental progression of drug involvement among young adult cocaine users (the probands) and two of their first-degree relatives, including factors motivating and hindering the transition between stages of involvement; (2) to identify familial patterns of substance use among young adult cocaine users and their first-degree relatives; and (3) to explore the medical consequences of drug abuse among the probands and their first-degree relatives. The study sample will consist of 360 individuals: (120 probands, 120 biological parents, and 120 biological siblings). The data collection includes a limited quantitative component and a qualitative, in-depth interview. Quantitative assessments will cover demographic characteristics, family characteristics, lifetime and recent drug use, HIV/AIDS and hepatits B and C risk behaviors, substance abuse and selected psychiatric disorders. The interview guide will cover domains such as family of origin, family tree, life stages -including early years, childhood, adolescence, and young adulthood, drug use -including tobacco and alcohol and with a focus on the drug use career trajectory, and health --including HIV/AIDS, hepatitis B and C, and mental health, specifically anxiety, antisocial personality disorder, depression, and post-traumatic stress disorder). Qualitative data analysis involves grounded theory and quantitative analyses includes descriptive statistics, least square analysis, and confirmatory factor analysis. The proposed study contributes to the research on the origins and multiple pathways to drug abuse and of factors (individual and familial) which may determine susceptibility and resistance at the various stages of drug involvement. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “drug abuse” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for drug abuse in the PubMed Central database: 3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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D is for drug addiction --- and disability. by Berger PB. 2001 May 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=81106
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Decreased expression of the transcription factor NURR1 in dopamine neurons of cocaine abusers. by Bannon MJ, Pruetz B, Manning-Bog AB, Whitty CJ, Michelhaugh SK, Sacchetti P, Granneman JG, Mash DC, Schmidt CJ. 2002 Apr 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=122957
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Drug supply and drug abuse. by Copeman M. 2003 Apr 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=153673
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Drug supply and drug abuse. by Wood E, Tyndall MW, Schechter MT. 2003 Apr 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=153674
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Right-sided endocarditis caused by Staphylococcus aureus in drug abusers. by Fortun J, Perez-Molina JA, Anon MT, Martinez-Beltran J, Loza E, Guerrero A. 1995 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=162572
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with drug abuse, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “drug abuse” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for drug abuse (hyperlinks lead to article summaries): •
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A biological view of drug abuse. Author(s): Altman J. Source: Molecular Medicine Today. 1996 June; 2(6): 237-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8796896&dopt=Abstract
PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A case-control study on alcohol and psychiatric disorders as risk factors for drug abuse pattern. Author(s): Lopes CS, Sichieri R. Source: Cadernos De Saude Publica / Ministerio Da Saude, Fundacao Oswaldo Cruz, Escola Nacional De Saude Publica. 2002 November-December; 18(6): 1571-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488883&dopt=Abstract
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A development perspective on adolescent drug abuse. Author(s): Baumrind D, Moselle KA. Source: Adv Alcohol Subst Abuse. 1985 Spring-Summer; 4(3-4): 41-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4013874&dopt=Abstract
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A discrete choice model of drug abuse treatment location. Author(s): Drug Alcohol Depend. 1999 Jan 7;53(2):171-87 Source: Health Services Research. 1998 April; 33(1): 125-45. /entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10080043
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A drug abuse prevention strategy for rural America. Author(s): Biglan A, Duncan T, Irvine AB, Ary D, Smolkowski K, James L. Source: Nida Res Monogr. 1997; 168: 364-97. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9260173&dopt=Abstract
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A review of the evaluation of 47 drug abuse prevention curricula available nationally. Author(s): Dusenbury L, Falco M, Lake A. Source: The Journal of School Health. 1997 April; 67(4): 127-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9130189&dopt=Abstract
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A study on drug abuse among the undergraduate medical students in Calcutta. Author(s): Naskar NN, Bhattacharya SK. Source: J Indian Med Assoc. 1999 January; 97(1): 20-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10549182&dopt=Abstract
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A survey of vocational rehabilitation counselors concerning American Indian and Alaska Native clients with alcohol and other drug abuse disorders. Author(s): Schacht RM, Gaseoma L. Source: Am Indian Alsk Native Ment Health Res. 1997; 7(3): 50-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9141300&dopt=Abstract
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A typology of St. Louis arrestees surveyed through the arrestee drug abuse monitoring (ADAM) program. Author(s): Yacoubian GS Jr. Source: Journal of Drug Education. 2000; 30(2): 247-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10920602&dopt=Abstract
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A unique hepatitis A virus strain caused an epidemic in Norway associated with intravenous drug abuse. The Hepatitis A Study Group. Author(s): Stene-Johansen K, Skaug K, Blystad H, Grinde B. Source: Scandinavian Journal of Infectious Diseases. 1998; 30(1): 35-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9670356&dopt=Abstract
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Abnormal T2 relaxation time in the cerebellar vermis of adults sexually abused in childhood: potential role of the vermis in stress-enhanced risk for drug abuse. Author(s): Anderson CM, Teicher MH, Polcari A, Renshaw PF. Source: Psychoneuroendocrinology. 2002 January-February; 27(1-2): 231-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11750781&dopt=Abstract
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Adolescent alcohol and drug abuse and health. Author(s): Aarons GA, Brown SA, Coe MT, Myers MG, Garland AF, Ezzet-Lofstram R, Hazen AL, Hough RL. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 1999 June; 24(6): 412-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10401969&dopt=Abstract
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Advancing from the ventral striatum to the extended amygdala. Implications for neuropsychiatry and drug abuse. Introduction. Author(s): McGinty JF. Source: Annals of the New York Academy of Sciences. 1999 June 29; 877: Xii-Xv. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10415639&dopt=Abstract
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Alcohol & drug abuse. HIV infection and risky sexual behaviors among women in treatment for noninjection drug dependence. Author(s): Malow RM, Jager KB, Ireland SJ, Penedo F. Source: Psychiatric Services (Washington, D.C.). 1996 November; 47(11): 1197-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8916235&dopt=Abstract
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Alcohol & drug abuse: a preliminary investigation of cocaine craving among persons with and without schizophrenia. Author(s): Carol G, Smelson DA, Losonczy MF, Ziedonis D. Source: Psychiatric Services (Washington, D.C.). 2001 August; 52(8): 1029-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11474045&dopt=Abstract
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Alcohol & drug abuse: alcohol, the “Un-Drug”. Author(s): Farabee D, Prendergast M, Cartier J. Source: Psychiatric Services (Washington, D.C.). 2002 November; 53(11): 1375-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12407261&dopt=Abstract
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Alcohol & drug abuse: principles of money management as a therapy for addiction. Author(s): Rosen MI, Bailey M, Rosenheck RR. Source: Psychiatric Services (Washington, D.C.). 2003 February; 54(2): 171-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556596&dopt=Abstract
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Alcohol & drug abuse: the transformation of the Veterans Affairs substance abuse treatment system. Author(s): Humphreys K, Huebsch PD, Moos RH, Suchinsky RT. Source: Psychiatric Services (Washington, D.C.). 1999 November; 50(11): 1399-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10543846&dopt=Abstract
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Alcohol and drug abuse among Connecticut youth: implications for adolescent medicine and public health. Author(s): Ungemack JA, Hartwell SW, Babor TF. Source: Conn Med. 1997 September; 61(9): 577-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9334513&dopt=Abstract
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Alcohol and drug abuse by migrant farmworkers: past research and future priorities. Author(s): Watson JM. Source: Nida Res Monogr. 1997; 168: 443-58. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9260176&dopt=Abstract
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Alcohol and drug abuse in patients with physical disabilities. Author(s): Hubbard JR, Everett AS, Khan MA. Source: The American Journal of Drug and Alcohol Abuse. 1996 May; 22(2): 215-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8727056&dopt=Abstract
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Alcohol and drug abuse in sexual and nonsexual violent offenders. Author(s): Abracen J, Looman J, Anderson D. Source: Sexual Abuse : a Journal of Research and Treatment. 2000 October; 12(4): 263-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11027111&dopt=Abstract
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Alcohol and drug abuse in trauma. Author(s): Hadfield RJ, Mercer M, Parr MJ. Source: Resuscitation. 2001 January; 48(1): 25-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11162880&dopt=Abstract
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Alcohol and illicit drug abuse and the risk of violent death in the home. Author(s): Rivara FP, Mueller BA, Somes G, Mendoza CT, Rushforth NB, Kellermann AL. Source: Jama : the Journal of the American Medical Association. 1997 August 20; 278(7): 569-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9268278&dopt=Abstract
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Alcohol use and wages: new results from the National Household Survey on Drug Abuse. Author(s): Zarkin GA, French MT, Mroz T, Bray JW. Source: Journal of Health Economics. 1998 January; 17(1): 53-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10176315&dopt=Abstract
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Alcohol, drug abuse, and mental health care for uninsured and insured adults. Author(s): Wells KB, Sherbourne CD, Sturm R, Young AS, Burnam MA. Source: Health Services Research. 2002 August; 37(4): 1055-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12236383&dopt=Abstract
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Alcoholism and drug abuse in three groups--bipolar I, unipolars and their acquaintances. Author(s): Winokur G, Turvey C, Akiskal H, Coryell W, Solomon D, Leon A, Mueller T, Endicott J, Maser J, Keller M. Source: Journal of Affective Disorders. 1998 September; 50(2-3): 81-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9858067&dopt=Abstract
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Ampicillin/sulbactam and cefoxitin in the treatment of cutaneous and other softtissue abscesses in patients with or without histories of injection drug abuse. Author(s): Talan DA, Summanen PH, Finegold SM. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2000 August; 31(2): 464-71. Epub 2000 September 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10987706&dopt=Abstract
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An adoption study of drug abuse/dependency in females. Author(s): Cadoret RJ, Yates WR, Troughton E, Woodworth G, Stewart MA. Source: Comprehensive Psychiatry. 1996 March-April; 37(2): 88-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8654068&dopt=Abstract
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An analysis of drug abuse policies in teaching hospitals. Author(s): Montoya ID, Carlson JW, Richard AJ. Source: The Journal of Behavioral Health Services & Research. 1999 February; 26(1): 2838. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10069139&dopt=Abstract
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An annotated bibliography of papers on drug abuse among Indian youth by staff of the Tri-Ethnic Center for Prevention Research. Author(s): Beauvais F. Source: Am Indian Alsk Native Ment Health Res. 1992; 5(1): 68-78. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1420542&dopt=Abstract
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An approach to drug abuse, intoxication and withdrawal. Author(s): Giannini AJ. Source: American Family Physician. 2000 May 1; 61(9): 2763-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10821156&dopt=Abstract
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An ethicist's commentary on the case of whether a veterinarian is obliged to relate a previous employee's history of drug abuse to a prospective employer. Author(s): Rollin BE. Source: Can Vet J. 1996 August; 37(8): 456-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8853879&dopt=Abstract
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An institutional analysis of HIV prevention efforts by the nation's outpatient drug abuse treatment units. Author(s): D'Aunno T, Vaughn TE, McElroy P. Source: Journal of Health and Social Behavior. 1999 June; 40(2): 175-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10467763&dopt=Abstract
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An outcome study of Missouri's CSTAR alcohol and drug abuse programs. Author(s): Evenson RC, Binner PR, Cho DW, Schicht WW, Topolski JM. Source: Journal of Substance Abuse Treatment. 1998 March-April; 15(2): 143-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9561954&dopt=Abstract
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Analysis and identification of zipeprol and its metabolites during drug abuse screening. Author(s): Athanaselis S, Dona A, Maravelias C, Koutselinis A. Source: Journal of Analytical Toxicology. 1996 November-December; 20(7): 564-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8934307&dopt=Abstract
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Application of case management to drug abuse treatment: overview of models and research issues. Author(s): Ridgely MS, Willenbring ML. Source: Nida Res Monogr. 1992; 127: 12-33. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1435992&dopt=Abstract
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Assessing sex differences on treatment effectiveness from the drug abuse treatment outcome study (DATOS). Author(s): Acharyya S, Zhang H. Source: The American Journal of Drug and Alcohol Abuse. 2003 May; 29(2): 415-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765214&dopt=Abstract
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Assessment of coercive and noncoercive pressures to enter drug abuse treatment. Author(s): Marlowe DB, Kirby KC, Bonieskie LM, Glass DJ, Dodds LD, Husband SD, Platt JJ, Festinger DS. Source: Drug and Alcohol Dependence. 1996 October; 42(2): 77-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8889406&dopt=Abstract
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Assessment of drug abuse prevention curricula developed at the local level. Author(s): Bosworth K. Source: Journal of Drug Education. 1998; 28(4): 307-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10097482&dopt=Abstract
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Assessment of neurotoxicity from potential medications for drug abuse: ibogaine testing and brain imaging. Author(s): Vocci FJ, London ED. Source: Annals of the New York Academy of Sciences. 1997 May 30; 820: 29-39; Discussion 39-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9237447&dopt=Abstract
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Associations of beta-endorphin with HVA and MHPG in the plasma of prepubertal boys: effects of familial drug abuse and antisocial personality disorder liability. Author(s): Moss HB, Yao JK. Source: Psychiatry Research. 1996 June 1; 62(3): 203-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8804130&dopt=Abstract
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Behavioral pharmacology of buprenorphine: issues relevant to its potential in treating drug abuse. Author(s): Woods JH, France CP, Winger GD. Source: Nida Res Monogr. 1992; 121: 12-27. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1406907&dopt=Abstract
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Behavioral strategies for the evaluation of new pharmacotherapies for drug abuse treatment. Author(s): Mello NK. Source: Nida Res Monogr. 1992; 119: 150-4. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1435971&dopt=Abstract
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Behavioral treatment of alcohol and drug abuse. What do we know and where shall we go? Author(s): Hester RK, Nirenberg TD, Begin AM. Source: Recent Dev Alcohol. 1990; 8: 305-27. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2185523&dopt=Abstract
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Benefit-cost analysis of drug abuse prevention programs: a macroscopic approach. Author(s): Kim S, Coletti SD, Crutchfield CC, Williams C, Hepler N. Source: Journal of Drug Education. 1995; 25(2): 111-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7658292&dopt=Abstract
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Between a “rock” and a hard place: perinatal drug abuse. Author(s): Chavkin W, Kandall SR. Source: Pediatrics. 1990 February; 85(2): 223-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2296513&dopt=Abstract
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Big health threat from drug abuse in south Asia. Author(s): Kumar S. Source: Lancet. 1999 February 20; 353(9153): 651. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10030343&dopt=Abstract
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Bilateral pyopneumothorax secondary to intravenous drug abuse. Author(s): Zorc TG, O'Donnell AE, Holt RW, Pappas LS, Slakey J. Source: Chest. 1988 March; 93(3): 645-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3277809&dopt=Abstract
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Biological basis of sex differences in drug abuse: preclinical and clinical studies. Author(s): Lynch WJ, Roth ME, Carroll ME. Source: Psychopharmacology. 2002 November; 164(2): 121-37. Epub 2002 September 05. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404074&dopt=Abstract
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Body composition and dietary intake in relation to drug abuse in a cohort of HIVpositive persons. Author(s): Forrester JE, Woods MN, Knox TA, Spiegelman D, Skinner SC, Gorbach SL. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2000 October 1; 25 Suppl 1: S43-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11126426&dopt=Abstract
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Bridging etiology and prevention in drug abuse research. Author(s): Jessor R. Source: Nida Res Monogr. 1985; 56: 257-68. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3929103&dopt=Abstract
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Bridging the gap between research and drug abuse treatment. Author(s): Sorensen JL, Midkiff EE. Source: J Psychoactive Drugs. 2000 October-December; 32(4): 379-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11210199&dopt=Abstract
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Buprenorphine for pain relief in a patient with drug abuse. Author(s): Hughes JR, Bickel WK, Higgins ST. Source: The American Journal of Drug and Alcohol Abuse. 1991; 17(4): 451-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1746507&dopt=Abstract
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Can 2 screening questions accurately detect alcohol and other drug abuse in the primary care setting? Author(s): Gittler M, Chen F. Source: The Journal of Family Practice. 2001 June; 50(6): 548. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11401746&dopt=Abstract
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Case management as a mechanism for linking drug abuse treatment and primary care: preliminary evidence from the ADAMHA/HRSA linkage demonstration. Author(s): Schlenger WE, Kroutil LA, Roland EJ. Source: Nida Res Monogr. 1992; 127: 316-30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1331803&dopt=Abstract
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Cerebral venous thrombosis associated with inhalational drug abuse. Author(s): Murthy BV, Wenstone R. Source: Rhinology. 1996 September; 34(3): 188-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8938893&dopt=Abstract
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Cerebrovascular complications of alcohol and sympathomimetic drug abuse. Author(s): Bruno A. Source: Curr Neurol Neurosci Rep. 2003 January; 3(1): 40-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12507409&dopt=Abstract
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Challenging report on pregnancy and drug abuse. Author(s): Marwick C. Source: Jama : the Journal of the American Medical Association. 1998 September 23-30; 280(12): 1039-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9757838&dopt=Abstract
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Changes in HIV risk behavior following alternative residential programs of drug abuse treatment and AIDS education. Author(s): McCusker J, Stoddard AM, Hindin RN, Garfield FB, Frost R. Source: Annals of Epidemiology. 1996 March; 6(2): 119-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8775591&dopt=Abstract
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Changes in HIV-related risk behaviors following drug abuse treatment. Author(s): Woods WJ, Guydish JR, Sorensen JL, Coutts A, Bostrom A, Acampora A. Source: Aids (London, England). 1999 October 22; 13(15): 2151-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10546869&dopt=Abstract
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Changes in nongonococcal septic arthritis: drug abuse and methicillin-resistant Staphylococcus aureus. Author(s): Ang-Fonte GZ, Rozboril MB, Thompson GR. Source: Arthritis and Rheumatism. 1985 February; 28(2): 210-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3844315&dopt=Abstract
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Child maltreatment and adulthood violence: the contribution of attachment and drug abuse. Author(s): Feerick MM, Haugaard JJ, Hien DA. Source: Child Maltreatment. 2002 August; 7(3): 226-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12139190&dopt=Abstract
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Chronic bromvalerylurea intoxication: dystonic posture and cerebellar ataxia due to nonsteroidal anti-inflammatory drug abuse. Author(s): Kawakami T, Takiyama Y, Yanaka I, Taguchi T, Tanaka Y, Nishizawa M, Nakano I. Source: Intern Med. 1998 September; 37(9): 788-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9804091&dopt=Abstract
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Chronological association between increases in drug abuse and psychosis in Connecticut state hospitals. Author(s): Boutros NN, Bowers MB Jr, Quinlan D. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 1998 Winter; 10(1): 48-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9547466&dopt=Abstract
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Client issues in drug abuse treatment: addressing multiple drug abuse. Author(s): Kosten TR. Source: Nida Res Monogr. 1991; 106: 136-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1922284&dopt=Abstract
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Clients entering drug abuse day treatment: 18-month outcomes. Author(s): Guydish J, Werdegar D, Tajima B, Price M, Acampora A. Source: The American Journal of Drug and Alcohol Abuse. 1997 February; 23(1): 99-114. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9048150&dopt=Abstract
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Clinical, radiological, and pathological aspects of cerebrovascular disease associated with drug abuse. Author(s): Brust JC. Source: Stroke; a Journal of Cerebral Circulation. 1993 December; 24(12 Suppl): I129-33; Discussion I134-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8249009&dopt=Abstract
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Cloned dopamine receptors: targets in therapy of drug abuse. Author(s): Seeman P. Source: Nida Res Monogr. 1992; 126: 34-47. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1491716&dopt=Abstract
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Cocaine dependence with and without PTSD among subjects in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Author(s): Najavits LM, Gastfriend DR, Barber JP, Reif S, Muenz LR, Blaine J, Frank A, Crits-Christoph P, Thase M, Weiss RD. Source: The American Journal of Psychiatry. 1998 February; 155(2): 214-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9464200&dopt=Abstract
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Community prevention efforts to reduce the spread of AIDS associated with intravenous drug abuse. Author(s): Battjes RJ, Leukefeld CG, Amsel Z. Source: Nida Res Monogr. 1990; 93: 288-99. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2300146&dopt=Abstract
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Community prevention efforts to reduce the spread of AIDS associated with intravenous drug abuse. Author(s): Leukefeld CG, Battjes RJ, Amsel Z. Source: Aids Education and Prevention : Official Publication of the International Society for Aids Education. 1990 Fall; 2(3): 235-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2265061&dopt=Abstract
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Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. Author(s): Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1990 November 21; 264(19): 2511-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2232018&dopt=Abstract
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Comparison of drug abuse fatalities and emergencies. Author(s): Schulz-Schaeffer W, Schmoldt A, Peters T, Puschel K. Source: Forensic Science International. 1993 November; 62(1-2): 161-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8300031&dopt=Abstract
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Compartment syndrome and drug abuse. Author(s): Torrens C, Marin M, Mestre C, Alier A, Nogues X. Source: Acta Orthop Belg. 1993; 59(2): 143-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8372649&dopt=Abstract
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Compulsive weight lifting and anabolic drug abuse among women rape victims. Author(s): Gruber AJ, Pope HG Jr. Source: Comprehensive Psychiatry. 1999 July-August; 40(4): 273-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10428186&dopt=Abstract
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Compulsory treatment for drug abuse. Author(s): Leukefeld CG, Tims FM. Source: Int J Addict. 1990 June; 25(6): 621-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2265866&dopt=Abstract
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Computed EEG abnormalities in panic disorder with and without premorbid drug abuse. Author(s): Abraham HD, Duffy FH. Source: Biological Psychiatry. 1991 April 1; 29(7): 687-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2054439&dopt=Abstract
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Conceptual framework for estimating the social cost of drug abuse. Author(s): French MT, Rachal JV, Hubbard RL. Source: J Health Soc Policy. 1991; 2(3): 1-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10170913&dopt=Abstract
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Conjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice. Author(s): Brown RL, Rounds LA. Source: Wis Med J. 1995; 94(3): 135-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7778330&dopt=Abstract
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Consumption of coffee during pregnancy: authors should adjust for history of drug abuse. Author(s): Sindos M, Pisal N, Michala S. Source: Bmj (Clinical Research Ed.). 2003 June 7; 326(7401): 1268; Author Reply 1269. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12791758&dopt=Abstract
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Contemporary issues in drug abuse treatment linkage with self-help groups. Author(s): Nurco DN, Stephenson P, Hanlon TE. Source: Nida Res Monogr. 1991; 106: 338-48. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1922296&dopt=Abstract
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Content and teaching strategies in 10 selected drug abuse prevention curricula. Author(s): Bosworth K, Sailes J. Source: The Journal of School Health. 1993 August; 63(6): 247-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8412035&dopt=Abstract
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Continuation high schools: youth at risk for drug abuse. Author(s): Sussman S, Stacy AW, Dent CW, Simon TR, Galaif ER, Moss MA, Craig S, Johnson CA. Source: Journal of Drug Education. 1995; 25(3): 191-209. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7500223&dopt=Abstract
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Contributions of drug epidemiology to the field of drug abuse prevention. Author(s): Johnston LD. Source: Nida Res Monogr. 1991; 107: 57-80. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1922312&dopt=Abstract
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Control theory, labeling theory, and the delivery of services for drug abuse to adolescents. Author(s): Downs WR, Robertson JF, Harrison LR. Source: Adolescence. 1997 Spring; 32(125): 1-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9105487&dopt=Abstract
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Correctional drug abuse treatment in the United States: an overview. Author(s): Lipton DS, Falkin GP, Wexler HK. Source: Nida Res Monogr. 1992; 118: 8-30. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1620228&dopt=Abstract
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Correlates of benzodiazepine use among a sample of arrestees surveyed through the Arrestee Drug Abuse Monitoring (ADAM) Program. Author(s): Yacoubian GS Jr. Source: Substance Use & Misuse. 2003 January; 38(1): 127-39. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602810&dopt=Abstract
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Correlates of drug abuse among homeless and transient people in the Washington, DC, metropolitan area in 1991. Author(s): Lambert EY, Caces MF. Source: Public Health Reports (Washington, D.C. : 1974). 1995 July-August; 110(4): 45561. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7638333&dopt=Abstract
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Correlation of length of VNTR alleles at the X-linked MAOA gene and phenotypic effect in Tourette syndrome and drug abuse. Author(s): Gade R, Muhleman D, Blake H, MacMurray J, Johnson P, Verde R, Saucier G, Comings DE. Source: Molecular Psychiatry. 1998 January; 3(1): 50-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9491813&dopt=Abstract
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Cost of maternal drug abuse drawing notice. Author(s): Wagner L. Source: Modern Healthcare. 1990 March 26; 20(12): 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10170522&dopt=Abstract
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Cost-effectiveness of drug abuse treatment for primary prevention of acquired immunodeficiency syndrome: epidemiologic considerations. Author(s): Lampinen TM. Source: Nida Res Monogr. 1991; 113: 114-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1762635&dopt=Abstract
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Crime, sin, or disease: drug abuse and AIDS in the African-American community. Author(s): Satcher D. Source: Journal of Health Care for the Poor and Underserved. 1990 Fall; 1(2): 212-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2130900&dopt=Abstract
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CT manifestation of sternoclavicular pyarthrosis in patients with intravenous drug abuse. Author(s): Alexander PW, Shin MS. Source: Journal of Computer Assisted Tomography. 1990 January-February; 14(1): 104-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2298971&dopt=Abstract
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Culturally appropriate guidelines for alcohol and drug abuse prevention. Author(s): Shoultz J, Tanner B, Harrigan R. Source: The Nurse Practitioner. 2000 November; 25(11): 50-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11107607&dopt=Abstract
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Culture, drug abuse and some reflections on the family. Author(s): Charles M, Masihi EJ, Siddiqui HY, Jogarao SV, D'Lima H, Mehta U, Britto G. Source: Bull Narc. 1994; 46(1): 67-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7833904&dopt=Abstract
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Current initiatives in drug abuse research in Spain. Author(s): Alvarez FJ, del Rio Mdel C. Source: Addiction (Abingdon, England). 2003 June; 98(6): 861. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12780379&dopt=Abstract
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Current issues and future needs in the assessment of adolescent drug abuse. Author(s): Winters KC, Stinchfield RD. Source: Nida Res Monogr. 1995; 156: 146-71. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8594470&dopt=Abstract
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Current patterns of drug abuse that involve smoking. Author(s): Wesson DR, Washburn P. Source: Nida Res Monogr. 1990; 99: 5-11. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2267013&dopt=Abstract
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Current situation relating to drug abuse assessment in European countries. Author(s): Hartnoll RL. Source: Bull Narc. 1986 January-June; 38(1-2): 65-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3490892&dopt=Abstract
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Cutaneous foreign body granulomas associated with intravenous drug abuse. Author(s): Posner DI, Guill MA 3rd. Source: Journal of the American Academy of Dermatology. 1985 November; 13(5 Pt 2): 869-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3905885&dopt=Abstract
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Deadliness of declining drug abuse. Author(s): Woodward A. Source: Public Health Reports (Washington, D.C. : 1974). 1998 May-June; 113(3): 234-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9696674&dopt=Abstract
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Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 year study of 1161 patients with human immunodeficiency virus disease predominantly acquired through intravenous drug abuse. Author(s): Munoz-Perez MA, Rodriguez-Pichardo A, Camacho F, Colmenero MA. Source: The British Journal of Dermatology. 1998 July; 139(1): 33-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9764146&dopt=Abstract
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Detection of drug abuse by health professionals. Author(s): Meeker JE, Mount AM, Ross W. Source: J Healthc Prot Manage. 2003 Winter; 19(1): 73-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629790&dopt=Abstract
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Detection of drug abuse by health professionals. Author(s): Meeker JE, Mount AM, Ross W. Source: Occup Health Saf. 2002 August; 71(8): 46-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197441&dopt=Abstract
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Detoxification of opiate addicts with multiple drug abuse: a comparison of buprenorphine vs. methadone. Author(s): Seifert J, Metzner C, Paetzold W, Borsutzky M, Passie T, Rollnik J, Wiese B, Emrich HM, Schneider U. Source: Pharmacopsychiatry. 2002 September; 35(5): 159-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12237786&dopt=Abstract
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Developing effective school-based drug abuse prevention programs. Author(s): Zavela KJ. Source: American Journal of Health Behavior. 2002 July-August; 26(4): 252-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12081358&dopt=Abstract
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Development and immediate impact of a self-instruction curriculum for an adolescent indicated drug abuse prevention trial. Author(s): Sussman S, Dent CW, Craig S, Ritt-Olsen A, McCuller WJ. Source: Journal of Drug Education. 2002; 32(2): 121-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12206062&dopt=Abstract
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Development of a parent questionnaire for use in assessing adolescent drug abuse. Author(s): Winters KC, Anderson N, Bengston P, Stinchfield RD, Latimer WW. Source: J Psychoactive Drugs. 2000 January-March; 32(1): 3-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10801063&dopt=Abstract
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Development of the drug abuse screening test for adolescents (DAST-A). Author(s): Martino S, Grilo CM, Fehon DC. Source: Addictive Behaviors. 2000 January-February; 25(1): 57-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10708319&dopt=Abstract
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Diagnostic evaluation of alcohol and drug abuse problems in women. Author(s): Mendelson JH, Mello NK. Source: Psychopharmacology Bulletin. 1998; 34(3): 279-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9803754&dopt=Abstract
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Differences in substance abuse patterns: multiple drug abuse alone versus schizophrenia with multiple drug abuse. Author(s): Lammertink M, Lohrer F, Kaiser R, Hambrecht M, Pukrop R. Source: Acta Psychiatrica Scandinavica. 2001 November; 104(5): 361-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11722317&dopt=Abstract
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Disaggregating the liability for drug abuse. Author(s): Tarter RE, Moss H, Blackson T, Vanyukov M, Brigham J, Loeber R. Source: Nida Res Monogr. 1998 March; 169: 227-43. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9686419&dopt=Abstract
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Divided loyalties. Legal and bioethical considerations of physician-pregnant patient confidentiality and prenatal drug abuse. Author(s): Plambeck CM. Source: The Journal of Legal Medicine. 2002 March; 23(1): 1-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11957326&dopt=Abstract
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Doctors' drug abuse reduced during contingency-contracting treatment. Author(s): Crowley TJ. Source: Alcohol Drug Res. 1985-86; 6(4): 299-307. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4091896&dopt=Abstract
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Does centralized intake improve drug abuse treatment outcomes? Author(s): Guydish J, Woods WJ, Davis T, Bostrom A, Frazier Y. Source: Journal of Substance Abuse Treatment. 2001 June; 20(4): 265-73; Discussion 2756. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11672641&dopt=Abstract
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Drug abuse and acquired immune deficiency syndrome. Author(s): Sheu Y. Source: Psychiatry and Clinical Neurosciences. 1998 December; 52 Suppl: S167-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9895137&dopt=Abstract
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Drug abuse and addiction in internal medicine. Author(s): Francis HL, Leshner AI. Source: Adv Intern Med. 2001; 47: 239-63. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11795077&dopt=Abstract
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Drug abuse and addiction research into the 21st century: where are we going from here? Author(s): Leshner A. Source: Soc Work Health Care. 2001; 33(1): 5-15. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11718537&dopt=Abstract
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Drug abuse and bipolar disorder: comorbidity or misdiagnosis? Author(s): Sherwood Brown E, Suppes T, Adinoff B, Rajan Thomas N. Source: Journal of Affective Disorders. 2001 July; 65(2): 105-15. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11356233&dopt=Abstract
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Drug abuse and bipolar disorders. Author(s): Estroff TW, Dackis CA, Gold MS, Pottash AL. Source: International Journal of Psychiatry in Medicine. 1985-86; 15(1): 37-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4055245&dopt=Abstract
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Drug abuse and dentistry. Author(s): Meechan JG. Source: Dent Update. 1999 June; 26(5): 182-7, 190. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10765752&dopt=Abstract
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Drug abuse and dependency: understanding gender differences in etiology and management. Author(s): Wasilow-Mueller S, Erickson CK. Source: Journal of the American Pharmaceutical Association (Washington,D.C. : 1996). 2001 January-February; 41(1): 78-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11216117&dopt=Abstract
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Drug abuse and developmental psychopathology. Author(s): Glantz MD, Leshner AI. Source: Development and Psychopathology. 2000 Autumn; 12(4): 795-814. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11202044&dopt=Abstract
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Drug abuse and eating disorders: prevention implications. Author(s): Watts WD, Ellis AM. Source: Journal of Drug Education. 1992; 22(3): 223-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1479487&dopt=Abstract
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Drug abuse and environment in youth. A study of a junior high school population in a county of Akershus, Norway. Author(s): Lavik NJ, Huseby AB, Rud MG. Source: Soc Psychiatry. 1985; 20(4): 179-85. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4071209&dopt=Abstract
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Drug abuse and illicit drug trafficking. Author(s): Manderson DR. Source: The Medical Journal of Australia. 1998 June 15; 168(12): 588-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9673616&dopt=Abstract
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Drug abuse and illicit trafficking in Italy: trends and countermeasures, 1979-1990. Author(s): Marotta E. Source: Bull Narc. 1992; 44(1): 15-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1477701&dopt=Abstract
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Drug abuse and incarcerated women. A research review. Author(s): Henderson DJ. Source: Journal of Substance Abuse Treatment. 1998 November-December; 15(6): 579-87. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9845871&dopt=Abstract
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Drug abuse and mental illness: progress in understanding comorbidity. Author(s): Volkow ND. Source: The American Journal of Psychiatry. 2001 August; 158(8): 1181-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11481146&dopt=Abstract
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Drug abuse and toxicological scene in Japan. Author(s): Nihira M. Source: J Toxicol Sci. 1998 July; 23 Suppl 2: 201-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9760465&dopt=Abstract
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Drug abuse as self-medication for depression: an empirical study. Author(s): Weiss RD, Griffin ML, Mirin SM. Source: The American Journal of Drug and Alcohol Abuse. 1992; 18(2): 121-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1562010&dopt=Abstract
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Drug abuse day treatment: a randomized clinical trial comparing day and residential treatment programs. Author(s): Guydish J, Werdegar D, Sorensen JL, Clark W, Acampora A. Source: Journal of Consulting and Clinical Psychology. 1998 April; 66(2): 280-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9583331&dopt=Abstract
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Drug abuse during pregnancy. Author(s): Curet LB, Hsi AC. Source: Clinical Obstetrics and Gynecology. 2002 March; 45(1): 73-88. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11862060&dopt=Abstract
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Drug abuse headache: recognition and management. Author(s): Antonaci F. Source: Cephalalgia : an International Journal of Headache. 1998 August; 18 Suppl 22: 47-52; Discussion 52-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9793712&dopt=Abstract
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Drug abuse history and treatment needs of jail inmates. Author(s): Peters RH, Kearns WD. Source: The American Journal of Drug and Alcohol Abuse. 1992; 18(3): 355-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1415086&dopt=Abstract
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Drug abuse in America: medical and socio-legal dilemmas. Author(s): Garcia SA. Source: Med Law. 1992; 11(5-6): 323-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1484457&dopt=Abstract
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Drug abuse in Cuba. Author(s): Lee RW. Source: Journal of Substance Abuse Treatment. 1998 March-April; 15(2): 131-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9561952&dopt=Abstract
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Drug abuse in Nepal: a rapid assessment study. Author(s): Chatterjee A, Uprety L, Chapagain M, Kafle K. Source: Bull Narc. 1996; 48(1-2): 11-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9839033&dopt=Abstract
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Drug abuse in the Bahamas. Author(s): Neville M, Clark N. Source: Journal of Substance Abuse Treatment. 1985; 2(3): 195-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4094008&dopt=Abstract
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Drug abuse in the community. Race or racism? Author(s): Primm BJ. Source: Annals of Epidemiology. 1993 March; 3(2): 171-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8269071&dopt=Abstract
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Drug abuse of Finnish male prisoners in 1995. Author(s): Korte T, Pykalainen J, Seppala T. Source: Forensic Science International. 1998 November 9; 97(2-3): 171-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9871996&dopt=Abstract
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Drug abuse prevention among minority adolescents: posttest and one-year follow-up of a school-based preventive intervention. Author(s): Botvin GJ, Griffin KW, Diaz T, Ifill-Williams M. Source: Prevention Science : the Official Journal of the Society for Prevention Research. 2001 March; 2(1): 1-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11519371&dopt=Abstract
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Drug abuse prevention for high-risk African American children and their families: a review and model program. Author(s): Van Hasselt VB, Hersen M, Null JA, Ammerman RT, Bukstein OG, McGillivray J, Hunter A. Source: Addictive Behaviors. 1993 March-April; 18(2): 213-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8506792&dopt=Abstract
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Drug abuse research and HIV/AIDS: a national perspective from the US. Author(s): Schuster CR. Source: British Journal of Addiction. 1992 March; 87(3): 355-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1559034&dopt=Abstract
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Drug abuse risks for acculturating immigrant adolescents: case study of Asian Indians in the United States. Author(s): Bhattacharya G. Source: Health & Social Work. 2002 August; 27(3): 175-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12230042&dopt=Abstract
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Drug abuse through a long-indwelling catheter cared for by an intravenous team. Author(s): Volkow P, Tellez O, Allende S, Vazquez C. Source: American Journal of Infection Control. 1999 October; 27(5): 459. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10511497&dopt=Abstract
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Drug abuse treatment and risky sex: evidence for a cumulative treatment effect? Author(s): Longshore D, Hsieh S. Source: The American Journal of Drug and Alcohol Abuse. 1998 August; 24(3): 439-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9741945&dopt=Abstract
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Drug abuse treatment as AIDS prevention. Author(s): Metzger DS, Navaline H, Woody GE. Source: Public Health Reports (Washington, D.C. : 1974). 1998 June; 113 Suppl 1: 97-106. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9722815&dopt=Abstract
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Drug abuse treatment as an HIV prevention strategy: a review. Author(s): Sorensen JL, Copeland AL. Source: Drug and Alcohol Dependence. 2000 April 1; 59(1): 17-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10706972&dopt=Abstract
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Drug abuse treatment as HIV prevention: changes in social drug use patterns might also reduce risk. Author(s): Iguchi MY. Source: J Addict Dis. 1998; 17(4): 9-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9848028&dopt=Abstract
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Drug abuse treatment entry and engagement: report of a meeting on treatment readiness. Author(s): Battjes RJ, Onken LS, Delany PJ. Source: Journal of Clinical Psychology. 1999 May; 55(5): 643-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10392794&dopt=Abstract
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Drug abuse treatment in criminal justice settings: enhancing community engagement and helpfulness. Author(s): Czuchry M, Dansereau DF. Source: The American Journal of Drug and Alcohol Abuse. 2000 November; 26(4): 53752. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11097191&dopt=Abstract
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Drug abuse treatment on demand in San Francisco: preliminary findings. Author(s): Guydish J, Moore L, Gleghorn A, Davis T, Sears C, Harcourt J. Source: J Psychoactive Drugs. 2000 October-December; 32(4): 363-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11210197&dopt=Abstract
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Drug abuse treatment outcome study of adolescents: a comparison of client characteristics and pretreatment behaviors in three treatment modalities. Author(s): Rounds-Bryant JL, Kristiansen PL, Hubbard RL. Source: The American Journal of Drug and Alcohol Abuse. 1999 November; 25(4): 57391. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10548436&dopt=Abstract
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Drug abuse treatment programs in the Federal Bureau of Prisons: initiatives for the 1990s. Author(s): Murray DW Jr. Source: Nida Res Monogr. 1992; 118: 62-83. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1620227&dopt=Abstract
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Drug abuse treatment success among needle exchange participants. Author(s): Brooner R, Kidorf M, King V, Beilenson P, Svikis D, Vlahov D. Source: Public Health Reports (Washington, D.C. : 1974). 1998 June; 113 Suppl 1: 129-39. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9722818&dopt=Abstract
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Drug abuse treatment training in Peru. A social policy experiment. Author(s): Johnson KW, Young LC, Suresh G, Berbaum ML. Source: Evaluation Review. 2002 October; 26(5): 480-519. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12243105&dopt=Abstract
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Drug abuse trends and epidemiological aspects of drug associated deaths in Korea. Author(s): Chung H. Source: J Toxicol Sci. 1998 July; 23 Suppl 2: 197-200. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9760464&dopt=Abstract
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Drug abuse with a difference. Author(s): Pradhan SC, Biswas A, Swain S. Source: J Assoc Physicians India. 1999 November; 47(11): 1123-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10862333&dopt=Abstract
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Drug abuse, methadone treatment, and health services use among injection drug users with AIDS. Author(s): Sambamoorthi U, Warner LA, Crystal S, Walkup J. Source: Drug and Alcohol Dependence. 2000 July 1; 60(1): 77-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10821992&dopt=Abstract
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Drug abuse: a review of explanations and models of explanation. Author(s): Lettieri DJ. Source: Adv Alcohol Subst Abuse. 1985 Spring-Summer; 4(3-4): 9-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4013875&dopt=Abstract
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Drug abuse--related mortality in the United States: patterns and correlates. Author(s): Kallan JE. Source: The American Journal of Drug and Alcohol Abuse. 1998 February; 24(1): 103-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9513632&dopt=Abstract
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Drug abuse-related mortality: a study of teenage addicts over a 20-year period. Author(s): Oyefeso A, Ghodse H, Clancy C, Corkery J, Goldfinch R. Source: Social Psychiatry and Psychiatric Epidemiology. 1999 August; 34(8): 437-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10501714&dopt=Abstract
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Drug diversion and prescription drug abuse--Part I. Author(s): Hobbs TR. Source: Pa Med. 1998 October; 101(10): 15. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9798406&dopt=Abstract
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Drug diversion and prescription drug abuse--Part II. Author(s): Hobbs TR. Source: Pa Med. 1998 November; 101(11): 17. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9842247&dopt=Abstract
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Drug supply and drug abuse. Author(s): Copeman M. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 April 29; 168(9): 1113; Author Reply 1113. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719309&dopt=Abstract
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Drug use and crime: a historical review of research conducted by the UCLA Drug Abuse Research Center. Author(s): Anglin MD, Perrochet B. Source: Substance Use & Misuse. 1998 July; 33(9): 1871-914. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9718183&dopt=Abstract
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Drug use, drug abuse, and labour market outcomes. Author(s): Buchmueller TC, Zuvekas SH. Source: Health Economics. 1998 May; 7(3): 229-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9639336&dopt=Abstract
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Dual diagnosis: approaches to the treatment of people with dual mental health and drug abuse problems. Author(s): Manley D. Source: Ment Health Care. 1998 February; 1(6): 190-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9791410&dopt=Abstract
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Federal block grants and state spending: the Alcohol, Drug Abuse, and Mental Health block grant and state agency behavior. Author(s): Jacobsen K, McGuire TG. Source: Journal of Health Politics, Policy and Law. 1996 Winter; 21(4): 753-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8892005&dopt=Abstract
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Fifteen solutions to the problems of prescription drug abuse. Author(s): Lurie P, Lee PR. Source: J Psychoactive Drugs. 1991 October-December; 23(4): 349-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1813607&dopt=Abstract
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Fighting drug abuse at the local level. Author(s): Jellinek PS, Hearn RP. Source: Issues in Science and Technology. 1991 Summer; 7(4): 78-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10170798&dopt=Abstract
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Fine needle aspiration cytology of talc granulomatosis in a peripheral lymph node in a case of suspected intravenous drug abuse. Author(s): Housini I, Dabbs DJ, Coyne L. Source: Acta Cytol. 1990 May-June; 34(3): 342-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2343689&dopt=Abstract
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First analytical chemistry study on drug abuse in the Buenos Aires (Argentina) University students. Author(s): Quiroga PN, Panzuto RI, Alvarez GB, Mirson DJ, Ochoa CF, Assem EM, Lopez CM, Schkolnik LC, Villaamil EC, Roses OE. Source: Farmaco (Societa Chimica Italiana : 1989). 1998 June 30; 53(6): 389-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9764470&dopt=Abstract
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Footnotes in the evolution of the American national response: some little known aspects of the first American Strategy for Drug Abuse and Drug Traffic Prevention. The Inaugural Thomas Okey memorial lecture. Author(s): Jaffe JH. Source: British Journal of Addiction. 1987 June; 82(6): 587-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3475098&dopt=Abstract
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French general practitioners' attitudes toward maintenance drug abuse treatment with buprenorphine. Author(s): Moatti JP, Souville M, Escaffre N, Obadia Y. Source: Addiction (Abingdon, England). 1998 October; 93(10): 1567-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9926562&dopt=Abstract
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From one addiction to another: life after alcohol and drug abuse. Author(s): Hatcher AS. Source: The Nurse Practitioner. 1989 November; 14(11): 13-4, 16-7, 20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2586856&dopt=Abstract
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From the Alcohol, Drug Abuse and Mental Health Administration. Author(s): Goodwin FK, Gause EM. Source: Jama : the Journal of the American Medical Association. 1991 March 27; 265(12): 1510. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1847980&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1992 February 19; 267(7): 910. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1310338&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1992 January 22-29; 267(4): 480. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1309583&dopt=Abstract
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From the alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK, Asher J. Source: Jama : the Journal of the American Medical Association. 1991 December 25; 266(24): 3403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1660543&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Johnson E. Source: Jama : the Journal of the American Medical Association. 1992 September 23-30; 268(12): 1518. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1325568&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Johnson E. Source: Jama : the Journal of the American Medical Association. 1992 August 19; 268(7): 854. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1640596&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Johnson EM. Source: Jama : the Journal of the American Medical Association. 1992 July 22-29; 268(4): 447. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1320132&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Johnson E. Source: Jama : the Journal of the American Medical Association. 1992 May 6; 267(17): 2293. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1314314&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Asher J. Source: Jama : the Journal of the American Medical Association. 1992 March 25; 267(12): 1584. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1311777&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1991 September 25; 266(12): 1619. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1832194&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1991 August 28; 266(8): 1056. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1650851&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1991 July 17; 266(3): 323. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1647468&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1991 June 26; 265(24): 3221. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1646339&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1991 May 22-29; 265(20): 2657. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1850809&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK, Gause EN. Source: Jama : the Journal of the American Medical Association. 1991 April 17; 265(15): 1926. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1848907&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK, Gause EM. Source: Jama : the Journal of the American Medical Association. 1991 February 27; 265(8): 956. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1846926&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1990 November 21; 264(19): 2495. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2172573&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1990 October 17; 264(15): 1928. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2170696&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1990 September 19; 264(11): 1389. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2167987&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1990 August 22-29; 264(8): 950. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2165532&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1990 June 20; 263(23): 3130. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2161466&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1990 May 23-30; 263(20): 2725. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2159077&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK, Gause EM. Source: Jama : the Journal of the American Medical Association. 1990 April 18; 263(15): 2029. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2157072&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1990 March 23-30; 263(12): 1610. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2155326&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK, Gause EM. Source: Jama : the Journal of the American Medical Association. 1990 January 19; 263(3): 352. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2294295&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1989 November 17; 262(19): 2654. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2572707&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1989 September 15; 262(11): 1439. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2769888&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1989 July 21; 262(3): 331. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2739028&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1989 June 23-30; 261(24): 3517. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2724493&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1989 May 12; 261(18): 2604. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2709535&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Cause of AIDS mental problems. Author(s): Goodwin FK. Source: Jama : the Journal of the American Medical Association. 1988 December 9; 260(22): 3250. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2846903&dopt=Abstract
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From the Alcohol, Drug Abuse, and Mental Health Administration. Serious infections other than human immunodeficiency virus among intravenous drug abusers. Author(s): Haverkos HW, Lange WR. Source: The Journal of Infectious Diseases. 1990 May; 161(5): 894-902. Review. Erratum In: J Infect Dis 1990 December; 162(6): 1421. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2182730&dopt=Abstract
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Fungal infection associated with intravenous drug abuse: a case of localized cerebral phycomycosis. Author(s): Miller NS, Nance MA, Brummitt CF, Hoj KB, Nichol K, Gold MS. Source: The Journal of Clinical Psychiatry. 1988 August; 49(8): 320-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3045104&dopt=Abstract
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Further validation of new scales measuring adolescent alcohol and other drug abuse. Author(s): Winters KC, Stinchfield RD, Henly GA. Source: J Stud Alcohol. 1993 September; 54(5): 534-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8412143&dopt=Abstract
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Future directions in drug abuse prevention research. Author(s): Battjes RJ, Bell CS. Source: Nida Res Monogr. 1985; 63: 221-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3934555&dopt=Abstract
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Future research needs in policy, prevention, and treatment for drug abuse problems. Author(s): Smart RG, Allison KR, Cheung Y, Erickson PG, Shain M, Single E. Source: Int J Addict. 1990-91; 25(2A): 117-25; Discussion 125-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2269549&dopt=Abstract
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Gallium-67 detection of intramammary injection sites secondary to intravenous drug abuse. Author(s): Swayne LC. Source: Clinical Nuclear Medicine. 1989 September; 14(9): 693-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2791426&dopt=Abstract
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Gamma hydroxybutyric acid (GHB): an increasing trend in drug abuse. Author(s): Boyce SH, Padgham K, Miller LD, Stevenson J. Source: European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine. 2000 September; 7(3): 177-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11142268&dopt=Abstract
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Gender and drug abuse research. Author(s): Millstein RA. Source: J Gend Specif Med. 1998 December; 1(3): 44-7. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11279864&dopt=Abstract
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Gender differences in drug treatment careers among clients in the national Drug Abuse Treatment Outcome Study. Author(s): Grella CE, Joshi V. Source: The American Journal of Drug and Alcohol Abuse. 1999 August; 25(3): 385-406. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10473004&dopt=Abstract
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Gender differences in manifestations of antisocial personality disorder among residential drug abuse treatment clients. Author(s): Goldstein RB, Powers SI, McCusker J, Mundt KA, Lewis BF, Bigelow C. Source: Drug and Alcohol Dependence. 1996 May; 41(1): 35-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8793308&dopt=Abstract
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Gender differences in the association of alcohol intoxication and illicit drug abuse among persons arrested for violent and property offenses. Author(s): Martin SE, Bryant K. Source: Journal of Substance Abuse. 2001; 13(4): 563-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775083&dopt=Abstract
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General practitioners and changing scenario in drug abuse. Author(s): Chowdhury JR, Bhattacharjee D. Source: J Indian Med Assoc. 1995 April; 93(4): 155-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8699047&dopt=Abstract
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Genes in drug abuse. Author(s): Kuhar MJ, Joyce A, Dominguez G. Source: Drug and Alcohol Dependence. 2001 May 1; 62(3): 157-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11295319&dopt=Abstract
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Genetic and biological markers in alcoholism and drug abuse. Author(s): Schuckit MA. Source: Nida Res Monogr. 1986; 66: 97-108. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3106821&dopt=Abstract
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Genetic and biological markers in drug abuse and alcoholism: a summary. Author(s): Nichols WW. Source: Nida Res Monogr. 1986; 66: 1-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3106813&dopt=Abstract
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Genetic approaches to studying drug abuse: correlates of drug self-administration. Author(s): George FR. Source: Alcohol (Fayetteville, N.Y.). 1990 May-June; 7(3): 207-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2184833&dopt=Abstract
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Genetic factors in drug abuse and dependence. Author(s): Comings DE. Source: Nida Res Monogr. 1996; 159: 16-38; Discussion 39-48. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8784854&dopt=Abstract
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Genetic factors in substance abuse based on studies of Tourette syndrome and ADHD probands and relatives. I. Drug abuse. Author(s): Comings DE. Source: Drug and Alcohol Dependence. 1994 March; 35(1): 1-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8082550&dopt=Abstract
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Genetic influences on DSM-III-R drug abuse and dependence: a study of 3,372 twin pairs. Author(s): Tsuang MT, Lyons MJ, Eisen SA, Goldberg J, True W, Lin N, Meyer JM, Toomey R, Faraone SV, Eaves L. Source: American Journal of Medical Genetics. 1996 September 20; 67(5): 473-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8886164&dopt=Abstract
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Genetic vulnerability to drug abuse. Author(s): Duaux E, Krebs MO, Loo H, Poirier MF. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2000 March; 15(2): 109-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10881207&dopt=Abstract
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Genetic vulnerability to drug abuse. Author(s): Pickens RW, Svikis DS. Source: Nida Res Monogr. 1988; 89: 1-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3147389&dopt=Abstract
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Genetic vulnerability to drug abuse. The D2 dopamine receptor Taq I B1 restriction fragment length polymorphism appears more frequently in polysubstance abusers. Author(s): Smith SS, O'Hara BF, Persico AM, Gorelick DA, Newlin DB, Vlahov D, Solomon L, Pickens R, Uhl GR. Source: Archives of General Psychiatry. 1992 September; 49(9): 723-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1355337&dopt=Abstract
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Genetics as a tool for identifying biological markers of drug abuse. Author(s): Collins AC. Source: Nida Res Monogr. 1986; 66: 57-70. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3106818&dopt=Abstract
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Hair analysis for drug abuse, Part II. Hair analysis for monitoring of methamphetamine abuse by isotope dilution gas chromatography/mass spectrometry. Author(s): Nakahara Y, Takahashi K, Takeda Y, Konuma K, Fukui S, Tokui T. Source: Forensic Science International. 1990 July; 46(3): 243-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2376365&dopt=Abstract
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Hair analysis for drug abuse. XIV. Identification of substances causing acute poisoning using hair root. I. Methamphetamine. Author(s): Nakahara Y, Kikura R, Yasuhara M, Mukai T. Source: Forensic Science International. 1997 January 17; 84(1-3): 157-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9042721&dopt=Abstract
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Hair analysis for drug abuse. XV. Disposition of 3, 4methylenedioxymethamphetamine (MDMA) and its related compounds into rat hair and application to hair analysis for MDMA abuse. Author(s): Kikura R, Nakahara Y, Mieczkowski T, Tagliaro F. Source: Forensic Science International. 1997 January 17; 84(1-3): 165-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9042722&dopt=Abstract
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Hair analysis for drug abuse: I. Determination of methamphetamine and amphetamine in hair by stable isotope dilution gas chromatography/mass spectrometry method. Author(s): Nakahara Y, Takahashi K, Shimamine M, Takeda Y. Source: J Forensic Sci. 1991 January; 36(1): 70-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2007882&dopt=Abstract
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Hashish and drug abuse in Egypt during the 19th and 20th centuries. Author(s): Nahas GG. Source: Bull N Y Acad Med. 1985 June; 61(5): 428-44. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3893585&dopt=Abstract
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Health insurance coverage questions, public health surveys, and drug abuse. Author(s): Cartwright WS, Woodward AM. Source: Nida Res Monogr. 1991; 113: 190-204. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1762640&dopt=Abstract
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Heavy metal music and drug abuse in adolescents. Author(s): King P. Source: Postgraduate Medicine. 1988 April; 83(5): 295-301, 304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3357864&dopt=Abstract
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Heavy metal music and drug abuse. Author(s): Proctor SD. Source: Postgraduate Medicine. 1988 September 1; 84(3): 29, 32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3413007&dopt=Abstract
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Hemolytic disease of the newborn as an unusual consequence of drug abuse. A case report. Author(s): Williamson I, Hofmeyr GJ, Crookes RL. Source: J Reprod Med. 1990 January; 35(1): 46-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2105395&dopt=Abstract
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Historical studies and strategies against alcohol and drug abuse. Author(s): Baasher T. Source: Drug and Alcohol Dependence. 1990 April; 25(2): 215-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2183988&dopt=Abstract
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History of drug abuse treatment in Texas. Author(s): Maddux JF. Source: Tex Med. 1988 May; 84(5): 57-61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3043744&dopt=Abstract
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HIV infection and intravenous drug abuse: world perspective and epidemiology in Israel. Author(s): Dan M. Source: Isr J Med Sci. 1993 October; 29(10 Suppl): 11-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8244674&dopt=Abstract
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HIV risk reduction in outpatient drug abuse treatment: individual and geographic differences. Author(s): Broome KM, Joe GW, Simpson DD. Source: Aids Education and Prevention : Official Publication of the International Society for Aids Education. 1999 August; 11(4): 293-306. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10494354&dopt=Abstract
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HIV risk reduction in the National Institute on Drug Abuse Cocaine Collaborative Treatment Study. Author(s): Woody GE, Gallop R, Luborsky L, Blaine J, Frank A, Salloum IM, Gastfriend D, Crits-Christoph P; Cocaine Psychotherapy Study Group. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2003 May 1; 33(1): 82-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792359&dopt=Abstract
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HIV screening and counseling for intravenous drug abuse patients. Staff and patient attitudes. Author(s): Curtis JL, Crummey FC, Baker SN, Foster RE, Khanyile CS, Wilkins R. Source: Jama : the Journal of the American Medical Association. 1989 January 13; 261(2): 258-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2909023&dopt=Abstract
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HIV/AIDS and drug abuse: epidemiology and prevention. Author(s): Haverkos HW. Source: J Addict Dis. 1998; 17(4): 91-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9848034&dopt=Abstract
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Homeless women with children. The role of alcohol and other drug abuse. Author(s): Robertson MJ. Source: The American Psychologist. 1991 November; 46(11): 1198-204. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1772157&dopt=Abstract
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Homelessness and drug abuse in New Haven. Author(s): Spinner GF, Leaf PJ. Source: Hosp Community Psychiatry. 1992 February; 43(2): 166-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1572614&dopt=Abstract
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How does stress increase risk of drug abuse and relapse? Author(s): Sinha R. Source: Psychopharmacology. 2001 December; 158(4): 343-59. Epub 2001 October 26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11797055&dopt=Abstract
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How effective is drug abuse resistance education? A meta-analysis of Project DARE outcome evaluations. Author(s): Ennett ST, Tobler NS, Ringwalt CL, Flewelling RL. Source: American Journal of Public Health. 1994 September; 84(9): 1394-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8092361&dopt=Abstract
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How helpful are drug abuse helplines? Author(s): Hughes JR, Riggs RL, Carpenter MJ. Source: Drug and Alcohol Dependence. 2001 May 1; 62(3): 191-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11295323&dopt=Abstract
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How to spot illicit drug abuse in your patients. Author(s): Johnson MD, Heriza TJ, St Dennis C. Source: Postgraduate Medicine. 1999 October 1; 106(4): 199-200, 203-6, 211-4 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10533519&dopt=Abstract
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How we marketed drug abuse testing. Author(s): Bennett WD. Source: Mlo: Medical Laboratory Observer. 1989 February; 21(2): 65-6, 70, 72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10318206&dopt=Abstract
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Human drug abuse liability assessment: opioids and analgesics. Author(s): Bigelow GE. Source: British Journal of Addiction. 1991 December; 86(12): 1615-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1686196&dopt=Abstract
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Human drug abuse liability: testing times ahead. Author(s): Cami J. Source: British Journal of Addiction. 1991 December; 86(12): 1525-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1786479&dopt=Abstract
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Human neuroscience at National Institute on Drug Abuse: implications for genetics research. Author(s): Gordon HW. Source: American Journal of Medical Genetics. 1994 December 15; 54(4): 300-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7726199&dopt=Abstract
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Human subject issues in drug abuse research. College on Problems of Drug Dependence. Author(s): Adler MW. Source: Drug and Alcohol Dependence. 1995 February; 37(2): 167-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7758406&dopt=Abstract
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I have no tolerance for impaired nurses. Melba Lee-Hosey addresses drug abuse among nurses. Author(s): Lee-Hosey M. Source: J Pract Nurs. 1996 June; 46(2): 19-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8716909&dopt=Abstract
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Identifying and responding to drug abuse in the workplace: an overview. Author(s): Seymour RB, Smith DE. Source: J Psychoactive Drugs. 1990 October-December; 22(4): 383-405. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2096184&dopt=Abstract
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Identifying high-risk youth: prevalence and patterns of adolescent drug abuse. Author(s): Newcomb MD. Source: Nida Res Monogr. 1995; 156: 7-38. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8594480&dopt=Abstract
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If a US drug abuse epidemic fails to include a major east coast city, can it be called an epidemic? Author(s): Rawson RA, Simon SL, Ling W. Source: J Addict Dis. 2002; 21(1): 1-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11831495&dopt=Abstract
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If you suspect drug abuse. Author(s): Johnson LJ. Source: Med Econ. 2002 August 9; 79(15): 104. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12232913&dopt=Abstract
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Illegal drug abuse and the community camp strategy in China. Author(s): Wang W. Source: Journal of Drug Education. 1999; 29(2): 97-114. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10429353&dopt=Abstract
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Illicit drug use by persons with disabilities: insights from the National Household Survey on Drug Abuse. Author(s): Gilson SF, Chilcoat HD, Stapleton JM. Source: American Journal of Public Health. 1996 November; 86(11): 1613-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8916529&dopt=Abstract
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Immunological approaches to clinical issues in drug abuse. Author(s): Kreek MJ. Source: Nida Res Monogr. 1988; 90: 77-86. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3151936&dopt=Abstract
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Impact evaluation of Drug Abuse Resistance Education (DARE). Author(s): Becker HK, Agopian MW, Yeh S. Source: Journal of Drug Education. 1992; 22(4): 283-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1484326&dopt=Abstract
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Impact of a Drug Abuse Resistance Education (D.A.R.E) program in preventing the initiation of cigarette smoking in fifth- and sixth-grade students. Author(s): Ahmed NU, Ahmed NS, Bennett CR, Hinds JE. Source: Journal of the National Medical Association. 2002 April; 94(4): 249-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11991337&dopt=Abstract
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Implementation and process evaluation of a school-based drug abuse prevention program: Project Towards No Drug Abuse. Author(s): Dent CW, Sussman S, Hennesy M, Galaif ER, Stacy AW, Moss M, Craig S. Source: Journal of Drug Education. 1998; 28(4): 361-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10097485&dopt=Abstract
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Implementation and process evaluation of a student “school-as-community” group. A component of a school-based drug abuse prevention program. Author(s): Sussman S, Galaif ER, Newman T, Hennesy M, Pentz MA, Dent CW, Stacy AW, Moss MA, Craig S, Simon TR. Source: Evaluation Review. 1997 February; 21(1): 94-123. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10183270&dopt=Abstract
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Implementation issues in drug abuse prevention research. Author(s): Pentz MA, Trebow E. Source: Nida Res Monogr. 1991; 107: 123-39. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1922302&dopt=Abstract
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Improvement of decreased critical flicker frequency (CFF) in headache patients with drug abuse after successful withdrawal. Author(s): Schnider P, Maly J, Grunberger J, Aull S, Zeiler K, Wessely P. Source: Headache. 1995 May; 35(5): 269-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7775190&dopt=Abstract
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Improving drug abuse treatment. Overview of treatment issues. Author(s): Pickens RW, Fletcher BW. Source: Nida Res Monogr. 1991; 106: 1-19. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1922282&dopt=Abstract
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Improving drug abuse treatment: recommendations for research and practice. Author(s): Leukefeld CG, Pickens RW, Schuster CR. Source: Nida Res Monogr. 1991; 106: 394-406. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1922299&dopt=Abstract
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Improving the detection of drug abuse, alcohol abuse, and depression in community health centers. Author(s): Olfson M, Tobin JN, Cassells A, Weissman M. Source: Journal of Health Care for the Poor and Underserved. 2003 August; 14(3): 386402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12955918&dopt=Abstract
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Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli. Author(s): Jentsch JD, Taylor JR. Source: Psychopharmacology. 1999 October; 146(4): 373-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10550488&dopt=Abstract
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Incidental myocarditis with intravenous drug abuse: the pathology, immunopathology, and potential implications for human immunodeficiency virusassociated myocarditis. Author(s): Turnicky RP, Goodin J, Smialek JE, Herskowitz A, Beschorner WE. Source: Human Pathology. 1992 February; 23(2): 138-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1740298&dopt=Abstract
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Inclusion of alcoholism and drug abuse content in curricula of varied health care professions. Author(s): Long P, Gelfand G, McGill D. Source: J N Y State Nurses Assoc. 1991 March; 22(1): 9-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1941272&dopt=Abstract
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Increased rates of drug abuse and dependence after onset of mood or anxiety disorders in adolescence. Author(s): Burke JD Jr, Burke KC, Rae DS. Source: Hosp Community Psychiatry. 1994 May; 45(5): 451-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8045539&dopt=Abstract
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Increasing access and providing social services to improve drug abuse treatment for women with children. Author(s): Marsh JC, D'Aunno TA, Smith BD. Source: Addiction (Abingdon, England). 2000 August; 95(8): 1237-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11092071&dopt=Abstract
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Increasing trend of illicit drug abuse in Thai parturient at Siriraj Hospital. Author(s): Inthawiwat S, Rattanachaiyanont M, Leerasiri P, Manoch D, Titapant V. Source: J Med Assoc Thai. 2002 October; 85(10): 1081-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12501899&dopt=Abstract
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Individual and family characteristics of middle class adolescents hospitalized for alcohol and other drug abuse. Author(s): Maltzman I, Schweiger A. Source: British Journal of Addiction. 1991 November; 86(11): 1435-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1777738&dopt=Abstract
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Infections secondary to intravenous drug abuse. Author(s): Reyes FA. Source: Hand Clin. 1989 November; 5(4): 629-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2808554&dopt=Abstract
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Infectious diseases and drug abuse. Prevention and treatment in the drug abuse treatment system. Author(s): Haverkos HW. Source: Journal of Substance Abuse Treatment. 1991; 8(4): 269-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1787552&dopt=Abstract
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Infective endocarditis due to Neisseria sicca and associated with intravenous drug abuse. Author(s): Valenzuela GA, Davis TD, Pizzani E, McGroarty D. Source: Southern Medical Journal. 1992 September; 85(9): 929. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1523457&dopt=Abstract
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Infective endocarditis not related to intravenous drug abuse in HIV-1-infected patients: report of eight cases and review of the literature. Author(s): Losa JE, Miro JM, Del Rio A, Moreno-Camacho A, Garcia F, Claramonte X, Marco F, Mestres CA, Azqueta M, Gatell JM; Hospital Clinic Endocarditis Study Group. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2003 January; 9(1): 45-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691542&dopt=Abstract
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Influence of antisocial personality subtypes on drug abuse treatment response. Author(s): King VL, Kidorf MS, Stoller KB, Carter JA, Brooner RK. Source: The Journal of Nervous and Mental Disease. 2001 September; 189(9): 593-601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11580002&dopt=Abstract
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Influence of psychiatric comorbidity on HIV risk behaviors: changes during drug abuse treatment. Author(s): King VL, Kidorf MS, Stoller KB, Brooner RK. Source: J Addict Dis. 2000; 19(4): 65-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11110066&dopt=Abstract
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Influences of family and friends on client progress during drug abuse treatment. Author(s): Knight DK, Simpson DD. Source: Journal of Substance Abuse. 1996; 8(4): 417-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9058354&dopt=Abstract
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Information and alternatives: the role of a youth non-governmental organization in drug abuse control. Author(s): Garvey M. Source: Bull Narc. 1991; 43(1): 29-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1817708&dopt=Abstract
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Informed consent, deception, and discovering drug abuse. Author(s): Regestein QR. Source: Jama : the Journal of the American Medical Association. 1992 August 12; 268(6): 790-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1640586&dopt=Abstract
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Initiation into drug abuse: the pathway from being offered drugs to trying cannabis and progression to intravenous drug abuse. Author(s): Stenbacka M, Allebeck P, Romelsjo A. Source: Scand J Soc Med. 1993 March; 21(1): 31-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8469942&dopt=Abstract
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Initiation into intravenous drug abuse. Author(s): Stenbacka M. Source: Acta Psychiatrica Scandinavica. 1990 May; 81(5): 459-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2356769&dopt=Abstract
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Initiatives at the National Institute on Drug Abuse. Author(s): Schuster C. Source: Nida Res Monogr. 1988; 81: 1-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3136350&dopt=Abstract
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Inmates in Irish prisons face drug abuse and disease. Author(s): Birchard K. Source: Lancet. 1999 August 28; 354(9180): 753. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10475200&dopt=Abstract
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Innovations in treatment for drug abuse: solutions to a public health problem. Author(s): Sindelar JL, Fiellin DA. Source: Annual Review of Public Health. 2001; 22: 249-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11274521&dopt=Abstract
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In-patient treatment for drug abuse. Author(s): Ghodse AH, London M, Bewley TH, Bhat AV. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1987 July; 151: 72-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3676628&dopt=Abstract
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Institutional barriers to alcohol and drug abuse prevention. Author(s): Goldstein GS. Source: Int J Addict. 1985 January; 20(1): 217-31. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3997311&dopt=Abstract
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Insurance coverage for drug abuse. Author(s): Rogowski JA. Source: Health Aff (Millwood). 1992 Fall; 11(3): 137-48. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1398436&dopt=Abstract
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Integrating psychotherapy and pharmacotherapy to improve drug abuse outcomes. Author(s): Carroll KM. Source: Addictive Behaviors. 1997 March-April; 22(2): 233-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9113217&dopt=Abstract
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International training for drug abuse treatment and the issue of cultural relevance. Author(s): Deitch D, Solit R. Source: J Psychoactive Drugs. 1993 January-March; 25(1): 87-95. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8483052&dopt=Abstract
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Interpretation of drug abuse testing: strengths and limitations of current methodology. Author(s): Verebey K, Martin DM, Gold MS. Source: Psychiatr Med. 1985; 3(3): 287-97. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3916677&dopt=Abstract
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Intraarterial drug abuse: new treatment options. Author(s): Silverman SH, Turner WW Jr. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1991 July; 14(1): 111-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2061951&dopt=Abstract
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Intra-articular drug abuse. Case report. Author(s): Kiburz D. Source: The Journal of Bone and Joint Surgery. American Volume. 1984 December; 66(9): 1469. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6501343&dopt=Abstract
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Intracerebral haemorrhage and drug abuse in young adults. Author(s): McEvoy AW, Kitchen ND, Thomas DG. Source: British Journal of Neurosurgery. 2000 October; 14(5): 449-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198766&dopt=Abstract
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Intracerebral haemorrhage caused by drug abuse. Author(s): McEvoy AW, Kitchen ND, Thomas DG. Source: Lancet. 1998 April 4; 351(9108): 1029. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9546511&dopt=Abstract
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Intra-cranial haemorrhage from drug abuse. Author(s): Ng LL, Hamilton DV, Chalmers TM. Source: Br J Clin Pract. 1986 June; 40(6): 255-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3741735&dopt=Abstract
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Intravenous drug abuse and AIDS transmission: Federal and State laws regulating needle availability. Author(s): Pascal CB. Source: Nida Res Monogr. 1988; 80: 119-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3136338&dopt=Abstract
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Intravenous drug abuse and one academic health center. Author(s): Dans PE, Matricciani RM, Otter SE, Reuland DS. Source: Jama : the Journal of the American Medical Association. 1990 June 20; 263(23): 3173-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2348527&dopt=Abstract
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Intravenous drug abuse and the accident and emergency department. Author(s): Dunlop MG, Steedman DJ. Source: Arch Emerg Med. 1985 June; 2(2): 73-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4015800&dopt=Abstract
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Intravenous drug abuse and the accident and emergency department: AIDS (HTLVIII) antibodies and hepatitis B markers. Author(s): Dunlop MG, Steedman DJ, Peutherer JF. Source: Arch Emerg Med. 1986 December; 3(4): 257-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3026414&dopt=Abstract
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Intravenous drug abuse causes Rh immunization. Author(s): Bowman J, Harman C, Manning F, Menticoglou S, Pollock J. Source: Vox Sanguinis. 1991; 61(2): 96-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1763505&dopt=Abstract
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Intravenous drug abuse in young men: risk factors assessed in a longitudinal perspective. Author(s): Stenbacka M, Allebeck P, Brandt L, Romelsjo A. Source: Scand J Soc Med. 1992 June; 20(2): 94-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1496337&dopt=Abstract
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Intravenous drug abuse is an indication for antepartum screening for RH alloimmunization. A case report and review of literature. Author(s): Dimer JA, David M, Dudenhausen JW. Source: Archives of Gynecology and Obstetrics. 1999 November; 263(1-2): 73-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10728634&dopt=Abstract
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Intravenous drug abuse--the major route of hepatitis C virus transmission among alcohol-dependent individuals? Author(s): Verbaan H, Andersson K, Eriksson S. Source: Scandinavian Journal of Gastroenterology. 1993 August; 28(8): 714-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7692588&dopt=Abstract
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Intravenous methylphenidate abuse. Prototype for prescription drug abuse. Author(s): Parran TV Jr, Jasinski DR. Source: Archives of Internal Medicine. 1991 April; 151(4): 781-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1849397&dopt=Abstract
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Introduction: individual differences in the biobehavioral etiology of drug abuse. Author(s): Gordon HW, Glantz MD. Source: Nida Res Monogr. 1996; 159: 1-15. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8784853&dopt=Abstract
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Irrational beliefs as predictors of adolescent drug abuse and running away. Author(s): Denoff MS. Source: Journal of Clinical Psychology. 1987 May; 43(3): 412-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3597796&dopt=Abstract
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Is consent to antipsychotic meds the answer to drug abuse? Author(s): Costa L. Source: Contemporary Longterm Care. 1989 July; 12(8): 52-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10318355&dopt=Abstract
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Issues in drug abuse prevention intervention research with African Americans. Author(s): Beatty LA. Source: Nida Res Monogr. 1994; 139: 171-201. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8742557&dopt=Abstract
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Issues in human drug abuse liability testing: overview and prospects for the future. Author(s): Brady JV. Source: Nida Res Monogr. 1989; 92: 357-70. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2512501&dopt=Abstract
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Joint action against drug abuse. Author(s): Maurer M. Source: World Health Forum. 1992; 13(4): 320-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1466729&dopt=Abstract
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Just say no. Strict policies can help supervisors keep on-the-job drug abuse in check. Author(s): Foltz-Gray D. Source: Contemporary Longterm Care. 1996 June; 19(6): 56-8, 60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10172677&dopt=Abstract
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Juvenile crime and drug abuse: a prospective study of high risk youth. Author(s): Dembo R, Williams L, Schmeidler J, Wish ED, Getreu A, Berry E. Source: J Addict Dis. 1991; 11(2): 5-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1811760&dopt=Abstract
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Knowledge and experience of young people of drug abuse 1969-84. Author(s): Wright JD, Pearl L. Source: British Medical Journal (Clinical Research Ed.). 1986 January 18; 292(6514): 17982. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3080126&dopt=Abstract
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Knowledge and experience of young people regarding drug abuse, 1969-89. Author(s): Wright JD, Pearl L. Source: Bmj (Clinical Research Ed.). 1990 January 13; 300(6717): 99-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2105785&dopt=Abstract
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Knowledge and views on drug abuse of primary health care workers in Nigeria. Author(s): Abiodun OA. Source: Drug and Alcohol Dependence. 1991 August; 28(2): 177-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1935567&dopt=Abstract
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Knowledge, attitudes and perceptions related to drug abuse in peninsula Malaysia: a survey report. Author(s): Low WY, Zulkifil SN, Yusof K, Batumalai S, Aye KW. Source: Asia Pac J Public Health. 1995; 8(2): 123-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9037810&dopt=Abstract
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Laboratory screening of body fluids in self poisoning and drug abuse. Author(s): Walker S, Johnston A. Source: Ann Acad Med Singapore. 1991 January; 20(1): 91-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2029172&dopt=Abstract
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Learning and unlearning drug abuse in the real world: clinical treatment and public policy. Author(s): Crowley TJ. Source: Nida Res Monogr. 1988; 84: 100-21. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3147378&dopt=Abstract
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Legal uncertainties complicate hospitals' testing for drug abuse. Author(s): Richman D. Source: Modern Healthcare. 1986 November 7; 16(23): 148. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10317808&dopt=Abstract
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Like other segments of culture, military has had to come to grips with drug abuse problems. Author(s): Marwick C, Gunby P. Source: Jama : the Journal of the American Medical Association. 1989 May 19; 261(19): 2784-5, 2788. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2709553&dopt=Abstract
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Liver biopsies in the acquired immune deficiency syndrome: influence of endemic disease and drug abuse. Author(s): Comer GM, Mukherjee S, Scholes JV, Holness LG, Clain DJ. Source: The American Journal of Gastroenterology. 1989 December; 84(12): 1525-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2596454&dopt=Abstract
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Long day's journey into night: women and prescription drug abuse. Author(s): Ogur B. Source: Women Health. 1986 Spring; 11(1): 99-115. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2874664&dopt=Abstract
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Longitudinal studies of drug abuse in a fifteen-year-old population. 1. Drug career. Author(s): Holmberg MB. Source: Acta Psychiatrica Scandinavica. 1985 January; 71(1): 67-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3969841&dopt=Abstract
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Longitudinal studies of drug abuse in a fifteen-year-old population. 2. Antecedents and consequences. Author(s): Holmberg MB. Source: Acta Psychiatrica Scandinavica. 1985 January; 71(1): 80-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3969842&dopt=Abstract
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Longitudinal studies of drug abuse in a fifteen-year-old population. 3. Hidden drug abuse. Author(s): Holmberg MB. Source: Acta Psychiatrica Scandinavica. 1985 February; 71(2): 197-200. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3872012&dopt=Abstract
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Longitudinal studies of drug abuse in a fifteen-year-old population. 5. Prognostic factors. Author(s): Holmberg MB. Source: Acta Psychiatrica Scandinavica. 1985 March; 71(3): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3984762&dopt=Abstract
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Long-term evaluation of a life skills approach for alcohol and drug abuse prevention. Author(s): Brochu S, Souliere M. Source: Journal of Drug Education. 1988; 18(4): 311-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3221282&dopt=Abstract
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Long-term evaluation of drug abuse resistance education. Author(s): Ennett ST, Rosenbaum DP, Flewelling RL, Bieler GS, Ringwalt CL, Bailey SL. Source: Addictive Behaviors. 1994 March-April; 19(2): 113-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8036959&dopt=Abstract
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Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. Author(s): Botvin GJ, Baker E, Dusenbury L, Botvin EM, Diaz T. Source: Jama : the Journal of the American Medical Association. 1995 April 12; 273(14): 1106-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7707598&dopt=Abstract
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Long-term impact of Drug Abuse Resistance Education (D.A.R.E.). Results of a 6-year follow-up. Author(s): Dukes RL, Stein JA, Ullman JB. Source: Evaluation Review. 1997 August; 21(4): 483-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10183294&dopt=Abstract
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Long-term outcome of patients with headache and drug abuse after inpatient withdrawal: five-year follow-up. Author(s): Schnider P, Aull S, Baumgartner C, Marterer A, Wober C, Zeiler K, Wessely P. Source: Cephalalgia : an International Journal of Headache. 1996 November; 16(7): 481-5; Discussion 461. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8933992&dopt=Abstract
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Major trends in drug abuse. Author(s): Alker A. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 1990 October 3-9; 5(2): 36-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2121228&dopt=Abstract
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Male drug abuse, criminality and subcultural affiliation in a career perspective. Author(s): Byqvist S, Olsson B. Source: J Psychoactive Drugs. 1998 January-February; 30(1): 53-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9565209&dopt=Abstract
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Management of drug abuse emergencies. Author(s): Henry JA. Source: Journal of Accident & Emergency Medicine. 1996 November; 13(6): 370-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8947788&dopt=Abstract
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Management of drug abuse in the hospital environment. Author(s): Mazzoni J. Source: Top Health Rec Manage. 1988 September; 9(1): 54-61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10318111&dopt=Abstract
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Management of drug abuse. Author(s): McNelly P. Source: Nursing (Lond). 1989 March; 3(35): 46-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2761821&dopt=Abstract
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Management of drug abuse. Author(s): Robertson JR, Roberts JJ, Black H, Davitt B, Stewart N. Source: Lancet. 1987 August 1; 2(8553): 284-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2886758&dopt=Abstract
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Managing alcohol and drug abuse in the nursing profession. Author(s): Booth PG. Source: Journal of Advanced Nursing. 1987 September; 12(5): 625-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3693720&dopt=Abstract
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Manifestation of severe coronary heart disease after anabolic drug abuse. Author(s): Mewis C, Spyridopoulos I, Kuhlkamp V, Seipel L. Source: Clin Cardiol. 1996 February; 19(2): 153-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8821428&dopt=Abstract
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Mapping-enhanced drug abuse counseling: urinalysis results in the first year of methadone treatment. Author(s): Dees SM, Dansereau DF, Simpson DD. Source: Journal of Substance Abuse Treatment. 1997 January-February; 14(1): 45-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9218236&dopt=Abstract
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Marijuana initiates and their impact on future drug abuse treatment need. Author(s): Gfroerer JC, Epstein JF. Source: Drug and Alcohol Dependence. 1999 May 3; 54(3): 229-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10372796&dopt=Abstract
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Maternal drug abuse and human term placental xenobiotic and steroid metabolizing enzymes in vitro. Author(s): Paakki P, Stockmann H, Kantola M, Wagner P, Lauper U, Huch R, Elovaara E, Kirkinen P, Pasanen M. Source: Environmental Health Perspectives. 2000 February; 108(2): 141-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10656854&dopt=Abstract
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Maternal drug abuse and its effects on young children. Author(s): Lewis KD, Schmeder NH, Bennett B. Source: Mcn. the American Journal of Maternal Child Nursing. 1992 July-August; 17(4): 198-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1635432&dopt=Abstract
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Maternal drug abuse: laws and ethics as agents of just balances and therapeutic interventions. Author(s): Garcia SA. Source: Int J Addict. 1993 November; 28(13): 1311-39. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8294173&dopt=Abstract
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Measures to prevent and reduce drug abuse among young people in Burma. Author(s): Khant U. Source: Bull Narc. 1985 April-September; 37(2-3): 81-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2934106&dopt=Abstract
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Measuring comorbidity and overlap in the hospitalization cost for alcohol and drug abuse and mental illness. Author(s): Rice DP, Kelman S. Source: Inquiry. 1989 Summer; 26(2): 249-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2526093&dopt=Abstract
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Mechanisms of phencyclidine (PCP)-n-methyl-d-aspartate (NMDA) receptor interaction: implications for drug abuse research. Author(s): Zukin SR, Javitt DC. Source: Nida Res Monogr. 1989; 95: 247-54. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2561829&dopt=Abstract
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Medicaid support of alcohol, drug abuse, and mental health services. Author(s): Wright GE, Buck JA. Source: Health Care Financing Review. 1991 Fall; 13(1): 117-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10170864&dopt=Abstract
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Medical and psychosocial services in drug abuse treatment: do stronger linkages promote client utilization? Author(s): Friedmann PD, D'Aunno TA, Jin L, Alexander JA. Source: Health Services Research. 2000 June; 35(2): 443-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10857471&dopt=Abstract
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Medical complications of cocaine and other illicit drug abuse simulating rheumatic disease. Author(s): Lie JT. Source: The Journal of Rheumatology. 1990 June; 17(6): 736-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2388197&dopt=Abstract
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Medical education for alcohol and other drug abuse in the United States. Author(s): Lewis DC. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1990 November 15; 143(10): 1091-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2224678&dopt=Abstract
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Medical students' decisions to report classmates impaired by alcohol or other drug abuse. Author(s): Brown RL, Edwards JA, Rounds LA. Source: Academic Medicine : Journal of the Association of American Medical Colleges. 1992 December; 67(12): 866. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1457029&dopt=Abstract
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Medication and drug abuse in relation to road traffic safety. Author(s): Lesch OM, Lentner S, Mader R, Musalek M, Nimmerrichter A, Walter H. Source: Pharmatherapeutica. 1989; 5(5): 338-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2748692&dopt=Abstract
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Medications development at the National Institute on Drug Abuse: focus on cocaine. Author(s): Johnson DN, Vocci FJ. Source: Nida Res Monogr. 1993; 135: 57-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8289904&dopt=Abstract
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Meeting the challenge of alcohol and drug abuse in the older adult. Author(s): Wade M. Source: Home Healthcare Nurse. 1987 September-October; 5(5): 19, 22-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3650245&dopt=Abstract
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Mefenamic acid prevents assessment of drug abuse with EMIT assays. Author(s): Crane T, Badminton MN, Dawson CM, Rainbow SJ. Source: Clinical Chemistry. 1993 March; 39(3): 549. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8448877&dopt=Abstract
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Methodological issues: drug abuse treatment research in prisons and jails. Author(s): Fletcher BW, Tims FM. Source: Nida Res Monogr. 1992; 118: 246-60. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1620221&dopt=Abstract
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Methods used to detect drug abuse in pregnancy: a brief review. Author(s): Strano-Rossi S. Source: Drug and Alcohol Dependence. 1999 February 1; 53(3): 257-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10080052&dopt=Abstract
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Methylene chloride inhalation: an unusual form of drug abuse. Author(s): Sturmann K, Mofenson H, Caraccio T. Source: Annals of Emergency Medicine. 1985 September; 14(9): 903-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4025992&dopt=Abstract
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Microcomputers and prevention of drug abuse. Author(s): Barber JG. Source: Md Comput. 1991 May-June; 8(3): 150-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1857192&dopt=Abstract
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Midazolam--iatrogenic drug abuse? Author(s): Eubanks JR Jr. Source: Ala Med. 1989 May; 58(11): 13-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2741759&dopt=Abstract
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Migraine headaches and drug abuse. Author(s): el-Mallakh RS. Source: Southern Medical Journal. 1989 June; 82(6): 805. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2734650&dopt=Abstract
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Mixed message on prescription drug abuse. Author(s): Vastag B. Source: Jama : the Journal of the American Medical Association. 2001 May 2; 285(17): 2183-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11325305&dopt=Abstract
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MMPI and critical flicker frequency (CFF) analysis in headache patients with and without drug abuse. Author(s): Schnider P, Maly J, Mraz M, Brantner-Inthaler S, Zeiler K, Wessely P. Source: Headache. 1995 January; 35(1): 17-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7868329&dopt=Abstract
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Mondor's disease secondary to intravenous drug abuse. Author(s): Cooper RA. Source: Archives of Surgery (Chicago, Ill. : 1960). 1990 June; 125(6): 807-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2346382&dopt=Abstract
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Monitoring treatment demand for drug abuse in Spain: perspective over a decade. Author(s): Alvarez-Requejo A, Suelves JM, Brugal MT, Correa JF. Source: European Addiction Research. 1999 December; 5(4): 179-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10705184&dopt=Abstract
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Morbidity risk for alcoholism and drug abuse in relatives of cocaine addicts. Author(s): Handelsman L, Branchey MH, Buydens-Branchey L, Gribomont B, Holloway K, Silverman J. Source: The American Journal of Drug and Alcohol Abuse. 1993; 19(3): 347-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8213698&dopt=Abstract
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More on self-medication and drug abuse. Author(s): Dackis CA, Gold MS. Source: The American Journal of Psychiatry. 1986 October; 143(10): 1309-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3766797&dopt=Abstract
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Mothers in the media: blamed and celebrated--an examination of drug abuse and multiple births. Author(s): Charles S, Shivas T. Source: Pediatric Nursing. 2002 March-April; 28(2): 142-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11962180&dopt=Abstract
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Motivational interviewing in drug abuse services: a randomized trial. Author(s): Miller WR, Yahne CE, Tonigan JS. Source: Journal of Consulting and Clinical Psychology. 2003 August; 71(4): 754-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924680&dopt=Abstract
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Mucor cerebral abscess associated with intravenous drug abuse. Author(s): Fong KM, Seneviratne EM, McCormack JG. Source: Aust N Z J Med. 1990 February; 20(1): 74-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2322206&dopt=Abstract
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Multiple intracerebral hemorrhages and vasospasm following antimigrainous drug abuse. Author(s): Nighoghossian N, Derex L, Trouillas P. Source: Headache. 1998 June; 38(6): 478-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9664756&dopt=Abstract
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Mycotic aneurysms in intravenous drug abuse. Author(s): Lewis ES, Singh I, Patel R, Purcell R. Source: Journal of the National Medical Association. 1986 April; 78(4): 273. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3754905&dopt=Abstract
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Mycotic aneurysms in intravenous drug abuse: diagnosis and management. Author(s): Tuckson W, Anderson BB. Source: Journal of the National Medical Association. 1985 February; 77(2): 99-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3838558&dopt=Abstract
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Mycotic endophthalmitis caused by Penicillium sp. after parenteral drug abuse. Author(s): Swan SK, Wagner RA, Myers JP, Cinelli AB. Source: American Journal of Ophthalmology. 1985 September 15; 100(3): 408-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4037026&dopt=Abstract
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Narcotic drug abuse in 152 countries: social and economic conditions as predictors. Author(s): Smart RG, Murray GF. Source: Int J Addict. 1985 May; 20(5): 737-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3876293&dopt=Abstract
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National and international strategies to control drug abuse. Author(s): Westermeyer J. Source: Adv Alcohol Subst Abuse. 1989; 8(2): 1-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2665435&dopt=Abstract
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National campaign against drug abuse. Author(s): Bell DS. Source: The Medical Journal of Australia. 1990 May 7; 152(9): 502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2381348&dopt=Abstract
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National campaign against drug abuse. Author(s): Howarth F. Source: The Medical Journal of Australia. 1989 April 3; 150(7): 408-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2716667&dopt=Abstract
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National campaign against drug abuse. Author(s): Bell DS. Source: The Medical Journal of Australia. 1989 January 16; 150(2): 109-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2725390&dopt=Abstract
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National campaign against drug abuse. Author(s): Bell DS. Source: The Medical Journal of Australia. 1987 July 6; 147(1): 51-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3626937&dopt=Abstract
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National campaign against drug abuse. Author(s): Blewett N. Source: The Medical Journal of Australia. 1987 January 19; 146(2): 117-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3796415&dopt=Abstract
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National campaign against drug abuse. Author(s): Bell DS. Source: The Medical Journal of Australia. 1986 July 7; 145(1): 59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3724638&dopt=Abstract
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National campaign against drug abuse. Author(s): Drew L. Source: The Medical Journal of Australia. 1986 March 31; 144(7): 340. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3959948&dopt=Abstract
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National concern about drug abuse brings athletes under unusual scrutiny. Author(s): Cowart V. Source: Jama : the Journal of the American Medical Association. 1986 November 14; 256(18): 2457-9, 2464-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3773145&dopt=Abstract
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National Institute on Drug Abuse may join in anabolic steroid research. Author(s): Cowart VS. Source: Jama : the Journal of the American Medical Association. 1989 April 7; 261(13): 1855-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2926915&dopt=Abstract
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Needle emboli to lung following intravenous drug abuse. Author(s): Angelos MG, Sheets CA, Zych PR. Source: The Journal of Emergency Medicine. 1986; 4(5): 391-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3805696&dopt=Abstract
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Needle embolus: a unique complication of intravenous drug abuse. Author(s): Lewis TD, Henry DA. Source: Annals of Emergency Medicine. 1985 September; 14(9): 906-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3896063&dopt=Abstract
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Network theory: a model for understanding drug abuse among African-American and Hispanic youth. Author(s): Krohn MD, Thornberry TP. Source: Nida Res Monogr. 1993; 130: 102-28. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8413503&dopt=Abstract
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Postgraduate medical fellowship training in alcoholism and drug abuse: national consensus standards. Author(s): Galanter M, Kaufman E, Schnoll S, Burns J. Source: The American Journal of Drug and Alcohol Abuse. 1991; 17(1): 1-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2038979&dopt=Abstract
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Research is badly needed to improve programmes for the prevention and treatment of drug abuse and drug dependence in Brazil. Author(s): Carlini EA. Source: Drug and Alcohol Dependence. 1990 April; 25(2): 169-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2183985&dopt=Abstract
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Research on drug dependence and epidemiological investigation of drug abuse in China. Author(s): Cai ZJ. Source: J Toxicol Sci. 1998 July; 23 Suppl 2: 191-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9760462&dopt=Abstract
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Research priorities for psychotherapy and counseling in the treatment of drug abuse: the psychotherapy research perspective. Author(s): London P. Source: Nida Res Monogr. 1990; 104: 121-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2092222&dopt=Abstract
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Residential drug abuse treatment for probationers. Use of node-link mapping to enhance participation and progress. Author(s): Pitre U, Dansereau DF, Newbern D, Simpson DD. Source: Journal of Substance Abuse Treatment. 1998 November-December; 15(6): 535-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9845867&dopt=Abstract
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Rhabdomyolysis and acute renal failure resulting from alcohol and drug abuse. Author(s): Deighan CJ, Wong KM, McLaughlin KJ, Harden P. Source: Qjm : Monthly Journal of the Association of Physicians. 2000 January; 93(1): 2933. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10623779&dopt=Abstract
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Risk factors for drug abuse in Pakistan: a replication. Author(s): Gillis JS, Mubbashar MH. Source: Psychological Reports. 1995 February; 76(1): 99-108. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7770599&dopt=Abstract
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Risk for affective disorder and alcohol and other drug abuse in the relatives of affectively ill adoptees. Author(s): Ingraham LJ, Wender PH. Source: Journal of Affective Disorders. 1992 September; 26(1): 45-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1430667&dopt=Abstract
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Risk reduction in sexual behavior: a condom giveaway program in a drug abuse treatment clinic. Author(s): Calsyn DA, Meinecke C, Saxon AJ, Stanton V. Source: American Journal of Public Health. 1992 November; 82(11): 1536-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1332520&dopt=Abstract
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Role of alcohol use by narcotic addicts as revealed in the DARP research on evaluation of treatment for drug abuse. Author(s): Sells SB, Simpson DD. Source: Alcoholism, Clinical and Experimental Research. 1987 October; 11(5): 437-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3314556&dopt=Abstract
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Role of the family in drug abuse. Author(s): Kartikeyan SK, Chaturvedi RM, Bhalerao VR. Source: Journal of Postgraduate Medicine. 1992 January-March; 38(1): 5-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1512731&dopt=Abstract
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Screening for drug abuse among adolescents in clinical and correctional settings using the Problem-Oriented Screening Instrument for Teenagers. Author(s): Latimer WW, Winters KC, Stinchfield RD. Source: The American Journal of Drug and Alcohol Abuse. 1997 February; 23(1): 79-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9048149&dopt=Abstract
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Searching for solutions to alcohol and other drug abuse during pregnancy: ethics, values, and constitutional principles. Author(s): Andrews AB, Patterson EG. Source: Social Work. 1995 January; 40(1): 55-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7863373&dopt=Abstract
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Secondary school teachers' knowledge and views about drug abuse in Ogun State, Nigeria--a pilot survey. Author(s): Adelekan ML, Ogunlesi GO, Akindele OM. Source: Journal of Drug Education. 1990; 20(2): 163-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2398450&dopt=Abstract
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Seizures associated with recreational drug abuse. Author(s): Alldredge BK, Lowenstein DH, Simon RP. Source: Neurology. 1989 August; 39(8): 1037-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2788249&dopt=Abstract
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Selected legal issues about AIDS for drug abuse treatment programs. Author(s): Pascal CB. Source: J Psychoactive Drugs. 1987 January-March; 19(1): 1-12. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3585590&dopt=Abstract
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Severe panarteritis associated with drug abuse. Author(s): Mockel M, Kampf D, Lobeck H, Frei U. Source: Intensive Care Medicine. 1999 January; 25(1): 113-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10051089&dopt=Abstract
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Sexual abuse, physical abuse, and posttraumatic stress disorder among women participating in outpatient drug abuse treatment. Author(s): Gil-Rivas V, Fiorentine R, Anglin MD. Source: J Psychoactive Drugs. 1996 January-March; 28(1): 95-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8714338&dopt=Abstract
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Should a psychiatrist report a bus driver's alcohol and drug abuse? An ethical dilemma. Author(s): Leeman CP, Cohen MA, Parkas V. Source: General Hospital Psychiatry. 2001 November-December; 23(6): 333-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11738464&dopt=Abstract
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Single photon emission computed tomography in phencyclidine and related drug abuse. Author(s): Hertzmann M, Reba RC, Kotlyarov EV. Source: The American Journal of Psychiatry. 1990 February; 147(2): 255-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2301671&dopt=Abstract
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Smoking as an issue in alcohol and drug abuse treatment. Author(s): Battjes RJ. Source: Addictive Behaviors. 1988; 13(3): 225-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3051913&dopt=Abstract
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Social and legal factors related to drug abuse in the United States and Japan. Author(s): Greberman SB, Wada K. Source: Public Health Reports (Washington, D.C. : 1974). 1994 November-December; 109(6): 731-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7800780&dopt=Abstract
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Socio-demographic correlates and pattern of drug abuse in eastern Saudi Arabia. Author(s): Hafeiz HB. Source: Drug and Alcohol Dependence. 1995 June; 38(3): 255-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7555626&dopt=Abstract
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Sociodemographic factors in drug abuse treatment. Author(s): Gorelick DA. Source: Journal of Health Care for the Poor and Underserved. 1992 Summer; 3(1): 49-58; Discussion 59. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1391388&dopt=Abstract
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Soft tissue abscesses associated with parenteral drug abuse: presentation, microbiology, and treatment. Author(s): Bergstein JM, Baker EJ 4th, Aprahamian C, Schein M, Wittmann DH. Source: The American Surgeon. 1995 December; 61(12): 1105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7486458&dopt=Abstract
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Soft tissue infections from drug abuse. A clinical and microbiological review of 145 cases. Author(s): Henriksen BM, Albrektsen SB, Simper LB, Gutschik E. Source: Acta Orthopaedica Scandinavica. 1994 December; 65(6): 625-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7839849&dopt=Abstract
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Some design, measurement, and analysis pitfalls in drug abuse prevention research and how to avoid them: let your model be your guide. Author(s): Collins LM. Source: Nida Res Monogr. 1994; 139: 95-114. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8742553&dopt=Abstract
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Some ocular manifestations of systemic drug abuse. Author(s): Urey JC. Source: J Am Optom Assoc. 1991 November; 62(11): 832-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1813511&dopt=Abstract
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Some special considerations for treatment of drug abuse and dependence in women. Author(s): Mendelson JH, Weiss R, Griffin M, Mirin SM, Teoh SK, Mello NK, Lex BW. Source: Nida Res Monogr. 1991; 106: 313-27. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1922294&dopt=Abstract
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Spiritual high vs high on spirits: is religiosity related to adolescent alcohol and drug abuse? Author(s): Pullen L, Modrcin-Talbott MA, West WR, Muenchen R. Source: Journal of Psychiatric and Mental Health Nursing. 1999 February; 6(1): 3-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10336731&dopt=Abstract
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Spontaneous remission from alcohol, tobacco, and other drug abuse: seeking quantitative answers to qualitative questions. Author(s): Walters GD. Source: The American Journal of Drug and Alcohol Abuse. 2000 August; 26(3): 443-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10976668&dopt=Abstract
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Stability and change in dimensional ratings of personality disorders in drug abuse patients during treatment. Author(s): de Groot MH, Franken IH, van der Meer CW, Hendriks VM. Source: Journal of Substance Abuse Treatment. 2003 March; 24(2): 115-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745028&dopt=Abstract
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Stages of drug use acquisition among college students: implications for the prevention of drug abuse. Author(s): Werch CE, Meers BW, Farrell J. Source: Journal of Drug Education. 1993; 23(4): 375-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8145114&dopt=Abstract
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Statement to the physicians of North Carolina from the Committee on Drug Abuse and Pharmacy of the North Carolina Medical Society. Author(s): Mack RB. Source: N C Med J. 1991 August; 52(8): 407. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1922401&dopt=Abstract
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Sterile needles and the epidemic of acquired immunodeficiency syndrome: issues for drug abuse treatment and public health. Author(s): Selwyn PA. Source: Adv Alcohol Subst Abuse. 1987; 7(2): 99-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3448896&dopt=Abstract
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Sternoclavicular arthritis and osteomyelitis due to Pseudomonas aeruginosa, not related to drug abuse. Author(s): Streifler J, Pitlik S, Garty M, Grosskopf I, Rosenfeld JB. Source: Isr J Med Sci. 1985 May; 21(5): 458-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4019134&dopt=Abstract
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Strategies for identifying genes underlying drug abuse susceptibility. Author(s): Crabbe JC, Buck KJ, Metten P, Belknap JK. Source: Nida Res Monogr. 1996; 161: 201-19. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8784852&dopt=Abstract
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Strengthening international action on drug abuse: outcomes from a very important meeting. Author(s): Oppenheimer T. Source: British Journal of Addiction. 1988 June; 83(6): 605-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3401607&dopt=Abstract
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Stress, the hypothalamic-pituitary-adrenal axis, and vulnerability to drug abuse. Author(s): Goeders NE. Source: Nida Res Monogr. 1998 March; 169: 83-104. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9686412&dopt=Abstract
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Student assistance programs: an important approach to drug abuse prevention. Author(s): McGovern JP, DuPont RL. Source: The Journal of School Health. 1991 August; 61(6): 260-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1956173&dopt=Abstract
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Substance abuse and dependence in physicians: an overview of the effects of alcohol and drug abuse. Author(s): Bohigian GM, Croughan JL, Sanders K. Source: Mo Med. 1994 May; 91(5): 233-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8041352&dopt=Abstract
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Sudden airway obstruction following inhalation drug abuse. Author(s): White MC, Reynolds F. Source: British Journal of Anaesthesia. 1999 May; 82(5): 808. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10536567&dopt=Abstract
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Suicide and alcoholism. Distinguishing alcoholic patients with and without comorbid drug abuse. Author(s): Porsteinsson A, Duberstein PR, Conwell Y, Cox C, Forbes N, Caine ED. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 1997 Fall; 6(4): 304-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9398928&dopt=Abstract
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Summary of critiques from the drug abuse epidemiology and prevention research review committee. Author(s): Crider R, Friedenberg E. Source: Nida Res Monogr. 1994; 139: 155-69. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8742556&dopt=Abstract
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Surveillance of poisoning and drug overdose through hospital discharge coding, poison control center reporting, and the Drug Abuse Warning Network. Author(s): Blanc PD, Jones MR, Olson KR. Source: The American Journal of Emergency Medicine. 1993 January; 11(1): 14-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8447863&dopt=Abstract
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Surveillance, prevention and control of drug abuse in hospitals. Author(s): Galarza NJ. Source: Bol Asoc Med P R. 1993 January-March; 85(1-3): 18-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8060438&dopt=Abstract
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Syphilis, gonorrhoea, and drug abuse among pregnant women in Jefferson County, Alabama, US, 1980-94: monitoring trends through systematically collected health services data. Author(s): Ebrahim SH, Andrews WW, Zaidi AA, Levine WC, DuBard MB, Goldenberg RL. Source: Sexually Transmitted Infections. 1999 October; 75(5): 300-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10616352&dopt=Abstract
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The correlates of addiction concern among adolescents at high risk for drug abuse. Author(s): Sussman S, Dent CW. Source: Journal of Substance Abuse. 1996; 8(3): 361-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8934440&dopt=Abstract
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The correlates of substance abuse and dependence among adolescents at high risk for drug abuse. Author(s): Sussman S, Dent CW, Galaif ER. Source: Journal of Substance Abuse. 1997; 9: 241-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9494952&dopt=Abstract
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The costs of drug abuse consequences: a summary of research findings. Author(s): French MT, Martin RF. Source: Journal of Substance Abuse Treatment. 1996 November-December; 13(6): 453-66. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9219142&dopt=Abstract
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The deficit syndrome in the DSM-IV Field Trial: I. Alcohol and other drug abuse. Author(s): Kirkpatrick B, Amador XF, Flaum M, Yale SA, Gorman JM, Carpenter WT Jr, Tohen M, McGlashan T. Source: Schizophrenia Research. 1996 May; 20(1-2): 69-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8794495&dopt=Abstract
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The dentist and prescription drug abuse. Author(s): Balevi B, Breen L, Krasnowski J. Source: Journal (Canadian Dental Association). 1996 January; 62(1): 56-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8673939&dopt=Abstract
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The design of Healthcare for Communities: a study of health care delivery for alcohol, drug abuse, and mental health conditions. Author(s): Sturm R, Gresenz C, Sherbourne C, Minnium K, Klap R, Bhattacharya J, Farley D, Young AS, Burnam MA, Wells KB. Source: Inquiry. 1999 Summer; 36(2): 221-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10459376&dopt=Abstract
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The drug abuse problem in Peninsular Malaysia: parent and child differences in knowledge, attitudes and perceptions. Author(s): Low WY, Zulkifli SN, Yusof K, Batumalail S, Aye KW. Source: Drug and Alcohol Dependence. 1996 October; 42(2): 105-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8889409&dopt=Abstract
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The drug abuse treatment gap: recent estimates. Author(s): Woodward A, Epstein J, Gfroerer J, Melnick D, Thoreson R, Willson D. Source: Health Care Financing Review. 1997 Spring; 18(3): 5-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10173122&dopt=Abstract
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The economic and social costs of drug abuse among the rural population. Author(s): Donnermeyer JF. Source: Nida Res Monogr. 1997; 168: 220-45. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9260171&dopt=Abstract
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The effectiveness of alternative planned durations of residential drug abuse treatment. Author(s): McCusker J, Vickers-Lahti M, Stoddard A, Hindin R, Bigelow C, Zorn M, Garfield F, Frost R, Love C, Lewis B. Source: American Journal of Public Health. 1995 October; 85(10): 1426-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7573630&dopt=Abstract
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The effectiveness of Drug Abuse Resistance Education (project DARE): 5-year followup results. Author(s): Clayton RR, Cattarello AM, Johnstone BM. Source: Preventive Medicine. 1996 May-June; 25(3): 307-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8781009&dopt=Abstract
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The effectiveness of drug abuse treatment: a meta-analysis of comparison group studies. Author(s): Prendergast ML, Podus D, Chang E, Urada D. Source: Drug and Alcohol Dependence. 2002 June 1; 67(1): 53-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12062779&dopt=Abstract
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The effects of drug abuse prevention at school: the 'Healthy School and Drugs' project. Author(s): Cuijpers P, Jonkers R, de WI, de JA. Source: Addiction (Abingdon, England). 2002 January; 97(1): 67-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11895272&dopt=Abstract
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The effects of planned duration of residential drug abuse treatment on recovery and HIV risk behavior. Author(s): McCusker J, Bigelow C, Frost R, Garfield F, Hindin R, Vickers-Lahti M, Lewis B. Source: American Journal of Public Health. 1997 October; 87(10): 1637-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9357345&dopt=Abstract
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The federal role in drug abuse technology transfer: a history and perspective. Author(s): Brown BS, Flynn PM. Source: Journal of Substance Abuse Treatment. 2002 June; 22(4): 245-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12072168&dopt=Abstract
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The impact of Federal Alcohol and Drug Abuse block grants on state and local government substance abuse program expenditures: the role of federal oversight. Author(s): Gamkhar S, Sim SC. Source: Journal of Health Politics, Policy and Law. 2001 December; 26(6): 1261-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11831580&dopt=Abstract
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The impact of HIV infection on medical services in drug abuse treatment programs. Author(s): Selwyn PA. Source: Journal of Substance Abuse Treatment. 1996 September-October; 13(5): 397-410; Discussion 439. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9142670&dopt=Abstract
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The impact of insurance status on drug abuse treatment completion. Author(s): Garcia LM, McGeary KA, Shultz JM, McCoy CB. Source: Journal of Health Care Finance. 1999 Fall; 26(1): 40-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10497750&dopt=Abstract
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The joint demand for cigarettes and marijuana: evidence from the National Household Surveys on Drug Abuse. Author(s): Farrelly MC, Bray JW, Zarkin GA, Wendling BW. Source: Journal of Health Economics. 2001 January; 20(1): 51-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11148871&dopt=Abstract
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The lack of selection bias in a snowball sampled case-control study on drug abuse. Author(s): Lopes CS, Rodrigues LC, Sichieri R. Source: International Journal of Epidemiology. 1996 December; 25(6): 1267-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9027534&dopt=Abstract
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The natural history of outpatient alcohol and drug abuse treatment in a private healthcare setting. Author(s): Pettinati HM, Belden PP, Evans BD, Ruetsch CR, Meyers K, Jensen JM. Source: Alcoholism, Clinical and Experimental Research. 1996 August; 20(5): 847-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8865959&dopt=Abstract
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The potential role of the cytochrome P-450 2D6 pharmacogenetic polymorphism in drug abuse. Author(s): Sellers EM, Otton SV, Tyndale RF. Source: Nida Res Monogr. 1997; 173: 6-26. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9260180&dopt=Abstract
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The prevalence and effect of alcohol and drug abuse on cohort-matched critically injured patients. Author(s): Cornwell EE 3rd, Belzberg H, Velmahos G, Chan LS, Demetriades D, Stewart BM, Oder DB, Kahaku D, Chan D, Asensio JA, Berne TV. Source: The American Surgeon. 1998 May; 64(5): 461-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9585786&dopt=Abstract
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The problem of HIV/AIDS as related to drug abuse: an introduction. Author(s): Gottheil E. Source: J Addict Dis. 1998; 17(4): 1-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9848027&dopt=Abstract
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The underreporting of cocaine-related trauma: drug abuse warning network reports vs hospital toxicology tests. Author(s): Brookoff D, Campbell EA, Shaw LM. Source: American Journal of Public Health. 1993 March; 83(3): 369-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8438974&dopt=Abstract
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Theoretical models used to guide NIDA's cooperative agreement research and intervention efforts. National Institute on Drug Abuse. Author(s): Stevens SJ, Kotranski L, Williams M, Bowen AE, McCoy HV. Source: J Psychoactive Drugs. 1998 July-September; 30(3): 231-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9798788&dopt=Abstract
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Therapeutic alliance as a predictor of outcome and retention in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Author(s): Barber JP, Luborsky L, Gallop R, Crits-Christoph P, Frank A, Weiss RD, Thase ME, Connolly MB, Gladis M, Foltz C, Siqueland L. Source: Journal of Consulting and Clinical Psychology. 2001 February; 69(1): 119-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11302268&dopt=Abstract
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Use of abnormal and health psychology as topics in a classroom format to reduce alcohol and other drug abuse among college students at risk. Author(s): Miley WM. Source: Psychological Reports. 2001 December; 89(3): 728-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11824744&dopt=Abstract
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Use of drug discrimination in drug abuse research. Author(s): Appel JB, Baker LE, Barrett RL, Broadbent J, Michael EM, Riddle EE, Van Groll BJ. Source: Nida Res Monogr. 1991; (116): 369-97. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1369679&dopt=Abstract
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Use of prescription forgeries in a drug abuse surveillance network. Author(s): Bergman U, Dahl-Puustinen ML. Source: European Journal of Clinical Pharmacology. 1989; 36(6): 621-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2776820&dopt=Abstract
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Using focus groups in drug abuse and HIV/AIDS research. Author(s): Shedlin MG, Schreiber JM. Source: Nida Res Monogr. 1995; 157: 136-55. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8684435&dopt=Abstract
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Using guiding-idea theories of the person to develop educational campaigns against drug abuse and other health-threatening behavior. Author(s): McGuire WJ. Source: Health Education Research. 1991 June; 6(2): 173-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10171670&dopt=Abstract
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Using psychotherapy effectively in drug abuse treatment. Author(s): Onken LS. Source: Nida Res Monogr. 1991; 106: 267-78. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1922291&dopt=Abstract
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Using research to guide culturally appropriate drug abuse prevention. Author(s): Catalano RF, Hawkins JD, Krenz C, Gillmore M, Morrison D, Wells E, Abbott R. Source: Journal of Consulting and Clinical Psychology. 1993 October; 61(5): 804-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8245277&dopt=Abstract
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Using the drug abuse screening test (DAST-10) to analyze health services utilization and cost for substance users in a community-based setting. Author(s): French MT, Roebuck MC, McGeary KA, Chitwood DD, McCoy CB. Source: Substance Use & Misuse. 2001 May-June; 36(6-7): 927-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11697616&dopt=Abstract
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Using the Trail Making test to screen for cognitive impairment in a drug abuse treatment sample. Author(s): Roberts C, Horton AM Jr. Source: The International Journal of Neuroscience. 2001 August; 109(3-4): 273-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11699333&dopt=Abstract
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Validity of the MCMI Drug Abuse Scale varies as a function of drug choice, race, and axis II subtypes. Author(s): Calsyn DA, Saxon AJ, Daisy F. Source: The American Journal of Drug and Alcohol Abuse. 1991 June; 17(2): 153-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1862789&dopt=Abstract
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Validity of the MCMI Drug Abuse Scale with drug abusing and psychiatric samples. Author(s): Calsyn DA, Saxon AJ, Daisy F. Source: Journal of Clinical Psychology. 1990 March; 46(2): 244-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2324309&dopt=Abstract
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Vanoxerine National Institute on Drug Abuse. Author(s): Preti A. Source: Curr Opin Investig Drugs. 2000 October; 1(2): 241-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11249581&dopt=Abstract
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Vascular complications related to drug abuse. Author(s): Yeager RA, Hobson RW 2nd, Padberg FT, Lynch TG, Chakravarty M. Source: The Journal of Trauma. 1987 March; 27(3): 305-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3560273&dopt=Abstract
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Vascular trauma in drug abuse: patterns of injury. Author(s): Benitez PR, Newell MA. Source: Annals of Vascular Surgery. 1986 September; 1(2): 175-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3504327&dopt=Abstract
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Verifying drug abuse prevention program effects using reciprocal best friend reports. Author(s): Donaldson SI, Thomas CW, Graham JW, Au JG, Hansen WB. Source: Journal of Behavioral Medicine. 2000 December; 23(6): 585-601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11199089&dopt=Abstract
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View from the Nation's Capital. Drug abuse policy: policy or politics? Author(s): Appler WD Jr. Source: Journal of Clinical Psychopharmacology. 1987 April; 7(2): 104-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3584513&dopt=Abstract
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Views of medical students and residents on education in alcohol and drug abuse. Author(s): Fassler D. Source: J Med Educ. 1985 July; 60(7): 562-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4009673&dopt=Abstract
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Violent traumatic events and drug abuse severity. Author(s): Clark HW, Masson CL, Delucchi KL, Hall SM, Sees KL. Source: Journal of Substance Abuse Treatment. 2001 March; 20(2): 121-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11306214&dopt=Abstract
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Visual illusions associated with previous drug abuse. Author(s): Levi L, Miller NR. Source: J Clin Neuroophthalmol. 1990 June; 10(2): 103-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2141849&dopt=Abstract
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Vulnerability to drug abuse among opioid addicts' siblings: individual, familial, and peer influences. Author(s): Luthar SS, Anton SF, Merikangas KR, Rounsaville BJ. Source: Comprehensive Psychiatry. 1992 May-June; 33(3): 190-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1591911&dopt=Abstract
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We can detect drug abuse--but will we? Author(s): Bateman C. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2000 August; 90(8): 751-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11022616&dopt=Abstract
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What role do GluR1 subunits play in drug abuse? Author(s): Stephens DN, Mead AN. Source: Trends in Neurosciences. 2003 April; 26(4): 181-2; Author Reply 182-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12689767&dopt=Abstract
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What to do about drug abuse. Author(s): Macnair A. Source: Lancet. 1986 October 4; 2(8510): 811. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2876263&dopt=Abstract
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What works in drug abuse epidemiology in Europe. Author(s): Kaplan CD. Source: J Addict Dis. 1991; 11(1): 47-59. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1790152&dopt=Abstract
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What's the connection? No easy answers for people with eating disorders and drug abuse. Author(s): Vastag B. Source: Jama : the Journal of the American Medical Association. 2001 February 28; 285(8): 1006-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11209156&dopt=Abstract
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When i.v. drug abuse complicates AIDS. Author(s): Schmitz D. Source: Rn. 1990 January; 53(1): 60-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2300755&dopt=Abstract
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When the nurse suspects drug abuse. Author(s): Newton M, Wulf BG, Lindeman M, Volcek MK. Source: Plastic Surgical Nursing : Official Journal of the American Society of Plastic and Reconstructive Surgical Nurses. 1986 Fall; 6(3): 113-5, 118-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3640499&dopt=Abstract
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Who is serving drug abuse clients: treatment delivery by professionals versus paraprofessionals, by paid staff versus volunteers. Author(s): Aiken LS, LoSciuto L, Ausetts M. Source: Nida Res Monogr. 1985; 58: 123-45. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3929124&dopt=Abstract
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Who will treat alcohol and drug abuse patients? Author(s): Millman RB, Steinberg SP. Source: Hosp Community Psychiatry. 1989 October; 40(10): 989. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2807215&dopt=Abstract
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Why has it proved so difficult to match drug abuse patients to appropriate treatment? Author(s): Ball JC. Source: Addiction (Abingdon, England). 1994 March; 89(3): 263-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8173492&dopt=Abstract
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Women living with drug abuse and HIV disease: drug abuse treatment access and secondary prevention issues. Author(s): Weissman G, Melchior L, Huba G, Smereck G, Needle R, McCarthy S, Jones A, Genser S, Cottler L, Booth R, et al. Source: J Psychoactive Drugs. 1995 October-December; 27(4): 401-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8788695&dopt=Abstract
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Women reaching women: a project on alcohol and other drug abuse. Author(s): Kravetz D, Jones LE. Source: Adm Soc Work. 1988; 12(2): 45-58. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10318174&dopt=Abstract
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Women's steps of change and entry into drug abuse treatment. A multidimensional stages of change model. Author(s): Brown VB, Melchior LA, Panter AT, Slaughter R, Huba GJ. Source: Journal of Substance Abuse Treatment. 2000 April; 18(3): 231-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10742636&dopt=Abstract
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Workforce drug abuse takes on new dimension for health profession. Author(s): Goerth CR. Source: Occup Health Saf. 1985 July; 54(7): 55. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4022537&dopt=Abstract
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Workplace drug abuse policy. Author(s): McGuire TG, Ruhm CJ. Source: Journal of Health Economics. 1993 April; 12(1): 19-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10171449&dopt=Abstract
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Workplace drug abuse policy. Author(s): Hirth RA. Source: Journal of Health Economics. 1994 October; 13(3): 373-8; Discussion 379. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10172171&dopt=Abstract
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Workplace urine screening for drug abuse. Author(s): Wright DS. Source: Journal of Medical Ethics. 1997 June; 23(3): 191. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9220335&dopt=Abstract
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Xylazine in human tissue and fluids in a case of fatal drug abuse. Author(s): Poklis A, Mackell MA, Case ME. Source: Journal of Analytical Toxicology. 1985 September-October; 9(5): 234-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4057964&dopt=Abstract
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Young people and the struggle against drug abuse in the Arab countries. Author(s): Okasha A. Source: Bull Narc. 1985 April-September; 37(2-3): 67-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3878175&dopt=Abstract
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CHAPTER 2. NUTRITION AND DRUG ABUSE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and drug abuse.
Finding Nutrition Studies on Drug Abuse The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “drug abuse” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following is a typical result when searching for recently indexed consumer information on drug abuse: •
Pharmacologic basis of drug-nutrient interaction related to drug abuse during pregnancy. Source: Enig, M.G. Nutrition-today (USA). (Nov-December 1987). volume 6(6) page 235243. women pregnancy pharmacology 0029-666X
The following information is typical of that found when using the “Full IBIDS Database” to search for “drug abuse” (or a synonym): •
Arrhythmias associated with cocaine abuse. Author(s): University of Miami, School of Medicine, Cardiology Section, Miami V.A. Medical Center, Miami, FL 33125, USA. Source: Chakko, Simon Card-Electrophysiol-Revolume 2002 February; 6(1-2): 168-9 1385-2264
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Drug abuse trends and epidemiological aspects of drug associated deaths in Korea. Author(s): Div. of Narcotic Analysis, National Institute of Scientific Investigation, Seoul, Korea. Source: Chung, H J-Toxicol-Sci. 1998 July; 23 Suppl 2197-200 0388-1350
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Eating disorders and alcohol and other drug abuse: Is there an association. Source: Jonas, J.M. Alcohol-Health-Res-World-Natl-Inst-Alcohol-Abuse-Alcohol. Washington, D.C. : U.S. Department of Health and Human Services. 1989. volume 13 (3) page 267-271. ill. 0090-838X
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French general practitioners' attitudes toward maintenance drug abuse treatment with buprenorphine. Author(s): INSERM Research Unit 379, Institut Paoli-Calmettes, Marseille, France.
[email protected] Source: Moatti, J P Souville, M Escaffre, N Obadia, Y Addiction. 1998 October; 93(10): 1567-75 0965-2140
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Multiple intracerebral hemorrhages and vasospasm following antimigrainous drug abuse. Author(s): Centre de Recherches sur I'Ataxie, Hopital Neurologique, Lyon, France. Source: Nighoghossian, N Derex, L Trouillas, P Headache. 1998 June; 38(6): 478-80 00178748
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Over-the-counter drug use in gymnasiums: an underrecognized substance abuse problem? Author(s): Biological Psychiatry Laboratory, McLean Hospital, Belmont, Mass, and Department of Psychiatry, Harvard Medical School, Boston, Mass, USA. Source: Kanayama, G Gruber, A J Pope, H G Jr Borowiecki, J J Hudson, J I PsychotherPsychosom. 2001 May-June; 70(3): 137-40 0033-3190
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Pergolide mesylate for cocaine abuse: a controlled preliminary trial. Author(s): Department of Psychiatry, Columbia University/New York State Psychiatric Institute, NY 10032, USA.
[email protected] Source: Levin, F R McDowell, D Evans, S M Brooks, D Spano, C Nunes, E V Am-JAddict. 1999 Spring; 8(2): 120-7 1055-0496
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The problem of drug addiction among secondary school students in Lublin. Young people's knowledge about the effects of taking drugs. Author(s): Miedzywydzialowa Katedra i Zaklad Zdrowia Publicznego Akademii Medycznej w Lublinie.
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Source: Zolnierczuk Kieliszek, D Chemperek, E Ann-Univ-Mariae-Curie-Sklodowska[Med]. 2000; 55: 235-44 0066-2240 •
Use of a four-layer bandage system in the treatment of an i.v. drug abuser with chronic upper extremity ulcerations: a case study. Author(s): Regional Burn Center, University of California San Diego 92103, USA. Source: Cortimiglia Bisch, L Brazinsky, B Ostomy-Wound-Manage. 1998 March; 44(3): 48-52, 54-5 0889-5899
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER 3. ALTERNATIVE MEDICINE AND DRUG ABUSE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to drug abuse. At the conclusion of this chapter, we will provide additional sources.
The Combined Health Information Database The Combined Health Information Database (CHID) is a bibliographic database produced by health-related agencies of the U.S. federal government (mostly from the National Institutes of Health) that can offer concise information for a targeted search. The CHID database is updated four times a year at the end of January, April, July, and October. Check the titles, summaries, and availability of CAM-related information by using the “Simple Search” option at the following Web site: http://chid.nih.gov/simple/simple.html. In the drop box at the top, select “Complementary and Alternative Medicine.” Then type “drug abuse” (or synonyms) in the second search box. We recommend that you select 100 “documents per page” and to check the “whole records” options. The following was extracted using this technique: •
Alternative Medicine Update Source: Alternative Health Practitioner. 3(3): 157-160. Fall/Winter 1997. Summary: This journal article reports the results of 12 studies funded by the Office of Alternative Medicine in 1993 and 1994. The studies were classified as either mind/body interventions or as pharmacological or biological treatments. The 10 mind/body intervention studies include the following therapies: biofeedback, dance movement therapy, guided imagery, hypnotic imagery, music therapy, prayer, and yoga. Conditions studied include pain, diabetes mellitus, cystic fibrosis, asthma, immunity, cancer, AIDS, brain injury, and drug abuse. The two pharmacological and biological studies were 'Enzyme Therapy and Experimental Memory Metastasis' and 'Pharmacological Treatment of Cancer by Antioxidants.'.
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National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to drug abuse and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “drug abuse” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to drug abuse: •
A rapid assessment study on prevalence of substance abuse disorders in metropolis Delhi. Author(s): Mohan D, Chopra A, Sethi H. Source: The Indian Journal of Medical Research. 2001 September; 114: 107-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11873400&dopt=Abstract
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Acceptability and availability of harm-reduction interventions for drug abuse in American substance abuse treatment agencies. Author(s): Rosenberg H, Phillips KT. Source: Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors. 2003 September; 17(3): 203-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14498814&dopt=Abstract
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Acupuncture and substance abuse: a synopsis, with indications for further research. Author(s): Otto KC. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2003 January-February; 12(1): 43-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623739&dopt=Abstract
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American Indian and Alaska Native substance abuse: co-morbidity and cultural issues. Author(s): Gray N, Nye PS. Source: Am Indian Alsk Native Ment Health Res. 2001; 10(2): 67-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11698984&dopt=Abstract
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An holistic approach to substance abuse treatment. Author(s): Breslin KT, Reed MR, Malone SB. Source: J Psychoactive Drugs. 2003 April-June; 35(2): 247-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924747&dopt=Abstract
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Are the treatment goals of culturally competent outpatient substance abuse treatment units congruent with their client profile? Author(s): Howard DL.
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Source: Journal of Substance Abuse Treatment. 2003 March; 24(2): 103-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745027&dopt=Abstract •
Cardiovascular manifestations of substance abuse: part 2: alcohol, amphetamines, heroin, cannabis, and caffeine. Author(s): Frishman WH, Del Vecchio A, Sanal S, Ismail A. Source: Heart Disease. 2003 July-August; 5(4): 253-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12877759&dopt=Abstract
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Clinical evaluation of substance abuse. Author(s): Kaul P, Coupey SM. Source: Pediatrics in Review / American Academy of Pediatrics. 2002 March; 23(3): 8594. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11875181&dopt=Abstract
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Cognitive-behavioral coping skills and psychoeducation therapies for adolescent substance abuse. Author(s): Kaminer Y, Burleson JA, Goldberger R. Source: The Journal of Nervous and Mental Disease. 2002 November; 190(11): 737-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436013&dopt=Abstract
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Commentary on auricular acupuncture for cocaine abuse. Author(s): Oleson TD. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2002 April; 8(2): 123-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12013511&dopt=Abstract
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Comparing inmate perceptions of two residential substance abuse treatment programs. Author(s): Stohr MK, Hemmens C, Shapiro B, Chambers B, Kelley L. Source: International Journal of Offender Therapy and Comparative Criminology. 2002 December; 46(6): 699-714. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12491846&dopt=Abstract
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Cultural connection and transformation: substance abuse treatment at Friendship House. Author(s): Edwards Y. Source: J Psychoactive Drugs. 2003 January-March; 35(1): 53-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12733758&dopt=Abstract
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Diagnostic profiles associated with use of mental health and substance abuse services among high-risk youths. Author(s): Garland AF, Aarons GA, Brown SA, Wood PA, Hough RL.
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Source: Psychiatric Services (Washington, D.C.). 2003 April; 54(4): 562-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12663846&dopt=Abstract •
Drug abuse with inhalated xylazine. Author(s): Elejalde JI, Louis CJ, Elcuaz R, Pinillos MA. Source: European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine. 2003 September; 10(3): 252-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12972909&dopt=Abstract
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Drug addiction and the veterinary profession. Author(s): Roach NJ, Willis J. Source: The Veterinary Record. 2002 June 15; 150(24): 760. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12092631&dopt=Abstract
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Gender differences and conduct disorder among American Indian adolescents in substance abuse treatment. Author(s): Fisckenscher A, Novins D. Source: J Psychoactive Drugs. 2003 January-March; 35(1): 79-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12733762&dopt=Abstract
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Healthy nations: reducing substance abuse in American Indian and Alaska Native communities. Author(s): Noe T, Fleming C, Manson S. Source: J Psychoactive Drugs. 2003 January-March; 35(1): 15-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12733754&dopt=Abstract
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Individual and contextual predictors of involvement in twelve-step self-help groups after substance abuse treatment. Author(s): Mankowski ES, Humphreys K, Moos RH. Source: American Journal of Community Psychology. 2001 August; 29(4): 537-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11554152&dopt=Abstract
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Isradipine enhancement of cerebral blood flow in abstinent cocaine abusers with and without chronic perfusion deficits. Author(s): Gottschalk PC, Kosten TR. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2002 Summer; 11(3): 200-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12202012&dopt=Abstract
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Matching substance abuse aftercare treatments to client characteristics. Author(s): Brown TG, Seraganian P, Tremblay J, Annis H.
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Source: Addictive Behaviors. 2002 July-August; 27(4): 585-604. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12188594&dopt=Abstract •
Migration, acculturation, displacement: migratory workers and “substance abuse”. Author(s): Alaniz ML. Source: Substance Use & Misuse. 2002 June-August; 37(8-10): 1253-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12180564&dopt=Abstract
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Mobilizing communities to reduce substance abuse in Indian country. Author(s): Ellis BH Jr. Source: J Psychoactive Drugs. 2003 January-March; 35(1): 89-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12733764&dopt=Abstract
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Outcomes and service use among homeless persons with serious mental illness and substance abuse. Author(s): Gonzalez G, Rosenheck RA. Source: Psychiatric Services (Washington, D.C.). 2002 April; 53(4): 437-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11919357&dopt=Abstract
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Oxycodone involvement in drug abuse deaths: a DAWN-based classification scheme applied to an oxycodone postmortem database containing over 1000 cases. Author(s): Cone EJ, Fant RV, Rohay JM, Caplan YH, Ballina M, Reder RF, Spyker D, Haddox JD. Source: Journal of Analytical Toxicology. 2003 March; 27(2): 57-67; Discussion 67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12669998&dopt=Abstract
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Process and outcome changes with relapse prevention versus 12-Step aftercare programs for substance abusers. Author(s): Brown TG, Seraganian P, Tremblay J, Annis H. Source: Addiction (Abingdon, England). 2002 June; 97(6): 677-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12084137&dopt=Abstract
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Relationship of treatment orientation and continuing care to remission among substance abuse patients. Author(s): Ritsher JB, Moos RH, Finney JW. Source: Psychiatric Services (Washington, D.C.). 2002 May; 53(5): 595-601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11986510&dopt=Abstract
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Spirituality and faith-based organizations: their role in substance abuse treatment. Author(s): Hester RD.
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Source: Administration and Policy in Mental Health. 2002 November; 30(2): 173-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12680620&dopt=Abstract •
Substance abuse and dependence in physicians: the Missouri Physicians Health Program--an update (1995-2001). Author(s): Bohigian GM, Croughan JL, Bondurant R. Source: Mo Med. 2002 April; 99(4): 161-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11977480&dopt=Abstract
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The role of functional social support in treatment retention and outcomes among outpatient adult substance abusers. Author(s): Dobkin PL, De CM, Paraherakis A, Gill K. Source: Addiction (Abingdon, England). 2002 March; 97(3): 347-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11964111&dopt=Abstract
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Use of therapeutic touch in treatment of drug addictions. Author(s): Hagemaster J. Source: Holistic Nursing Practice. 2000 April; 14(3): 14-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12119624&dopt=Abstract
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Utilization Sobriety: brief, individualized substance abuse treatment employing ideomotor questioning. Author(s): Walsh BJ. Source: Am J Clin Hypn. 2003 January; 45(3): 217-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12570092&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to drug abuse; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Alcoholism Source: Integrative Medicine Communications; www.drkoop.com Amenorrhea Source: Integrative Medicine Communications; www.drkoop.com Bulimia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Integrative Medicine Communications; www.drkoop.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com Hypertension Source: Integrative Medicine Communications; www.drkoop.com Insomnia Source: Integrative Medicine Communications; www.drkoop.com Post Traumatic Stress Disorder Source: Integrative Medicine Communications; www.drkoop.com Pulmonary Hypertension Source: Integrative Medicine Communications; www.drkoop.com Sleeplessness Source: Integrative Medicine Communications; www.drkoop.com Stress Source: Integrative Medicine Communications; www.drkoop.com Stroke Source: Integrative Medicine Communications; www.drkoop.com
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Alternative Therapy Acupuncture Source: Healthnotes, Inc. www.healthnotes.com Biofeedback Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,675,00.html Meditation Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,717,00.html Quan Chi Chi Gong Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/q.html Relaxation Techniques Source: Integrative Medicine Communications; www.drkoop.com Yoga Source: Integrative Medicine Communications; www.drkoop.com
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Herbs and Supplements Eugenia Clove Alternative names: Cloves; Eugenia sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Tyrosine Source: Integrative Medicine Communications; www.drkoop.com
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON DRUG ABUSE Overview In this chapter, we will give you a bibliography on recent dissertations relating to drug abuse. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “drug abuse” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on drug abuse, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Drug Abuse ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to drug abuse. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Comparative Needs Assessment: the Perceptions of Program Administrators, Counselors and Women Who Are Battered and Substance Abusers (battered Women) by May, Joan Frances, Phd from University of Maryland College Park, 1992, 244 pages http://wwwlib.umi.com/dissertations/fullcit/9315696
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A Comparative Study of Two Eighth Grade Groups Participating in Diverse Drug Abuse Education Programs in the Greater Houston Area by Weaver, Sue Carol, Edd from University of Houston, 1970, 177 pages http://wwwlib.umi.com/dissertations/fullcit/7103953
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A Comparison of the Attitudinal Changes of Inservice Teachers Participating in an Experimental Psychology of Drug Abuse Course by Prescott, Donald Robert, Phd from University of Minnesota, 1972, 111 pages http://wwwlib.umi.com/dissertations/fullcit/7310621
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A Comparison of the Effects of Social Setting Detoxification and Subacute Detoxification on Further Treatment of Problem Drinkers Seen in Public Alcohol and
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Drug Abuse Treatment Programs in a Southeastern State by Rabb, Moses, Jr., Phd from University of South Carolina, 1981, 89 pages http://wwwlib.umi.com/dissertations/fullcit/8129473 •
A Descriptive Study of a Drug Abuse Prevention Program Delivery System. by Keller, James L. (jake), Edd from Temple University, 1974, 132 pages http://wwwlib.umi.com/dissertations/fullcit/7528284
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A Descriptive Study of Alcohol and Other Drug Abuse Elements in Nursing Curricula (alcohol Abuse Education, Drug Abuse Education) by Parrott, Thena Elizabeth, Phd from Texas A&m University, 1993, 123 pages http://wwwlib.umi.com/dissertations/fullcit/9410846
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A Descriptive Study of Oregon Schools/school Districts to Investigate How They Planned to Implement Oregon Administrative Rule 581-22-413 (drug Abuse, Alcohol Abuse) by Denevan, James P., Edd from Oregon State University, 1990, 108 pages http://wwwlib.umi.com/dissertations/fullcit/9125141
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A Descriptive Study of the Relationships between College Student Personnel Officers and Probation Officers Involving Selected Student Drug Abuse Arrest Cases by Condon, William Joseph, Jr., Edd from Columbia University, 1973, 135 pages http://wwwlib.umi.com/dissertations/fullcit/7331269
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A Film and 'teacher's Resource Booklet' in Drug Abuse Education for Secondary School Students. by Martin, John Joseph, Edd from Columbia University Teachers College, 1975, 183 pages http://wwwlib.umi.com/dissertations/fullcit/7603266
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A Multicomponent Approach to Prevention of Adolescent Substance Abuse (peer Pressure, Utah) by Durrant, Lynne Hyatt, Phd from The University of Utah, 1986, 138 pages http://wwwlib.umi.com/dissertations/fullcit/8611318
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A Prevention Program to Address the Societal Influences on Substance Abuse in Egypt by Elshiwick, Enas; Psyd from Alliant International University, San Diego, 2003, 121 pages http://wwwlib.umi.com/dissertations/fullcit/3075281
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A Study of Drug Abuse Education Programs of Selected Public High Schools in Michigan by Sakamoto, Paul Shigeichi, Phd from Michigan State University, 1971, 150 pages http://wwwlib.umi.com/dissertations/fullcit/7123239
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A Study of Drug Abuse Programs at Selected Universities with Implications for Southern University, Baton Rouge, Louisiana. by Wallace, William, Phd from Kansas State University, 1973, 162 pages http://wwwlib.umi.com/dissertations/fullcit/7414350
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A Study of Factors Relating to Drug Abuse and Treatment Results in a Selected High School Population. by Bethea, Charles William, Phd from Michigan State University, 1975, 231 pages http://wwwlib.umi.com/dissertations/fullcit/7612399
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A Study of Organizational Dynamics and Environmental Influences in the Development of a Drug Abuse Center for Youth by Deleon, Lon, Edd from University of Massachusetts, 1986, 143 pages http://wwwlib.umi.com/dissertations/fullcit/8612029
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A Study of Relationships between Drug Abuse Education and Attitudes toward Six Classes of Abused Drugs by Johnson, David Pittman, Dsw from The Catholic University of America, 1972, 212 pages http://wwwlib.umi.com/dissertations/fullcit/7319765
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A Study of Student, Teacher and Administrative Attitudes and Information Regarding Drugs and Drug Abuse in Selected Up-state New York Schools by Dunigan, Jay T., Edd from State University of New York at Albany, 1972, 154 pages http://wwwlib.umi.com/dissertations/fullcit/7231765
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A Study of Tenth-grade Student Attitudes toward and Drug Knowledge of Drug Abuse When Related to a Drug Education Program. by Jones, Wyman Lloyd, Edd from The University of Southern Mississippi, 1974, 136 pages http://wwwlib.umi.com/dissertations/fullcit/7425509
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A Study of the Availability, Accessibility, and Efficacy of Substance Abuse Prevention Service Delivery Systems Employed to Address the Potential for Substance Abuse by Law Enforcement Officers in the Commonwealth of Virginia by Wright, Delmar Pernell, Phd from Virginia Commonwealth University, 1999, 179 pages http://wwwlib.umi.com/dissertations/fullcit/9932547
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A Study of the Effectiveness of Alcohol and Drug Abuse Training for Professionals in Russia and the Ukraine by Shafer, Kathryn Caroline, Phd from Barry University School of Social Work, 1994, 145 pages http://wwwlib.umi.com/dissertations/fullcit/9532522
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A Study to Assist Administrators of Public, Four-year Colleges and Universities in Establishing Alcohol and Other Drug Abuse Prevention and Education Programs (alcohol Abuse Prevention) by Woods, Brenda Ann, Edd from Texas Tech University, 1993, 161 pages http://wwwlib.umi.com/dissertations/fullcit/9416636
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A Study to Determine the Increase in Knowledge of Drugs and Drug Abuse by Fourth-graders As a Result of the 'here's Looking at You Two' Drug and Alcohol Abuse Education Curriculum by Mahaffey, James Michael, Phd from University of South Carolina, 1988, 124 pages http://wwwlib.umi.com/dissertations/fullcit/8910267
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A Suggested Drug Abuse Education Program for Freshman Women Students Attending an Urban College by Tobin, Frances Mae, Edd from Columbia University, 1972, 171 pages http://wwwlib.umi.com/dissertations/fullcit/7217227
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A Survey of Drug Use and an Examination of the Relationship of Self-perceptions and Adjustment to Adolescent Drug Abuse by Walpole, James Wallace, Edd from University of Northern Colorado, 1973, 141 pages http://wwwlib.umi.com/dissertations/fullcit/7326523
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Adaptation of Urban Institutional Resources: a Case Study of an In-service Training Program for Paraprofessional Substance Abuse Counselors by Hall, Perry Alonzo, Edd from Harvard University, 1977, 181 pages http://wwwlib.umi.com/dissertations/fullcit/8127144
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Addiction Treatment: the Policy of Separate Alcoholism and Drug Abuse Services by Camp, Joy Mary, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1982, 199 pages http://wwwlib.umi.com/dissertations/fullcit/8222728
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Adolescent Substance Abuse Treatment: a Unified Model by Berlin, Matthew; Psyd from Alliant International University, San Diego, 2002, 163 pages http://wwwlib.umi.com/dissertations/fullcit/3056173
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Adolescent Substance Use As Related to Parental Support and Parental Control (drug Abuse, Alcohol Use) by Edwards, Dennis Wayne, Phd from Purdue University, 1990, 119 pages http://wwwlib.umi.com/dissertations/fullcit/9104627
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Alcohol and Drug Abuse Policy: a Case Study of the California State University System (alcohol Policy) by Battle, Oscar, Jr., Dpa from University of Southern California, 1993 http://wwwlib.umi.com/dissertations/fullcit/f2631075
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Alcohol and Drug Abuse Programs in Selected Universities in the South and Southwest by Ponder, Fred Thomas, Phd from University of North Texas, 1987, 118 pages http://wwwlib.umi.com/dissertations/fullcit/8713974
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Allocating Federal Drug Enforcement Resources: the Case of Marijuana (organized Crime, Price-elasticity, Drug Abuse, Policy, Illicit Markets) by Kleiman, Mark Albert Robert, Phd from Harvard University, 1985, 218 pages http://wwwlib.umi.com/dissertations/fullcit/8520228
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An Alternatives Prevention Approach to Drug Abuse by Busse, Wilma Joan, Edd from Western Michigan University, 1979, 132 pages http://wwwlib.umi.com/dissertations/fullcit/8002732
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An Analysis of Anxiety and Depression Levels in Out-of-treatment Drug Abusers: Implications for Counseling by Ataabadi, Ali Nateghi, Edd from Texas Southern University, 1997, 139 pages http://wwwlib.umi.com/dissertations/fullcit/9809905
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An Analysis of Applicable Legal Issues Concerning Employee Substance Abuse Policies for the Florida Community College System (employee Testing) by Elliott, Scott David, Edd from University of Florida, 1994, 428 pages http://wwwlib.umi.com/dissertations/fullcit/9607057
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An Analysis of Interorganizational Cooperation in Drug Abuse Programs by Mccune, Donald Allan, Edd from Stanford University, 1971, 98 pages http://wwwlib.umi.com/dissertations/fullcit/7206033
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An Analysis of Principals' Attitudes Regarding Drug Abuse Prevention Education Programs in Selected Public Schools in Michigan. by Branson, James Otto, Ii, Phd from Michigan State University, 1974, 94 pages http://wwwlib.umi.com/dissertations/fullcit/7427392
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An Analysis of the Relationships among Selected Attitudinal, Demographic, and Behavioral Variables and the Self-reported Intent to Use and Actual Use of Alcohol and Other Drugs by Adolescents with Learning Disabilities (alcohol Abuse, Drug Abuse, Middle S by Rodeheffer, Beverly Pinder, Phd from The Ohio State University, 1995, 237 pages http://wwwlib.umi.com/dissertations/fullcit/9612266
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An Analysis of the Sex-role Attitudes of Drug Abuse Treatment Counselors by Schor, Carole Sue, Phd from The Catholic University of America, 1980, 92 pages http://wwwlib.umi.com/dissertations/fullcit/8013224
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An Application of Attachment Theory to the Etiology of Drug Abuse by Mottola, Carolyn Anne, Phd from California School of Professional Psychology - Los Angeles, 1984, 124 pages http://wwwlib.umi.com/dissertations/fullcit/8428850
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An Assessment of Attitudes toward Drug Abuse and Preventative Programs Held by Marine Officers and Non-commissioned Officers. by Adkins, Sidney C., Edd from University of Virginia, 1973, 151 pages http://wwwlib.umi.com/dissertations/fullcit/7331111
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An Assessment of the Chehalis Police Department's Drug Abuse Resistance Education (d.a.r.e.) Program (washington) by Hunziker, Keith Michael, Edd from Washington State University, 1995, 238 pages http://wwwlib.umi.com/dissertations/fullcit/9613589
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An Assessment of the Effectiveness of a Suburban Police Department's Project Dare (drug Abuse Resistance Education) Program on Student Knowledge of Drugs, Alcohol, and Tobacco by Johnson, Timmy Dane, Edd from Wayne State University, 1994, 129 pages http://wwwlib.umi.com/dissertations/fullcit/9423725
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An Evaluation of a School-community Team for the Primary Prevention of Drug Abuse. by Stokely, Barbara Lafot, Phd from University of Southern California, 1978 http://wwwlib.umi.com/dissertations/fullcit/f2145814
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An Evaluation of the Effectiveness of the San Antonio Police Department Drug Abuse Resistance Education (d.a.r.e.) Program (texas) by Silfen, Roberta Dawn, Edd from Texas A&m University, 1991, 85 pages http://wwwlib.umi.com/dissertations/fullcit/9206451
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An Evaluation of the Spokane Regional Drug Abuse Training Center. by Payne, William Dennison, Phd from The University of Utah, 1974, 191 pages http://wwwlib.umi.com/dissertations/fullcit/7419098
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An Examination of the Historical Development of Drug Abuse Treatment, Rehabilitation, and Education in the City of Detroit: Educational and Sociological Implications by Sall, James Franklin, Phd from Wayne State University, 1982, 196 pages http://wwwlib.umi.com/dissertations/fullcit/8216165
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An Examination of the Organismic, Behavioral, and Contextual Covariates of Risk Behaviors among Diverse Groups of Adolescents (drug Abuse, Delinquency, Sexual Activity, School Misconduct) by Perkins, Daniel Francis, Phd from Michigan State University, 1995, 403 pages http://wwwlib.umi.com/dissertations/fullcit/9619887
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An Experimental Investigation of Assertion Training As a Drug Abuse Prevention Strategy by Williams, John Myers, Ded from The Pennsylvania State University, 1980, 107 pages http://wwwlib.umi.com/dissertations/fullcit/8024507
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An Experimental Program in the Treatment and Training of Former Heroin Addicts Preparing for Employment As Paraprofessional Drug Abuse Counselors. by Petros, Sam A., Phd from Wayne State University, 1974, 175 pages http://wwwlib.umi.com/dissertations/fullcit/7429842
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An Exploration of Patterns of Drug Use and of the Effectiveness of a Substance Abuse Prevention Program According to Adolescents' Level of Academic Achievement by Bennett, Gary T., Phd from University of Kentucky, 1995, 320 pages http://wwwlib.umi.com/dissertations/fullcit/9507112
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An Exploratory Study of the Social Networks and Social Support of a Community Sample of Women in Recovery from Alcohol and Other Drug Abuse by O'dell, Kristi Jane, Phd from University of Kansas, 1996, 258 pages http://wwwlib.umi.com/dissertations/fullcit/9721769
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An Intense Study by Interview of Methadone Treated African-american Patients (methadone Treatment, Drug Addiction) by Hodges, James Elmer, Phd from The Union Institute, 1991, 186 pages http://wwwlib.umi.com/dissertations/fullcit/9217640
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An Interpersonal Approach to Substance Abuse (women, Incarceration, Drug Abuse) by Sandor, Colleen, Phd from The University of Utah, 1996, 145 pages http://wwwlib.umi.com/dissertations/fullcit/9619227
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An Investigation of the Relationship between Social Structural Variables and Selfconcept among African American Novice Substance Abusers by Hamilton, Flora Terrell, Dsw from Howard University School of Social Work, 1991, 156 pages http://wwwlib.umi.com/dissertations/fullcit/9220108
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An Organizational Analysis of Access to Female-sensitive Treatment Services in Outpatient Substance Abuse Treatment by Campbell, Cynthia Im; Phd from University of Michigan, 2003, 346 pages http://wwwlib.umi.com/dissertations/fullcit/3079418
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An Organizational Analysis of an Adolescent Substance Abuse Treatment Program: a Case Study by Hilton, Raymond Leon, Edd from University of Massachusetts, 1981, 211 pages http://wwwlib.umi.com/dissertations/fullcit/8201343
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An Organizational Analysis of the Use of Medical and Psychosocial Services in Outpatient Substance Abuse Treatment by Durkin, Elizabeth M. Phd from The University of Chicago, 2000, 231 pages http://wwwlib.umi.com/dissertations/fullcit/9965074
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An Understanding of Compulsive Drug Abuse from an Onto-theological Concept of Man, As Illustrated by Interview Studies of Compulsive Drug Abusers from Crisis House by Slack, Sam Lee, Thd from School of Theology at Claremont, 1972, 229 pages http://wwwlib.umi.com/dissertations/fullcit/7224647
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Analyzing Retention in Treatment for Drug Abuse: a Study of Gamesmanship in Action. by Brawn, Richard Guy, Phd from Fordham University, 1975, 304 pages http://wwwlib.umi.com/dissertations/fullcit/7604109
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Assessment of Drug Abuse Education Curricula Using Process Evaluation Techniques. by Hardgrave, John Graham, Edd from University of Southern California, 1978 http://wwwlib.umi.com/dissertations/fullcit/f2133302
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Assessment of Maternal Substance Abuse and Neonatal Exposure (substance Abuse) by Giese, Carol Jean Dauenhauer, Drph from Loma Linda University, 1990, 454 pages http://wwwlib.umi.com/dissertations/fullcit/9117240
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Attitudes toward Drug Abuse and the Role of the Secondary School by Cook, Glenn Dearle; Mullender, John Wayne, Edd from University of Southern California, 1972, 318 pages http://wwwlib.umi.com/dissertations/fullcit/7221660
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Barriers to Alcoholism and Other Drug Abuse Treatment for Women: Comparing Alaska Native and Non-native Women by Mann, Cheryl; Phd from Case Western Reserve University, 1999, 186 pages http://wwwlib.umi.com/dissertations/fullcit/9948411
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Bilingual Drug Abuse Communication. by Hepler, Susanne Elster, Phd from Texas A&m University, 1975, 148 pages http://wwwlib.umi.com/dissertations/fullcit/7525110
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Boston against Drugs: an Analysis of Business Involvement in the Community (drug Abuse Prevention, Massachusetts) by Forlani, Victor M., Dba from Boston University, 1995, 279 pages http://wwwlib.umi.com/dissertations/fullcit/9533132
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Building a Babes Community: a Case Study of a Total Systems Approach to the Prevention of Substance Abuse (drug Abuse Education) by Jones, Lottie Vivian, Edd from Wayne State University, 1990, 235 pages http://wwwlib.umi.com/dissertations/fullcit/9118892
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Chipping Away at Dogma: Policy Implications of the Existence of Formerlycompulsive-now-controlled Opiate Users (drug Abuse, Occasional Users) by Harding, Wayne Michael, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1992, 131 pages http://wwwlib.umi.com/dissertations/fullcit/9227595
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College Women and Alcohol: a Case Studies Analysis (self Esteem, Drug Abuse) by Cohn, Wendy Fran, Phd from University of Virginia, 1994, 153 pages http://wwwlib.umi.com/dissertations/fullcit/9425731
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Combined Treatment: Alcohol and Drug Abuse by Ralston, Edward James, Phd from Saint Louis University, 1983, 124 pages http://wwwlib.umi.com/dissertations/fullcit/8418688
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Community Resources and Drug Abuse: a Strategy for Preventive Drug Education by Zide, Michele Moran, Edd from University of Massachusetts, 1973, 203 pages http://wwwlib.umi.com/dissertations/fullcit/7314692
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Community Response to Drug Abuse Problems: a Comparative Study of Selected Satellite Cities in the Los Angeles Metropolitan Area. by Scott, Patrick Woodward, Phd from University of Southern California, 1975 http://wwwlib.umi.com/dissertations/fullcit/f4198022
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Comparing the Efficiency and Effectiveness of Substance Abuse Treatment Programs Using a Two-stage Data Envelopment Analysis by Porto, James V., Jr. Phd from The University of North Carolina at Chapel Hill, 2000, 235 pages http://wwwlib.umi.com/dissertations/fullcit/9993363
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Comparison of Juvenile Delinquents' and Counselors' Perceptions of Reasons for Drug Abuse by Dugan, Mary Jane, Phd from University of Pittsburgh, 1991, 320 pages http://wwwlib.umi.com/dissertations/fullcit/9129209
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Components of a Model Adolescent Aids/drug Abuse Prevention Program: a Delphi Study (drug Abuse Prevention, Immune Deficiency) by Adams, Rebecca Bodenmiller, Phd from Purdue University, 1990, 154 pages http://wwwlib.umi.com/dissertations/fullcit/9116343
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Concurrent Evaluation of Selective Psychological and Social Factors Influencing Adolescent Drug Abuse (psychological Factors) by Williams, Joseph Beckham, Phd from The University of Alabama, 1989, 129 pages http://wwwlib.umi.com/dissertations/fullcit/9022278
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Corrective Measures Used by Faculties As a Deterrent to Drug Abuse among Students of Selected High Schools in California by Gregory, Francis Cuthbert, Edd from University of Southern California, 1970, 189 pages http://wwwlib.umi.com/dissertations/fullcit/7013658
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Creating Femininity: on Women in Drug Abuse Treatment by Laanemets, Leili Elisabeth; Phd from Lunds Universitet (sweden), 2002, 283 pages http://wwwlib.umi.com/dissertations/fullcit/f931729
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Development and Implementation of a Residential Free-standing Treatment Facility for Juvenile Offenders with Alcohol and Drug Abuse Problems by Cascarino, Thomas Joseph, Phd from Ohio University, 1982, 143 pages http://wwwlib.umi.com/dissertations/fullcit/8304356
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Development of a Test for Teachers of Knowledge and Attitudes Concerning Drug Abuse. (volumes I & Ii) by Kent, Margaret Templeton, Phd from The University of Connecticut, 1976, 557 pages http://wwwlib.umi.com/dissertations/fullcit/7704319
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Dissemination and Targeting of Anti-drug Psas: an Interplay of Individual Differences and Program Context in a Televised Drug Abuse Prevention Campaign by Dsilva, Margaret Usha, Phd from University of Kentucky, 1993, 125 pages http://wwwlib.umi.com/dissertations/fullcit/9418505
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Distributive Benefits, Symbolic Politics, and the Lowi Typology: an Analysis of the Anti-drug Abuse Acts of 1986 and 1988 by Parent, Patricia Caperton, Phd from The University of Texas at Austin, 1997, 301 pages http://wwwlib.umi.com/dissertations/fullcit/9825047
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Drinking Patterns among Seasonal Agricultural Workers, 1982 (alcoholism, Blacks, Rural, Drug Abuse, Family Structures, Migrants) by Morales, Richard, Phd from Syracuse University, 1985, 218 pages http://wwwlib.umi.com/dissertations/fullcit/8524430
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Drug Abuse amongst Adolescents in an Urban Area. (afrikaans Text) by Willemse, Hendrina, Ded from University of Pretoria (south Africa), 1991 http://wwwlib.umi.com/dissertations/fullcit/f1385444
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Drug Abuse and Social Policy in Great Britain by Gillespie, Duff G., Phd from Washington University, 1969, 548 pages http://wwwlib.umi.com/dissertations/fullcit/7010954
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Drug Abuse Maintenance among Teen-aged Youth: a Comparison of Selected Youths from the General Population and Youths in Custody in the Northeast Region of the State of Missouri by Lyman, Michael D., Phd from University of Missouri - Columbia, 1992, 108 pages http://wwwlib.umi.com/dissertations/fullcit/9307436
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Drug Abuse on Seven College Campuses in a New England City by Smith, Archie, Jr., Phd from Brandeis University, 1973, 242 pages http://wwwlib.umi.com/dissertations/fullcit/7324246
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Drug Abuse: Causal Attributions by Policy Stakeholders by Perfas, Fernando B. Dsw from Adelphi University, School of Social Work, 2002, 173 pages http://wwwlib.umi.com/dissertations/fullcit/3045673
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Drug Abuse: a Challenge to the Work Ethic. by Arkin, William, Phd from Washington University, 1972, 283 pages http://wwwlib.umi.com/dissertations/fullcit/7224207
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Drug Abuse: the Role of the Secondary School Administrator in Selected School Districts of New York State by Heath, Robert Charles, Edd from Cornell University, 1972, 275 pages http://wwwlib.umi.com/dissertations/fullcit/7309348
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Drug Addiction: from a Study of Women and Criminal Justice by Faith, Karlene, Phd from University of California, Santa Cruz, 1981, 182 pages http://wwwlib.umi.com/dissertations/fullcit/8218359
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Effectiveness of a Drug Abuse Primary Prevention Program for High School Students (program Evaluation) by Godley, Mark Dominic, Phd from Southern Illinois University at Carbondale, 1984, 144 pages http://wwwlib.umi.com/dissertations/fullcit/8510020
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Effects of Multidimensional Family Therapy on the School Performance of Adolescent Substance Abusers by Palmer, Ruth Baugher, Phd from Temple University, 1994, 147 pages http://wwwlib.umi.com/dissertations/fullcit/9512857
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Elements of Effective Treatment for Adolescent Drug Abusers: Family Communication, Cohesion and Adaptability by Terjanian, David C. Psyd from Antioch University/new England Graduate School, 2002, 35 pages http://wwwlib.umi.com/dissertations/fullcit/3077545
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Employment in Drug Abuse: Evidence from the Supported Work Experiment by Dickinson, Katherine Paup, Phd from The Pennsylvania State University, 1980, 220 pages http://wwwlib.umi.com/dissertations/fullcit/8105725
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Evaluating the Drug Abuse Resistance Education Program (d.a.r.e.): a State-wide Analysis by Ferrell, Ronald G., Phd from The Ohio State University, 1997, 158 pages http://wwwlib.umi.com/dissertations/fullcit/9801686
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Evaluating the Effects of Project Dare in Rural Southeast Minnesota Schools (prevention, Substance Abuse, Drug Education) by Thompson, David Drew, Edd from Drake University, 1993, 153 pages http://wwwlib.umi.com/dissertations/fullcit/9502219
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Examination of a Cumulative Strategies Model for Drug Abuse Prevention: Risk Factor Reduction in High-risk Children by Horn, Kimberly Ann, Edd from West Virginia University, 1997, 112 pages http://wwwlib.umi.com/dissertations/fullcit/9819089
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Exploring a Possible Linkage between Drug Addiction and School Dropouts in a Western Massachusetts Urban School System by Ayerve, Miguel A., Edd from University of Massachusetts, 1988, 171 pages http://wwwlib.umi.com/dissertations/fullcit/8906251
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Factors Related to Outcomes of Drug Abusers' Participation in a Prison Therapeutic Community by Schaefer, Mildred (millie); Phd from City University of New York, 2002, 128 pages http://wwwlib.umi.com/dissertations/fullcit/3047262
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Familial Variables Related to Retention of Young Drug Abusers in Treatment by Friesen, Victor I., Phd from Temple University, 1986, 156 pages http://wwwlib.umi.com/dissertations/fullcit/8627454
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Familial, Academic, and Behavioral Differences in Juvenile Delinquent Alcohol and Substance Abusers (familial Differences, Academic Differences, Alcohol Abusers) by Barnes, Earl Glenn, Edd from Peabody College for Teachers of Vanderbilt University, 1992, 50 pages http://wwwlib.umi.com/dissertations/fullcit/9224295
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Family Adaptability and Cohesion in Relation to the Severity of Drug Abuse by Noone, Robert John, Phd from University of Illinois at Chicago, 1983, 160 pages http://wwwlib.umi.com/dissertations/fullcit/8320629
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Family Systems and Adolescent Drug Abuse by Volk, Robert Joseph, Phd from Purdue University, 1989, 181 pages http://wwwlib.umi.com/dissertations/fullcit/9008708
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Four Approaches to Drug Abuse Education: an Investigation of High School Counselors' Ability to Withhold Reinforcement in Behavioral Counseling by Hawk, Richard Stanley, Ded from The Pennsylvania State University, 1972, 158 pages http://wwwlib.umi.com/dissertations/fullcit/7313988
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Freshman College Students' Perceptions of National Collegiate Alcohol Awareness Week: a Test of Psychological Reactance Theory (drug Abuse Prevention) by Moore, Roberta Sparrow, Phd from Seton Hall University, School of Education, 1995, 130 pages http://wwwlib.umi.com/dissertations/fullcit/9531667
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Gender Differences in Mental Health and Substance Abuse Disorders As Predictors of Gambling Disorders by Broffman, Thomas E. Phd from Boston College, 2002, 289 pages http://wwwlib.umi.com/dissertations/fullcit/3053653
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Generating Information for Policy-making in the Field of Drug Abuse. by Grizzle, Gloria Ann, Phd from The University of North Carolina at Chapel Hill, 1973, 495 pages http://wwwlib.umi.com/dissertations/fullcit/7415339
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High School Completion, Self-concept and Psychopathology among Black Male Drug Abusers by Barnes, Robert William, Phd from Howard University, 1987, 239 pages http://wwwlib.umi.com/dissertations/fullcit/8810954
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High-risk Sexual Behavior and Drug Abuse: a Case Study of Women Who Trade Sex for Crack/cocaine by Ellis, Richard Bernhardt, Phd from Kansas State University, 1997, 147 pages http://wwwlib.umi.com/dissertations/fullcit/9736729
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Identification of Factors Associated with the Employment Characteristics of Methadone Clients: Targeting Vocational Services (drug Abuse) by Metzger, David
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Scott, Phd from Rutgers the State University of New Jersey - New Brunswick, 1987, 165 pages http://wwwlib.umi.com/dissertations/fullcit/8723272 •
Identity Transformation in Drug Addiction by Anderson, Tammy L., Phd from The American University, 1991, 377 pages http://wwwlib.umi.com/dissertations/fullcit/9225456
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Impact of Public Policy on Judicial Review of Arbitral Awards Involving Substance Abuse by Grainger, John Steven, Phd from Texas A&m University, 1988, 296 pages http://wwwlib.umi.com/dissertations/fullcit/8815869
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Integration Versus Separation of Alcoholism and Drug Abuse Programming. by Lambert, Mckinney Dow, Iii, Phd from Washington University, 1976, 219 pages http://wwwlib.umi.com/dissertations/fullcit/7704042
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International Drug Abuse Control: Problems of Transformation and Expansion. by Roth, Alan David, Phd from New York University, 1974, 413 pages http://wwwlib.umi.com/dissertations/fullcit/7509692
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Interorganizational Response to Social Change: Professional Control of Drug Abuse by Youth in Two Cities, 1972-1973. by Beniger, James Ralph, Phd from University of California, Berkeley, 1978, 432 pages http://wwwlib.umi.com/dissertations/fullcit/7914540
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Interpersonal Matching and Compliance (alcohol Abuse, Drug Abuse) by Luongo, Peter Felice, Phd from University of Maryland at Baltimore, 1990, 192 pages http://wwwlib.umi.com/dissertations/fullcit/9019879
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'just Say No' and Young Adults: a Study of the Relationships between Understanding, Acceptance, and Saying No (drug Abuse Prevention) by Johnson, Katherine A., Phd from Indiana University of Pennsylvania, 1994, 177 pages http://wwwlib.umi.com/dissertations/fullcit/9511356
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Juvenile Substance Abuse and Criminal Career Continuity by Langsam, Adam H. Phd from University of North Texas, 2000, 160 pages http://wwwlib.umi.com/dissertations/fullcit/3019195
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Key Factors Contributing to Organizational Response to Aids among Outpatient Substance Abuse Treatment Organizations in the United States (immune Deficiency) by Clapp, John Donovan, Phd from The Ohio State University, 1995, 177 pages http://wwwlib.umi.com/dissertations/fullcit/9612164
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Linking the Academy and the Community: an Assessment of a Treatment Program for Homeless Substance Abusers by Joyner, Laurie Mire, Phd from Tulane University, 1995, 232 pages http://wwwlib.umi.com/dissertations/fullcit/9620855
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Measurement of Knowledge of Drug Abuse in Human Service Training Programs. by Gardner, Keith Allen, Phd from The University of Wisconsin - Madison, 1974, 148 pages http://wwwlib.umi.com/dissertations/fullcit/7508619
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Met and Unmet Need for Substance Abuse Treatment among American Adults with a Self-reported Dual Diagnosis of Substance Abuse and Mental Disease by Chiou, Jengyuan; Phd from University of South Carolina, 2002, 104 pages http://wwwlib.umi.com/dissertations/fullcit/3076756
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Motivation for Drug Abuse Treatment and Retention Rates in Standard and Enhanced Methadone Maintenance Programs by Marin, Mary Elizabeth, Phd from University of California, Los Angeles, 1995, 176 pages http://wwwlib.umi.com/dissertations/fullcit/9608060
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Motivational Interviewing As a Precursor to a Substance Abuse Program for Offenders by Vanderburg, Susan Alexandra; Phd from Carleton University (canada), 2002, 318 pages http://wwwlib.umi.com/dissertations/fullcit/NQ71951
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New Federalism at Work? the Case of the Alcohol and Drug Abuse Block Grant and Substance Abuse Spending in the American States by Sim, Shao-chee; Phd from The University of Texas at Austin, 2000, 216 pages http://wwwlib.umi.com/dissertations/fullcit/9983344
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Opioid-based and Behavioral Treatments for Drug Abuse: a Primate Model by Cosgrove, Kelly Patricia; Phd from University of Minnesota, 2002, 180 pages http://wwwlib.umi.com/dissertations/fullcit/3056311
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Parenting and Substance Abuse: a Longitudinal Analysis by Goldstein, Marilyn Sylvia; Phd from Wayne State University, 2002, 102 pages http://wwwlib.umi.com/dissertations/fullcit/3071781
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Patterns of Multiple Drug Abuse in Methadone-maintained Heroin Addicts by Smith, Thomas M., Phd from Rutgers the State University of New Jersey - New Brunswick, 1986, 119 pages http://wwwlib.umi.com/dissertations/fullcit/8612137
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Pcp Users Vs. Users of Other Drugs on Background, Personality and Outcome Variables (drug Abuse) by Vayhinger, Beverly, Phd from University of Maryland College Park, 1989, 165 pages http://wwwlib.umi.com/dissertations/fullcit/8924246
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Perceived Causes and Consequences of Drug Abuse on the Community of Khorog in Mountain Badakhshan Autonomous Province, Tajikistan by Aliberdieva, Madina; Msc from University of Guelph (canada), 2003, 107 pages http://wwwlib.umi.com/dissertations/fullcit/MQ76045
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Perceived Family Dynamics of Cocaine Abusers, As Compared to Opiate Abusers and Non-drug Abusers by Douglas, Lorraine Jean, Phd from University of Florida, 1987, 168 pages http://wwwlib.umi.com/dissertations/fullcit/8809631
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Perceptions of School Environment and Locus of Control As Determinants of Outcome in Three School-based Drug Abuse Prevention Projects by Olton, Andre Lech, Phd from The University of Wisconsin - Milwaukee, 1982, 231 pages http://wwwlib.umi.com/dissertations/fullcit/8227466
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Posttraumatic Stress Disorder, Dissociation and Substance Abuse As Long-term Sequelae in a Population of Adult Children of Substance Abusers by Weinstein, Diane Weber, Phd from New York University, 1998, 203 pages http://wwwlib.umi.com/dissertations/fullcit/9839558
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Predicting Combined Alcohol and Other Drug Abuse: the Contribution of Child Maltreatment, Adult Partner Assault, and Trauma Symptomatology by Lovald, Benedicte Ehly; Ma from York University (canada), 2002, 139 pages http://wwwlib.umi.com/dissertations/fullcit/MQ71601
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Predicting Drug Abuse and Evaluating Selected Educational Approaches to Preventing Drug Abuse by Bruett, Terrill Lewis, Edd from University of Georgia, 1972, 93 pages http://wwwlib.umi.com/dissertations/fullcit/7305657
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Predictors of Drug Abuse among a Group of Urban Black Male Adolescents by Johnson, Elaine Mcdowell, Phd from University of Maryland at Baltimore, 1988, 248 pages http://wwwlib.umi.com/dissertations/fullcit/9022343
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Public Policy Regarding Pregnant Substance Abusers: the Rise of Fetal Rights by Aumann, Gretchen Margaret-elisabeth, Phd from The University of Texas Graduate Sch. of Biomedical Sci. at Galveston, 1998, 305 pages http://wwwlib.umi.com/dissertations/fullcit/9826221
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Risk Factors Associated with Suicidal Ideation in Adolescent and Young Adult Substance Abusers by Woods, Dorris Stubbs, Phd from The Claremont Graduate University, 1990, 168 pages http://wwwlib.umi.com/dissertations/fullcit/9032602
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School Alcohol and Drug Abuse Education and Prevention Programs: a Multiple Case Study by Brookover, Charlene T., Phd from Kansas State University, 1999, 321 pages http://wwwlib.umi.com/dissertations/fullcit/9933075
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School-based Assessment of Students at Risk for Drug Abuse (risk Assessment) by Richards-colocino, Nancy, Phd from United States International University, 1991, 100 pages http://wwwlib.umi.com/dissertations/fullcit/9127152
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Service Productivity in Urban Drug Abuse Treatment Organizations by Rinaldo, Suzanne Gelber, Phd from The University of Michigan, 1981, 156 pages http://wwwlib.umi.com/dissertations/fullcit/8125189
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Short-term Economic Change and Deviance (mental Illness, Drug Abuse, Alcoholism) by Zent, Michael Robert, Phd from The University of Texas at Austin, 1985, 260 pages http://wwwlib.umi.com/dissertations/fullcit/8527676
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Social Order and Drug Abuse: Identification of Deviance in the Hospital Emergency Room. by Mcaulay, Robert Ernest, Phd from Washington University, 1978, 281 pages http://wwwlib.umi.com/dissertations/fullcit/7904193
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Substance Abuse among College Students with Disabilities: the Relationship between Adult Children of Alcoholics and Codependency by Baker, Debbie Ann, Phd from Mississippi State University, 1996, 75 pages http://wwwlib.umi.com/dissertations/fullcit/9640082
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Substance Abuse Prevention: Effects of a Developmentally Based Psychological Education Curriculum by Phillips, Kathleen Jean, Edd from University of Massachusetts, 1980, 233 pages http://wwwlib.umi.com/dissertations/fullcit/8019483
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Substance Abuse Recidivism in Saudi Arabia by Abdulaziz, Saud Dohayan, Phd from University of Pittsburgh, 1992, 284 pages http://wwwlib.umi.com/dissertations/fullcit/9226590
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Substance Abuse, Personality Disorders, and Comorbid Disorders among Parolees and Probationers by Merchant, Rose Coretta; Phd from Howard University, 2002, 107 pages http://wwwlib.umi.com/dissertations/fullcit/3066514
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Suburban Students' Awareness, Attitudes, and Use of Alcohol and Other Drugs, Grades 6 Through 12 (sixth-grade, Twelfth-grade, Alcohol Attitudes, Drug Abuse Prevention) by Paulucci, Candace Jean, Phd from The Ohio State University, 1992, 117 pages http://wwwlib.umi.com/dissertations/fullcit/9227354
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Systems and Communication Control: an Analysis of the Process of Evaluating Films on Drug Abuse. by Ostman, Ronald Elroy, Phd from University of Minnesota, 1974, 248 pages http://wwwlib.umi.com/dissertations/fullcit/7426222
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Teaching Content, Policies, Attitudes and Religious Beliefs about Alcohol and Drug Abuse in Clients and Professionals among Illinois Nursing Faculty (addictions Education) by Hees, Alice Jane Thornton, Phd from Southern Illinois University at Carbondale, 1991, 291 pages http://wwwlib.umi.com/dissertations/fullcit/9219728
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The Affective Attitudes of Drug Abuse Education Workshop Participants toward Selected Concepts of Narcotic and Drug Abuse by Leary, William J., Jr., Phd from University of Pittsburgh, 1972, 174 pages http://wwwlib.umi.com/dissertations/fullcit/7313172
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The Chemical People Project: a Case Study Analysis of Three Task Forces from 1981 to 1989 (pittsburgh, Pennsylvania, Drug Abuse, Prevention) by Mccall, Dorothy Kay, Phd from University of Pittsburgh, 1989, 207 pages http://wwwlib.umi.com/dissertations/fullcit/8923918
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The Criminal Responsibility for Drug Abuse in South Africa by Levin, Alfred, Lld from University of Pretoria (south Africa), 1984 http://wwwlib.umi.com/dissertations/fullcit/f2297685
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The Development and Field Testing of a Competency-based Teacher Education Module in Drug Abuse Education for Prospective Elementary School Teachers. by Kesselschmidt, Norma Laks, Edd from Columbia University Teachers College, 1977, 226 pages http://wwwlib.umi.com/dissertations/fullcit/7714733
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The Development of a Substance Abuse Prevention Programme for Early Adolescents in Kwazulu Natal (south Africa) by Brandt, Carien Catharina Johanna; Dphil from University of Pretoria (south Africa), 2003 http://wwwlib.umi.com/dissertations/fullcit/f185505
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The Effectiveness of Operation Aware: the Impact of a Drug Abuse Prevention Program on Self-concept and Locus-of-control by Cunningham, Nancy Jones, Edd from United States International University, 1987, 282 pages http://wwwlib.umi.com/dissertations/fullcit/8713040
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The Effects of a Manual-guided Cognitive Intervention Program upon Substance Abusers by Lamson, Ralph J., Phd from University of Southern California, 1989 http://wwwlib.umi.com/dissertations/fullcit/f3139844
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The Effects of a Self-directed Drug Abuse Education Program on Attitudes of College Students by Blackwell, James Toy, Jr., Edd from Auburn University, 1972, 141 pages http://wwwlib.umi.com/dissertations/fullcit/7219033
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The Effects of Age and Psychiatric Disorder on Criminality in a Jailed Population (alcoholism, Drug Abuse, Antisocial Personality, Mental Illness) by Koerber, Anne, Phd from Northwestern University, 1989, 166 pages http://wwwlib.umi.com/dissertations/fullcit/9015387
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The Effects of Alcohol and Drug Abuse on the Sternal End of the Fourth Rib by Taylor, Katherine Markham; Phd from The University of Arizona, 2000, 188 pages http://wwwlib.umi.com/dissertations/fullcit/9965932
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The Effects of Conflicting Treatment Approaches on the Operations and Procedures of Two Types of Methadone Treatment Programs: a Study in Institutional Analysis (organizational Theory, Detoxification, Drug Abuse) by Rainone, Gregory Anthony, Phd from Fordham University, 1985, 378 pages http://wwwlib.umi.com/dissertations/fullcit/8521413
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The Effects of Differing Stages of Homosexual Identity Integration, Diminished Selfesteem and a Substance Abusive Familial History on Substance Abuse among Homosexual Men by Ghindia, Dennis John, Phd from Case Western Reserve University, 1994, 208 pages http://wwwlib.umi.com/dissertations/fullcit/9502729
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The Effects of Drug Abuse Resistance Education on Students' Attitudes toward the Police by Edwards-brown, Kim Eleanor, Edd from Wayne State University, 1994, 131 pages http://wwwlib.umi.com/dissertations/fullcit/9423708
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The Emerging Federal Drug Abuse Education Strategy by Dobin, Daniel, Edd from Harvard University, 1973, 98 pages http://wwwlib.umi.com/dissertations/fullcit/7326691
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The Implementation Perspective of 'changing Attitudes': a Qualitative Study of an Anti-drug Abuse Policy in Columbus, Ohio by Boyd, Terry Alan, Phd from The Ohio State University, 1993, 316 pages http://wwwlib.umi.com/dissertations/fullcit/9401216
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The Influence of the Passage of Time on Effects Resulting from Viewing Film on Drug Abuse by Schell, William Raymond, Edd from University of California, Los Angeles, 1969, 197 pages http://wwwlib.umi.com/dissertations/fullcit/7008200
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The Life Cycle of Addiction: a Conceptual Framework for the Examination of Careers in Drug Abuse by Alksne, Harold, Phd from City University of New York, 1980, 281 pages http://wwwlib.umi.com/dissertations/fullcit/8023683
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The Origin and Development of the State Drug Abuse Agency in New Jersey by Baker, James Clifford, Edd from Rutgers the State University of New Jersey - New Brunswick, 1986, 336 pages http://wwwlib.umi.com/dissertations/fullcit/8709317
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The Perceived Attitudes of Medical and Health School Faculty Deans Concerning Selected Factors of Employee Assistance Programs (counseling, Alcoholism, Drug Abuse) by Scherschell, Jack Roland, Phd from University of North Texas, 1984, 120 pages http://wwwlib.umi.com/dissertations/fullcit/8414119
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The Predictive Capability of Psychological Testing Measures As an Assessment and Diagnostic Aid in Drug Abuse Counseling. by Deal, Charles Edward, Edd from Baylor University, 1978, 134 pages http://wwwlib.umi.com/dissertations/fullcit/7909295
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The Reaction of Treatment Boundary Spanners to the Eruption of a Drug Epidemic (anti Drug Abuse Bill) by Horne, Malaika Beverly, Phd from Saint Louis University, 1991, 246 pages http://wwwlib.umi.com/dissertations/fullcit/9131002
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The Relation of Drug Abuse and Selected Demographic Variables to Rates of Recidivism by Summitt, William Shouse, Phd from University of Louisville, 1987, 77 pages http://wwwlib.umi.com/dissertations/fullcit/8809913
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The Relation of the Value Training Approach to Drug Abuse Prevention and Drug Attitude by Simpson, Charles Dennis, Edd from Indiana University, 1980, 69 pages http://wwwlib.umi.com/dissertations/fullcit/8022700
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The Relationship between Similarity of Clients in Drug Abuse Programs and Treatment Outcome by Battjes, Robert James, Dsw from The Catholic University of America, 1982, 249 pages http://wwwlib.umi.com/dissertations/fullcit/8213743
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The Role of Cultural Traditions in Alcohol and Drug Abuse Prevention: a Native American Study (alcohol Abuse Prevention) by Parker, Linda Ann, Phd from Brown University, 1990, 152 pages http://wwwlib.umi.com/dissertations/fullcit/9101819
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The Role of Resilience and Protective Factors in Predicting Alcohol, Tobacco, and Other Drug Abuse in Youth by Dugan, Margret Ann, Phd from The Claremont Graduate University, 1996, 130 pages http://wwwlib.umi.com/dissertations/fullcit/9707501
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The Social Organization of Community Based Drug Abuse Treatment by Peyrot, Mark Franklin, Phd from University of California, Los Angeles, 1982, 317 pages http://wwwlib.umi.com/dissertations/fullcit/8212868
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The Social Support Networks of Street Drug Abusers by Fraser, Mark William, Phd from University of Washington, 1981, 173 pages http://wwwlib.umi.com/dissertations/fullcit/8212534
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The Social World of Injection Drug Users and the Adoption of Aids Preventative Practices (immune Deficiency, Drug Addiction) by Connors, Margaret Mary, Phd from University of Massachusetts, 1993, 287 pages http://wwwlib.umi.com/dissertations/fullcit/9329586
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The Status of Drug Abuse Education in the Social Studies Curricula of Texas Public Senior High Schools by Mccreight, Boyd, Edd from Baylor University, 1971, 125 pages http://wwwlib.umi.com/dissertations/fullcit/7204149
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The Utility of a Measure of Personality in Understanding Female Substance Abusers by Jacobson, Bruce Kenneth, Phd from The University of Utah, 1989, 204 pages http://wwwlib.umi.com/dissertations/fullcit/9003698
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Therapeutic Aspects of a Pentecostal Church on Alcohol and Drug Abusers by Womack, Sheila Ann, Phd from The University of Texas at Austin, 1980, 252 pages http://wwwlib.umi.com/dissertations/fullcit/8100984
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Therapeutic Communities: a Family-centered Approach to Drug Addiction by Brieland, Christine Grant, Phd from University of Illinois at Urbana-champaign, 1983, 173 pages http://wwwlib.umi.com/dissertations/fullcit/8324515
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Therapeutic Community Treatment Outcomes for Substance Abusers with Antisocial Personality Disorder by Messina, Nena Portia; Phd from University of Maryland College Park, 2000, 91 pages http://wwwlib.umi.com/dissertations/fullcit/9967943
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Toward a Basis for Treatment Matching for Pregnant/post-partum Crack Cocaine Users: a Preliminary Study of Clinical Profiles, Perceived Treatment Needs, and Drug Abuse Etiologies by Higgs, Kerry I., Phd from University of South Florida, 1995, 209 pages http://wwwlib.umi.com/dissertations/fullcit/9542074
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Trauma, Social Support and Substance Abuse in Relation to Recidivism in Canadian Women Offenders by Dixon, Jeannette; Msc from Acadia University (canada), 2002, 78 pages http://wwwlib.umi.com/dissertations/fullcit/MQ72683
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Treating the Substance Abusive Homeless: Implications of the New Orleans Homeless Substance Abusers Project (louisiana) by Hall, John Forrest; Phd from Tulane University, 2003, 180 pages http://wwwlib.umi.com/dissertations/fullcit/3084115
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Vocational Status As a Moderator of Substance Abusers' Employability by Karuntzos, Georgia Tryphon; Phd from North Carolina State University, 2002, 149 pages http://wwwlib.umi.com/dissertations/fullcit/3076418
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Walk the Walk and Talk the Talk: an Ethnography of a Drug Abuse Treatment Facility (semiotics, Social Control) by Skoll, Geoffrey R., Phd from The University of Wisconsin - Milwaukee, 1990, 455 pages http://wwwlib.umi.com/dissertations/fullcit/9035154
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Wellness Circles: the Alkali Lake Model in Community Recovery Processes (native Americans, Canada, Recovery Programs, Substance Abuse) by Ben, Leon Walter, Edd from Northern Arizona University, 1991, 113 pages http://wwwlib.umi.com/dissertations/fullcit/9209520
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When Words Aren't Enough. a Study of the Use of Art Therapy in the Treatment of Chemically Dependent Adolescents with Special Focus upon the Spiritual Dimension (addiction, Alcoholism, Drug Abuse, Healing and Art, Intervention) by Burke, Kathleen, Phd from The Union for Experimenting Colleges and Universities, 1985, 360 pages http://wwwlib.umi.com/dissertations/fullcit/8523669
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Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND DRUG ABUSE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning drug abuse.
Recent Trials on Drug Abuse The following is a list of recent trials dedicated to drug abuse.8 Further information on a trial is available at the Web site indicated. •
Assessment of Potential Interactions Between Intravenous Methamphetamine and Oral Selegiline - 1 Condition(s): Infusions, Intravenous; Substance Abuse, Intravenous; Substance-Related Disorders Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: An assessment of potential interactions between intravenous methamphetamine and oral selegiline. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00033072
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Family Intervention for Mental Illness and Substance Abuse Condition(s): Mental Disorders; Substance-Related Disorders; Psychotic Disorders Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH)
8
These are listed at www.ClinicalTrials.gov.
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Purpose - Excerpt: The purpose of this study is to establish and evaluate a new family intervention program for individuals with mental illness and substance use disorders and their families. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00043693 •
Improving Substance Abuse Treatment Aftercare Adherence and Outcome Condition(s): Substance Abuse; Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Purpose - Excerpt: Although substance abuse treatment aftercare participation is strongly related to positive treatment outcomes, aftercare participation rates are low and relatively few interventions have been developed that improve aftercare adherence and outcome. We have shown in preliminary studies that contracting, prompting with feedback, and providing social reinforcement independently increase aftercare participation and improve treatment outcome. We propose a randomized clinical trial to examine a behaviorally based substance abuse treatment adherence intervention. We have 3 goals: 1) to compare the effectiveness of an aftercare intervention consisting of a participation contract, attendance prompts with feedback, and attendance reinforcers (CPR) to a standard treatment (STX) on adherence to aftercare therapy; 2) to assess the effects of this intervention on treatment outcome; and 3) to understand the process by which this intervention works. Over a 1.5-year period, we will recruit 160 veterans seeking residential or intensive outpatient treatment at the Salem VAMC's Substance Abuse Residential Rehabilitation Treatment Program (SARRTP) who can participate in aftercare therapy. Our population is highly similar to those in SARRTP's throughout the VAMC (95% male, 52% Caucasian, 48% minority, 44 years mean age, 47% alcohol dependent, 16% drug dependent, 37% both alcohol and drug dependent, and 36% dual diagnosis). In this randomized clinical trial, participants will be assigned to the STX or the CPR condition. Treatment adherence and outcome will be measured 3-, 6- and 12months after participants enter treatment and will be compared to baseline levels using structured interviews, questionnaires, urine alcohol and drug screens, VAMC databases, medical records, and therapist ratings. The basic study design is a repeated measures nested cohort design, with an intervention group and a standard care group. The primary outcome, abstinence rate, will be analyzed using a logistic regression model in which the parameters of interest are estimated using Generalized Estimating Equations (GEE). We will analyze secondary outcomes using both marginal and linear mixedeffects models. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057187
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Motivational Enhancement Treatment (MET) to Improve Treatment Engagement and Outcome in Subjects Seeking Treatment for Substance Abuse - 1 Condition(s): Substance-Related Disorders Study Status: This study is currently recruiting patients.
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Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: Motivational Enhancement Treatment (MET) to Improve Treatment Engagement and Outcome in Subjects Seeking Treatment for Substance Abuse Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00032981 •
Motivational Incentives for Enhanced Drug Abuse Recovery: Drug Free Clinics 1 Condition(s): Substance-Related Disorders Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: Motivational Incentives for Enhanced Drug Abuse Recovery: Drug Free Clinics Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00033007
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Onsite versus Referral Models of Primary Care for Substance Abusing Patients Condition(s): Substance Abuse Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Purpose - Excerpt: Veterans presenting for treatment of substance use disorders (SUDs) have multiple and often serious comorbid medical conditions that may affect functional health status and health care costs. Prior studies have shown higher rates of medical followup when onsite primary health care was provided within the addiction clinic. However, no data are available on differences between onsite versus referral models of primary care delivery in terms of clinical outcomes and total health care costs. The objectives of this study are to compare patients with SUDs who receive onsite primary care in a VA outpatient addictions clinic to those referred for primary care to the general internal medicine clinic on: 1) medical outcomes and quality of life; 2) SUD treatment outcomes; and 3) overall health care costs. This information will assist in identifying practice guidelines for providing preventive services and treatment for acute and chronic medical conditions to individuals receiving SUD treatment. The design of this study is a randomized clinical trial with two treatment conditions: 1) onsite primary care from a provider based in the Addictions Treatment Center (ATC) (experimental); or 2) referral for primary care to the General Internal Medicine Clinic (GIMC) (control). Subjects complete baseline assessment and 3, 6, and 12-month followups. Settings are the ATC and GIMC at the VA Puget Sound Health Care System (VAPSHCS), Seattle. The sample includes 800 (400 per group) patients ages 18-80 newly presenting or returning to SUD treatment. Inclusion criteria are: 1) initiating SUD treatment; and 2) has chronic medical condition as determined by medical evaluation. Exclusion criteria are: 1) current relationship with primary care provider; and 2) presence of serious medical condition requiring ongoing care in three or more organ systems. Major
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variables and source(s) of data include the following: Medical outcomes and scores on SF-36V health status questionnaire and are number of emergency room visits and medical/surgical inpatient admissions. SUD outcomes are treatment retention, changes in Addiction Severity Index scores, urine toxicology results, and self-reported alcohol use on the Form 90 timeline follow-back interview. Lastly, overall VA health care costs per subject per year for the 12-month period following randomization will be tracked. The main analysis involves intent-to-treat analysis of group (on-site vs. referral) by time (admission, 3, 6, 12-month) repeated-measures MANOVA. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057096 •
A Laboratory Model for Heroin Abuse Medications - 8 Condition(s): Heroin Dependence; Opioid-Related Disorders; Substance-Related Disorders Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA); New York State Psychiatric Institute Purpose - Excerpt: To evaluate the effects of treatment medications (methadone, buprenorphine, LAAM, naltrexone, naltrexone microcapsules, and methoclocinnamox) on I.V. and smoked heroin self-administration. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000273
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Cognitive Correlates of Substance Abuse, Part 1 - 11 Condition(s): Amphetamine-Related Disorders Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: Part 1: Characterize the cognitive performance of methamphetamine abusers by comparing them with cocaine abusers and normal controls. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000346
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Cognitive Correlates of Substance Abuse, Part 2 - 16 Condition(s): Amphetamine-Related Disorders Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA)
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Purpose - Excerpt: Part II: Examine cognitive performance of stimulant abusers (methamphetamine and cocaine) during recovery by assessing their cognitive function at monthly intervals. Phase(s): Phase IV Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000351 •
Motivational Incentives for Enhanced Drug Abuse Recovery: Methadone Clinics - 1 Condition(s): Substance-Related Disorders Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: Motivational Incentives for Enhanced Drug Abuse Recovery: Methadone Clinics. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00033020
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Motivational Interviewing (MI) to Improve Treatment Engagement and Outcome in Subjects Seeking Treatment for Substance Abuse - 1 Condition(s): Substance-Related Disorders Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: Motivational Interviewing (MI) to Improve Treatment Engagement and Outcome in Subjects Seeking Treatment for Substance Abuse Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00032994
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The Maternal Lifestyle Study (MLS) Condition(s): Cocaine Abuse; Cocaine Dependence; Opiate Dependence Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Child Health and Human Development (NICHD); National Institute on Drug Abuse (NIDA) Purpose - Excerpt: This study will evaluate the effects of a mother's use of cocaine and opiates during pregnancy on her infant. The study will assess both the short-term complications and the long-term outcomes. Phase(s): Phase IV Study Type: Observational
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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00059540 •
Tryptophan and Behavior Therapy for Cocaine Abuse - 1 Condition(s): Cocaine-Related Disorders Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA); Johns Hopkins University Purpose - Excerpt: To assess the efficacy of tryptophan vs. placebo, and voucher payments vs. a control condition, in the treatment of cocaine dependence. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000324
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Cocaine Abuse and ADHD - 10 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); New York State Psychiatric Institute Purpose - Excerpt: To evaluate the safety and efficacy of buproprion in treating individuals with adult attention-deficit hyperactivity disorder (ADHD) and cocaine dependence. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000275
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Cocaine Abuse and Attention Deficit Disorder - 3 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); New York State Psychiatric Institute Purpose - Excerpt: Cocaine Abuse and Attention Deficit Disorder Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000268
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Counseling Conditions for Thrice Weekly Buprenorphine in a Primary Care Clinic - 1 Condition(s): Heroin Dependence; Opioid-Related Disorders; Substance Abuse, Intravenous Study Status: This study is not yet open for patient recruitment.
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Sponsor(s): National Institute on Drug Abuse (NIDA); Yale University Purpose - Excerpt: Counseling for Buprenorphine in Primary Care Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00023283 •
Dopamine Reuptake Inhibitors of Cocaine Abuse - 1 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); VA Connecticut Healthcare System Purpose - Excerpt: To evaluate dopamine reuptake inhibitors for cocaine abuse. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000276
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Effect of Nefazodone on Relapse in Females with Cocaine Abuse - 10 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); University of Minnesota Purpose - Excerpt: To determine the effect of nefazodone on relapse to cocaine use in depressed and non-depressed females with cocaine abuse/dependence. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000293
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Evaluation of a Desipramine Ceiling in Cocaine Abuse - 1 Condition(s): Cocaine-Related Disorders; Substance-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Friends Research Institute Purpose - Excerpt: Randomized trial of placebo versus a fixed dose of desipramine on cocaine dependent individuals. Purpose is to confirm whether a blood level "ceiling" exists on desipramine effect in cocaine abuse. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000245
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Flupenthixol and Haloperidol for Treating Cocaine Abuse Schizophrenics - 9 Condition(s): Cocaine-Related Disorders; Substance-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); New York State Psychiatric Institute Purpose - Excerpt: To evaluate the safety and efficacy of flupenthixol and haloperidol for cocaine dependence in individuals with schizophrenia/schizoaffective illness. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000274
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Glutaminergic Agents for Cocaine Abuse - 5 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); VA Connecticut Healthcare System Purpose - Excerpt: To evaluate glutaminergic agents for cocaine abuse. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000280
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Human Dopamine Transported Imaging in Cocaine Abuse: 1 - 1 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Johns Hopkins University Purpose - Excerpt: To determine the density of DA transporters during prolonged cocaine abuse and during withdrawal from cocaine use. This aim will test the hypothesis that DA transporters are altered by cocaine abuse and reestablished during withdrawal. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000315
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Human Dopamine Transported Imaging in Cocaine Abuse: 2 - 2 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Johns Hopkins University
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Purpose - Excerpt: To determine the density of DA transporters during prolonged cocaine abuse and during withdrawal from cocaine use. This aim will test the hypothesis that DA transporters are altered by cocaine abuse and reestablished during withdrawal. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000316 •
IV Cocaine Abuse: A Laboratory Model - 1 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Columbia University Purpose - Excerpt: To evaluate the effects of desipramine DMI maintenance on cocaine taking and on the physiological and subjective effects of cocaine, including cocaine craving. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000212
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IV Cocaine Abuse: A Laboratory Model - 2 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Columbia University Purpose - Excerpt: To evaluate the effects of fluoxetine maintenance on cocaine taking and on the physiological and subjective effects of cocaine, including cocaine craving. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000213
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IV Cocaine Abuse: A Laboratory Model - 3 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Columbia University Purpose - Excerpt: Evaluate effects of buprenorpine on cocaine taking and on the physiological and subjective effects of cocaine, including cocaine craving in non-opiate dependent cocaine users. Phase(s): Phase II Study Type: Interventional
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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000214 •
IV Cocaine Abuse: A Laboratory Model - 4 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Columbia University Purpose - Excerpt: Evaluate effects of pergolide on cocaine taking and on the physiological and subjective effects of cocaine, including cocaine craving in non-opiate dependent cocaine users. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000215
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Matching, Outcomes and Costs in Substance Abuse/Psychiatric Treatment Condition(s): Diagnosis, Dual (Psychiatry); Substance-Related Disorders Study Status: This study is completed. Sponsor(s): Department of Veterans Affairs; Department of Veterans Affairs Health Services Research and Development Service Purpose - Excerpt: This project is providing information on current efforts to transfer mental health care away from hospitals and to match patients to different types of community care. Its ultimate goal is to improve the quality of care and reduce treatment costs for veterans with substance abuse and psychiatric problems. This project is evaluating a patient-treatment matching strategy to improve hospital- and communitybased residential treatment for substance abuse patients with psychiatric disorders. Its immediate objective is to examine whether the matching strategy results in more effective and cost-effective treatment in VA programs. We hypothesize that patients with severe clinical and functional problems will have better outcomes when they are matched to service-intensive programs; patients with moderate problems will have better outcomes when they are matched to programs having a lower intensity of services. For both patient groups, community-based treatment should prove to be more cost-effective than hospital-based treatment. The project is utilizing a stratified randomized design. We have paired each of three VA hospital-based programs that treat dual diagnosis patients and are high on intensity with a nearby high-intensity community residential facility (CRF) that contracts with the VA. We have also paired four VA hospital and four community programs that are low on intensity. Veterans who apply for substance abuse treatment at VA facilities are randomly assigned to either the VA hospital or community program. Patient assessments are conducted at intake (to date, N=224), discharge, and 4- and 12-month follow-ups. Primary outcomes are patients? severity of substance abuse and psychiatric problems. Secondary outcomes are patients? functional status and their VA and non-VA health care utilization and its costs. Phase(s): Phase II Study Type: Interventional
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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00012727 •
Mazindol for Cocaine Abuse - 2 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); VA Connecticut Healthcare System Purpose - Excerpt: To evaluate high and low dose mazindol for cocaine abuse. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000277
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New Approaches to Cocaine Abuse Medications (A) - 6 Condition(s): Cocaine-Related Disorders; Substance-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); New York State Psychiatric Institute Purpose - Excerpt: To measure the effect of desipramine in cocaine abusers selected for major depression or dysthymia. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000271
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New Approaches to Cocaine Abuse Medications (B) - 7 Condition(s): Cocaine-Related Disorders; Substance-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); New York State Psychiatric Institute Purpose - Excerpt: To measure the effect of risperidone in cocaine abusers. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000272
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Pemoline for Cocaine Abuse - 7 Condition(s): Cocaine-Related Disorders Study Status: This study is completed.
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Sponsor(s): National Institute on Drug Abuse (NIDA); VA Connecticut Healthcare System Purpose - Excerpt: To evaluate treatment of pemoline for cocaine abuse. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000282 •
Pharmacotherapy and Intensive Treatment of Drug Abuse - 1 Condition(s): Cocaine-Related Disorders; Substance-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Department of Veterans Affairs Purpose - Excerpt: Double-blind controlled evaluation of desipramine and carbamazepine in reducing cocaine craving; increase outpatient treatment capacity and evaluate their incidence of psychiatric disorders. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000217
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Treatment Efficacy for Drug Abuse and AIDS Prevention - 1 Condition(s): Cocaine-Related Disorders; Heroin Dependence Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Mclean Hospital Purpose - Excerpt: Assessment of safety and effectiveness of buprenorphine for treatment of concurrent intravenous heroin and cocaine dependence. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000210
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Treatment Efficacy for Drug Abuse and AIDS Prevention - 2 Condition(s): Cocaine-Related Disorders; Heroin Dependence Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); Mclean Hospital Purpose - Excerpt: Assessment of safety and effectiveness of buprenorphine for treatment of concurrent intravenous heroin and cocaine dependence. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000211
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Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “drug abuse” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON DRUG ABUSE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “drug abuse” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on drug abuse, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Drug Abuse By performing a patent search focusing on drug abuse, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on drug abuse: •
Anti-needle strike and anti-drug abuse syringe Inventor(s): Foster; Clark B. (El Toro, CA), Haber; Terry M. (Lake Forest, CA), Smedley; William H. (Lake Elsinore, CA) Assignee(s): Habley Medical Technology Corporation (Laguna Hills, CA) Patent Number: 4,710,170 Date filed: February 12, 1987 Abstract: A disposable, anti-needle strike, anti-drug abuse syringe which reduces the frequency of accidental needle strikes to health care workers and prevents healththreatening reuse of the needle canula by drug abusers. The syringe has a needle carrying base and an attached hypodermic needle assembly which are relocatable within the syringe cylinder from a distally disposed first position to a proximally disposed second position. A piston assembly having a detachable stem moves reciprocally and axially through the syringe cylinder to expulse fluidic medication and to selectively engage the needle carrying base at the distal bore of the cylinder, whereby to relocate the needle carrying base and its attached needle assembly from the first position to the second position. The needle carrying base is anchored at the second position, such that the used needle extends into and is shielded by the syringe cylinder. The stem is then detached from the piston assembly and inserted through the now open orifice at the distal bore of the cylinder. The piston assembly stem is axially advanced through the syringe cylinder until contact is made with the needle canula which is anchored at and extended into the cylinder from the second cylinder position. The piston stem is further advanced to thereby bend, rather than unsafety snap, the needle canula. The stem is locked at its final position within the syringe cylinder to create a disposal cartridge with the needle canula destroyed, shielded and rendered irretrievable therewithin. Excerpt(s): This invention relates to a disposable hypodermic syringe which is adapted to reduce the frequency of accidental and, in some cases, life threatening, needle strikes while reducing instances of possible drug abuse by preventing reuse of the syringe needle by drug abusers. Hypodermic syringes are used for a variety of injection procedures including the delivery of medicinal drugs to a recipient. However, once the injection procedure is completed and the syringe cylinder emptied, problems may arise as a consequence of failing to properly and adequately dispose of the syringe. By way of a first example, the syringe may be used to treat a patient having a communicable disease. To prevent reuse, the hypodermic needle is sometimes broken before the syringe is discarded. Health care workers are susceptible to accidental and potentially infectious needle strikes due to the careless handling of the hypodermic needle when breaking the needle or disposing of the syringe after use. The resulting mini-accidents caused by an accidental needle strike typically require a blood test for such disease as AIDS and hepatitis. The corresponding cost and inefficiency of testing health care workers who have received an inadvertent needle strike results in considerable waste, which may be particularly damaging to a health care facility striving for economy and efficiency. By way of second example, drug addicts have been known to rummage through the trash of a health facility in an effort to find emptied syringes which have been discarded after use. Such syringes are often reused in an illicit capacity, whereby to promote drug abuse and the possible spread of contagious disease among drug users.
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Unfortunately, no disposable syringe is presently known which includes means to reliably reduce the frequency of accidental needle strikes suffered by health care workers while preventing reuse of the syringe by drug users. Web site: http://www.delphion.com/details?pn=US04710170__ •
Carrier for detecting drug abuse compounds Inventor(s): Blum; Kenneth (San Antonio, TX), Wallace; Jack E. (San Antonio, TX) Assignee(s): Matrix Technologies, Inc. (League City, TX) Patent Number: 4,844,866 Date filed: November 13, 1984 Abstract: A carrier for detecting drug abuse compounds which changes color upon contact with such compounds. Metabolites of abusable drugs such as natural opiates, i.e., morphine and heroin, are qualitatively and semi-quantitatively detected in physiological fluids by the use of the carrier which has been treated with certain stainproducing components adapted to react with the dug abuse compound residues to form colored products and which may be enhanced by intense light and/or heat. Excerpt(s): This application, in part, relates to methodology for qualitatively detecting the presence of metabolites of natural opiate-type compounds in physiological fluids, particularly human urine. Additionally, it includes a carrier, i.e., a treated paper or dipstick, which has been proven to be especially useful for the qualitative or semiquantitative analysis of body fluids such as urine or saliva for the presence of drug abuse compound residues. The need for a rapid qualitative and semi-quantative screening device for the detection of natural opiate-type compounds and resultant metabolites is increasing with the enhanced worldwide utilization of these compounds as well as their structurally similar synthetic analogs. Currently, most of the available analytical procedures for determining opiates in urine are either insufficiently sensitive, unacceptably slow, or involve testing with expensive instruments at a cost that prevents their utilization in situations other than a reference laboratory environment. In drug abuse testing, the requirements for detectability are very low and the range of compounds is extremely expansive; a need exists for a method of rapid drug detection which identifies drugs by a simple and direct method not requiring solvent extraction. Web site: http://www.delphion.com/details?pn=US04844866__
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Drug abuse prevention computer game Inventor(s): Urquhart; William Eldridge (Wetumpka, AL), Rapoza; Darion (Durham, NC) Assignee(s): Entertainment Science, Inc. (Durham, NC) Patent Number: 6,561,811 Date filed: March 20, 2002 Abstract: An intervention method in which computer-based role-playing games are utilized to allow players to experience simulated effects of substance abuse on the individual, family, friends, and community, and thus learn by experience to avoid the adverse consequences of drug abuse through abstinence, promotion of abstinence by others, and treatment and correction of substance abusers. Role-playing games allow
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players to pretend to be a character in a story, much like being in a play. Each player takes the role of a character in the story, making the decisions and saying the things that character would say in the situations that happen along the way. Game objectives are set which the player or players attempt to complete through game-play. The intervention method involves realistically portraying the consequences of substance abuse and its interference with the individual's or group's chances of meeting the game objectives. To better meet the game objectives, players must practice social resistance skills, and are rewarded for avoiding drugs as well as for helping other characters avoid drug use. Thus, within the safety of the role-playing game environment, conditioned learning is used to teach players to avoid substance abuse as they learn by experience about the effects of drugs, their adverse consequences, how to resist pressures to use drugs and how to help others to do so as well. Excerpt(s): A portion of the disclosure of this patent document contains material that is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction by any-one of the patent document or patent disclosure, as it appears in the Patent and Trademark Office patent file or records, but otherwise reserves all copyrights whatsoever. The invention relates to an interactive computer-based roleplaying game to promote abstinence from substance abuse. 1) The approach should be research based/theory driven. Research that focuses on tests of theory-driven ideas and that successfully incorporates tests of hypotheses permits the design of interventions that rely on methods proven to be effective, while discarding those methods proven to be ineffective. Web site: http://www.delphion.com/details?pn=US06561811__ •
Educational apparatus in the shape of a human doll utilized in teaching kids the dangers of drug abuse Inventor(s): Pan; Chiou-Wen S. (1700 Robb St., Apt. 20, Lakewood, CO 80215) Assignee(s): none reported Patent Number: 4,768,960 Date filed: June 11, 1987 Abstract: An apparatus in the shape of a transparent human doll having an opening at its top and an open-end box as its base. Several transparent slides, one with a stylized graph of a healthy person's insides with said person's beautiful red arteries, clear blue veins and undamaged internal organs; the rest transparent slides bearing stylized graphs of partially symbolically damaged internal organs depicted as black areas as a result of drug use are to be inserted into or removed from the said doll from its top. The integration or disintegration of the image of the black areas of the transparent slides depicts increasing or decreasing in damage by drug use and disuse. The picture of the transparencies inside said doll give kids strong and direct message of health effects of drug abuse. The doll can be personalized with the photography of the kid who plays with the doll. Two non-transparent slides are also included. One shows a slogan "No! Don't poison me", and the other shows healthy human organs not damaged by drug abuse with vivid red arteries and blue veins on white board. For visual impact, orange colored cardboard can be used for the "No! Don't poison me" slide. Excerpt(s): This invention relates to an apparatus in the form of a toy for educational purposes. It forcefully demonstrates to kids in a direct and visible way the potential damage to their internal organs by drug abuse and ensuing deterioration of their health
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by showing them pictures of internal organs damaged by illegal drug use or increased damage by multiple illegal drug use by a combination of transparencies. Such timely teaching in their formative ages will thereby cultivate in them the desire not to use illegal drugs and to withdraw from said drugs if in use. Kids need to stay healthy so that they can develop physically and mentally, and therefore there is an urgent need for this educational apparatus in the shape of a human doll that they can identify themselves with and play with it so that an emotional impact will result in their firm refusal to use illegal drugs or if already using them to withdraw from using said drugs at once. Heretofore movies and posters are used to discourage drug abuse. However, none of them are specifically for young kids and none of the prior arts kids can identify personally and emotionally with themselves in order to achieve the best results in preventing drug abuse. This invention remedies this situation. Previously transparent conduits have been used as a teaching aid to demonstrate circulation of a drug being administered either orally or intravenously, and which includes a transparent model of the upper portion of human body (1). Also an educational device for demonstrating the progressive depth layers of the human body. The device uses multilayer of slides manipulated with pulleys (2). Also an educational kit for teaching children letters of alphabet vocally. No transparency is used in the device (3). None of these inventions contributed directly to the said invention which is an apparatus and a toy. It is a transparent doll with an opening at its top for the insertion and retriever of educational slides symbolically showing damages caused by drug abuse. (1) James R. Rader and Paul W. Smith. Teaching aid for demonstrating drug circulation or the like in human body. U.S. Pat. No. 3,748,366 (07/24/73). Web site: http://www.delphion.com/details?pn=US04768960__ •
Hapten-carrier conjugates for use in drug-abuse therapy and methods for preparation of same Inventor(s): Exley; Mark Adrian (Chestnut Hill, MA), Powers; Stephen P. (Waltham, MA), Gefter; Malcolm L. (Lincoln, MA), Swain; Philip A. (Brighton, MA), Schad; Victoria Carol (Cambridge, MA), Greenstein; Julia Lea (West Newton, MA), Fox; Barbara Saxton (Wayland, MA) Assignee(s): ImmuLogic, Inc. (Waltham, MA) Patent Number: 5,773,003 Date filed: June 1, 1995 Abstract: Hapten-carrier conjugates capable of eliciting anti hapten antibodies in vivo by administering, in a therapeutic composition, are disclosed. Anti-hapten antibodies elicited compete with free hapten upon subsequent challenge of a vaccinated individual. Methods of preparing the conjugates and therapeutic compositions are also disclosed. Where the hapten is a drug of abuse, a therapeutic composition containing the haptencarrier conjugate is particularly useful in the treatment of drug addiction, more particularly, cocaine addiction. Passive immunization using antibodies raised against conjugates of the instant invention is also disclosed. The therapeutic composition is suitable for co-therapy with other conventional drugs. Excerpt(s): The prevalence of drug use and abuse worldwide, especially in the United States, has reached epidemic levels. There are a plethora of drugs, both legal and illegal, the abuse of which have become serious public policy issues affecting all strata of society with its obvious medical and social consequences. Some users live in an extremely high risk population associated with poverty and illegal activity. Other users
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who might class themselves as recreational users are at risk due to (a) properties of the drug(s) which make them addictive, (b) a predisposition of the user to become a heavy user or (c) a combination of factors including personal circumstances, hardship, environment and accessibility. Adequate treatment of drug abuse, including polydrug abuse, requires innovative and creative programs of intervention. An especially problematic drug is cocaine, an alkaloid derived from the leaves of the coca plant (Erythroxylon coca). In the United States alone, there currently are more than 5 million regular cocaine users of whom at least 600,000 are classified as severely addicted (1, 2). Within this population, a significant number of addicts actively are seeking therapy. For example, in 1990, 380,000 people sought medical treatment for cocaine addiction and the number is increasing. At that time, it was estimated that 100,000 emergency room admissions per year involve cocaine use. The cumulative effects of cocaine-associated violent crime, loss in individual productivity, illness, and death is an international problem. The lack of effective therapies for the treatment of cocaine addiction strongly suggests that novel approaches must be developed. Additional factors contributing to the lack of successful treatment programs is that patterns of cocaine abuse have varied with time. In an article entitled "1994 Chemical Approaches to the Treatment of Cocaine Abuse", (F. Ivy Carroll et al., Pharm. News, Vol. 1, No. 2, 1994 Chemical Approaches to the Treatment Cocaine Abuse.), F. Ivy Carroll reports that since the mid-1980's, intravenous and nasal dosing of the hydrochloride salt (coke, snow, blow) and smoking of cocaine free-base (crack) have become common routes of administration, producing euphoria and psychomotor stimulation which last 30-60 minutes. Unlike some other abused drugs, cocaine can be taken in binges lasting for several hours. This behavior leads to addiction, and in some cases, to toxic consequences (F. Ivy Caroll et al., Pharm. News, supra.). Web site: http://www.delphion.com/details?pn=US05773003__ •
Method and composition for treating obesity, drug abuse, and narcolepsy Inventor(s): Hohenwarter; Mark (Mobile, AL) Assignee(s): Serotonin Industries of Charleston (Charleston, SC) Patent Number: 4,843,071 Date filed: December 5, 1986 Abstract: Compositions and methods are disclosed for the treatment of obesity, depression, drug abuse, and narcolepsy. The compositions comprise a norepinephrine precursor such as L-tyrosine or L-phenylalanine in combination with a norepinephrine re-uptake inhibitor such as desipramine. In another embodiment of the invention, the compositions further comprise enzymatic cofactors for the biosynthesis of norepinephrine. Excerpt(s): This invention relates to compositions comprising a norepinephrine precursor, such as L-tyrosine or L-phenylalanine in combination with a norepinephrine re-uptake inhibitor such as desipramine. The compositions are useful in controlling obesity, depression, drug abuse, and narcolepsy in animals. The invention also relates to said compositions further comprising one or more enzymatic cofactors for the biosynthesis of norepinephrine. This invention further relates to a method of controlling obesity, depression, drug abuse, or narcolepsy in an animal comprising administering an effective amount of the compositions of this invention to said animal. The use of appetite supressants such as diethylproprion and phenylpropanolamine operate by directly and/or indirectly stimulating noradrenergic receptors in the brain. However,
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long-term use of these drugs is met with increasing tolerance in most patients, requiring increased dosage and more frequent administration to achieve continued appetite suppression. Tolerance to these products occurs as the result of a depletion of norepinephrine from storage sites in the neuron with the use of indirect-acting agents. Catecholamines are stored in subcellular granules and released by exocytosis in the adrenal medulla and sympathetic nerve endings. The biosynthesis of catecholamines proceeds from the amino acid phenylalanine which is sequentially hydroxylated to form tyrosine, then 3,4-dihydroxyphenylalanine (DOPA). DOPA is decarboxylated to form dopamine. Hydroxylation on the beta position of the side chain forms norepinephrine. Web site: http://www.delphion.com/details?pn=US04843071__ •
Method and test kit for detecting inherited substance abuse dependency Inventor(s): Bradley; Ronald H. (Williamston, MI) Assignee(s): Board of Trustees operating Michigan State University (East Lansing, MI) Patent Number: 5,081,011 Date filed: January 26, 1990 Abstract: A method and test kit for detecting and treating inherited substance abuse dependency by counting viable T-cell suppressor cells (CD8) is described. In the preferred form the T-cell suppressor cells are isolated and then counted. The method and test kit are important for distinguishing a genetic deficiency with a tendency towards alcoholism as opposed to a psychological dependency on drugs. Excerpt(s): The present invention relates to a method and test kit for the diagnosis of an inherited substance abuse dependency in humans as a basis for subsequent treatment. In particular, the present invention relates to a method and test kit which detects low levels of lymphocyte T-cell suppressor cells (CD8) as evidence of the inherited substance abuse trait. The use and abuse of alcohol and other mind altering drugs which can be coupled with chemical dependency is a very serious problem. Alcoholism and mixed chemical dependency of alcohol with other drugs is a major concern of the health care system. It is a major concern of the gross national indebtedness of the U.S.A. with estimates ranging from $116 billion annual loss in manpower to $125 billion of the national health care cost. This is a total cost of over $200 billion being lost due to a disease called "alcoholism". The range of the economic consequences of alcoholism is felt on the industrial line, through airplane accidents, motor vehicle accidents, and from major oil spills to legislative leaders who are intoxicated or who deny that they have any problem, and various professionals. Political leaders are using the only problem-solving tactic known to them, which is to eliminate a very small portion of the problem through the "drug wars". In the hospitals the costs of alcoholism is seen in the number of patient beds occupied by medical side effects of alcoholism. These side effects of alcoholism (whether it is acute or chronic) are an increased incidence of lung cancer, prostatic cancer, HIV (AIDS) syndromes, and other immunological and end organ consequences of ethanol toxicity. Web site: http://www.delphion.com/details?pn=US05081011__
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Method for prevention of specimen tampering in substance abuse testing and test area relating thereto Inventor(s): Copelan; Herbert W. (8706 Via Reale, Boca Raton, FL 33496) Assignee(s): none reported Patent Number: 5,039,616 Date filed: August 31, 1989 Abstract: This invention provides a method and a test area to prevent tampering in the collection of specimens for substance abuse testing from a subject utilizing a specimen collection container. More particularly, the present invention prevents the substitution of the subject by another person and prevents the subject from introducing a previously obtained and concealed false specimen while minimizing intrusion on the subject's privacy. Excerpt(s): This invention relates to a method and a test area to prevent tampering in the collection of specimens for substance abuse testing and, more particularly, to prevent tampering in the collection of specimens for substance abuse testing from a subject utilizing a specimen collection container. In recent years, a considerable amount of attention has been focused on the social and economic, as well as other, consequences of substance abuse, that is, the use of illegal drugs, the illegal or deleterious use of legally controlled drugs, or the deleterious use of freely available drugs including alcohol. The efforts to control and eradicate substance abuse and the consequences thereof encompass many diverse strategies, however, a feature common to many of these approaches places a strong emphasis on the testing of specimens from human subjects to determine whether substance abuse has occurred. Not only is such testing conducted as part of many programs concerned with matters in the nature of drug/alcohol rehabilitation and probation and parole of criminal offenders (e.g., no substance abuse as a condition of parole; drunk driving) but it is also increasingly required as a condition of gaining or retaining employment, particularly where safety or integrity is important (e.g., airline pilots, railroad engineers, truck drivers, and public officials). In each case, the subject who abuses such substances has a considerable social and financial incentive to tamper with specimens which would indicate substance abuse upon testing, that is test positive. For instance, depending on the subject's circumstances, a positive test could mean denial or loss of employment and therefore income, dismissal from military service, change in parole or probation status, criminal prosecution, designation as a chronic abuser, and/or designation as a security risk. In order to foil detection a subject may tamper with a substance abuse test in at least two ways. One way is to substitute another person, one who is not a substance abuser, for the actual subject. Another way is for the subject to introduce a false specimen instead of his own during the specimen collection process. A false specimen is defined as: a specimen given by the subject at a prior time when drug-free; a specimen obtained by the subject from another person; or a substance with properties similar to that of a specimen; which is free of detectable amounts of the substance that is to be tested for, and which is concealed beforehand and introduced by the subject instead of a valid specimen. Web site: http://www.delphion.com/details?pn=US05039616__
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Method for treating drug addiction Inventor(s): Revici; Emanuel (New York, NY) Assignee(s): Avram; Elena (New York, NY) Patent Number: 4,565,690 Date filed: April 12, 1985 Abstract: A method for treating drug addiction from compounds which cause a catabolic effect on the human body, which comprises administering to said body, a sufficient amount of an anabolic agent containing bivalent negative selenium or sulfur. Excerpt(s): The invention relates to methods and compositions for treating drug addiction, particularly for the treatment of the symptoms of withdrawal when the patient terminates using drugs. In treating patients for drug addiction, the most common method employed is that of allowing the patient to "dry out" or eliminate the drug from their system. This period, called withdrawal, is a very difficult time for the patient, since the body is in need of the drug due to its previous habitual use and dependence thereon. It was previously not recognized that the effect of the drug on the body would be counteracted by administering a compound which produces an opposite effect on the body so as to offset and neutralize the detrimental defense effects of the body. The present invention provides one such solution for this problem. Web site: http://www.delphion.com/details?pn=US04565690__
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Method for treating substance abuse Inventor(s): Beasley; Charles M (Indianapolis, IN), Rasmussen; Kurt (Fishers, IN), Tollefson; Gary D (Indianapolis, IN) Assignee(s): Eli Lilly and Company (Indianapolis, IN) Patent Number: 6,159,963 Date filed: November 25, 1997 Abstract: The invention provides a method for treating substance abuse comprising administering an effective amount of olanzapine or pharmaceutically acceptable salt thereof to a patient in need thereof. Excerpt(s): This invention provides a method for using 2-methyl-4-(4-methyl-1piperazinyl)-10H-thieno[2,3-b][1,5]benzodiazepine, (hereinafter referred as "olanzapine"), for the treatment of dependence on a controlled substance. The present method provides a method for helping the patient to want to stop taking the drug, lessen the adverse symptoms of withdrawal from the drug and to minimize the relapse into abuse of the drug. As long as history has been recorded, every society has used drugs that alter mood, thought, and feeling. In addition, pharmacological advances sometimes have been paralleled by physical as well as unfortunate behavioral dependence on agents initially consumed for therapeutic purposes. Therefore, the alleviation and eventual withdrawal from undesired physical and psychological dependence and tolerance of a substance has been a challenge throughout history. Although there are some treatments available for such withdrawal from addictive and/or mind altering substances, there is a great need for safer and more effective treatments. It would be particularly desired to provide an effective treatment that could minimize hospitalization or institutionalization of a patient. The treatment must be nonaddictive and provide a favorable side effect profile. It is particularly desired to provide
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a method that can help the patient want to stop taking the substance and ease the withdrawal effects when the patient stops taking the undesired substance. It is especially desired if the method minimizes the instances of relapse into abuse of the substance. Applicants believe that olanzapine could fulfill these needs. Web site: http://www.delphion.com/details?pn=US06159963__ •
Method for treating substance abuse disorders Inventor(s): Bjork; Anders (Bjarred, SE), Andersson; Gunnar (Lund, SE) Assignee(s): Pharmacia AB (Stockholm, SE) Patent Number: 5,565,455 Date filed: November 30, 1994 Abstract: A method for relief or prevention of a withdrawal syndrome resulting from addiction to a drug or substance of abuse and/or for the suppression of dependence on drugs or substances of abuse which comprises administering to a patient in need thereof an effective amount of a bisphenylalkylpiperazinde derivative, wherein said withdrawal syndrome comprises at least one of the symptoms selected from the group consisting of sleep disturbance, mood disturbance, and craving for the drug or substance of abuse. Excerpt(s): This application is a 371 of PCT/SE93/00339 filed 04/19/93. The present invention relates to a new use of certain pyridyl- and pyrimidyl-substituted bisphenylalkylpiperazines in the treatment of substance abuse disorders. More particularly, this invention relates to the amelioration of withdrawal symptoms and to modify drug-seeking behaviour. Drug dependency is extremely difficult to escape. This is true whether the dependency is one based on ethanol, amphetamine, barbiturates, benzodiazepines, cocaine, nicotine, opioids, and phencyclidine or the like. There is a need, therefore for an agent decreasing or overcoming such addiction and, if possible reducing or eliminating the symptoms related to the withdrawal of such drugs or substances of abuse. Web site: http://www.delphion.com/details?pn=US05565455__
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Method of treating drug abuse Inventor(s): Dudley; Mark W. (Somerville, OH), Carr; Albert A. (Cincinnati, OH), Dage; Richard C. (Cincinnati, OH), Koerner; John E. (Cincinnati, OH), Li; Tung (Cincinnati, OH), Nieduzak; Thaddeus R. (Golf Manor, OH), Schmidt;. Christopher J. (Oregonia, OH), Miller; Francis P. (Loveland, OH), Frank; Robert A. (Cincinnati, OH) Assignee(s): Merrell Pharmaceuticals Inc. (Cincinnati, OH) Patent Number: 5,500,433 Date filed: January 10, 1995 Abstract: The present invention is directed to a new class of piperidinyl medicinal agents which are useful for treating drug abuse. Excerpt(s): The present invention is directed to 1-(4-fluorophenyl)-2-[4-[(4methanesulfonamidophenyl)carbonyl]-1-piperidin yl]ethanone and 1-(4-fluorophenyl)2-[4-[(4acetamidophenyl)carbonyl]-1-piperidinyl]-ethano ne, their use as antithrombotic agents, their use as serotonin 5HT.sub.2 antagonists, their use as D.sub.2 antagonists,
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their use in the treatment of drug abuse and to their use as antiarrhythmic agents. This reference does not disclose the compounds, 1-(4-fluorophenyl)-2-[4-[(4methanesulfonamidophenyl)carbonyl]-lpiperidiny l]-ethanone and 1-(4-fluorophenyl)-2[4-[(4acetamidophenyl)carbonyl]-1-piperidinyl]-ethano ne. This application's disclosure is limited to compounds in which there is an unsubstituted alkylene bridging group between the 1-position of the piperidinyl ring and the phenyl ring. This reference does not disclose any compounds in which a carbonyl group occupies this position. This application discloses neither 1-(4-fluorophenyl)-2-[4[(4methanesulfonamidophenyl)carbonyl]-1-piperidiny l]-ethanone nor 1-(4fluorophenyl)-2-[4-[(4-acetamidophenyl)carbonyl]-lpiperidinyl]-ethano ne. Web site: http://www.delphion.com/details?pn=US05500433__ •
Test area for prevention of specimen tampering in substance abuse testing Inventor(s): Copelan; Herbert W. (8706 Via Reale, Boca Raton, FL 33496) Assignee(s): none reported Patent Number: 5,133,935 Date filed: July 29, 1991 Abstract: The invention provides a method and a test area to prevent tampering in the collection of specimens for substance abuse testing from a subject utilizing a specimen collection container. More particularly, the present invention prevents the substitution of the subject by another person and prevents the subject from introducing a previously obtained and concealed false specimen while minimizing intrusion on the subject's privacy. Excerpt(s): This invention relates to a method and a test area to prevent tampering in the collection of specimens for substance abuse testing and, more particularly, to prevent tampering in the collection of specimens for substance abuse testing from a subject utilizing a specimen collection container. In recent years, a considerable amount of attention has been focused on the social and economic, as well as other, consequences of substance abuse, that is the use of illegal drugs, the illegal or deleterious use of legally controlled drugs, or the deleterious use of freely available drugs including alcohol. The efforts to control and eradicate substance abuse and the consequences thereof encompass many diverse strategies; however, a feature common to many of these approaches places a strong emphasis on the testing of specimens from human subjects to determine whether substance abuse has occurred. Not only is such testing conducted as part of many programs concerned with matters in the nature of drug/alcohol rehabilitation and probation and parole of criminal offenders (e.g., no substance abuse as a condition of parole: drunk driving) but it is also increasingly required as a condition of gaining or retaining employment, particularly where safety or integrity is important (e.g., airline pilots, railroad engineers, truck drivers, and public officials). In each case, the subject who abuses such substances has a considerable social and financial incentive to tamper with specimens which would indicate substance abuse upon testing, that is test positive. For instance, depending on the subject's circumstances, a positive test could mean denial or loss of employment and therefore income, dismissal from military service, change in parole or probation status, criminal prosecution, designation as a chronic abuser, and/or designation as a security risk. In order to foil detection a subject may tamper with a substance abuse test in at least two ways. One way is to substitute another person, one who is not a substance abuser, for the actual subject. Another way is for the subject to introduce a false specimen instead of his own during the specimen
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collection process. A false specimen is defined as: (1) a specimen given by the subject at a prior time when drug-free; (2) a specimen obtained by the subject from another person; or (3) a substance with properties similar to that of a specimen which is free of detectable amounts of the substance that is to be tested for, and which is concealed beforehand and introduced by the subject instead of a valid specimen. Web site: http://www.delphion.com/details?pn=US05133935__ •
Use of gamma-hydroxybutyric acid amides in the treatment of drug addiction and in particular of alcoholism Inventor(s): Loche; Antonella (Sanremo, IT), Perlini; Vincenzo (Matelica, IT), Cacciaglia; Roberto (Ospedaletti, IT), Guano; Lorenza (Sanremo, IT) Assignee(s): Laboratoric Farmaceutico C.T. S.r.l. (Sanremo, IT) Patent Number: 6,436,998 Date filed: September 2, 1999 Abstract: The present invention relates to the use of.gamma.-hydroxybutyric acid amides in the treatment of drug addiction and alcoholism, more particularly in reducing chronic alcoholics' desire for and habit of consuming alcoholic drinks and in the treatment of the syndrome of abstinence from alcohol. Excerpt(s): The present invention relates to the use of amides of.gamma.-hydroxybutyric acid, herein referred to as GHB, in the treatment of drug addiction, such as heroine, cocaine and, in particular, in the treatment of alcoholism, and more particularly in reducing chronic alcoholics desire for and habit of consuming alcoholic drinks and in the treatment of abstinence syndrome. The salts of 4-hydroxybutyric acid, e.g. the sodium salt, proved to be effective both in the treatment of the syndrome of abstinence from alcohol and in reducing the desire for and addiction to alcohol in alcoholic patients and disclosed in EP-A-344,704 and in the treatment of drug addiction, as reported in WO 93/00083. One of the advantages of said salts is that they do not cause the inconveniences of Disulfiram (Antabuse.RTM.), a drug having several untoward effects, such as for example the symptoms known as the "acetaldehyde syndrome", which may also result in fatality. The sodium salt of GHB is absorbed very quickly by the gastroenteric apparatus with a maximum concentration peak already at about 35-40 min after administration. However, it presents a half-life time of about 20-25 min, its elimination from the body being rather quick [EP-A-635,265]. Web site: http://www.delphion.com/details?pn=US06436998__
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Use of sigma receptor antagonists for treatment of cocaine abuse Inventor(s): Cook; Leonard (Newark, DE) Assignee(s): Du Pont Merck Pharmaceutical Company (Wilmington, DE) Patent Number: 5,180,729 Date filed: February 22, 1991 Abstract: The invention relates to a method of treating cocaine abuse or addiction in a mammal which comprises administering to the mammal an effective amount of a sigma receptor antagonist lacking or having relatively weak dopamine receptor-blocking activity, to reduce the pharmacological effects of the cocaine.
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Excerpt(s): Cocaine abuse has become a major public health problem in the United States, with over 20 million abusers in 1989. The quantity and frequency of cocaine use is increased markedly in the "recreational" cocaine user who switches to the highintensity routes of cocaine administration, such as intravenous or free-base smoking. This high-intensity transition may lead to neurochemical and functional changes in the brain (Kosten (1989) J. Nervous and Mental Disease 177: 379-389). There is, therefore, presently an urgent need for improved methods of treatment for drug abuse involving cocaine. In addition to purely psychological treatments for helping cocaine abusers, there is a need for pharmacological treatments, especially for severe intravenous and free-base cocaine abusers. Cocaine is reported to exert at least some of its pharmacological effects via the dopaminergic system. Chronic cocaine use in animals induces changes and increased sensitivity in postsynaptic dopaminergic receptors (Kosten (1989) J. Nervous and Mental Disease 177: 379-389). Neuroleptic drugs, which are the primary antipsychotic drugs used in the treatment of schizophrenia, have been suggested for pharmacotherapy to treat psychotic symptoms during the early phase of withdrawal and recovery from cocaine abuse (Kosten (1989) J. Nervous and Mental Disease 177: 379-389). Such neuroleptics exert their therapeutic effects by binding to and blocking dopamine receptors, primarily D.sub.2 receptors (Snyder and Largent (1989) J. Neuropsychiatry 1: 7-15). Some neuroleptics, such as cinuperone, tiospirone, and haloperidol, are known to nonselectively antagonize both sigma and dopamine D.sub.2 receptors (Snyder and Largent (1989) J. Neuropsychiatry 1: 7-15). Web site: http://www.delphion.com/details?pn=US05180729__
Patent Applications on Drug Abuse As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to drug abuse: •
Compounds for the treatment of psychiatric or substance abuse disorders Inventor(s): Renshaw, Perry F. (Arlington, MA) Correspondence: CLARK & ELBING LLP; 176 FEDERAL STREET; BOSTON; MA; 02110-2214; US Patent Application Number: 20020019364 Date filed: March 15, 2001 Abstract: The invention provides methods for treating or preventing psychiatric and substance abuse disorders, involving administration of a therapeutically-effective amount of a cytosine-containing or cytidine-containing compound, creatine-containing compound, adenosine-containing, or adenosine-elevating compound to a mammal. Excerpt(s): The application claims priority to U.S. Provisional application 60/189,727, 60/189,811, and 60/189,728, filed Mar. 16, 2000. This invention relates to methods for the treatment of psychiatric or substance abuse disorders. Psychiatric and substance abuse disorders present unique complications for patients, clinicians, and care givers. These disorders are difficult to diagnose unequivocally and fear of societal condemnation, as
10
This has been a common practice outside the United States prior to December 2000.
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well as lack of simple and effective therapies, often results in patients who are reluctant to disclose their symptoms to health professionals, leading to adverse societal and health consequences. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
DRUG ABUSE PREVENTION COMPUTER GAME Inventor(s): Urquhart, William Eldridge; (Wetumpka, AL), Rapoza, Darion; (Durham, NC) Correspondence: DANIELS & DANIELS, P.A. SUITE 200, GENERATION PLAZA; 1822 N.C. HIGHWAY 54, EAST; DURHAM; NC; 27713; US Patent Application Number: 20030017439 Date filed: March 20, 2002 Abstract: An intervention method in which computer-based role-playing games are utilized to allow players to experience simulated effects of substance abuse on the individual, family, friends, and community, and thus learn by experience to avoid the adverse consequences of drug abuse through abstinence, promotion of abstinence by others, and treatment and correction of substance abusers. Role-playing games allow players to pretend to be a character in a story, much like being in a play. Each player takes the role of a character in the story, making the decisions and saying the things that character would say in the situations that happen along the way. Game objectives are set which the player or players attempt to complete through game-play. The intervention method involves realistically portraying the consequences of substance abuse and its interference with the individual's or group's chances of meeting the game objectives. To better meet the game objectives, players must practice social resistance skills, and are rewarded for avoiding drugs as well as for helping other characters avoid drug use. Thus, within the safety of the role-playing game environment, conditioned learning is used to teach players to avoid substance abuse as they learn by experience about the effects of drugs, their adverse consequences, how to resist pressures to use drugs and how to help others to do so as well. Excerpt(s): A portion of the disclosure of this patent document contains material that is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction by any-one of the patent document or patent disclosure, as it appears in the Patent and Trademark Office patent file or records, but otherwise reserves all copyrights whatsoever. The invention relates to an interactive computer-based roleplaying game to promote abstinence from substance abuse. 1) The approach should be research based/theory driven. Research that focuses on tests of theory-driven ideas and that successfully incorporates tests of hypotheses permits the design of interventions that rely on methods proven to be effective, while discarding those methods proven to be ineffective. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Hapten-carrier conjugates for use in drug-abuse therapy and methods for preparation of same Inventor(s): Exley, Mark A. (Chestnut Hill, MA), Schad, Victoria C. (Cambridge, MA), Gefter, Malcolm L. (Lincoln, MA), Powers, Stephen P. (Waltham, MA), Fox, Barbara S. (Wayland, MA), Greenstein, Julia L. (West Newton, MA), Swain, Philip A. (Boston, MA) Correspondence: KLARQUIST SPARKMAN CAMPBELL; LEIGH & WHINSTON, LLP; One World Trade Center, Suite 1600; 121 S.W. Salmon Street; Portland; OR; 97204; US Patent Application Number: 20030069400 Date filed: April 1, 2002 Abstract: Hapten-carrier conjugates capable of eliciting anti-hapten antibodies in vivo by administering, in a therapeutic composition, are disclosed. Methods of preparing said conjugates and therapeutic compositions are also disclosed. Where the hapten is a drug of abuse, a therapeutic composition containing the hapten-carrier conjugate is particularly useful in the treatment of drug addiction, more particularly, cocaine addiction. Passive immunization using antibodies raised against conjugates of the instant invention is also disclosed. The therapeutic composition is suitable for cotherapy with other conventional drugs. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 08/563,673 filed Nov. 28, 1995, which is a continuation-in-part of U.S. patent application Ser. No. 08/414,971 filed Mar. 30, 1995. The present invention relates to treatment of drug abuse. More specifically, the present invention relates to methods of treating drug abuse using drug/hapten-carrier conjugates which elicit antibody responses and/or using the antibodies to the drug/hapten-carrier conjugates. The prevalence of drug use and abuse worldwide, especially in the United States, has reached epidemic levels. There are a plethora of drugs, both legal and illegal, the abuse of which have become serious public policy issues affecting all strata of society with its obvious medical and social consequences. Some users live in an extremely high risk population associated with poverty and illegal activity. Other users who might classify themselves as recreational users are at risk due to (a) properties of the drug(s) which make them addictive, (b) a predisposition of the user to become a heavy user or (c) a combination of factors including personal circumstances, hardship, environment and accessibility. Adequate treatment of drug abuse, including polydrug abuse, requires innovative and creative programs of intervention. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Identification of molecular targets useful in treating substance abuse and addiction Inventor(s): Chen, Hao; (Columbia, MD), Manyak, David M. (Ellicott City, MD) Correspondence: Finnegan, Henderson, farabow,; Garrett & Dunner, L.L.P. 1300 I Street, N.W. Washington; DC; 20005-3315; US Patent Application Number: 20020187514 Date filed: March 26, 2002 Abstract: The invention provides methods determining a set of one or more molecular targets for developing a treatment for abuse of, or addiction to, a substance. The methods involve determining a biological activity profile by determining a set of molecular targets whose activity is effected by the abused or addictive substance. The
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biological activity profile may then be used in other methods of the invention to identify at least one chemical compound to treat abuse or addiction. The chemical compounds interact with the molecular targets in a manner substantially the same as the abused or addictive substance. The invention also provides methods for treating substance abuse wherein chemical compounds identified by the methods of the invention are administered in effective amounts to patients in need thereof. A computer system for implementing the methods of the invention is also provided. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 09/558,232, filed Apr. 26, 2000, which claims the benefit of U.S. provisional application No. 60/130,992, filed Apr. 26, 1999, and a continuation-in-part of U.S. provisional application No. ______, for Drug Discovery Method and Apparatus, filed Mar. 25, 2002, which are incorporated by reference herein. The present invention relates generally to a combination of chemoinformatics and bioinformatics and data on chemical-molecular target interactions to create multi-dimensional databases. More particularly, this invention relates to databases comprising chemical compound, molecular target, and biological or clinical information in which patterns or relationships of interactions between chemical compounds and molecular targets are determined and compared with other information in the database in order to draw conclusions that are useful for drug discovery and development and for related areas. The present invention also relates to methods for determining a biological activity profile for an abused or addictive substance. A biological activity profile is a subset of molecular targets whose activity is affected by the abused or addictive substance, as determined by testing for the interaction of the substance with each of a broader set of molecular targets. The biological activity profile is useful in methods for identifying a set of molecular targets that serve as a guide for the design of therapeutic regimens and for the development of new treatments and therapeutics for treating substance abuse and addiction. For example, the biological activity profile for cocaine includes as molecular targets the dopamine transporter ("DAT"), serotonin transporter ("SERT"), and norepinephrine (also known as noradrenaline) transporter ("NET"). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Pharmaceutical composition which reduces or eliminates drug abuse potential Inventor(s): Somma, Russell; (Sparta, NJ), Joshi, Yatindra; (Princeton, NJ) Correspondence: THOMAS HOXIE; NOVARTIS CORPORATION; PATENT AND TRADEMARK DEPT; 564 MORRIS AVENUE; SUMMIT; NJ; 079011027 Patent Application Number: 20020187192 Date filed: August 30, 2001 Abstract: A pharmaceutical composition which reduces or eliminates the drug abuse potential of central nervous system stimulant comprising: (a) a drug selected from the group consisting of methylphenidate, amphetamine, methamphetamine, and combinations thereof; and (b) a gel forming polymer wherein the gel forming polymer is a polymer that forms a gel when contacted with moisture or placed in an aqueous solution. The present invention is based on the discovery that a central nervous system stimulant such as methylphenidate in combination with a gel forming polymer reduces or eliminates drug abuse potential by swelling in the presence of moisture, and thus, preventing nasal absorption and injectability of the drug.
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Excerpt(s): The present invention relates to a pharmaceutical composition which reduces or eliminates drug abuse potential. More specifically, the composition comprises a central nervous system stimulant and a gel forming polymer. Methylphenidate, which is commercially available under the trademark Ritalin.RTM. from Novartis Pharmaceuticals Corporation, is a central nervous system stimulant. Other examples of central nervous stimulants are amphetamine and methamphetamine. Central nervous stimulants activate the brain stem arousal system to effect stimulation of the patient. Methylphenidate is the most commonly prescribed psychotropic medication for children in the United States, primarily for the treatment of children diagnosed with attention deficit disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD), and thus, is widely available. In addition, methylphenidate has been found to be particularly useful for treating Acquired Immunodeficiency Syndrome (AIDS) patients who suffer from cognitive decline. See Navia et al., Annals of Neurology, 19:517-524 (1986). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Use of y-hydroxybutyric acid amides in the treatment of drug addiction and in particular of alcoholism Inventor(s): Perlini, Vincenzo; (Matelica, IT), Cacciaglia, Roberto; (Ospedaletti, IT), Guano, Lorenza; (Sanremo, IT), Loche, Antonella; (Sanremo, IT) Correspondence: James V. Costigan, Esq. HEADMAN & COSTIGAN, P.C. Suite 2003; 1185 Avenue of the Americas; New York; NY; 10036-2646; US Patent Application Number: 20020165224 Date filed: December 11, 2001 Abstract: Gamma-hydroxybutryic acid amides are used in the treatment of drug addiction and especially in the treatment of alcoholism. Excerpt(s): The present invention relates to the use of amides of.gamma.-hydroxybutyric acid, herein referred to as GHB, in the treatment of drug addiction, such as heroine, cocaine and, in particular, in the treatment of alcoholism, and more particularly in reducing chronic alcoholics desire for and habit of consuming alcoholic drinks and in the treatment of abstinence syndrome. The salts of 4-hydroxybutyric acid, e.g. the sodium salt, proved to be effective both in the treatment of the syndrome of abstinence from alcohol and in reducing the desire for and addiction to alcohol in alcoholic patients and disclosed in EP-A- 344,704 and in the treatment of drug addiction, as reported in WO 93/00083. One of the advantages of said salts is that they do not cause the inconveniences of Disulfiram (Antabuse.RTM.), a drug having several untoward effects, such as for example the symptoms known as the "acetaldehyde syndrome", which may also result in fatality. The sodium salt of GHB is absorbed very quickly by the gastroenteric apparatus with a maximum concentration peak already at about 35-40 min after administration. However, it presents a half-life time of about 20-25 min, its elimination from the body being rather quick [EP-A-635,265]. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Keeping Current In order to stay informed about patents and patent applications dealing with drug abuse, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “drug abuse” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on drug abuse. You can also use this procedure to view pending patent applications concerning drug abuse. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON DRUG ABUSE Overview This chapter provides bibliographic book references relating to drug abuse. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on drug abuse include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “drug abuse” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on drug abuse: •
Drug Abuse and HIV/AIDS : Lessons Learned : Case Studies Booklet : Central and Eastern Europe and the Central Asian States Contact: World Health Organization, Joint United Nations Programme on HIV/AIDS, 20 Avenue Appia, CH-1211 Geneva, http://www.unaids.org. Summary: This monograph provides information about the correlation of drug use and the global spread of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), and the challenges that professionals and policy makers must confront in shaping national and local policies, developing and implementing preventive policies, and providing treatment and rehabilitative services. It reviews the fieldwork, political mobilization, the development of national HIV prevention strategies, and the training of healthcare and drug abuse treatment personnel to deal with HIV/AIDS by local organizations in Eastern Europe and Central Asia.
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Integrating Cultural, Observational, and Epidemiological Approaches in the Prevention of Drug Abuse and HIV/AIDS Contact: National Institute on Drug Abuse, Division of Epidemiology Services and Prevention Research, 6001 Executive Blvd, Rm 5153 MSC 9589, Bethesda, MD, 208929589, (301) 443-6504, http://www.nida.nih.gov/DESPR. Summary: This monograph provides both a historical and future perspective on the evolving substantive and methodological dialog between epidemiologists and ethnographers who focus on risk behaviors, the human immunodeficiency virus (HIV) transmission, and strategies to prevent further spread of the infection. The following topics are covered: Frontiers in acquired immune deficiency syndrome (AIDS) and Drug Abuse Prevention Research; Toward a Critical Biocultural Model of Drug Use and Health Risk; Anthropological Research in Drugs and AIDS; Interdisciplinary Research on the Transmission of Blood-Borne Pathogens in Drug Injection Practices; Complexities in the Lives of Female Drug Users in the AIDS Era; Prevention Research on Substance Abuse, Sexual Behavior, and HIV/AIDS in Asia and Australia; Neighborhood Violence in New York City and Indigenous Attempts to Contain It; Access and Adherence to Combination Antiretroviral Therapy for HIV/AIDS in Injection Drug Users; Ethics, Ethnography, Drug Use, and AIDS; An Approach to Ethical Decision Making in Ethnographic Research on HIV Prevention and Drug Use; and the Ethnography of Street Drug Use Before AIDS.
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Qualitative Methods in Drug Abuse and HIV Research Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse, Division of Clinical Research, Parklawn Bldg Rm 10-A-38, 5600 Fishers Ln, Rockville, MD, 20857, (301) 443-1263. Summary: This monograph presents the results of a technical review of qualitative methods in drug abuse and HIV research. The review determined the appropriateness of qualitative methods in different settings, their strengths, limitations, and indications for use. Participants in the technical review prepared presentations from a qualitative methodologist's perspective, addressing specific issues such as: how to define and develop the scope of qualitative research; recruitment and sampling methods; ethical issues; remuneration and incentives; selection, training, and security for field researchers; cultural and other barriers; processing and interpreting data; and resolution of issues that arise when combining qualitative and quantitative methods of research. Chapters are organized by in the order that papers were given in the technical review, and cover a variety of themes, including HIV/AIDS prevention research, ethnographic research methods, drug use patterns among women, the study of injection-related HIV risks, and evaluating AIDS outreach to the homeless. At the conclusion of the technical review meeting, participants identified several key recommendations for advancing drug abuse and HIV-prevention research.
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The Second Annual National Conference on Preventing and Treating Alcohol and Other Drug Abuse, HIV Infection, and AIDS in Black Communities; From Advocacy to Action Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: These proceedings summarize the speeches given at plenary sessions and at workshops, as well as presenting academic papers and personal essays. Workshops
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focused on Black males, drug-related HIV infection and AIDS, prevention, treatment, and youth. The papers and essays are organized into seven categories: African American males; women, drugs, and AIDS; youth at risk; family; community; voices; and facts and figures. The section on African American males discusses social conditions that contribute to or inhibit alcohol and other drug use, the criminal justice system, spirituality, and effective public education. Drug-exposed and drug-impaired babies, maternal drug use, and drug-related HIV infection are examined in the segment on women. The proceedings address family, community, spirituality, and facts and figures with topics such as the role of the family, community at risk, community empowerment, total healing, and federal funding opportunities. •
Behavioral Treatments for Drug Abuse and Dependence Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: This monograph reviews technical papers on the application of behavior treatment; methadone treatment; behavioral interventions; cure reactivity; cocaine dependence; cognitive therapy; harm reduction; multisystemic treatment of serious juvenile offenders; dialectical behavior therapy; substance abuse research; and clinical trials.
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Alcohol and Other Drug Abuse: The Challenge of HIV/AIDS; A Guide for Training Mental Health Providers Contact: New York University, School of Education Health Nursing and Arts Professions, Department of Health Studies, AIDS/SIDA Mental Hygiene Project, 35 W 4th St Ste 1200, New York, NY, 10012, (212) 998-5614. Summary: This training guide is part of a project to provide HIV/AIDS education and training to mental health and other care providers in agencies under contract to the New York City Department of Mental Health, Mental Retardation, and Alcoholism Services (DMHMRAS). The curriculum modules address the following topics: health implications of alcohol and other drug problems; prevention of HIV infection in substance users; maternal drug use; assessment of the adult client; treatment and recovery from alcohol and other drug dependencies; and spiritual discernment in alcohol, other drugs, and HIV issues.
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Drug Abuse Treatment in Prisons and Jails Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: This monograph presents a collection of papers examining treatment of drug abuse and dependence among incarcerated populations. It is based on the papers from a technical review on "Drug Abuse Treatment in Prisons and Jails", sponsored by the National Institute on Drug Abuse (NIDA) in 1990. The papers discuss issues of program effectiveness, voluntary participation versus programs based on legal sanctions, and evaluation methods. Models, designs and evaluations of prerelease and aftercare programs are analyzed, including Federal initiatives, a Wisconsin demonstration program, and programs in Delaware, Florida, and Oregon. Other papers address the following topics: HIV-1 infection in the correctional setting, evaluation of in-jail methadone maintenance, and management of the drug-abusing offender.
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AIDS and Alcohol/Drug Abuse: Psychosocial Research Contact: Haworth Press, Incorporated, Harrington Park Press, Incorporated, 12 W 32 St, New York, NY, 10001, (212) 563-4247. Summary: This monograph presents the text of seven papers dealing with AIDS and alcohol and/or drug abuse. The first discusses racial prejudice in AIDS research and prevention programs, noting the disproportionate rate of HIV infection among minority populations. It charges that the poor health care received by these populations makes them vulnerable to a higher infection rate. Prevention and research programs are seen as either unfairly singling out minorities, or as ignoring them. The next three papers look at various aspects of the problem of injecting drug use among Alaska Natives and other Native Americans, including the first report specifically devoted to injection drug use in Alaska to appear in open print. It states that Alaska has a major problem, and injecting drug users (IDUs) are a potential vector of HIV transmission into the general population. Another paper presents epidemiological data on AIDS and attitudinal surveys which show the need for ongoing research into injection drug abuse among Native Americans. It argues for expanding alcoholism treatment programs to include injection drug use and HIV education. The next paper looks at the epidemiology of HIV in Alaska and its connection with IV drug use. The fifth paper presents the results of a study of alcohol abuse and sexual behavior among a sample of 604 gay men in New York City who do not have AIDS. The sixth looks at shooting galleries and the potential for their owners to participate in AIDS education, while the final paper looks at health psychology research and HIV-prevention campaigns. It analyzes San Francisco's Bleachman campaign.
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Workplace Drug Abuse and AIDS: A Guide to Human Resource Management Policy and Practice Contact: Greenwood Publishing Group, Inc., Quorum Books, 88 Post Rd W, Westport, CT, 06881, (203) 226-3571. Summary: This monograph addresses the growing concern over substance abuse by employees, and its connection with the Acquired immunodeficiency syndrome (AIDS) epidemic. It starts off by pointing out that substance-abuse has become of increasing concern to employers in the last five years because of its costs in lost productivity, increased health-care expense, and liability risks. However, programs which test employees for substance abuse often seem degrading and invasive, creating a dilemma when determining appropriate policy. AIDS further complicates the issue because it is unfailingly fatal, it attacks many younger employees, and it results in soaring medical costs. Taken together, the two have a tremendous impact on personnel management. The monograph looks at a solution adopted by many employers: Utilizing a two-tiered system of employment with one group of full-time benefitted employees and another of temporary, part-time, and seasonal employees who do not receive benefits. The monograph says that while it makes sense for an individual employer to screen out applicants with substance-abuse problems or AIDS, and relegate them to the second group, that this increases the burden on society as a whole. Also, pre-employment testing will not keep these problems from spreading into the group of benefitted employees. The monograph then goes on to consider substance-abuse testing, looking at substance abuse on the job, testing techniques, legal issues, personnel policy issues, employee assistance programs, and working with unions. It then turns to testing for Human immunodeficiency virus (HIV) infection, considering the problem of AIDS, the technology of the HIV-antibody test, legal implications, and policies and practices. The monograph concludes with a look at the future.
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SIDA, Toxicomanie: Une Lecture Documentaire. [AIDS and Drug Addiction.] Contact: Centres Regionaux d'Information et de Prevention du SIDA, PO Box BP 53, Paris, http://www.lecrips.net. Summary: This collection of articles synthesizes French and international research concerning the interrelation of drug abuse and HIV infection. The first article surveys how the HIV threat has impacted international drug abuse. The following article presents statistics of seropositive drug users. Two articles analyze the epidemiology of drug abusing AIDS patients and their need for drug treatment. The following two articles evaluate the AIDS threat for two special populations--addicted prison inmates and addicted pregnant women. An article dealing with social security issues surveys international approaches to paying for the treatment of addicted AIDS patients. The next article traces the French policy of fighting the HIV threat related to drug abuse. Other articles deal with such varied topics as the medical and psychological needs of addicted AIDS patients; addicts' knowledge, attitudes, and practices in response to AIDS; collective strategies of AIDS prevention in the drug user community; the social relations of drug addicts; and AIDS information geared toward addicts.
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Effects of Substance Abuse Treatment on AIDS Risk Behaviors Contact: Haworth Press, 10 Alice Street, Binghamton, NY, 13904-9981, (800) 342-9678. Summary: This monograph contains one editorial, six research articles, and one discussion article concerning the role of drug abuse treatment as a potentially powerful means of preventing the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS): (1) Editorial: The Problem of HIV/AIDS as Related to Drug Abuse: An Introduction; (2) Drug Abuse Treatment as HIV Prevention: Changes in Social Drug Use Patterns Might Also Reduce Risk; (3) Stimulant Abuse Treatment as HIV Prevention; (4) AIDS Risk Behavior in Opioid Dependent Patients Treated with Community Reinforcement Approach and Relationships with Psychiatric Disorders; (5) Assessment of HIV Risk; (6) Does Intensive Outpatient Cocaine Treatment Reduce AIDS Risky Behavior?; (7) Changes in HIV Risk Behaviors Among Cocaine-Using Methadone Patients; and (8) HIV/AIDS and Drug Abuse: Epidemiology and Prevention. The monograph also includes a selected guide to current reference sources on topics discussed in the monograph.
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Advanced Methodological Issues in Culturally Competent Evaluation for Substance Abuse Prevention Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: This monograph defines and initiates a new discipline of culturally competent prevention program evaluation. The monograph examines topics and substantive areas relevant to program evaluation across diverse, culturally defined settings regardless of the ethnic/racial populations served. This monograph is the sixth in a series of cultural competence publications that address and synthesize the complex methodology issues involved in evaluation programs within multicultural contexts. The monograph integrates advanced methodological issues in program evaluation with cultural competence. The individual chapters develop a framework and provide suggestions for evaluation. Eight complementary chapters address critical methodological issues in program evaluation within diverse cultural settings including community participation; cultural approaches to perceiving and understanding; the
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cultural context of epidemiologic research; the role of ethics in evaluation, psychometrics, and culture, the history and philosophy of science, and acculturation. •
Substance Abuse: The Nation's Number One Health Problem; Key Indicators for Policy Contact: Robert Wood Johnson Foundation, PO Box 2316, Princeton, NJ, 08543-2316, (609) 452-8701, http://www.rwjf.org. Brandeis University, Heller Graduate School, Institute for Health Policy, 415 South St, Waltham, MA, 02254-9110. Summary: This report presents data on trends in substance abuse (alcohol, tobacco, and illicit drugs), consequences, and intervention efforts, as well as comparisons among subgroups of the population on these issues. It provides: 1) an overview of substance abuse, use, and dependence, 2) data on use including early use, heavy use, and perception of risk, 3) consequences of use including death, illness, effects on the family and workplace, and crime, and 4) information on interventions such as drug control, community action, taxes, restrictions on smoking and alcohol consumption, drug and alcohol abuse treatment programs, and smoking cessation programs.
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Kids Making Quilts for Kids: A Young Person's Guide for Having Fun While Helping Others and Learning About AIDS and Substance Abuse Contact: Quilt Digest Press, PO Box 1331, Gualala, CA, 95445. Summary: This monograph gives instructions for children's groups who want to make baby quilts for children born with Human immunodeficiency virus (HIV) infection or birth defects caused by alcohol or other drugs. Its chapters cover getting started, four different types of quilts, adding borders, and making an AC quilt. A section of facts and discussion starters about Acquired immunodeficiency syndrome (AIDS) and substance abuse explodes many of the myths associated with AIDS.
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Discussion: Subject Selection, Recruitment, and Retention in Longitudinal Studies Involving Perinatal Substance Abuse and Human Immunodeficiency Virus Infection Source: Methodological Issues in Epidemiological, Prevention, and Treatment Research on Drug-Exposed Women and Their Children. Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: This book chapter presents the text of a paper given at a technical review on "Methodological Issues in Epidemiological, Prevention and Treatment Research on Drug-Exposed Women and Their Children" held July 25-26, 1990, in Baltimore, MD. It says that subject selection and retention are challenges in longitudinal studies involving perinatal substance abuse and Human immunodeficiency virus (HIV) infection. The paper says that perinatal substance abuse researchers need to know basic science, medicine, psychology, social services, public health policy, and legal issues. It looks at the need to break down "turf-protection barriers" that impede successful use of ethnic groups in studies. Confidentiality issues are examined. It concludes that with careful study designs, nonjudgmental approaches to subjects and their families, adequate incentives, and the use of computerized databases for tracking subjects, clinical studies should yield meaningful data into the 21st century.
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Perinatal Substance Abuse and AIDS: Subject Selection, Recruitment, and Retention Source: Methodological Issues in Epidemiological, Prevention, and Treatment Research on Drug-Exposed Women and Their Children. Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: This book chapter presents the text of a paper given at a technical review on "Methodological Issues in Epidemiological, Prevention and Treatment Research on Drug-Exposed Women and Their Children" held July 25-26, 1990, in Baltimore, MD. It looks at problems that can arise when performing studies on perinatal substance abuse and Acquired immunodeficiency syndrome (AIDS). It points out that Human immunodeficiency virus (HIV) infection has become so common, that the infection can influence commonly used endpoints in perinatal substance abuse studies. Therefore, it must be considered whenever these studies are performed. The paper says that researchers need to consider the diagnosis and stages of HIV illness; the consequences of central nervous system (CNS) disease; the effects of treatment, especially with azidothymidine (AZT); and the biases that can arise in subject selection due to inaccurately reported information. Persons conducting studies also need to remember that fear and bias on the part of both the community and staff are often encountered when caring for HIV-positive persons. It suggests that retention of a study group may be aided by the establishment of services that include general medical care, HIV care, access to treatment protocols, and psychosocial care.
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Training Outline for Substance Abuse Treatment Facility Trainers Contact: West Virginia Department of Health and Human Resources, Bureau for Public Health, Office of Epidemiology and Health Promotion, Division of Surveillance and Disease Control, 350 Capitol St Rm 125, Charleston, WV, 25301-3715, (304) 558-7078, http://www.wvdhhr.org/bph/oehp/sdc/aids.htm. Summary: This teaching guide outlines a training program for Substance Abuse treatment facility trainers. The program covers HIV transmission and prevention, how HIV affects the immune system, risk factors, symptoms of AIDS, myths of casual contact transmission, statistics, infection control, counseling and testing, and legislative issues. Supplementary materials are included.
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Integrating HIV Disease Prevention With Substance Abuse Treatment: A Training Program for VA Staff Working With Substance Abusing Clients Contact: US Department of Veterans Affairs, Health Services and Research Administration, Office of Academic Affairs, 810 Vermont Ave NW, Washington, DC, 20420, (202) 233-3843. Summary: This manual presents an eight-section training program for Veterans Administration (VA) staff working with substance-abusing clients. The program assists participants in integrating Human immunodeficiency virus (HIV) prevention activities into existing substance abuse treatment and facilitate both addiction recovery and HIV prevention. Upon completion of the program, participants will fulfill the following objectives: They will be able to identify how HIV prevention can be integrated into substance-abuse treatment settings, compare and contrast behavioral change and maintenance issues, assist clients in learning methods of self-empowerment, integrate the impact of sexuality into substance-abuse treatment, specify ways in which sexuality issues affect recovery and HIV prevention, assist clients in ways of incorporating risk
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reduction into their lifestyles, counsel clients about issues involved in HIV-antibody testing, and recognize those factors which impinge on the integration of HIV risk reduction and substance-abuse treatment in the clinical setting.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “drug abuse” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “drug abuse” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “drug abuse” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Adolescents, Alcohol and Substance Abuse: Reaching Teens through Brief Interventions by Peter M. Monti (Editor), et al; ISBN: 1572306580; http://www.amazon.com/exec/obidos/ASIN/1572306580/icongroupinterna
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AIDS and IV Drug Abusers: Current Perspectives by Robert P. Galea, et al; ISBN: 0932500714; http://www.amazon.com/exec/obidos/ASIN/0932500714/icongroupinterna
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Alcoholism, Drug Addiction, and the Road to Recovery: Life on the Edge by Barry Stimmel; ISBN: 0789005530; http://www.amazon.com/exec/obidos/ASIN/0789005530/icongroupinterna
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American Psychiatric Press Textbook of Substance Abuse Treatment by Marc Galanter (Editor), Herbert D. Kleber (Editor); ISBN: 0880488204; http://www.amazon.com/exec/obidos/ASIN/0880488204/icongroupinterna
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Before It's Too Late: Working With Substance Abuse in the Family by David C. Treadway, David C. Tradway (1989); ISBN: 0393700682; http://www.amazon.com/exec/obidos/ASIN/0393700682/icongroupinterna
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Brain Imaging in Substance Abuse: Research, Clinical, and Forensic Applications by Marc J., Ph.D. Kaufman (Editor), Joseph, Ph.D. Frascella; ISBN: 0896037703; http://www.amazon.com/exec/obidos/ASIN/0896037703/icongroupinterna
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Case Management and Substance Abuse Treatment: Practice and Experience by Harvey A., Phd Siegal (Editor), Richard C. Rapp (Editor) (1996); ISBN: 0826191703; http://www.amazon.com/exec/obidos/ASIN/0826191703/icongroupinterna
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Chemical Dependency and the Dysfunctional Family (Drug Abuse Prevention) by Jeff Biggers; ISBN: 0823927490; http://www.amazon.com/exec/obidos/ASIN/0823927490/icongroupinterna
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Clinial Assessment and Substance Abuse Treatment: The Target Cities Experience (Suny Series, the New Inequalities) by Richard C. Stephens (Editor), et al (2003); ISBN: 0791455947; http://www.amazon.com/exec/obidos/ASIN/0791455947/icongroupinterna
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Clinical Supervision in Alcohol and Drug Abuse Counseling : Principles, Models, Methods by David J. Powell (Author) (1998); ISBN: 0787940747; http://www.amazon.com/exec/obidos/ASIN/0787940747/icongroupinterna
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Cognitive Therapy of Substance Abuse by Aaron T. Beck, et al; ISBN: 0898621151; http://www.amazon.com/exec/obidos/ASIN/0898621151/icongroupinterna
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Drug Abuse Prevention: A School and Community Partnership, Web-Enhanced Edition by Richard W. Wilson, Cheryl A. Kolander; ISBN: 0763711756; http://www.amazon.com/exec/obidos/ASIN/0763711756/icongroupinterna
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Drug Abuse Treatment Through Collaboration: Practice and Research Partnerships That Work by James L. Sorensen (Editor), et al (2003); ISBN: 1557989850; http://www.amazon.com/exec/obidos/ASIN/1557989850/icongroupinterna
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Drug Abuse: Investigation and Control by Paul Q. Fuqua; ISBN: 0070226652; http://www.amazon.com/exec/obidos/ASIN/0070226652/icongroupinterna
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Drug Information for Teens: Health Tips about the Physical and Mental Effects of Substance Abuse (Teen Health Series) by Karen Bellenir (2002); ISBN: 0780804449; http://www.amazon.com/exec/obidos/ASIN/0780804449/icongroupinterna
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Drugs and Date Rape (Drug Abuse Prevention Library) by Maryann Miller; ISBN: 082392064X; http://www.amazon.com/exec/obidos/ASIN/082392064X/icongroupinterna
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Drugs and Death : Profiles of Illegal Drug Abuse by Joseph C. Rupp (1998); ISBN: 0967095905; http://www.amazon.com/exec/obidos/ASIN/0967095905/icongroupinterna
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Drugs and Domestic Violence (Drug Abuse Prevention Library) by Raymond M. Jamiolkowski; ISBN: 0823920623; http://www.amazon.com/exec/obidos/ASIN/0823920623/icongroupinterna
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Drugs and Drug Abuse: A Reference Text Se: A Reference Text by Michael R. Jacobs, Kevin O'B. Fehr (Editor) (1987); ISBN: 0888681399; http://www.amazon.com/exec/obidos/ASIN/0888681399/icongroupinterna
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Drugs and Sleeping Disorders (Drug Abuse Prevention Library) by Gina Strazzabosco-Hayn (1995); ISBN: 0823921441; http://www.amazon.com/exec/obidos/ASIN/0823921441/icongroupinterna
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Drugs: Issues for Today with Powerweb: Drugs and Substance Abuse by R. R. Pinger (Editor), et al; ISBN: 007250627X; http://www.amazon.com/exec/obidos/ASIN/007250627X/icongroupinterna
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Ethnocultural Factors in Substance Abuse Treatment by Shulamith Lala Ashenberg Straussner (Editor); ISBN: 1572306300; http://www.amazon.com/exec/obidos/ASIN/1572306300/icongroupinterna
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Family Therapy of Drug Abuse and Addiction by M. Duncan Stanton (Editor), Thomas C. Todd (Editor); ISBN: 0898620376; http://www.amazon.com/exec/obidos/ASIN/0898620376/icongroupinterna
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Fetal Alcohol Syndrome (Revised)(Drug Abuse Prevention) by Amy Nevitt; ISBN: 0823928292; http://www.amazon.com/exec/obidos/ASIN/0823928292/icongroupinterna
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Food for Recovery : The Complete Nutritional Companion for Overcoming Alcoholism, Drug Addiction, and Eating Disorders by Joseph D., M.D. Beasley, Susan Knightly; ISBN: 0517881810; http://www.amazon.com/exec/obidos/ASIN/0517881810/icongroupinterna
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Handbook of Drug Abuse Prevention: Theory, Science, and Practice (Handbooks of Sociology and Social Research) by Zili Sloboda (Editor), William J. Bukoski (Editor) (2003); ISBN: 0306473429; http://www.amazon.com/exec/obidos/ASIN/0306473429/icongroupinterna
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Influence, Choice, and Drugs: Towards a Systematic Approach to the Prevention of Substance Abuse by Martin. Shain; ISBN: 0669015970; http://www.amazon.com/exec/obidos/ASIN/0669015970/icongroupinterna
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It Won't Happen to Me/True Stories of Teen Alcohol and Drug Abuse by Susan Newman, George Tiboni (Photographer); ISBN: 0399513426; http://www.amazon.com/exec/obidos/ASIN/0399513426/icongroupinterna
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Karch's Pathology of Drug Abuse, Third Edition by Steven B. Karch; ISBN: 0849303435; http://www.amazon.com/exec/obidos/ASIN/0849303435/icongroupinterna
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Love First: A New Approach to Intervention for Alcoholism and Drug Addiction (A Hazelden Guidebook) by Jeff Jay, Debra Erickson Jay; ISBN: 1568385218; http://www.amazon.com/exec/obidos/ASIN/1568385218/icongroupinterna
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Loving the Addict, Hating the Addiction: For Christian Families Coping With Drug Addiction by Kecia C. Sims (2003); ISBN: 059528888X; http://www.amazon.com/exec/obidos/ASIN/059528888X/icongroupinterna
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Methods in Drug Abuse Research: Cellular and Circuit Level Analyses by Barry D. Waterhouse (Editor), Sidney A. Simon (Editor); ISBN: 0849323452; http://www.amazon.com/exec/obidos/ASIN/0849323452/icongroupinterna
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Network Therapy for Alcohol and Drug Abuse by Marc Galanter; ISBN: 1572304413; http://www.amazon.com/exec/obidos/ASIN/1572304413/icongroupinterna
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Parenting 911: How to Safeguard and Rescue Your 10 to 15 Year-Old from Substance Abuse, Sexual Encounters.and Other Risky Situations by Charlene C. Giannetti, Margaret Sagarese; ISBN: 0767903218; http://www.amazon.com/exec/obidos/ASIN/0767903218/icongroupinterna
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Prescription Drug Addiction: The Hidden Epidemic by Rod Colvin (2001); ISBN: 1886039526; http://www.amazon.com/exec/obidos/ASIN/1886039526/icongroupinterna
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Preventing Workplace Substance Abuse: Beyond Drug Testing to Wellness by Joel B. Bennett (Editor), Wayne E. K. Lehman (Editor) (2002); ISBN: 1557989362; http://www.amazon.com/exec/obidos/ASIN/1557989362/icongroupinterna
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Solutions Step by Step: A Substance Abuse Treatment Manual by Insoo Kim Berg, Norman H. Reuss (2000); ISBN: 0393702510; http://www.amazon.com/exec/obidos/ASIN/0393702510/icongroupinterna
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Steroids (Drug Abuse Prevention Library) by Lawrence Clayton (1998); ISBN: 0823928888; http://www.amazon.com/exec/obidos/ASIN/0823928888/icongroupinterna
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Substance Abuse : A Global View by Andrew Cherry (Author), et al; ISBN: 0313312184; http://www.amazon.com/exec/obidos/ASIN/0313312184/icongroupinterna
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Substance Abuse and Kids: A Directory of Education, Information, Prevention, and Early Intervention Programs; ISBN: 0897745833; http://www.amazon.com/exec/obidos/ASIN/0897745833/icongroupinterna
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Substance Abuse Counseling by Judith A. Lewis, et al; ISBN: 0534364284; http://www.amazon.com/exec/obidos/ASIN/0534364284/icongroupinterna
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Substance Abuse in Adolescents and Young Adults: A Guide to Treatment by Joseph Nowinski (1990); ISBN: 0393700976; http://www.amazon.com/exec/obidos/ASIN/0393700976/icongroupinterna
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Substance Abuse Prevention : The Intersection of Science and Practice by Julie Hogan (Author), et al; ISBN: 0205341624; http://www.amazon.com/exec/obidos/ASIN/0205341624/icongroupinterna
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Substance Abuse Prevention Activities for Elementary Children by Timothy A. Gerne, Patricia J. Gerne (Photographer); ISBN: 0138590753; http://www.amazon.com/exec/obidos/ASIN/0138590753/icongroupinterna
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Substance Abuse Prevention Activities for Secondary Students: Ready-To-Use Lessons, Fact Sheets and Resources for Grades 7-12 by Patricia J. Gerne, et al; ISBN: 0138767076; http://www.amazon.com/exec/obidos/ASIN/0138767076/icongroupinterna
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Substance Abuse Sourcebook: Basic Health-Related Information About the Abuse of Legal and Illegal Substances Such As Alcohol, Tobacco, Prescription Drugs, Marijuana, Cocaine, and (Health Reference Series, Volume 14) by Karen Bellenir (Editor) (1996); ISBN: 0780800389; http://www.amazon.com/exec/obidos/ASIN/0780800389/icongroupinterna
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Substance Abuse Treatment and the Stages of Change: Selecting and Planning Interventions by Gerard Joseph Connors, et al; ISBN: 1572306572; http://www.amazon.com/exec/obidos/ASIN/1572306572/icongroupinterna
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Substance Abuse Treatment for Criminal Offenders: An Evidence-Based Guide for Practitioners (Forensic Practice Guidebooks Series) by David W. Springer, et al (2003); ISBN: 1557989907; http://www.amazon.com/exec/obidos/ASIN/1557989907/icongroupinterna
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Substance Abuse: Information for School Counselors, Social Workers, Therapists, and Counselors (2nd Edition) by Gary L. Fisher (Author), Thomas C. Harrison (Author); ISBN: 0205306225; http://www.amazon.com/exec/obidos/ASIN/0205306225/icongroupinterna
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Swallowing a Bitter Pill: How Prescription and Over-The-Counter Drug Abuse Is Ruining Lives - My Story by Cindy R. Mogil (2001); ISBN: 088282211X; http://www.amazon.com/exec/obidos/ASIN/088282211X/icongroupinterna
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The Alcoholism and Drug Abuse Patient Workbook by Robert R. Perkinson (Author) (2003); ISBN: 0761928669; http://www.amazon.com/exec/obidos/ASIN/0761928669/icongroupinterna
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The Betty Ford Center Book of Answers: Help for Those Struggling With Substance Abuse and for the People Who Love Them by James W. West M.D., Betty Ford (1997); ISBN: 0671001825; http://www.amazon.com/exec/obidos/ASIN/0671001825/icongroupinterna
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The Chemical Dependence Treatment Documentation Sourcebook: A Comprehensive Collection of Program Management Tools, Clinical Documentation, and Psychoeducational Materials for Substance Abuse Treatment Professionals by James R. Finley (Author), Brenda S. Lenz (Author); ISBN: 0471312851; http://www.amazon.com/exec/obidos/ASIN/0471312851/icongroupinterna
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The Craving Brain : A bold new approach to breaking free from *drug addiction *overeating *alcoholism *gambling by Ronald A. Ruden (Author) (2000); ISBN: 0060928999; http://www.amazon.com/exec/obidos/ASIN/0060928999/icongroupinterna
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The Emergence of Crack Cocaine Abuse by Edith Fairman Cooper, Edith Fairman Copper (2002); ISBN: 1590335120; http://www.amazon.com/exec/obidos/ASIN/1590335120/icongroupinterna
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The Enemy Is Us: How to Defeat Drug Abuse and End the "War on Drugs" by Robert H. Dowd (1997); ISBN: 0965399974; http://www.amazon.com/exec/obidos/ASIN/0965399974/icongroupinterna
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The Rehabilitation Model of Substance Abuse Counseling by John J. Benshoff, Timothy P. Janikowski; ISBN: 053434223X; http://www.amazon.com/exec/obidos/ASIN/053434223X/icongroupinterna
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The Science of Prevention: Methodological Advances from Alcohol and Substance Abuse Research by Kendall J. Bryant (Editor), et al (1997); ISBN: 1557984395; http://www.amazon.com/exec/obidos/ASIN/1557984395/icongroupinterna
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The Tao of Sobriety: Helping You to Recover from Alcohol and Drug Addiction by David Gregson, et al (2002); ISBN: 0312242506; http://www.amazon.com/exec/obidos/ASIN/0312242506/icongroupinterna
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Tough Love: How Parents Can Deal With Drug Abuse by Pauline Neff (1996); ISBN: 0687018250; http://www.amazon.com/exec/obidos/ASIN/0687018250/icongroupinterna
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Women and Substance Abuse by Edith S Lisansky Gomberg (Author), Ted D. Nirenberg (Author) (1993); ISBN: 1567500668; http://www.amazon.com/exec/obidos/ASIN/1567500668/icongroupinterna
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Women and Substance Abuse: Gender Transparency by Sally J. Stevens (Editor), Harry K. Wexler (Editor) (1998); ISBN: 0789003899; http://www.amazon.com/exec/obidos/ASIN/0789003899/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “drug abuse” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11
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In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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Dealing with drug abuse; a report to the Ford Foundation. Patricia M. Wald, cochairman. Author: Drug Abuse Survey Project.; Year: 1972; New York, Praeger [1972]
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Drug abuse: research on treatment may not address current needs: report to the chairman, Select Committee on Narcotics Abuse and Control, House of Representatives. Author: United States. General Accounting Office.; Year: 1990; Washington, D.C.: U.S. General Accounting Office, [1990]
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Drug abuse technology transfer. Author: Backer, Thomas E.; Year: 1991; [Washington, D.C.?]: U.S. Dept. of Health and Human Services, Public Health Service, Alcohol,
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Drug Abuse Warning Network sample design and estimation procedures: technical report Author: United States. Substance Abuse and Mental Health Services Administration. Office of Applied Studies.; Year: 1997; Rockville, MD (5600 Fishers Lane, Rm. 16-105, Rockville 20857): Dept. of Health and Human Services, Substance
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Evaluation of drug abuse services program: DASP Author: Roberts, Chester F.; Year: 1978; [Sacramento]: State of California, Dept. of the Youth Authority, 1978
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Federal priorities in funding alcohol and drug abuse programs Author: Stimmel, Barry,; Year: 1983; New York: Haworth Press, c1983; ISBN: 0866561951 http://www.amazon.com/exec/obidos/ASIN/0866561951/icongroupinterna
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Highlights from the National Survey on Drug Abuse: 1977 Author: Cisin, Ira H.; Year: 1978; Rockville, Md.: National Institute on
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Highlights from the National Survey on Drug Abuse, 1979 Author: Miller, Judith Droitcour.; Year: 1980; Rockville, Md.: National Institute on
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Irregularities in contracting at the National Institute on Drug Abuse: hearing before the Subcommittee on Oversight and Investigations of the Committee on Interstate and Foreign Commerce, House of Representatives, Ninety-fifth Congress, second session, July 31, 1978. Author: United States. Congress. House. Committee on Interstate and Foreign Commerce. Subcommittee on Oversight and Investigations.; Year: 1978; Washington: U. S. Govt. Print. Off., 1978
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National Institutes of Health, National Institute on Drug Abuse, Medications Development Division. Author: National Institute on Drug Abuse. Medications Development Division.; Year: 1993; Rockville, MD: The Division, [1993?]
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National Survey on Drug Abuse, 1977: a nationwide study: youth, young adults, and older adults Author: Abelson, Herbert I. (Herbert Irving),; Year: 9999; Princeton, N. J.: Response Analysis, 1977-
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Oversight on prevention activities of the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse, 1982: hearing before the Subcommittee on Alcoholism and Drug Abuse of the Committee on Labor and Human Resources, United States Senate, Ninety-seventh Congress, second session. February 24, 1982. Author: United States. Congress. Senate. Committee on Labor and Human Resources. Subcommittee on Alcoholism and Drug Abuse.; Year: 1982; Washington: U.S. G.P.O., 1982
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Socioeconomic and demographic correlates of drug and alcohol use: findings from the 1988 and 1990 National Household Surveys on Drug Abuse Author: Flewelling, Robert L.; Year: 1992; Rockville, Md. (5600 Fishers Lane, Rockville 20857): U.S. Dept. of Health and Human Services, Public Health Service, Alcohol,
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Substance abuse in states and metropolitan areas: model based estimates from the 1991-1993 National Household Surveys on Drug Abuse: methodology report Author: Folsom, Ralph E.; Year: 1997; Rockville, MD: Dept. of Health and Human Services, Substance
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Supplemental tables: population projections based on the National Survey on Drug Abuse: 1977 Author: George Washington University. Social Research Group.; Year: 1978; [Rockville, Md.]: Dept. of Health, Education, and Welfare, Public Health Service, Alcohol,
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The Commission on Marihuana and Drug Abuse; report to accompany H. R. 5674. Author: United States. Congress. House. Committee on Interstate and Foreign Commerce.; Year: 1971; [Washington, 1971]
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The development and implementation of a new data collection instrument for the 1994 National Household Survey on Drug Abuse. Author: Research Triangle Institute.; Year: 1996; Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Substance
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The National Campaign Against Drug Abuse, 1985-88: evaluation and future directions Author: National Campaign against Drug Abuse (Australia); Year: 1989; Canberra: Australian Government Pub. Service, 1989; ISBN: 0644101717
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Year-end preliminary estimates from the 1996 Drug Abuse Warning Network Author: Greenblatt, Janet.; Year: 1997; Rockville, MD: Office of Applied Studies, Dept. of Health and Human Services, Substance
Chapters on Drug Abuse In order to find chapters that specifically relate to drug abuse, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and drug abuse using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “drug abuse” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on drug abuse: •
Substance Abuse and Deaf People Source: in Lala, F.J.J., Jr. Counseling the Deaf Substance Abuser. Chicago, IL: Adams Press. 1998. p. 139-175. Contact: Available from Midas Management Company. P.O. Box 27740, Las Vegas, NV 89126-1740. PRICE: $28.95 plus shipping and handling. ISBN: 0966375300. Summary: This chapter on substance abuse and deaf people is from a book intended to focus attention on the problem of substance abuse in the Deaf community. It aims to help people affected by addiction, and provide preventive information and incentives to preclude the development of alcoholism and substance abuse in the next generation. Originally published as the author's dissertation, the book states that up to 35 percent of people with significant hearing impairment have abused substances, including alcohol. This is almost double the estimated rate of comparable abuse among people who do not suffer impaired hearing. This chapter reviews the literature on substance abuse as it relates to the deaf population of the U.S. The author surveys basic information, such as names (some brand and some generic) and classifications of assorted drugs, controlled substances and chemicals; differentiation of psychological dependence, habituation, and physical addiction; assorted physical effects of various drugs, both individually and in combination; estimates of incidence and prevalence of substance abuse, including substance abuse among deaf people; research regarding any predisposing factors
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involved in addiction; characteristics of addicts and of addiction, with special implications for deaf people; prognosis of substance abuse prevention and treatment among the deaf population; and literature summaries and opinion regarding prerequisites of effective drug treatment. 3 tables. •
Renal Disease in Patients with Substance Abuse Source: in Schena, F.P., ed. Nephrology. New York, NY: McGraw-Hill, Inc. 2001. p. 237243. Contact: Available from McGraw-Hill, Inc. Shoppenhangers Road, Maidenhead, Berkshire SL6 2QL. 44 (0)1628 502700. Fax: +44 (0)1628 635895 E-mail:
[email protected]. Website: www.mcgraw-hill.co.uk. PRICE: $79.95; plus shipping and handling. ISBN: 0077095251. Summary: The use of various different prescription and nonprescription drugs that may lead to dependency or that may have recreational or psychological effects can cause renal (kidney) disease. This chapter on renal disease in patients with substance abuse is from a book on nephrology (the study of the kidney and kidney diseases) designed for general practitioners and family care providers that offers strategies for the management of patients with renal (kidney) damage. The authors suggest a syndrome analytic approach as the easiest first step in differentiating these renal diseases. Patients who use alcohol or cocaine may develop acute renal failure (ARF) from rhabdomyolysis (a potentially fatal disease of skeletal muscle) and myoglobinuria (myoglobin, responsible for the red color of muscle tissue and its ability to store oxygen, in the urine), which may be traumatic or nontraumatic, the latter often a direct effect of muscle injury caused by alcohol. The authors caution that any drug that causes central nervous system depression may be critical in the pathogenesis of rhabdomlyolysis, since muscular compression and seizures may be associated with the outpouring of intracellular contents that causes the nephropathy (kidney disease). Compression of muscles may be the critical factor in producing rhabdomyolysis in patients with drug-related coma or stupor. Rhabdomyolysis may present with weakness and myalgia (pain in the muscles), nausea and vomiting, disorientation, stupor or coma, and hard swollen muscles. This chapter also discusses nephrotic syndrome associated with intravenous drug use, including infective endocarditis, vasculitis, hepatitis B or C infections, and HIV infection; and chronic renal disease, including amyloidosis (accumulation of a waxy, glycoprotein in tissues and organs), problems arising from nonsteroidal antiinflammatory drugs (NSAIDs), heroin nephropathy, HIV associated nephropathy, and lead nephropathy. 1 table. 14 references.
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Substance Abuse Source: in Ciancio, S.G., ed. ADA Guide to Dental Therapeutics. 2nd ed. Chicago, IL: American Dental Association (ADA). 2000. p. 559-568. Contact: Available from American Dental Association (ADA). Catalog Sales, P.O. Box 776, St. Charles, IL 60174-0776. (800) 947-4746. Fax (888) 476-1880 or (630) 443-9970. Website: www.ada.org. PRICE: $44.95 for members; $64.95 for nonmembers, plus shipping and handling. Summary: Dentists are prescribing more medications than ever before and patients seeking dental care are using a wide range of medications for medical problems. And both dentists and patients have choices to make about the variety of nonprescription products available for treating various disorders of the mouth. This chapter on substance abuse is from a detailed guide to dental therapeutics. The author offers
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information to help practitioners safely manage patients who have or are suspected of having substance abuse problems, including alcohol abuse. Topics include defining addiction, the dentist's role with addicted patients, recognizing addicted patients, guarding against drug theft, and actions dentists should take after recognizing an addicted patient. One table provides a summary of some prescribing considerations for dentists who have patients with a history of substance abuse or dependence; another table reviews the dental implications of substances of abuse, including alcohol, amphetamines, barbituates, benzodiazepines, cocaine, inhalants, lysergic acid diethylamide (LSD), marijuana, nicotine, opioids, and phenycyclidine hydrochloride (PCP). 2 tables. 6 references.
Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to drug abuse have been published that consolidate information across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:12 •
Directory of medical faculty: Faculty Development Program in Alcohol and Other Drug Abuse Source: Rockville, MD: Center for Substance Abuse Prevention, U.S. Department of Health and Human Services. 1993. 19 pp. Contact: Available from U.S. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, Rockwall II Building, 5600 Fishers Lane , Rockville, MD 20857. Telephone: (301) 443-5052 / fax: (301) 480- 3144 / Web site: http://www.samhsa.gov. Summary: This directory provides a listing of medical school faculty who participated in a faculty development program for alcohol and other drug abuse. The faculty have a broad range of expertise in the substance abuse field, in areas of clinical teaching, practice, and research. This directory includes information for each individual by teaching institution and specialty, and, in addition, identifies specific areas of faculty expertise and interest in the alcohol and drug abuse field. It is designed to be used as a resource guide to educators, health professionals, and community groups interested in alcohol and drug abuse prevention and treatment. Cultures include: 1) European, 2) Latino, 3) African American, 4) Native American, 5) Chinese, 6) Japanese, 7) Southeast Asian, 8) Korean, 9) Asian Indian, 10) Christian, 11) Amish, 12) Jewish, and 13) deaf.
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Directory of nursing faculty: Faculty Development Program in Alcohol and Other Drug Abuse Source: Rockville, MD: Center for Substance Abuse Prevention, U.S. Department of Health and Human Services. 1993. 11 pp. Contact: Available from U.S. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, Rockwall II Building, 5600
12
You will need to limit your search to “Directory” and “drug abuse” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “drug abuse” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.
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Fishers Lane , Rockville, MD 20857. Telephone: (301) 443-5052 / fax: (301) 480- 3144 / Web site: http://www.samhsa.gov. Summary: This directory provides a listing of nursing faculty who participated in a faculty development program for alcohol and other drug abuse. The faculty have a broad range of expertise in the substance abuse field, in areas of clinical teaching, practice, and research. This directory includes information for each individual by teaching institution and specialty, and, in addition, identifies specific areas of faculty expertise and interest in the alcohol and drug abuse field. It is designed to be used as a resource guide to educators, health professionals, and community groups interested in alcohol and drug abuse prevention and treatment. •
Directory of social work faculty: Faculty Development Program in Alcohol and Other Drug Abuse Source: Rockville, MD: Center for Substance Abuse Prevention, U.S. Department of Health and Human Services. 1993. 7 pp. Contact: Available from U.S. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, Rockwall II Building, 5600 Fishers Lane , Rockville, MD 20857. Telephone: (301) 443-5052 / fax: (301) 480- 3144 / Web site: http://www.samhsa.gov. Summary: This directory provides a listing of social work faculty who participated in a faculty development program for alcohol and other drug abuse. The faculty have a broad range of expertise in the substance abuse field, in areas of clinical teaching, practice, and research. This directory includes information for each individual by teaching institution and specialty, and, in addition, identifies specific areas of faculty expertise and interest in the alcohol and drug abuse field. It is designed to be used as a resource guide to educators, health professionals, and community groups interested in alcohol and drug abuse prevention and treatment.
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Alcohol and other drug abuse curricula for medical and nursing education Source: Washington, DC: National Institute on Alcohol Abuse and Alcoholism, U. S. Department of Health and Human Services. 1993. 13 pp. Contact: Available from National Institute on Alcohol Abuse and Alcoholism, Willco Building, Suite 409, 6000 Executive Boulevard, Bethesda, MD 20892-7003. Telephone: (301) 443-3860 / fax: (301) 443-6077 / Web site: http://www.niaaa.nih.gov. Summary: This directory provides a listing of curricula on alcohol and other drug abuse that is designed to assist health professionals into integrating substance abuse teaching into their instructional activities. It includes a broad spectrum of materials that can be used in primary care and specialty teaching sessions and the audiences can be undergraduate, graduate or continuing education. It also includes materials that can be offered as a single teaching session or part of a comprehensive substance abuse curriculum. The directory is divided into a section on medical education and one on nursing education.
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CHAPTER 8. MULTIMEDIA ON DRUG ABUSE Overview In this chapter, we show you how to keep current on multimedia sources of information on drug abuse. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on drug abuse is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “drug abuse” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “drug abuse” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on drug abuse: •
Drug Abuse and HIV: Reaching Those at Risk Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: This videotape features community-based intervention, outreach, and counseling strategies and programs funded by the National Institute on Drug Abuse (NIDA) that target injecting drug users (IDUs) at risk for transmitting or contracting HIV. Excerpts of an interview with Harvey A. Segal, PhD, the principal investigator of the AIDS Prevention Research Project in Dayton, Ohio, and other project staff, reveal that the goals of the project are the identification of those at risk for HIV infection, the development of strategies to reach this population within its own community, and effecting behavioral changes that reduce the risk. Richard H. Needle, PhD, Chief of the NIDA Community Research Branch, explains that behavioral interventions are the primary technique for preventing the spread of HIV in the at-risk population. NIDA staff develops these behavioral interventions to help people reduce the risk of
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transmission. Measurable change includes the reduction of syringe reuse, fewer IDUs, and the increased use of condoms. The video also highlights an indigenous leader outreach model that utilizes street outreach staff to bring the prevention and intervention message directly into the community. The video includes a visit to a shooting gallery. In this segment, the peer outreach worker demonstrates the proper techniques for needle and syringe sterilization. Other strategies described include an HIV Counseling and Educational Intervention Model, which provides HIV testing with pre- and post-test counseling, and the Behavioral Counseling Model, which increases the number of counseling sessions to four and helps the client to identify and modify risky behavior. •
Drug Abuse: Meeting the Challenge Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: Presented in a documentary format, this videorecording targets substance abuse and addiction as a major public health issue. Topics addressed include the epidemiology of drug usage in the U.S. population, basic research on the social and physiological mechanisms of addiction, preventive education, and drugs in the workplace. Because of its association with Acquired immunodeficiency syndrome (AIDS), drug abuse merits special concern among health planners. Since 1974, the National Institute on Drug Abuse (NIDA) has collected risk-factor intervention data from selected households, high schools, and health service organizations to monitor drug abuse activity and provide technical assistance to community health education and employer-sponsored drug prevention programs. The videorecording emphasizes the position of NIDA to assist public awareness campaigns for the prevention of Human immunodeficiency virus (HIV) transmission.
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Sorting It Out: Drug Abuse Contact: National Safety Council, 1121 Spring Lake Dr, Itascao, IL, 60143-0201, (800) 6217619, http://www.nsc.org. Summary: Directed toward adolescents, this videorecording considers the connection between substance abuse and addictive behaviors, as well as the accompanying psychosocial problems which typify the teenage drug addict. Anecdotal material from recovering addicts at the Gateway Foundation in Chicago and the Cook County Department of Corrections is presented. Preventive education to discourage drug use is urged. The videorecording emphasizes the adverse health effects of IV-drug use, including exposure to Human immunodeficiency virus (HIV) infection and other serious diseases. It explains that drug abuse can be fatal and that it impairs judgement regarding sexual activity or needle sharing. Youths with drug and alcohol problems are urged to seek counseling and rehabilitation programs.
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Conversations About AIDS and Drug Abuse Contact: Conversations Video, San Francisco General Hospital, Substance Abuse Services, 1001 Potrero Ave Ward 92, San Francisco, CA, 94110, (415) 821-8764. Summary: Through candid interviews with IV-drug users (IVDU's) with Acquired immunodeficiency syndrome (AIDS), this videorecording presents facts about Human immunodeficiency virus (HIV) prevention and transmission with emphasis on drug abusers. Included are descriptions of high-risk groups and behaviors, as well as
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preventive measures such as condom use, avoidance of IV-needle sharing, and the practice of monogamy and safer sex. Patients of the disease describe their fears and society's prejudices and anxieties concerning the virus. Information is provided on cleaning drug paraphernalia with bleach and alcohol. •
High Impact: Substance Abuse and HIV Care Contact: University of Washington Center for Health Education and Research, Northwest AIDS Education and Training Center, 901 Boren Ave Ste 1100, Seattle, WA, 98104-3596, (206) 221-4964, http://depts.washington.edu/nwaetc/. Summary: This video examines issues related to the medical care of substance abusers with the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). The video provides information about harm reduction among HIV-positive substance abusers, initiating antiretroviral therapy, possible drug interactions between illicit and anti-HIV drugs, pain management, and ways to promote and support regimen adherence among HIV-positive substance abusers.
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Substance Abuse, Part II - Prevention & Beyond: A National Conference on HIV Infection and AIDS Among Racial and Ethnic Populations Summary: This videorecording presents the second part of a workshop on substance abuse, taped at a conference on HIV/AIDS among racial and ethnic populations. An intervention specialist from Miami, FL, opens the session with a description of her project on "cocaine babies". Under Florida law, babies testing positive for drugs at birth are removed from their mother; the mother must enter drug treatment and the babies are cared for by other relatives or foster care. However, many questions have arisen, such as what to do with other children in the family. The next speaker is from the Veteran's Administration (VA), and outlines the VA's drug and alcohol treatment programs. He relates how intravenous drug use has increased rates of HIV, with higher rates among veterans than in the general population. A physician with a methadone treatment center in Brooklyn, NY, addresses problems facing minority intravenous drug users (IVDUs). He claims that drug abuse is a multifactorial disease and should be treated with a comprehensive approach including counseling and treatment. The final speaker represents the Asian American Drug Use Program in Los Angeles, CA. He sees a waning public policy effort for fighting drug abuse. Outlining Asian and Pacific Islander mores, he reflects on the intense denial concerning drug abuse in those cultures.
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AIDS and Substance Abuse Speakers Network Media Video Contact: AIDS and Substance Abuse Speakers Network, 828 W Peachtree St Ste 202, Atlanta, GA, 30308, (770) 977-7797. Summary: This videotape contains a set of media clips and news segments that discuss the Substance Abuse Speakers Network and provide information on HIV and AIDS. Originally seen on television stations in North Carolina, South Carolina, and Georgia, the segments depict the many faces of AIDS. Profiled are Kevin Kearny, an HIV-positive gay man who became infected through substance abuse; and Julie Martin, who became infected through casual heterosexual contact with an injecting drug user (IDU). Extensive interviews with them, and also Lee Kearny, Kevin's mother, are included, in which their hopes, fears, anger, and other emotions, are expressed.
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The Whiz Kids - El Alcoholismo, El Vicio de Fumar y Las Drogas. [The Whiz Kids Alcohol, Smoking, and Substance Abuse.] Contact: Chrysalis Production, Incorporated, 1325 Pennsylvania Ave, Ste 290, Fort Worth, TX, 76104, (817) 878-5292. Summary: This animated videorecording portrays four infants in the womb discussing alcohol, smoking, and substance abuse and their effects on the fetus when a mother-tobe uses them during pregnancy.
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HIV/AIDS: Substance Abuse Issues Contact: Ohio State University, Department of Family Medicine, AIDS Education and Training Center, 1314 Kinnear Rd Area 300, Columbus, OH, 43212, (614) 292-4056. Summary: This videorecording presents a teleconference on the relationship between alcoholism and/or drug abuse and Acquired immunodeficiency syndrome (AIDS), caused by Human immunodeficiency virus (HIV). The four participants -Rebecca Ashery, Director, AIDS Education, National Institute on Drug Abuse (NIDA); Ruth Frankenfield, DaytonColumbus AIDS/Outreach; Ron Rucker, Certified Counselor, Cincinnati Health Department; and Dr. Ted Parran, Associate Director, Chemical Dependency, St. Vincent Charity Hospital -- discuss treatment programs available to assist health professionals with care of Intravenous drug users (IVDU's), medical management issues, psychosocial management, and counseling and support services. The videorecording describes HIV transmission through IV-needle sharing or through sexual intercourse with an IVDU and emphasizes the need for educational programs, outreach, and behavior modification in HIV prevention among this population. Several participants outline research programs and AIDS training programs for staff members of substance-abuse facilities. This teleconference included a phone-in questionandanswer session.
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The Whiz Kids - Alcohol, Smoking, and Substance Abuse Contact: Chrysalis Production, Incorporated, 1325 Pennsylvania Ave, Ste 290, Fort Worth, TX, 76104, (817) 878-5292. Summary: This animated videorecording portrays four infants in the womb discussing alcohol, smoking, and substance abuse and their effects on the fetus when a mother-tobe uses them during pregnancy.
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Trackman: A Substance Abuse Video Education Series for Deaf and Hard of Hearing Youth Source: Lansing, MI: Michigan Association for Deaf, Hearing and Speech Services (MADHS). 1994. (videocassette, teaching guide, poster, stickers and t-shirt). Contact: Available from Michigan Association for Deaf, Hearing and Speech Services (MADHS). 2929 Covington Court, Suite 200, Lansing, MI 48912-4939. VOICE-TTY (800) YOUR-EAR; VOICE (517) 487-0066; TTY (517) 487-0207; FAX (517) 487-2586. PRICE: $279.00 plus shipping and handling; individual components of the package available separately; contact to ask about available discounts. Summary: This audiovisual program is a substance abuse education program that educates deaf and hard of hearing youth about drugs and alcohol. The videotape program includes three 10-minute segments that raise questions about alcohol and substance use, and making choices about alcohol and drug behaviors. The students and
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adults in the film use sign language and the film is captioned with voice over. The videotape is designed to be a starting point for discussion and exercises. A comprehensive leader's guide provides teaching aids and creative discussion ideas to approach the questions raised by the film. Four components draw participants into the discussion with problem solving and behavioral role-modeling exercises. The program also includes a poster of the Trackman logo, 24 motivational stickers, and a t-shirt with the Trackman logo. •
Silent Stalker: A Video Promoting Prevention of Hepatitis and Substance Abuse Source: Cedar Grove, NJ: Hepatitis Foundation International. 2000. (videocassette). Contact: Available from Hepatitis Foundation International. 30 Sunrise Terrace, Cedar Grove, NJ 07009-1423. (800) 891-0707. E-mail:
[email protected]. Website: www.hepfi.org. PRICE: $35.00 plus shipping and handling. Summary: This health promotion video describes hepatitis, a viral infection of the liver. The program begins in black and white, with spooky music, and introduces hepatitis as the Silent Stalker; various people are shown running in fear from a mysterious assailant. Then, young adult narrators stress that knowledge is power, which can be used to prevent hepatitis. The anatomy and physiology of the liver is briefly reviewed; the liver's roles as the body's chemical power plant, storage for energy supply, protein manufacturer (to build and repair muscles), and protector against germs, viruses, and poisons from alcohol and drugs. The program notes that the body usually offers pain to indicate damage or disease, however, the liver is an uncomplaining organ, so it can be under great stress or damage without symptoms. Hepatitis B and hepatitis C are reviewed, and viewers are encouraged to get the hepatitis B vaccine. The narrators then review the strategies to prevent hepatitis C, including avoiding shared injectable drug equipment (needles), making sure that body piercing or tattooing needles used are sterilized, and practicing safe sex by using a condom. The narrators stress that they are not judging peoples' activities, just providing information and encouraging viewers to make healthy decisions for themselves. The theme of 'you've got the power' (to prevent infection) is reiterated. The program concludes with the same people that were shown fleeing at the beginning; the ending is filmed in color, with upbeat music and smiling faces. Contact information for the Hepatitis Foundation International is also provided (www.hepfi.org; 800-891-0707).
Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “drug abuse” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on drug abuse: •
Drug Abuse and AIDS: Interventions in African American Populations Contact: Audio Visual, Incorporated, 5542 Tuxedo Rd, Cheverly, MD, 20781, (301) 3225600. Summary: This sound recording of a National Institute on Drug Conference held Jan. 13, 1991 deals with culturally appropriate intervention strategies for Black Americans to
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prevent Acquired immunodeficiency syndrome (AIDS) and Human immunodeficiency virus (HIV) transmission. The first speaker presents an overview of Public Health Service (PHS) programs. He discusses who is infected by race and sex categories, how they became infected, its effects of drug use, the effects on orphaned children, and the increasing need for early detection and treatment of HIV infection. The second speaker explains research done by the Addiction Research and Maintenance Corporation, including behavioral and clinical interventions they have developed. Their research shows that drug use, including crack and alcohol, is responsible for much HIV transmission. Heterosexual transmission is increasing. IV-needle exchanges may somewhat decrease transmission, but sexual behavior must also change. •
Prevention of HIV Infections and AIDS in Drug Abuser Contact: Audio Visual, Incorporated, 5542 Tuxedo Rd, Cheverly, MD, 20781, (301) 3225600. Summary: This sound recording of a National Institute on Drug Abuse Conference session held on January 13, 1991, presents a panel discussion of intervention strategies to prevent Human immunodeficiency virus (HIV) infection and Acquired immunodeficiency syndrome (AIDS) in drug abusers. The first speaker discusses drug buying and IV-needle sharing behavior. The second speaker describes two culturally sensitive programs for women of color in Los Angeles, who must overcome poverty and illiteracy. The third speaker examines a study of two types of intervention used for heroin addicts. The panel extensively analyzes the effects of paid interviews.
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AIDS and Risk Reduction in Drug Abuse Treatment Settings Contact: Audio Visual, Incorporated, 5542 Tuxedo Rd, Cheverly, MD, 20781, (301) 3225600. Summary: This sound recording of a National Institute on Drug Abuse Conference session held January 14, 1991, presents a panel discussion of various types of treatment for drug and alcohol abuse, and how risk reduction for Human immunodeficiency virus (HIV) transmission can be modeled on these, or integrated into them. The first speaker discusses a variety of treatment programs and what types of tactics work. Programs for adolescents require special consideration. The second speaker describes personality disorders frequently found in drug and alcohol abusers which affect treatment outcome. The third speaker explains the health-belief model as an Acquired immunodeficiency syndrome (AIDS) preventive measure.
•
Psychological Aspects of AIDS and Drug Abuse Clients Contact: Audio Visual, Incorporated, 5542 Tuxedo Rd, Cheverly, MD, 20781, (301) 3225600. Summary: This sound recording of a National Institute on Drug Abuse Conference on January 13, 1991, examines the psychological and psychosocial aspects of Human immunodeficiency virus (HIV) infection and drug abuse. The first speaker describes the psychological continuum of Acquired immunodeficiency syndrome (AIDS) from diagnosis to death. It analyzes the characteristics, needs, and treatment of each phase of the disease. The second speaker continues this discussion and examines the need for support groups and counseling.
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Infectious Diseases and HIV Drug Abusers Contact: Audio Visual, Incorporated, 5542 Tuxedo Rd, Cheverly, MD, 20781, (301) 3225600. Summary: This sound recording of a National Institute on Drug Abuse Conference presents a panel discussion held January 15, 1991 of a variety of infectious diseases which affect people with Human immunodeficiency virus (HIV) infection or Acquired immunodeficiency syndrome (AIDS). The first speaker describes the diseases, besides HIV, which he found in a cohort of 800 Intravenous drug users (IVDU's) in the Bronx. Tuberculosis (TB), bacterial pneumonia, and pneumocystis carinii pneumonia (PCP) were among the most common ones found. The second speaker examines vaccines which HIV-positive people may take without ill effects. These include hepatitis, pneumococcal, and various influenza vaccines. Oral polio vaccine should never be given. The third speaker discusses results of examining the death certificates of drug addicts.
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Drug Abuse and AIDS: Intervention in Hispanic American Populations Contact: Audio Visual, Incorporated, 5542 Tuxedo Rd, Cheverly, MD, 20781, (301) 3225600. Summary: This sound recording of a National Institute on Drug Abuse Conference held Jan. 13, 1991, deals with culturally appropriate intervention strategies for the prevention of Human immunodeficiency virus (HIV) transmission among Hispanic-American populations. The first speaker describes a community outreach program in Arizona. Participants are questioned about their knowledge of HIV transmission and their own risky behaviors. Cultural acceptance of certain behavior changes may be difficult to bring about. The second speaker describes a National Institute on Drug Abuse (NIDA) community-based research program for pregnant women. Women who have exchanged sex for drugs, who use no protection or contraceptives, or who have had many pregnancies have extra risk for HIV infection. Treatment barriers include fear of losing their children because of their drug use, lack of transportation, and lack of child care. Provision of a food pantry and clothes closet, and traveling to homeless shelters prove successful intervention strategies with this group. The third speaker compares health problems and risk factors among Blacks, Hispanics, and whites. Transmission among Hispanics is mainly by IV-needle sharing and heterosexual transmission. Other topics include substance-abuse patterns, sexual behavior of males, condom use, and psychological symptoms. The also discuss Hispanic sexual and cultural biases.
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Drug Abuse and AIDS: Interventions in Asian American Populations Contact: Audio Visual, Incorporated, 5542 Tuxedo Rd, Cheverly, MD, 20781, (301) 3225600. Summary: This sound recording of a National Institute on Drug Abuse Conference held Jan. 13, 1991, deals with culturally appropriate intervention strategies to prevent HIV transmission among Asian-Americans. The first speaker explains Asian cultural values and traditions, and how varying degrees of acculturation may change them. He also discusses results of a sexual behavior and risk factors study. The second speaker describes the situation in San Francisco, where outreach workers cope with the widely held belief that Asians do not get AIDS. He analyzes statistics on Asian substance abuse and risk factors. The third speaker discusses the dynamics, role, and history of the AIDS Committee of the Asian Pacific Planning Council, including treatment barriers to the Asian community.
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Drug Abuse & AIDS Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse, Center on AIDS and Other Medical Consequences of Drug Abuse, Rm 5213 MSC 9561, 6001 Executive Blvd, Bethesda, MD, 20892-9561, (301) 443-1124, http://www.nida.nih.gov. Summary: This sound recording of three public service announcements (PSA's) addresses the topic of alcohol and drug abuse and Acquired immunodeficiency syndrome (AIDS). The three PSA's look at how substance abuse can impair judgment and lead to risky sexual behaviors, which may result in Human immunodeficiency virus (HIV) transmission. These PSA's are part of a campaign aimed at reducing AIDS risk among adolescents. They are titled Tony (60 seconds), Denise (60 seconds), and Denise (30 seconds).
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AIDS and Substance Abuse - Closing Remarks Contact: Audio Visual, Incorporated, 5542 Tuxedo Rd, Cheverly, MD, 20781, (301) 3225600. Summary: This sound recording of the proceedings of a session of the National Institute on Drug Abuse Conference held January 15, 1991, deals with the spread of the Human immunodeficiency virus (HIV) from Intravenous drug users (IVDU's) to others. Heterosexual transmission is rising in this group, and consequently, the number of children with Acquired immunodeficiency syndrome (AIDS).
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Working With Substance Abusers - Intervention Contact: Health Impact, PO Box 9443, Seattle, WA, 98109-9443, (206) 284-3865, http://www.healthimpact.org/. Summary: This sound recording deals with intervention to change and eliminate patterns of drug or alcohol abuse. Such abuse is associated with high rates of infection with the Human immunodeficiency virus (HIV), which is the etiologic agent of Acquired immunodeficiency syndrome (AIDS). A variety of intervention strategies are presented, generally based on explaining the risks associated with continuing abuse. Barriers to behavioral modification are also discussed, along with suggestions for surmounting these barriers. Of paramount importance in all these methods is the need to establish a trusting, nonjudgemental relationship with the clients. References and a post-test questionnaire are given in the booklet that accompanies this sound recording.
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Working With Substance Abusers - Identification and Assessment Contact: Health Impact, PO Box 9443, Seattle, WA, 98109-9443, (206) 284-3865, http://www.healthimpact.org/. Summary: This sound recording deals with the relationship between Acquired immunodeficiency syndrome (AIDS) and drug and alcohol abuse. For several reasons, both drug and alcohol abusers seem to become infected more frequently with the Human immunodeficiency virus (HIV) and to respond less favorably to treatment. Needle-use practices and decreased sexual inhibitions while under the influence of drugs or alcohol are probably the major risks involved. Debilitated physical conditions and suppressed immune systems, which are common to addicts, are also contributing factors. Treatment may be complicated by drug and alcohol interaction with medication and by the lack of personal stability of the addicts. Drug and alcohol abusers and their children, especially Blacks and Hispanics, are the fastest-growing group of HIV-positive
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persons in the United States, and meeting their needs will be the challenge in the future. A list of symptoms of substance abusers is given at the end of the recording to assist health professionals in identifying these people, even when they may not themselves be aware of their problem. References and a post-test questionnaire are given in the booklet that accompanies this sound recording.
Bibliography: Multimedia on Drug Abuse The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in drug abuse (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on drug abuse: •
Adolescent drug abuse [videorecording] Source: J. Fred. E. Shick; [produced by] American Journal of Nursing Co. Educational Services Division; Year: 1975; Format: Videorecording; New York: The Division, c1975
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Alcohol and drug abuse [videorecording]: emergency management Source: William Coopwood, Lynne Lennox Bashir, John E. Arradondo; produced by Meharry Medical College; Year: 1977; Format: Videorecording; Chapel Hill, N. C.: Health Sciences Consortium, c1977
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Alcoholism and drug abuse [sound recording] Source: American Psychiatric Association; produced by Audio-Digest Foundation; Year: 1976; Format: Sound recording; Glendale, Calif.: The Foundation, p1976
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Drug abuse: a report [videorecording] Source: Cheston M. Berlin, Jr. [made by] Penn State Television; Year: 1977; Format: Videorecording; University Park, Pa.: Pennsylvania State University: [for loan or sale by its Audio-Visual Services], c1977
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Drug abuse [videorecording] Source: Kathleen Doyle; [produced by] Office of Biomedical Communication and the Dept. of Preventive Medicine and Community Health, College of Medicine and Dentistry of New Jersey, New Jersey Medical School; Format: Videorecording; [Newark, N. J.]: The College: [for sale its Office of Biomedical Communication], c1978-
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Drug abuse and forensic medicine [sound recording] Source: Continuing Education Committee, New York State Podiatry Society Western Division, in cooperation with Lakes Area Regional Medical Program; Year: 1975; Format: Sound recording; [Buffalo, N. Y.: Communications in Learning, 1975]
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Drug abuse emergencies [videorecording] Source: with Edward Bernstein; Year: 1985; Format: Videorecording; Secaucus, N.J.: Network for Continuing Medical Education, 1985
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Drug abuse in adolescents [videorecording] Source: with Paul G. Rossman; Year: 1985; Format: Videorecording; New York, N.Y.: Network for Continuing Medical Education, 1985
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Hepatitis B & I.V. drug abuse [slide] Source: P.D. Welsby; Year: 1984; Format: Slide; Chelmsford, Essex, UK: Graves Medical Audiovisual Library, [1984]
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The drug abuse patient [videorecording] Source: written by Julie Rennecker; produced by STE, Audio-Visual Department, Saint Elizabeth Hospital Medical Center, Lafayette,
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Indiana; Year: 1985; Format: Videorecording; [New York, N.Y.]: Educational Services Division, American Journal of Nursing Company, c1985 •
What did you take? [motion picture]: the drug abuse emergency Source: [presented by] the New York State Department of Health; by Knightsbridge Productions, Inc; Year: 1971; Format: Motion picture; [New York, N.Y.]: N.Y. State Dept. of Health, c1971
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Year-end. emergency department data from the Drug Abuse Warning Network Source: Office of Applied Studies; Year: 9999; Rockville, MD: Dept. of Health and Human Services, Substance
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute13: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
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These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.14 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:15 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
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Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 15 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “drug abuse” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “drug abuse” (or synonyms) into the “For these words:” box. The following is a sample result: •
College students survey on drug abuse: 1980-1990 Source: Rockville, MD: National Institute on Drug Abuse, U.S. Department of Health and Human Services. 1991. 2 pp. Contact: Available from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Telephone: (301) 468-2600 or (800) 729-6686 or (800) 487-4889 TDD / fax: (301) 468-6433 / e-mail:
[email protected] / Web site: http://www.health.org. Single copies available at no charge; $1.00 for each title over 10. Summary: This fact sheet presents data from the nationwide survey on drug use among high school seniors, conducted annually for the National Institute of Drug Abuse by the University of Michigan Institute for Social Research. Each year, since 1977, some participants from all previously graduated high school classes have been followed through the use of mailed questionnaires. These follow-up surveys include a sample of about 1,200 full time American college students one to four years past high school. The fact sheet includes tables on annual and 30-day prevalence of drug use.
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Social Networks, Drug Abuse, and HIV Transmission Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse, Center on AIDS and Other Medical Consequences of Drug Abuse, Rm 5213 MSC 9561, 6001 Executive Blvd, Bethesda, MD, 20892-9561, (301) 443-1124, http://www.nida.nih.gov. Summary: This report is based on papers from a technical review on "Social Networks, Drug Abuse, and HIV Transmission" held in August 1993. The first article in the collection reports on using dyadic data for a network analysis of HIV infection and risk behaviors among injecting drug users (IDUs). The next article explores relationships among injecting drug use, characteristics of significant others, and HIV risk behaviors. The authors base their examination of the social network approach to drug abuse on seroepidemiological data from St. Louis, MO, drug users. Another article analyses focal networks and HIV risk among African American male injecting drug users. The next article discusses network models for HIV outreach and prevention programs for drug users. It describes a model that combines social network considerations with psychosocial approaches to HIV risk reduction. The final article describes the Stop AIDS
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for Everyone (SAFE) study, a social network-oriented experimental intervention designed to reduce HIV risk behaviors in IDUs. It examines a personal network approach to HIV prevention for IDUs not in treatment, and examines evidence of the social influence of drug-sharing sub-networks on the HIV risk behaviors of their members. •
Office of National Drug Control Policy: Pulse Check National Trends in Drug Abuse Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Office of National Drug Control Policy, Executive Office of the President, Washington, DC, 20500, (202) 467-9884. Summary: This report describes the results of a "pulse check" survey conducted in Summer 1995. The survey consists of conversations with police, drug ethnographers and epidemiologists working in the drug field, and providers of drug treatment services across the country to develop a current picture of illicit drug use and emerging trends therein. It provides information about what they were seeing in terms of the use and distribution of heroin, cocaine, marijuana, and other drugs.
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The Tuberculosis Epidemic : Legal and Ethical Issues for Alcohol and Other Drug Abuse Treatment Providers Contact: US Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Office for Treatment Improvement, 5600 Fishers Ln Ste 740, Rockville, MD, 20852, (301) 443-6533. Summary: This guideline for substance abuse treatment personnel explains the legal and ethical issues surrounding the management and treatment of patients with tuberculosis (TB). The guideline discusses TB, the difference between active TB and TB infection, methods of transmission, diagnosis, as well as treatment options for both types. It examines federal and State laws concerning alcohol and other drug (AOD) programs, and the protection of the confidentiality of TB infected patients. It describes how AOD programs can provide services for persons with TB that are within federal and State laws/regulations, while keeping employees of the program safe from transmission of TB.
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Simple Screening Instruments for Outreach for Alcohol and Other Drug Abuse and Infectious Diseases Contact: US Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 5600 Fisher Lane, Rockwall 2, Rockville, MD, 20852, (301) 443-7730. Summary: This treatment protocol is designed to address the twin epidemics of substance abuse and infectious diseases. Service providers from many systems and agencies are increasingly encountering individuals with alcohol and other drug abuse (AOD) abuse problems which place them at a higher risk for diseases. This protocol presents two screening instruments--one for AOD abuse and one for infectious diseases-that were designed to be administered by a wide range of providers and that are relatively simple to score and integrate. The AOD instrument is intended for use primarily by infectious-disease personnel, whereas the infectious-disease screening instrument is designed for use primarily by AOD workers. The use of instruments in this manner can enhance the detection of these often co-morbid conditions. This protocol also describes considerations for the development of these instruments and offers guidelines for their use in field test. Guidelines for training staff in the use of these
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instruments are also presented, and legal and ethical concerns, especially in the area of confidentiality, are discussed. Following an introductory chapter, the next chapters describe the procedures used to develop the instruments. Then, chapter 4 provides a training guide for individual service providers and agencies wishing to implement the screening instruments. The concluding chapter describes legal and ethical issues relating to screening for these problems. •
Women and Drug Abuse; A Position Paper by the United Nations System Contact: United Nations Office for Drug Control and Crime Prevention, Vienna International Centre, PO Box 500, Vienna, http://www.undcp.org. Summary: This paper contains an assessment by the United Nations on the worldwide issues surrounding women and drug abuse. Gender analysis helps determine the scope of drug-related problems in societies and develop effective interventions. Drug abuse affects women in many social, cultural, and economic contexts, even if they do not use drugs. The paper explores the social and health implications of drug abuse, including HIV transmission. It examines women's roles in drug supply and gender effects of migration and employment. Local and international responses to drug abuse and related problems include developing national drug plans, improving family counseling services, integrating drug education and life skills training early in school curriculums, and promoting research into drug abuse prevention, treatment, and social reintegration efforts for women.
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Baseline Data: Year 1; Evaluation of the Effects of Ryan White Title I Funding on Services to HIV - Infected Drug Abusers, Summary Report Contact: US Department of Health and Human Services, Health Resources and Services Administration, HIV/AIDS Bureau, Office of Science and Epidemiology, 5600 Fishers Ln Rm 7A-08, Rockville, MD, 20857, (301) 443-6560, http://www.hrsa.dhhs.gov/hab. Summary: This report analyzes the data from five longitudinal studies of services available to drug abusers living with HIV/AIDS. It focuses on the barriers that keep individual drug abusers from accessing these services and evaluates the effects of the introduction of Ryan White CARE Act funding on the availability of these services. With a number of charts and graphs, it compares usage of drug abuse services between males and females; lists types of services, such as overnight shelters, family, and emergency medical care; and discusses client interview results. The report provides information on clients' behaviors related to risk of HIV transmission other than injection drug use, experience with HIV testing, discovering HIV status, and experience with learning of AIDS symptoms. It also lists numbers of barriers endorsed for each service type. An appendix provides a survey of service provider attitudes about priorities given to substance abusers with HIV/AIDS and copies of data collection instruments.
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Broadcasters and Their Communities: An Effective Team Against Drug Abuse and AIDS Contact: Entertainment Industries Council, Los Angeles, CA, 90025. Summary: This publication gathers together some of the methods that have been used by radio and television stations around the United States to effectively and creatively present drug and AIDS information. It begins with an overview of the HIV/AIDS problem and the way that broadcasters can help. It continues with brief descriptions of awareness campaigns, printed materials, special phone lines, funding and community sponsorship programs, student contests, and ongoing campaigns. A resource list and
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nomination form for the Community Outreach Awards for Ideal Substance Abuse Prevention and AIDS Education Projects is included. •
New Media Approaches to Communicating AIDS and Drug Abuse Information Contact: Human Interaction Research Institute, Focus Project, 1849 Sawtelle Blvd Ste 102, Los Angeles, CA, 90025-7007, (310) 479-3028. Summary: This report examines the use of mass communication approaches to disseminate information about urgent health and social issues, such as HIV and AIDS. Beyond the traditional public service announcements (PSA's), booklets, and posters, lie video news releases, satellite teleconferences, entertainment-education methods, and many other new media methods. Some of these new media approaches are documented in this report. On behalf of the National Institute on Drug Abuse (NIDA), the study authors explored the uses of entertainment strategies in promoting public awareness and education regarding drug abuse and AIDS. The authors sought to identify a number of "new media" approaches to disseminate information on AIDS and drug abuse, to develop a preliminary scheme for classifying these new media approaches, to identify representative underlying theories in which new media approaches can fit, and to make suggestions to NIDA to consider future research, technology transfer, and public affairs activities regarding the dissemination of scientific knowledge about AIDS and drug abuse. The study points out possible paths for further work and suggests reasons why analysis of new media strategies and use of any underlying theory can help in strategic planning for AIDS and drug abuse communication campaigns.
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Getting to the Point: HIV, Drug Abuse and Syringe Exchange in the United States Contact: National Conference of State Legislatures, 1560 Broadway Ste 700, Denver, CO, 80202-5140, (303) 830-2200, http://www.ncsl.org. Summary: This report describes the relationship between injection drug use and the HIV epidemic, focusing on syringe exchange as an HIV prevention method. It outlines the increased interest in syringe exchange in the United States and explains how the program works, what is known about its effectiveness, and how to evaluate it. Legal issues are addressed.
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Coordination of Alcohol, Drug Abuse, and Mental Health Services Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: This report reviews the current knowledge about coordination of alcohol, drug, and mental health (ADM) services and describes the major models and mechanisms available for this purpose. The report presents recommendations regarding the process of developing coordinated ADM services. The report is organized into six chapters. Chapter 1 is a brief introduction, followed by a historical overview of previous attempts to coordinate services in chapter 2. Chapter 3 discusses multiple needs of patients with ADM disorders that make it necessary to coordinate services for them. Chapter 4 defines coordination and provides some related concepts and working principles of services coordination. The core chapter of the report is chapter 5, which presents specific mechanisms and models of coordination and offers case examples to illustrate them. Chapter 6 presents recommendations for the future.
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Followup Fieldwork: AIDS Outreach and IV Drug Abuse Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse, Center on AIDS and Other Medical Consequences of Drug Abuse, Rm 5213 MSC 9561, 6001 Executive Blvd, Bethesda, MD, 20892-9561, (301) 443-1124, http://www.nida.nih.gov. Summary: This manual addresses the problem of following up respondents who have been injecting drug users (IDUs) or their sex partners, and who also have AIDS. It stems from a national outreach effort mounted by the National Institute on Drug Abuse (NADR), which aims to implement and evaluate community-based outreach intervention models. The project targets IDUs not in treatment and the sex partners of IDUs. The manual looks at the methodological problems involved in this new area of research and the opposition from major societal institutions such as health systems, the criminal justice system, and legislative systems. It discusses the need for assurance of confidentiality when dealing with subjects, special considerations for ethnic groups, the definition of the outreach population, sampling, locating subjects, followup, and interviewing.
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Delta Alcohol, Drug Abuse and AIDS Community Education Project; National Training Manual Contact: Delta Sigma Theta Sorority, Alcohol, Drug Abuse, and AIDS Community Education Project, 1707 New Hampshire Ave, Washington, DC, 20009, (202) 483-5460. Summary: This manual was developed in response to the epidemic of Acquired immunodeficiency syndrome (AIDS) among young people. It identifies the broad relationship among alcohol and drug abuse, and the spread of Human immunodeficiency virus (HIV) infection. It also draws upon African American heritage that calls on indivuduals to take responsiblity for the present and future of other African Americans. The curriculum portion of the manual looks at the project background and its key concepts and objectives. After explaining the manual content and processes, it then turns to five training models. They include setting the stage; alcohol abuse, drug abuse, Acquired immunodeficiency syndrome (AIDS) and conceptualizing the African American context; knowledge and attitudes for healthy living; behavior for healthy living; and contemporary concerns regarding violence and victimization, and safer sex. It concludes with trainer and educator tips.
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The Demographics of Drug Abuse in Hispanic Communities: An Overview Contact: National Council of La Raza, 1111 19th St NW Ste 1000, Washington, DC, 20036, (202) 785-1670, http://www.nclr.org. Summary: An overview of illicit drug use in the Hispanic population, this report examines demographics that link AIDS and drug abuse in this community. The author states that the data on the nature and extent of drug abuse is inadequate, but that the available data indicates a serious problem among Hispanics. One chapter presents data reflecting overrepresentation of Hispanics such as: Hispanics comprise only 8 percent of the United States population, and they have reported 15.7 percent of all AIDS cases as of September 1990. In addition, over half of these cases involve intravenous drug use. One fourth of all pediatric AIDS cases are Hispanics with 71 percent linked with either the mother's own drug use, 44.2 percent; or with mothers who have sexual relations with drug users. Drug-induced judgment impairment can lead to higher-risk sexual behavior. The author concludes that improved data collection and increased Hispanic-focused
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research are vital to implementing effective education, prevention, and treatment programs. •
What Works in HIV Prevention for Substance Abusers Contact: AIDS Action, 1906 Sunderland Pl NW, Washington, DC, 20036-1608, (202) 5308030, http://www.aidsaction.org. Summary: This guide, for individuals and community-based organizations (CBOs) involved in the prevention of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) among substance users, showcases a number of strategies and techniques that have reduced the transmission of HIV among substance abusers. It discusses the statistics of HIV/AIDS within the substance user community; it outlines strategies and models from the research literature that may be useful in designing effective risk reduction programs; it provides descriptions of CBOs actively involved in the fight against HIV infection among substance users; and it contains resources and references to aid in further research.
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Substance Abuse Treatment for Persons with HIV/AIDS Source: Treatment Improvement Protocol (TIP) Series;37:1-316. Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: This manual presents guidelines for creating a comprehensive, integrated system of care for HIV-infected abusers of alcohol and other drugs (AOD). The guidelines identify a spectrum of core services and treatment approaches that should ideally be available to this population. Specifically it provides information on medical assessment and treatment, mental health treatment, primary and secondary HIV prevention, the integration of treatment services, the accessing and obtainment of needed services, the counseling of clients with HIV and substance abuse disorders, ethical and legal issues, and funding and policy considerations.
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Under the Influence: Making the Connection Between HIV/AIDS and Substance Abuse Contact: Canadian AIDS Society, 130 Albert St Ste 900, Ottawa, (613) 230-3580, http://www.cdnaids.ca. Canadian Public Health Association, Canadian HIV/AIDS Clearinghouse, 400-1565 Carling Ave Ste 400, Ottawa, (613) 725-3434, http://www.cpha.ca. Summary: This manual, for drug abuse clinic counselors and service organizations, examines how to counsel substance abusers with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). It discusses attitudes, values, and beliefs; relationships, boundaries, and ethics; listening skills; self care including health promoting activities to enhance physical, emotional, psychological, sexual, and spiritual health; and developing policies and procedures around substance abuse. It provides information on different substances, their effects, how they are used, and treatment options to use with clients.
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Que Necesitan los Usuarios de Drogas en la Prevencion del VIH? (1997). [What Are Substance Abusers' HIV Prevention Needs?] Contact: University of California San Francisco, Center for AIDS Prevention Studies, 74 New Montgomery St Ste 600, San Francisco, CA, 94105, (415) 597-9100, http://www.caps.ucsf.edu/capsweb. Summary: This fact sheet discusses the specific HIV-prevention needs of substance abusers. Sharing needles is a high-risk activity for HIV transmission. People who abuse alcohol, amphetamines, and other drugs are also more likely than non-substance abusers to be HIV positive and to engage in high-risk sexual activity. Possible explanations for the increased risk of HIV are reviewed, including poor oral hygiene, oral damage, unprotected intercourse, and impaired judgement. The fact sheet addresses potential obstacles to prevention and the importance of substance abuse treatment. Several community-based safer sex intervention strategies are described. The need for gender-specific programs, programs for substance abusers, and programs for high-risk groups is noted.
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Texas State Plan to Serve Substance Abusers at Risk of HIV, STDs and TB Contact: Texas Commission on Alcohol and Drug Abuse, 720 Brazos Ste 403, Austin, TX, 78701-2506, (512) 867-8700. Summary: The efforts of nine Texas state agencies working in the area of HIV/AIDS prevention and treatment for drug abusers are described in this report. New issues and trends, including those associated with high-risk behaviors are outlined along with data on national and state HIV/AIDS incidence broken down for a variety of populations. The goals and objectives for education and outreach, HIV counseling and testing, treatment programs and training are presented along with the status of the specific implementation strategies designed to achieve these goals.
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HIV, Psychology and Substance Abuse; Trainer's Manual Contact: American Psychological Association, AIDS Office, 750 1st St NE, Washington, DC, 20002-4242, (202) 336-6042, http://www.apa.org. Summary: This training module provides insight and information for psychologists who treat chemically dependent patients with HIV. The module highlights the interrelationships between IV drug use and HIV transmission as well as alcohol intoxication as a cause of disinhibition and subsequent risk-taking behavior. The module identifies common characteristics of chemically dependent persons. The module also allows the psychologist to identify his/her own feelings and attitudes toward HIV. The course addresses myths and information about chemical dependence and HIV disease, the bio- psycho-social model, advocacy, and drug treatment referrals. Using the biopsycho-social model of HIV and substance abuse, the practitioner is encouraged to develop an integrated approach to treatment.
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Strategic Plan for HIV/AIDS: Substance Abuse and Mental Health Services Administration (SAMHSA) Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: This plan examines the projected course of the HIV/AIDS epidemic in relation to key target populations served by the Substance Abuse and Mental Health
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Services Administration (SAMHSA). These groups include homosexuals and bisexuals; injecting drug users; the seriously mentally ill; racial and ethnic minorities; women; adolescents; and children. It describes SAMHSA's organizational and programmatic responses to the epidemic. The five goals of SAMHSA's three formal AIDS-related programs are listed with descriptions of activities which address each goal. Also included are nine principles which guide SAMHSA's ongoing HIV-related efforts. Conclusions are made concerning the epidemic and SAMHSA's role in leading the response to the epidemic. •
Screening for Infectious Diseases Among Substance Abusers Contact: US Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 5600 Fisher Lane, Rockwall 2, Rockville, MD, 20852, (301) 443-7730. Summary: The screening, prevention, and control of infectious diseases has become a critically important function for alcohol and other drug abuse (AOD) treatment programs, both to protect staff and patients. These protocols provide screening, counseling, and treatment guidelines to AOD treatment providers in all settings who screen and test patients for infectious disease, provide risk-reduction education, and provide treatment to patients with early and asymptomatic HIV as well as preventive therapy for patients with TB. The focus is on the infectious diseases that occur frequently among treatment populations, such as HIV, AIDS, tuberculosis, syphilis, and hepatitis B and C. Included also are discussions of other infectious diseases common to treatment populations, such as chlamydia, gonorrhea, herpes simplex, chancroid, and hepatitis A and D. Information is provided about transmission, symptoms, and indications for screening. The protocols are intended to guide and instruct a broad spectrum of treatment for health care providers. Some of the guidelines provide information for specific disciplines, and other parts provide legal and ethical guidelines. The first portion addresses issues that affect and support the entire infectious disease screening and treatment process. The remaining chapters provide protocols for specific infectious diseases.
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Florida's Response to AIDS and Substance Abuse Contact: Florida Department of Health and Rehabilitative Services, Alcohol, Drug Abuse and Mental Health Program Office, AIDS Unit, 1317 Winewood Blvd, Tallahassee, FL, 32399, (904) 487-2478. Summary: This report details the efforts of the Florida Alcohol and Drug Abuse Program to respond to the Acquired immunodeficiency syndrome (AIDS) epidemic. The early portion of the report describes six projects: HIV-Antibody Counseling and Testing Services; Primary Care and Substance Abuse Integrated Treatment; Comprehensive Substance Abuse/AIDS Training Program; HIV and Substance Abuse Outreach Services; Risk Assessment Survey Analysis; and Knowledge, Attitudes, Behaviors, and Beliefs (KABB) Survey. The remaining four sections consist of research papers on various aspects of the AIDS epidemic in Florida: They examine the topics of women and AIDS, substance abuse and AIDS, program evaluation, and recovery for the family affected by alcohol abuse.
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Adolescent Substance Abuse: Risk Factors and Prevention Strategies Contact: National Center for Education in Maternal and Child Health, 2000 Fifteenth St N Ste 701, Arlington, VA, 22201-2617, (703) 821-8955, http://www.ncemch.org.
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Summary: This article reviews information concerning the prevalence of adolescent alcohol and drug abuse and related health problems. A survey of research shows drug and alcohol abuse is related to many of the problems affecting adolescents, including accidents, suicides, sexual activity, and inadequate use of contraception. The article details associated psychological and behavioral issues, risk factors, and prevention strategies. The conclusion indicates the most effective prevention strategies utilize a social influence approach or emphasize personal and social skills teaching; the largest effects are produced by programs combining features of both. The author suggests that if drug-using behavior is not learned during adolescence due to infrequent exposure to risk, the chances are better that drugs will never be used. He argues this implies that drug prevention programs should focus on reducing exposure to risk factors and modifying factors already present, including disrupted family environments and nonconformist attitudes. •
A Comparative Analysis of Two Methods of AIDS Education in a Population of Methadone and Non-Methadone Taking Substance Abusers: Preliminary Report Contact: Greenwich House, 27 Barrow St, New York, NY, 10014, (212) 242-4140. Summary: This report of a study, using a longitudinal, quasi-experimental pre- and post-test design, determines the comparative effectiveness of facilitative (participatory) and didactic (lecture) methods of delivering an AIDS education and HIV prevention program to methadone taking and non-methadone taking injecting drug users (IDUs). Both education programs include role playing, videos, and published materials. The study also yielded baseline information about knowledge and opinions on AIDS, and sexual and drug-taking practices among this population. The measurements were taken immediately preceding education intervention, immediately following educational intervention, and three months following educational intervention. The data were analyzed by nine independent variables: type of educational intervention, methadone use or non-use, sex, age, race, sexual orientation, level of education, marital status, and household income. Knowledge, opinion, and safer sexual and drug-taking practices were the dependent variables. An AIDS knowledge scale encompassed three subscales: general AIDS knowledge, sex-related AIDS knowledge, and drug-related AIDS knowledge. The findings indicate that overall knowledge levels were increased as a result of either type of AIDS educational intervention; the intervention had an increasing impact as the general educational level increased. However, the facilitative approach produced a higher increase in all AIDS knowledge scales, for reasons not yet determined. Despite an original hypothesis, methadone users appeared to experience a slightly higher increase in the total AIDS knowledge scale.
The NLM Gateway16 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.17 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd.
16 17
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).
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Type “drug abuse” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 136681 7371 515 3372 462 148401
HSTAT18 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.19 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.20 Simply search by “drug abuse” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists21 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.22 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.23 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/. 18
Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.
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The HSTAT URL is http://hstat.nlm.nih.gov/.
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Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 21 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 22
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 23 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
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Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
The Genome Project and Drug Abuse In the following section, we will discuss databases and references which relate to the Genome Project and drug abuse. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).24 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “drug abuse” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for drug abuse: •
Polysubstance Abuse, Susceptibility to Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?606581 Genes and Disease (NCBI - Map)
The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may 24
Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
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wish to revisit it from time to time. The following systems and associated disorders are addressed: •
Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html
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Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html
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Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html
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Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html
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Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html
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Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html
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Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez
Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases:
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3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
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Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
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NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
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Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
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OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
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Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “drug abuse” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database25 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. 25
Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html.
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The Genome Database26 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “drug abuse” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).
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Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on drug abuse can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to drug abuse. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to drug abuse. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “drug abuse”:
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Other guides Alcohol and Youth http://www.nlm.nih.gov/medlineplus/alcoholandyouth.html Alcohol Consumption http://www.nlm.nih.gov/medlineplus/alcoholconsumption.html Alcoholism http://www.nlm.nih.gov/medlineplus/alcoholism.html Amphetamine Abuse http://www.nlm.nih.gov/medlineplus/amphetamineabuse.html Club Drugs http://www.nlm.nih.gov/medlineplus/clubdrugs.html Fetal Alcohol Syndrome http://www.nlm.nih.gov/medlineplus/fetalalcoholsyndrome.html Marijuana Abuse http://www.nlm.nih.gov/medlineplus/marijuanaabuse.html Prescription Drug Abuse http://www.nlm.nih.gov/medlineplus/prescriptiondrugabuse.html
Within the health topic page dedicated to drug abuse, the following was listed: •
General/Overviews Drugs and Pregnancy Source: American Council for Drug Education http://www.acde.org/parent/Pregnant.htm Illegal Drugs and Pregnancy Source: American College of Obstetricians and Gynecologists http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZN0X8997C& sub_cat=2005
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Treatment Drug Abuse and Treatment Source: National Women's Health Information Center http://www.4woman.gov/faq/substanc.htm Principles of Treatment (Drug Addiction) Source: Office of National Drug Control Policy http://www.whitehousedrugpolicy.gov/treat/bestpractice.html Types of Treatment (Drug Addiction) Source: Office of National Drug Control Policy http://www.whitehousedrugpolicy.gov/treat/treatment.html
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Specific Conditions/Aspects Cocaine Use during Pregnancy Source: March of Dimes Birth Defects Foundation
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http://www.marchofdimes.com/professionals/681_1169.asp Health & Economic Impact: Smoking Cessation for Pregnant Women Source: Centers for Disease Control and Prevention http://www.cdc.gov/tobacco/research_data/economics/health_econ_impact.htm Heroin Abuse and Addiction-How Does Heroin Abuse Affect Pregnant Women? Source: National Institute on Drug Abuse http://www.nida.nih.gov/ResearchReports/heroin/heroin4.html Smoking and Pregnancy Source: American Lung Association http://www.lungusa.org/tobacco/smosmpreg.html •
From the National Institutes of Health Drinking and Your Pregnancy http://www.niaaa.nih.gov/publications/brochure.htm
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Latest News Effective Methadone Dose Does Not Harm Newborns Source: 09/17/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14007 .html Rat Study Shows Exposure to Ecstasy Early in Pregnancy Induces Brain, Behavior Changes Source: 09/02/2003, National Institute on Drug Abuse http://www.nih.gov/news/pr/aug2003/nida-29.htm Smoking Linked to Cleft Palate Source: 09/22/2003, United Press International http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14076 .html
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Organizations March of Dimes Source: March of Dimes Birth Defects Foundation http://www.marchofdimes.com/ National Center on Birth Defects and Developmental Disabilities Source: Centers for Disease Control and Prevention http://www.cdc.gov/ncbddd/default.htm National Clearinghouse for Alcohol and Drug Information Source: Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration http://www.health.org/ National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/ National Institute on Drug Abuse http://www.nida.nih.gov/NIDAHome.html
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Prevention/Screening Government Warning Label Source: National Council on Alcoholism and Drug Dependence http://www.ncadd.org/facts/govwarn.html
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Research Prenatal Drug Exposure and Drug-Abusing Environments Source: National Institute on Drug Abuse http://www.nida.nih.gov/about/organization/ICAW/prenatal/Prenatalfindings9 01.html Rat Study Shows Exposure to Ecstasy Early in Pregnancy Induces Brain, Behavior Changes Source: National Institute on Drug Abuse http://www.nih.gov/news/pr/aug2003/nida-29.htm Significant Deficits in Mental Skills Observed in Toddlers Exposed to Cocaine before Birth Source: National Institute on Drug Abuse http://www.nih.gov/news/pr/apr2002/nida-19.htm
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Statistics Pregnancy and Drug Use Trends Source: National Institute on Drug Abuse http://www.nida.nih.gov/Infofax/pregnancytrends.html Preventing Smoking during Pregnancy Source: National Center for Chronic Disease Prevention and Health Promotion http://www.cdc.gov/nccdphp/pe_factsheets/pe_smoking.htm Smoking during Pregnancy Rates Drop Steadily in the 1990's, but among Teen Mothers Progress Has Stalled Source: Centers for Disease Control and Prevention http://www.cdc.gov/od/oc/media/pressrel/r010828.htm Tobacco and Alcohol Use Among Pregnant Women Source: Substance Abuse and Mental Health Services Administration http://www.health.org/govstudy/shortreports/femalctob/
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on drug abuse. CHID offers summaries that
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describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
HIV/AIDS and Drug Abuse : A Devastating Combination Contact: World Health Organization, Joint United Nations Programme on HIV/AIDS, 20 Avenue Appia, CH-1211 Geneva, http://www.unaids.org. Summary: This pamphlet, for substance abusers, discusses the relationship between substance abuse and the transmission of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). It explains the pathogenesis of HIV to AIDS and how HIV is transmitted. It examines why substance abusers may be at risk for contracting HIV.
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Based on Tip 11: Simple Screening Instruments for Outreach for Alcohol and Other Drug Abuse and Infectious Diseases Source: Treatment Improvement Protocol 1994;11:1-83. Contact: US Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 5600 Fisher Lane, Rockwall 2, Rockville, MD, 20852, (301) 443-7730. Summary: This pamphlet is based on a more detailed publication, which discusses the twin epidemics of substance abuse and infectious disease. The pamphlet contains a simple screening instrument for alcohol and drug abuse and another for infectious diseases. Both instruments can indicate to the interviewer whether the client needs more comprehensive assessment.
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How to Succeed in Siting a Drug Abuse Treatment Center Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: This booklet is a collection of basic principles gleaned from providers who have sited new drug abuse treatment facilities successfully. It is an overview of the steps that need to be taken to move into or establish a new center. They include: 1) assessing the situation; 2) developing community support; 3) choosing the right location; 3) establishing good community relations; 4) relating to the community; 5) educating the community; 6) presenting a good image; 6) maintaining positive community relations. It stresses that the best way to win support is not to create opposition.
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The Fact Is. Education Can Help Prevent AIDS and Drug Abuse Among Women Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: This fact sheet focuses on education programs to help prevent Human immunodeficiency virus (HIV) transmission to women. Facts about HIV transmission to women are included, as are sources for additional Acquired immunodeficiency
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syndrome (AIDS) information. Specialized information for minorities, sex workers, and pregnant women is also included. •
Foundations for decision making: Arming children with knowledge to fight drug abuse Source: Cedar Grove, NJ: American Liver Foundation. n.d. 26 items. Contact: Available from American Liver Foundation, 2021 A Pontius Avenue, Los Angeles, CA 90025. Telephone: (310) 477-4615 / fax: (310) 478- 4685 / e-mail:
[email protected] / Web site: www.liver411.com. Summary: This packet contains brochures, a coloring book, stickers, and fact sheets designed to educate children on the dangers of drug and alcohol abuse with a particular focus on the liver, the dangers to the liver that such abuse could do, and the effects that that would have on the person's life. Other information in the packet promotes and explains the need for immunization to prevent hepatitis B and other liver diseases.
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Drug Abuse and AIDS Contact: Connecticut Clearinghouse, 334 Farmington Ave, Plainville, CT, 06062-1321, (800) 232-4424, http://www.ctclearinghouse.org. Summary: This fact sheet examines the relationship between drug abuse and the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Behavior associated with drug abuse is the single largest factor in the spread of HIV in the United States (US). HIV is a virus that weakens the immune system over a period of time and develops into AIDS, an incurable disease. Shared needles, cotton swabs, rinse water, and cookers for injecting drugs leaves the abuser vulnerable to contracting or transmitting HIV. Research has shown that substance abuse interferes with judgement about sexual (and other) behavior, making it more likely that users have unplanned and unprotected sex. The fact sheet reviews some statistics regarding the epidemiology of HIV/AIDS among substance abusers, particularly injection drug users (IDUs). Research has shown that drug abuse treatment is a proven means of preventing the spread of HIV and AIDS, especially when combined with prevention and community-based outreach programs for at-risk people. A table shows the epidemiology and incidence rates of HIV/AIDS among high-risk groups such as IDUs, men who have sex with men (MSM), and at-risk heterosexuals.
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Drug Abuse Can Hurt Your Kidneys Source: New York, NY: The National Kidney Foundation. 1992. 2 p. Contact: National Kidney Foundation. 30 East 33rd Street, New York, NY 10016. (800) 622-9010. PRICE: Single copy free. Order Number 02-22NN. Summary: This fact sheet, written in question and answer format, discusses kidney damage caused by drug abuse. Written in simple language, the fact sheet covers drugs that are harmful to the kidneys, including pain medicines, alcohol, antibiotics, and illegal drugs. The fact sheet emphasizes the importance of not using any medicines or drugs without a medical reason. The activities of the National Kidney Foundation and its affiliates are also summarized.
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Facts about teenagers and drug abuse Source: Rockville, MD: National Institute on Drug Abuse, U.S. Department of Health and Human Services. 1991. 2 pp. Contact: Available from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Telephone: (301) 468-2600 or (800) 729-6686 or (800) 487-4889 TDD / fax: (301) 468-6433 / e-mail:
[email protected] / Web site: http://www.health.org. Single copies available at no charge. Summary: This publication presents data from three National Institute on Drug Abuse surveys: the 1990 National Household Survey, the 1990 National High School Senior Survey, and the Drug Abuse Warning Network (DAWN). These surveys indicate that although there has been a continuing and significant decline in the use of many illicit drugs among adolescents since the 1970s, serious problems remain. Other NIDA fact sheets include: the College Students Survey on Drug Use 1980-1990, High School Senior Drug Use 1975-1990, Highlights of National Adolescent School Health Survey on Drug and Alcohol Use, and Drug Abuse During Pregnancy.
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Drug Abuse and AIDS Public Education Program Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse, Center on AIDS and Other Medical Consequences of Drug Abuse, Rm 5213 MSC 9561, 6001 Executive Blvd, Bethesda, MD, 20892-9561, (301) 443-1124, http://www.nida.nih.gov. Summary: This news release deals with some new resources available for drug education to help prevent transmission of the Human immunodeficiency virus (HIV), the etiologic agent of Acquired immunodeficiency syndrome (AIDS). The news release includes a list of print materials, such as posters and transit cards, and a list of radio materials.
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Look at Alcohol and Other Drug Abuse Prevention and Deafness and Hearing Loss Source: Washington, DC: Resource Center on Substance Abuse Prevention and Disability. 1995. 8 p. Contact: Available from Resource Center on Substance Abuse Prevention and Disability. 1819 L Street, N.W., Suite 300, Washington, DC 20036. Voice (202) 628-8080; TTY (202) 638-5862; Fax (202) 628-3812. PRICE: Single copy free. Summary: This fact sheet presents general information about deafness, hearing loss, and the implications of alcohol and other drug use on hearing loss, deafness, and service delivery. The fact sheet begins with an outline of the types of communication problems related to hearing loss and the types of schools and educational methods used with children who have hearing loss. The fact sheet provides suggestions on how to improve positive communication interactions between persons who hear and persons who are deaf. Additional topics include suggestions for communicating in group meetings and training sessions, addressing accessibility problems, and general myths and facts about deafness and communication. The fact sheet concludes with an annotated resources list (publications and audiovisual materials) and a list of resource organizations. 14 references.
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Look at Alcohol and Other Drug Abuse Prevention and Americans with Disabilities Source: Washington, D.C.: Resource Center on Substance Abuse Prevention and Disability. 1992. 8 p. Contact: Available from Resource Center on Substance Abuse Prevention and Disability. 1819 L Street, N.W., Suite 300, Washington, D.C. Voice (800) 628-8442 or (202) 638-5862; TTY (202) 638-5862; Fax (202) 628-3812. PRICE: Single copy free. Summary: This fact sheet is designed for those working in the field of alcohol and other drug abuse services, as well as for those involved in the disability and rehabilitation fields. The fact sheet reviews the Americans With Disabilities Act of 1990 and its impact on alcohol and other drug abuse services. The fact sheet provides information on architectural and communication barriers, as well as discrimination and other barriers and provides suggestions to improve access and positive interactions. A list of resource organizations and agencies to contact for more information is provided. 19 references. (AA-M).
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Look at Alcohol and Other Drug Abuse Prevention and Learning Disabilities Source: Washington, DC: Resource Center on Substance Abuse Prevention and Disability. 1992. 4 p. Contact: Available from Resource Center on Substance Abuse Prevention and Disability. 1818 L Street, N.W., Suite 300, Washington, DC 20036. Voice (800) 628-8442 or (202) 6288080; TTY (202) 638-5862; Fax (202) 628-3812. PRICE: Single copy free. Summary: This fact sheet on learning disabilities is designed for those working in the field of alcohol and other drug abuse services, as well as for those involved in the disability and rehabilitation fields. The fact sheet describes the implications of alcohol and other drug abuse for a person with a learning disability, focusing on suggestions to improve access and positive interactions. Myths and facts about learning disabilities are included. A list of resource organizations and agencies to contact for more information is provided. 5 references. (AA-M).
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NCADD fact sheet: Alcoholism, other drug addictions and related problems among women Source: New York, NY: National Council on Alcoholism and Drug Dependence. 1990. 2 pp. Contact: Available from Jeffrey Hon, Director of Public Information, National Council on Alcoholism and Drug Dependence, 12 West 21st Street, Eighth Floor, New York, NY 10010. Telephone: (212) 206-6770 or (800) NCA-CALL / fax: (212) 645-1690 / e-mail:
[email protected] / Web site: http://www.ncadd.org. Available at no charge. Summary: NCADD Fact Sheet: Alcoholism, Other Drug Addictions and Related Problems Among Women discusses consumption patterns and practices, physiological effects of alcohol, and treatment issues.
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The Connection Between Substance Abuse and Sexually Transmitted Diseases, Hepatitis B, Tuberculosis, HIV/AIDS Contact: Massachusetts Department of Public Health, Bureau of Communicable Disease Control, Division of Tuberculosis Prevention and Control, State Laboratory Institute, 305 South St, Jamaica Plain, MA, 02130-3515, (617) 983-6970, http://www.state.ma.us/dph/cdc/tb/INDEX.HTM.
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Summary: This pamphlet discusses the relationship between drug and alcohol abuse and sexually transmitted diseases (STDs), hepatitis B, tuberculosis (TB), and the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). It discusses the transmission, symptoms, and prevention of these infectious diseases and how substance abuse affects individuals with HIV/AIDS. •
Talking Straight With Your Teenager About Substance Abuse: A Parent's & Caregiver's Guide to Straight Talk Contact: Learning Partnership, PO Box 199, Pleasantville, NY, 10570, (914) 769-0055. Summary: This guide for parents and caregivers is designed to accompany the Substance Abuse issue of Straight Talk magazine. It is designed to help parents and caregivers understand the normal devlopment of their children during adolescence, to realize the positive effects they can have on their children's behavior, and to help their teens understand the differences between adult and teen alcohol use. It will help parents and caregivers know how to open a discussion with their teens about alcohol, tobacco, and other drugs (ATOD); how to clarify values and set rules, which help prevent ATOD use; and how to build a safety net for their teens by teaching them decision-making and refusal skills. It also discusses the identification of early warning signs of ATOD abuse and what to do about them, what parents and caregivers can do if someone in the family is using ATOD, and how to help teens use other resources to find out more about ATOD.
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El Abuso de Sustancias y el SIDA. [Substance Abuse and AIDS.] Contact: Visiting Nurse Association of Staten Island, 400 Lake Ave, Staten Island, NY, 10303, (718) 720-2245, http://www.vnasi.org. Summary: This brochure emphasizes that active users of drugs and alcohol are one of the highest risk groups for acquiring HIV. It outlines methods of transmission and protection, promoting condom use and avoidance of being active. Those who are already actively using are urged to avoid sharing needles and works, and to use bleach to clean syringes and works. An eight-step illustration demonstrates rinsing a syringe with bleach and water three times.
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The HIV and Substance Abuse Training Curriculum: A Catalog of Training Courses Available From the Center for Substance Abuse Treatment, Office of Human Resources Development Contact: Center for HIV and Substance Abuse Training, 4501 Ford Ave Ste 310, Alexandria, VA, 22302, (703) 998-0287, http://www.hitechintl.com. Summary: This draft of 1992 revised catalog lists the 18 courses offered by the Center for Substance Abuse Treatment (CSAT), through various contractor agencies, relating to substance abuse and Human immunodeficiency virus (HIV). Each course listing consists of the course title, target audience, course goals, time length, type of course material available, additional materials needed, and access information. Among the topics covered by the courses are HIV prevention among Blacks, substance abusers, female sex partners of Intravenous drug users (IVDU's), Hispanic women, and adolescents. There is a series of courses on Acquired immunodeficiency syndrome (AIDS) outreach in the community, accompanied by offerings on assessment interviewing, basic management skills, and community education. Another course discusses strategies for attracting and retaining clients in methadone treatment programs. A modular curriculum on substance abuse counseling in the age of HIV covers counseling on the HIV-antibody test, death
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and dying, dysfunctional families, women, human sexuality, support groups, issues of lesbians and homosexuals, relapse prevention, risk-reduction counseling, and treatment planning for HIV-positive persons. •
Straight Talk: Substance Abuse Source: Straight Talk: A Magazine for Teens 1997;1-25. Contact: Learning Partnership, PO Box 199, Pleasantville, NY, 10570, (914) 769-0055. Summary: Straight Talk is a series of publications in contemporary-teen-magazine format that addresses critical health and behavioral issues confronting today's adolescents and serves as a resource for risk-reduction and prevention programs for youth aged 12 to 15 in a variety of settings. The series is organized around a central concept of enhancing individual self-esteem. Each title focuses on a specific topical area: the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and other sexually transmitted diseases (STDs), self-esteem, substance abuse, and teen relationships and choices. This prevention program helps professionals foster and enhance critical thinking skills, refusal skills, decision-making skills, communications and persuasion skills, coping skills, conflict-resolution skills, and acceptance of responsibility for self and others. The Substance Abuse module provides articles and illustrative materials combined to provide important facts, challenge and explore attitudes, enhance skills development, and model healthy behaviors and lifestyles. The entire module emphasizes and reinforces drug-free values and behaviors while confronting negative consequences of substance abuse for the individual, the family, and the community. Firsthand accounts from young people are included. Article topics include a discussion with the director of the National Institute on Drug Abuse about alcohol, tobacco, and other drugs; alcoholism and children of alcoholics; tobacco and tobacco addiction; substance advertising; spit tobacco; signs of substance addiction; youth advocacy and activism; and steroids. A Discussion Leader's Guide, which contains suggested discussion questions, individual and small group activities, duplicating masters, and a set of family/home involvement activities, is available.
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The Whiz Kids - El Alcoholismo, el Vicio de Fumar y las Drogas. [The Whiz Kids Alcohol, Smoking and Substance Abuse.] Contact: Chrysalis Production, Incorporated, 1325 Pennsylvania Ave, Ste 290, Fort Worth, TX, 76104, (817) 878-5292. Summary: This teaching aid is designed for health educators to use with English and Spanish speaking low-income and minority women of childbearing age, in teaching them about the effects of alcohol, smoking and substance abuse during pregnancy. The potential for contracting Acquired immunodeficiency syndrome (AIDS) through unprotected sex and passing it on to the unborn child is also noted. The aid contains a videorecording, an instructor's guide, two posters, 100 brochures, one guide to package contents and one tote bag. The producers of the educational kit recommend it for use in pre-natal clinics and classrooms, elementary, junior and senior high schools, WIC sites, childbirth education classes, family planning clinics, public health departments, volunteer organizations, hospitals, HMOs, physicians' offices, corporate health programs, and medical and public libraries.
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Information Package: Resource Center on Substance Abuse Prevention and Disability Source: Washington, D.C.: Resource Center on Substance Abuse Prevention and Disability. 1993. (information package).
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Contact: Available from Resource Center on Substance Abuse Prevention and Disability. 1819 L Street, N.W., Suite 300, Washington, D.C. 20036. Voice (800) 628-8442 or (202) 628-8080; TTY (202) 628-3812; Fax (202) 628-3812. PRICE: Single copy free. Summary: This information packet is designed for those working in the field of alcohol and other drug abuse services, as well as for those involved in the disability and rehabilitation fields. The packet includes fact sheets on alcohol and drug abuse prevention, the Americans With Disabilities Act, attention deficit disorders, blindness and visual impairments, deafness and hearing loss, hidden disabilities, learning disabilities, mental illness, mental retardation, mobility limitations, spinal cord injury, traumatic brain injury, disability and enabling, disability and the family, disability and health implications, and service delivery settings. Each fact sheet lists truths and myths about the subject, provides information about resource organizations and publications, and includes references. An order form for additional copies of the fact sheets is also included. •
[Student-to-Student Substance Abuse Prevention Project information kit] Source: Washington, DC: Nalle Elementary School. 1994. 1 fact sheet (1 p.), 1 pamphlet (4 pp.), 1 newsletter (10 pp.), 1 program description (6 pp.). Contact: Available from Nalle Elementary School, Student-to-Student Substance Abuse Prevention Project, 50th and C Streets, S.E., Washington, DC 20019. Telephone: (202) 767-7029 or (202) 806-7343. Summary: This information kit contains descriptions of an alcohol and substance use prevention project at the J. C. Nalle Elementary School in Washington, D.C. The project was established in cooperation with Howard University, the city school system, and the faculty and students at the school to develop a model program involving the school, parents, the community, and the university. The project focuses on students in grades from three to six and operates from 3:15 to 5:15 during the school year. Materials in the kit include a fact sheet describing the project; a handbook for parents; a sample of a newsletter developed for the students; and a description of the project that includes information on its history, goals, and management approach, and notes significant accomplishments.
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Substance Abuse Treatment for Injection Drug Users: A Strategy with Many Benefits Contact: CDC National Prevention Information Network, PO Box 6003, Rockville, MD, 20849-6003, (800) 458-5231, http://www.cdcnpin.org. Summary: This series of fact sheets addresses the importance of ensuring that injection drug users (IDUs) receive substance abuse treatment in an effort to reduce drug use and reduce their risks of blood-borne disease such as the human immunodeficiency virus (HIV), hepatitis C (HCV) and hepatitis B (HBV). The other fact sheets are titled 'What Can We Expect from Substance Abuse Treatment', 'Linking HIV Prevention Services and Substance Abuse Treatment Programs', 'Methadone Maintenance Treatment', 'Policy Issues and Challenges in Substance Abuse Treatment' and 'Substance Abuse Treatment and Public Health: Working Together to Benefit Injection Drug Users'.
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Substance abuse among Hispanic Americans Source: Rockville, MD: National Institute on Drug Abuse, U.S. Department of Health and Human Services. 1990. 2 pp.
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Contact: Available from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Telephone: (301) 468-2600 or (800) 729-6686 or (800) 487-4889 TDD / fax: (301) 468-6433 / e-mail:
[email protected] / Web site: http://www.health.org. Single copies available at no charge; $1.00 for each title over 10. Summary: This fact sheet provides an overview of the problem of alcohol and other use among Hispanic Americans. The fact sheet is written in English (page one) and in Spanish (page two).
The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “drug abuse” (or synonyms). The following was recently posted: •
Brief interventions and brief therapies for substance abuse Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2541&nbr=1767&a mp;string=drug+AND+abuse
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Comprehensive case management for substance abuse treatment Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1998; 122 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1564&nbr=790&am p;string=drug+AND+abuse
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Enhancing motivation for change in substance abuse treatment Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2542&nbr=1768&a mp;string=drug+AND+abuse
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Integrating substance abuse treatment and vocational services Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 2000; 225 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2651&nbr=1877&a mp;string=drug+AND+abuse
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Substance abuse among older adults Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1998; 173 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1563&nbr=789&am p;string=drug+AND+abuse
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Substance abuse treatment for persons with child abuse and neglect issues Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 2000; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2543&nbr=1769&a mp;string=drug+AND+abuse
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Substance abuse treatment for persons with HIV/AIDS Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 2000; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2544&nbr=1770&a mp;string=drug+AND+abuse Healthfinder™
Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
Club Drugs: Community Drug Alert Bulletin Summary: This advisory from the Director of the National Institute on Drug Abuse to community leaders, parents and the general public addresses the Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5010
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Cocaine Abuse and Addiction Summary: A compilation of scientific information on cocaine that will help to inform readers about the harmful effects of cocaine abuse, and assist in prevention and treatment efforts. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4472
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Dictionary of Street Drug Slang Summary: Search this site for online assistance in finding basic definitions for some general terms, symbols and acronyms related to substance abuse. Source: Educational Institution--Follow the Resource URL for More Information http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1979
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Does Your Friend Have an Alcohol or Drug Problem?: A Guide For Teens Summary: This brochure advises young people on how to help a friend who may have a substance abuse problem. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5558
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Drug Abuse Source: U.S. Department of Health and Human Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7357
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Drug Abuse Prevention and Education Summary: Parents, health professionals and community workers can find information about effective strategies for preventing drug use, and keeping drugs out of neighborhoods and schools. Source: Office of National Drug Control Policy, The White House http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2146
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Drugs of Abuse Summary: The focus of this publication is the physiological effects of drug abuse. Source: U.S. Department of Justice http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2908
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Employment Opportunities - National Institute on Drug Abuse (NIDA/NIH) Summary: A listing of current job and research development opportunities at NIDA offices--includes all details pertinent to the position and the application procedure and links to other NIH vacancies. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2774
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Epidemiology of Youth Drug Abuse Summary: This section lists selected summaries from NIDA funded research projects that investigate the epidemiology, etiology, and prevention research. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7245
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Feel Better and Stay Safe Summary: Facts for children living with parents and other caregivers who are alcoholics or drug abusers. Source: Children of Alcoholics Foundation http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5664
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Infant, Child, & Adolescent Workgroup - National Institute On Drug Abuse (NIDA) Summary: NIDA is the lead Federal agency for the conduct of basic, clinical, and epidemiological research designed to improve the understanding, treatment, and prevention of drug abuse and addiction and the Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1217
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Keep Your Brain Healthy: Don't Use Drugs Summary: A National Institute on Drug Abuse (NIDA) nation wide public service campaign designed to help America's youth understand the risks associated with drug use. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5503
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Keeping Youth Drug-Free Summary: A substance abuse guide for adults that outlines reasons children give for using drugs. Specific examples teach adults how to address peer pressure among youth and provide other practical skills. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=933
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Making Prevention Work: Actions For African Americans Summary: This fact sheet was written to assist African Americans in supporting drug abuse prevention in their communities. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=919
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Making Prevention Work: Actions For Business Summary: This fact sheet summarizes actions for employers and business owners who want to become part of the drug abuse prevention movement. Workplace policy and prevention are addressed. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=917
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Making Prevention Work: Actions For Colleges And Universities Summary: Ways to deter substance abuse among college students are given. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=923
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Making Prevention Work: Actions For Family Members Of People With Disabilities Summary: People with disabilities are at risk for substance abuse problems. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=929
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Making Prevention Work: Actions For Health Professionals Summary: Health professionals are assisted in identifying and treating substance abuse. Training employers on prevention and learning about local resources are two suggestions. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=912
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Making Prevention Work: Actions For Hispanics/Latinos Summary: This fact sheet lists steps that Hispanics/Latinos can follow to become involved in drug abuse prevention in their communities. Key issues and intervention strategies are explored. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=915
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Making Prevention Work: Actions For Individuals Summary: Every individual can be part of the drug abuse prevention movement. This list of action steps suggests ways for the general population to become involved in prevention. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=914
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Making Prevention Work: Actions For Older Americans Summary: This list provides steps that older Americans can take to prevent alcohol and other drug abuse and remain active and vital members of society. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=913
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Making Prevention Work: Actions For The Judiciary Summary: Professionals in the judicial system can deter substance abuse. Recommendations are made, including types of prevention programs to implement, and ways to involve the community. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=924
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Making Prevention Work: Actions For Parents, Guardians, And Caretakers Summary: This fact sheet calls on all adults to take responsibility for preventing alcohol, tobacco, and drug abuse among America's youth. Specific action steps and suggestions are included. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=920
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Mind Over Matter Series Index Summary: The Mind Over Matter series is designed to encourage young people in grades five through nine to learn about the effects of drug abuse on the body and the brain. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3804
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National Institute on Drug Abuse Prescription Drugs Initiative Summary: NIDA's public health initiative is intended to raise awareness about recent trends in the misuse and abuse of prescription drugs in the United States. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6249
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National Survey on Drug Use and Health Summary: SAMHSA's National Survey on Drug Use & Health [formerly called the National Household Survey on Drug Abuse (NHSDA)] is the primary source of information on the prevalence, patterns, and consequences Source: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4695
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NIDA Public Service Announcements Summary: This page features public service campaigns from NIDA about the risks of alcohol and drug abuse. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6712
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NIDA Publications Catalog Summary: Browse this site for a listing of material -- research monographs, brochures, fact sheets, newsletters, posters, and videos -- available from the National Institute on Drug Abuse. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3808
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NIDA's Asian Americans and Pacific Islanders Calendar--2003 Summary: This is a science-based resource calendar on the health effects of drugs of abuse and on drug addiction, its prevention, and its treatment. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7171
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Notes on Drug Abuse Research, National Institute on Drug Abuse Summary: NIDA Notes is a newsletter that reports on treatment and prevention research, epidemiology, neuroscience, behavioral research, health services research, and AIDS. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=334
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Partnership for a Drug-Free America: Help for Teens Summary: Teenagers can browse through this list to find answers to questions about drugs and drug abuse among their peers. Find out how you can help or get help for a friend with a drug problem. Source: Partnership for a Drug-Free America http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5669
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Prevention Primer Summary: This reference tool targets substance abuse prevention practitioners. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=956
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Principles of Drug Addiction Treatment: A Research-Based Guide Summary: Intended for health care professionals and the general public, this sciencebased guide details principles and concepts to drug addiction treatment. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4880
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Quiz on Drugs Summary: Kids can solve this word quiz and learn the truth about drug abuse. This page is designed especially for Native American children but can benefit all kids. Source: Indian Health Service http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5840
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Safe & Drug Free Schools Program Summary: This is the home page of the Safe and Drug Free Schools Program (SDFSP), the Federal government's primary vehicle for reducing substance abuse, and violence, through education and prevention Source: U.S. Department of Education http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1161
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Sara's Quest Summary: Sara's Quest is a science-based drug abuse educational game. Players search out the correct answers to questions about how marijuana affects the brain. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5668
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Women and Drug Abuse Summary: Today, more than 4 million women in this country use drugs. Women of all ages, races and cultures. Women just like your best friend, your sister, your co-worker, or your daughter. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=876
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Women's Health and Gender Differences: Women and Gender Research Summary: Information related to drug abuse research that focus on women and gender differences. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3810 The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to drug abuse. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources
A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDHealth: http://my.webmd.com/health_topics
Associations and Drug Abuse The following is a list of associations that provide information on and resources relating to drug abuse:
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American Association for the Treatment of Opioid Dependence, Inc Telephone: (212) 566-5555 Fax: (212) 349-2944 Email:
[email protected] Web Site: www.aatod.org Background: The American Association for the Treatment of Opioid Dependence, Inc. was founded in 1984 to promote the growth and development of opioid treatment services. The Association currently represents 20 states and the District of Columbia, providing treatment to individuals in approximately 700 programs. Committed to enhancing the quality of patient care, the American Association for the Treatment of Opioid Dependence, in conjunction with the American Society of Addiction Medicine, developed clinical guidelines to assist individual practitioners and policy makers in the development of effective opioid treatment services. In addition, the Association focuses on federal, state, and program specific treatment policies; advocates on behalf of affected individuals and their families; engages in professional and public education; and promotes the coordination of and communication among opioid treatment programs. The Association also convenes a National Conference every 18 months for researchers, treatment personnel, and policy makers. The Association also provides a variety of materials including fact sheets and brochures, and maintains a website with information about opioid treatment for patients and practitioners, national advisories and policy statements, news from the states, and Conference/Symposium registration materials. Relevant area(s) of interest: Drug Abuse
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Hepatitis Foundation International Telephone: (301) 622-4200 Toll-free: (800) 891-0707 Fax: (301) 622-4702 Email:
[email protected] Web Site: http://www.hepatitisfoundation.org Background: Hepatitis Foundation International (HFI) is a voluntary not-for-profit membership organization dedicated to increasing awareness of the worldwide problem of viral hepatitis and educating the public and health care providers about its prevention, diagnosis, and treatment. Viral hepatitis is inflammatory liver disease caused by viral infection. There are several different forms of viral hepatitis that may be caused by different viruses. Such forms of hepatitis include hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E. Depending upon the specific form of the disease and other factors, viral hepatitis may cause liver cell damage, associated scarring of the liver (cirrhosis), and, in some cases, an increased risk of liver cancer. In some cases, affected individuals may have no apparent symptoms. In other cases, some adults with hepatitis A may have dark urine and light stools and may experience fatigue, nausea, vomiting, fever, abdominal pain, and/or abnormal yellowing of the skin and the whites of the eyes (jaundice). Some individuals with hepatitis B, C, D, or E may have dark urine and light stools and experience mild flu-like symptoms, fatigue, fever, and/or jaundice. Hepatitis Foundation International was established in 1995 and currently consists of approximately 35,000 members. The Foundation focuses exclusively on bringing viral hepatitis under control by supporting research to find cures; providing educational programs and materials to inform health professionals, affected individuals, family
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members, and the public concerning new diagnostic and treatment methods; and offering a support network for those who are affected by viral hepatitis. Hepatitis Foundation International also engages in patient advocacy and lobbying, provides appropriate referrals, and has a registry. The Foundation offers a wide range of educational materials including brochures, posters, information sheets, booklets, a primer for teachers concerning hepatitis B and substance abuse prevention, a coloring book for children, and a regular newsletter entitled 'Hepatitis Alert.'. •
National Healthy Mothers, Healthy Babies Telephone: (703) 836-6110 Fax: (703) 836-3470 Email: None. Web Site: None Background: National Healthy Mothers, Healthy Babies is a not-for-profit, self-help, service organization dedicated to promoting public awareness and education concerning perinatal health issues, particularly preventive health habits for pregnant women and their families. Established in 1990, this national coalition has over 100 members, representing national voluntary organizations, health professional organizations, and the Federal Government. This service group is organized into several working issue committees: adolescent pregnancy, breast feeding promotion, genetics, immunization, injury/violence prevention, oral health, and substance abuse. National Healthy Mothers, Healthy Babies assists the development of state and local Healthy Mothers, Healthy Babies Coalitions. The organization provides technical assistance and resource materials; develops networks for sharing information among groups concerned about improving the health of mothers and babies; and conducts quarterly membership meetings. It promotes maternal and infant health educational campaigns and conducts biennial national conferences for health care professionals and administrators. Healthy Mothers, Healthy Babies also distributes public and professional educational materials including a quarterly newsletter, brochures, audiovisual aids, posters, and resource lists of additional publications.
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to drug abuse. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with drug abuse. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about drug abuse. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797.
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Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “drug abuse” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “drug abuse”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “drug abuse” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “drug abuse” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.27
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
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Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)28: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
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Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries 403
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
404 Drug Abuse
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
405
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on drug abuse: •
Basic Guidelines for Drug Abuse Drug abuse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm Drug abuse and dependence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001522.htm Drug abuse first aid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000016.htm
•
Signs & Symptoms for Drug Abuse Abdominal cramping Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Agitation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm
406 Drug Abuse
Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Ataxia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003198.htm Behavior changes Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003255.htm Bluish lips and fingernails Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003215.htm Changes in behavior Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003255.htm Clammy skin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003216.htm Cold sweat Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003216.htm Coma Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Convulsions Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Diarrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm Difficulty breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Dizziness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm Double vision Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003029.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Excitement Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm
Online Glossaries 407
Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Flushing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003241.htm Frightening hallucinations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003258.htm Hallucinations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003258.htm High blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003082.htm Hyperactivity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003256.htm Impaired memory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003257.htm Insomnia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Lack of coordination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003198.htm Loss of consciousness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Memory loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003257.htm Muscle rigidity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Obesity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003101.htm Paleness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003244.htm Rapid breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003071.htm Rapid heart rate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm
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Respiratory arrest Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003069.htm Restlessness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Seizures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Sleep disturbances Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Sleepiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Slurred speech Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003204.htm Staggering Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003199.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Sweating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Tachycardia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm Tachypnea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003071.htm Tension Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Unsteady gait Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003199.htm Vomit Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm
Online Glossaries 409
•
Diagnostics and Tests for Drug Abuse Attention span Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003326.htm Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm Cocaine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm Heart rate Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm Heroin Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm Hydromorphone Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm Phencyclidine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm Pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm THC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm
•
Nutrition for Drug Abuse Caffeine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002445.htm
•
Background Topics for Drug Abuse Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Alcoholism - support group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002199.htm Allergic reaction Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000005.htm Analgesic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm Analgesics Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm
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Cannabis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm Central nervous system Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002311.htm Chemical dependence - support group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002169.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Convulsion, first aid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000021.htm Deodorants Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002696.htm Drug abuse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm Drug abuse first aid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000016.htm Gasoline Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002806.htm Hallucinogens Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm Illicit drug use Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm INCIDENCE Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Intravenous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002383.htm Labored breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000007.htm LSD Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm Marijuana Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm Metabolite Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002258.htm
Online Glossaries 411
Respiratory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002290.htm Self-help groups Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002150.htm Shock Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000039.htm Stimulants Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002308.htm Stimuli Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002309.htm Support groups Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002150.htm Symptomatic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002293.htm Typewriter correction fluid Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002909.htm Unconscious Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000022.htm Unconsciousness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000022.htm Vital signs Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002341.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
413
DRUG ABUSE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Acculturation: Process of cultural change in which one group or members of a group assimilates various cultural patterns from another. [NIH] Acetaldehyde: A colorless, flammable liquid used in the manufacture of acetic acid, perfumes, and flavors. It is also an intermediate in the metabolism of alcohol. It has a general narcotic action and also causes irritation of mucous membranes. Large doses may cause death from respiratory paralysis. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and
414 Drug Abuse
biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adolescent Behavior: Any observable response or action of an adolescent. [NIH] Adolescent Medicine: A branch of medicine pertaining to the diagnosis and treatment of diseases occurring during the period beginning with puberty until the cessation of somatic growth. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Obstruction: Any hindrance to the passage of air into and out of the lungs. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH]
Dictionary 415
Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allium: A genus of liliaceous herbs containing onions (Allium cepa), garlic (Allium sativum), and others; many produce pungent, often bacteriostatic and physiologically active compounds and are used as food, condiment, and medicament, the latter in traditional medicine. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alum: A type of immune adjuvant (a substance used to help boost the immune response to a vaccine). Also called aluminum sulfate. [NIH] Amalgamation: The formation of an amalgam. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints,
416 Drug Abuse
heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anionic: Pertaining to or containing an anion. [EU] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antecedent: Existing or occurring before in time or order often with consequential effects. [EU]
Anthropology: The science devoted to the comparative study of man. [NIH] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of
Dictionary 417
which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antibody Affinity: A measure of the binding strength between antibody and a simple hapten or antigen determinant. It depends on the closeness of stereochemical fit between antibody combining sites and antigen determinants, on the size of the area of contact between them, and on the distribution of charged and hydrophobic groups. It includes the concept of "avidity," which refers to the strength of the antigen-antibody bond after formation of reversible complexes. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several monoamine oxidase inhibitors are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents also appear to act through brain catecholamine systems. A third group (antidepressive agents, secondgeneration) is a diverse group of drugs including some that act specifically on serotonergic systems. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic
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and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antithrombotic: Preventing or interfering with the formation of thrombi; an agent that so acts. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Approximate: Approximal [EU] Aqueous: Having to do with water. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Articular: Of or pertaining to a joint. [EU] Artifacts: Any visible result of a procedure which is caused by the procedure itself and not by the entity being analyzed. Common examples include histological structures introduced by tissue processing, radiographic images of structures that are not naturally present in living tissue, and products of chemical reactions that occur during analysis. [NIH] Artificial Organs: Devices intended to replace non-functioning organs. They may be temporary or permanent. Since they are intended always to function as the natural organs they are replacing, they should be differentiated from prostheses and implants and specific types of prostheses which, though also replacements for body parts, are frequently cosmetic (artificial eye) as well as functional (artificial limbs). [NIH] Aspartate: A synthetic amino acid. [NIH] Aspiration: The act of inhaling. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition,
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or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Audiovisual Aids: Auditory and visual instructional materials. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Auricular: Pertaining to an auricle or to the ear, and, formerly, to an atrium of the heart. [EU] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Avidity: The strength of the interaction of an antiserum with a multivalent antigen. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Barbiturates: A class of chemicals derived from barbituric acid or thiobarbituric acid. Many of these are medically important as sedatives and hypnotics (sedatives, barbiturate), as anesthetics, or as anticonvulsants. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form
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salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Behavioral Sciences: Disciplines concerned with the study of human and animal behavior. [NIH]
Benchmarking: Method of measuring performance against established standards of best practice. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Beta-Endorphin: A peptide consisting of amino acid sequence 61-91 of the endogenous pituitary hormone beta-lipotropin. The first four amino acids show a common tetrapeptide sequence with methionine- and leucine enkephalin. The compound shows opiate-like activity. Injection of beta-endorphin induces a profound analgesia of the whole body for several hours. This action is reversed after administration of naloxone. [NIH] Beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. EC 3.5.2.6. [NIH] Beta-pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc. [NIH] Biological Psychiatry: An interdisciplinary science concerned with studies of the biological bases of behavior - biochemical, genetic, physiological, and neurological - and applying these to the understanding and treatment of mental illness. [NIH] Biological Sciences: All of the divisions of the natural sciences dealing with the various aspects of the phenomena of life and vital processes. The concept includes anatomy and physiology, biochemistry and biophysics, and the biology of animals, plants, and microorganisms. It should be differentiated from biology, one of its subdivisions, concerned
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specifically with the origin and life processes of living organisms. [NIH] Biomedical Engineering: Application of principles and practices of engineering science to biomedical research and health care. [NIH] Biophysics: The science of physical phenomena and processes in living organisms. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bivalent: Pertaining to a group of 2 homologous or partly homologous chromosomes during the zygotene stage of prophase to the first metaphase in meiosis. [NIH] Bladder: The organ that stores urine. [NIH] Blennorrhoea: A general term including any inflammatory process of the external eye which gives a mucoid discharge, more exactly, a discharge of mucus. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH]
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Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breast Feeding: The nursing of an infant at the mother's breast. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Buprenorphine: A derivative of the opioid alkaloid thebaine that is a more potent and longer lasting analgesic than morphine. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use. [NIH] Butorphanol: A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Cannabidiol: Compound isolated from Cannabis sativa extract. [NIH] Cannabinoids: Compounds extracted from Cannabis sativa L. and metabolites having the cannabinoid structure. The most active constituents are tetrahydrocannabinol, cannabinol, and cannabidiol. [NIH] Cannabinol: A physiologically inactive constituent of Cannabis sativa L. [NIH] Cannabis: The hemp plant Cannabis sativa. Products prepared from the dried flowering tops of the plant include marijuana, hashish, bhang, and ganja. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU]
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Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cefoxitin: Semisynthetic cephamycin antibiotic resistant to beta-lactamase. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the
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brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chancroid: Acute, localized autoinoculable infectious disease usually acquired through sexual contact. Caused by Haemophilus ducreyi, it occurs endemically almost worldwide, especially in tropical and subtropical countries and more commonly in seaports and urban areas than in rural areas. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemical Warfare: Tactical warfare using incendiary mixtures, smokes, or irritant, burning, or asphyxiating gases. [NIH] Chemical Warfare Agents: Chemicals that are used to cause the disturbance, disease, or death of humans during war. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Child Behavior: Any observable response or action of a child from 24 months through 12 years of age. For neonates or children younger than 24 months, infant behavior is available. [NIH]
Child Care: Care of children in the home or institution. [NIH] Child Welfare: Organized efforts by communities or organizations to improve the health and well-being of the child. [NIH] Chlamydia: A genus of the family Chlamydiaceae whose species cause a variety of diseases in vertebrates including humans, mice, and swine. Chlamydia species are gram-negative and produce glycogen. The type species is Chlamydia trachomatis. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become
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confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Chromaffin System: The cells of the body which stain with chromium salts. They occur along the sympathetic nerves, in the adrenal gland, and in various other organs. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Coal: A natural fuel formed by partial decomposition of vegetable matter under certain environmental conditions. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive Therapy: A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. [NIH]
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Coke: A residue of coal, left after dry (destructive) distillation, used as a fuel. [NIH] Colchicine: A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (periodic disease). [NIH] Communicable disease: A disease that can be transmitted by contact between persons. [NIH] Communication Barriers: Those factors, such as language or sociocultural relationships, which interfere in the meaningful interpretation and transmission of ideas between individuals or groups. [NIH] Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Competency: The capacity of the bacterium to take up DNA from its surroundings. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH]
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Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compulsion: In psychology, an irresistible urge, sometimes amounting to obsession to perform a particular act which usually is carried out against the performer's will or better judgment. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Concept Formation: A cognitive process involving the formation of ideas generalized from the knowledge of qualities, aspects, and relations of objects. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective tissue: The supporting or framework tissue of the animal body, formed of fibrous and ground substance with more or less numerous cells of various kinds. [NIH] Connective tissue: The supporting or framework tissue of the animal body, formed of fibrous and ground substance with more or less numerous cells of various kinds. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH]
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Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]
Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Convulsion: A violent involuntary contraction or series of contractions of the voluntary muscles. [EU] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or
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clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Cost-benefit: A quantitative technique of economic analysis which, when applied to radiation practice, compares the health detriment from the radiation doses concerned with the cost of radiation dose reduction in that practice. [NIH] Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results. [NIH] Crack Cocaine: The purified, alkaloidal, extra-potent form of cocaine. It is smoked (freebased), injected intravenously, and orally ingested. Use of crack results in alterations in function of the cardiovascular system, the autonomic nervous system, the central nervous system, and the gastrointestinal system. The slang term "crack" was derived from the crackling sound made upon igniting of this form of cocaine for smoking. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]
Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Creatinine clearance: A test that measures how efficiently the kidneys remove creatinine and other wastes from the blood. Low creatinine clearance indicates impaired kidney function. [NIH] Criminology: The study of crime and criminals with special reference to the personality factors and social conditions leading toward, or away from crime. [NIH] Criterion: A standard by which something may be judged. [EU] Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Cultured cells: Animal or human cells that are grown in the laboratory. [NIH] Curative: Tending to overcome disease and promote recovery. [EU]
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Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytidine: A pyrimidine nucleoside that is composed of the base cytosine linked to the fivecarbon sugar D-ribose. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Death Certificates: Official records of individual deaths including the cause of death certified by a physician, and any other required identifying information. [NIH] Deception: The act of deceiving or the fact or condition of being deceived. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Decontamination: The removal of contaminating material, such as radioactive materials, biological materials, or chemical warfare agents, from a person or object. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment.
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Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Designer Drugs: Drugs designed and synthesized, often for illegal street use, by modification of existing drug structures (e.g., amphetamines). Of special interest are MPTP (a reverse ester of meperidine), MDA (3,4-methylenedioxyamphetamine), and MDMA (3,4methylenedioxymethamphetamine). Many drugs act on the aminergic system, the physiologically active biogenic amines. [NIH] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH]
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Detoxification: Treatment designed to free an addict from his drug habit. [EU] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Dextromethorphan: The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is a NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is used widely as an antitussive agent, and is also used to study the involvement of glutamate receptors in neurotoxicity. [NIH] Dextrorphan: Dextro form of levorphanol. It acts as a noncompetitive NMDA receptor antagonist, among other effects, and has been proposed as a neuroprotective agent. It is also a metabolite of dextromethorphan. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diethylproprion: An appetite suppressant prescribed in the treatment of obesity. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place,
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or identity. [EU] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH] Disposition: A tendency either physical or mental toward certain diseases. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dissociative Disorders: Sudden temporary alterations in the normally integrative functions of consciousness. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Domestic Violence: Deliberate, often repetitive, physical abuse by one family member against another: marital partners, parents, children, siblings, or any other member of a household. [NIH] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Doping: The action of administering a drug to someone before a sports event (originally to a horse before a race); the substance thus administered. [EU] Drinking Behavior: Behaviors associated with the ingesting of water and other liquids; includes rhythmic patterns of drinking (time intervals - onset and duration), frequency and satiety. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Dronabinol: A synthetic pill form of delta-9-tetrahydrocannabinol (THC), an active ingredient in marijuana that is used to treat nausea and vomiting associated with cancer chemotherapy. [NIH] Drug Delivery Systems: Systems of administering drugs through controlled delivery so that an optimum amount reaches the target site. Drug delivery systems encompass the carrier, route, and target. [NIH]
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Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dynorphins: A class of opioid peptides including dynorphin A, dynorphin B, and smaller fragments of these peptides. Dynorphins prefer kappa-opioid receptors (receptors, opioid, kappa) and have been shown to play a role as central nervous system transmitters. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Educational Status: Educational attainment or level of education of individuals. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elasticity: Resistance and recovery from distortion of shape. [NIH] Electroencephalography: Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the
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latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryology: The study of the development of an organism during the embryonic and fetal stages of life. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endophthalmitis: Suppurative inflammation of the tissues of the internal structures of the eye; not all layers of the uvea are affected. Fungi, necrosis of intraocular tumors, and retained intraocular foreign bodies often cause a purulent endophthalmitis. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used
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for the broader group. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enhancers: Transcriptional element in the virus genome. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme-Linked Immunosorbent Assay: An immunoassay utilizing an antibody labeled with an enzyme marker such as horseradish peroxidase. While either the enzyme or the antibody is bound to an immunosorbent substrate, they both retain their biologic activity; the change in enzyme activity as a result of the enzyme-antibody-antigen reaction is proportional to the concentration of the antigen and can be measured spectrophotometrically or with the naked eye. Many variations of the method have been developed. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] ERV: The expiratory reserve volume is the largest volume of gas that can be expired from the end-expiratory level. [NIH] Erythrocyte Volume: Volume of circulating erythrocytes. It is usually measured by
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radioisotope dilution technique. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Escalation: Progressive use of more harmful drugs. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Euphoria: An exaggerated feeling of physical and emotional well-being not consonant with apparent stimuli or events; usually of psychologic origin, but also seen in organic brain disease and toxic states. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocytosis: Cellular release of material within membrane-limited vesicles by fusion of the vesicles with the cell membrane. [NIH] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Expiratory Reserve Volume: The extra volume of air that can be expired with maximum effort beyond the level reached at the end of a normal, quiet expiration. Common abbreviation is ERV. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Family Characteristics: Size and composition of the family. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH] Father-Child Relations: Interaction between the father and the child. [NIH] Fathers: Male parents, human or animal. [NIH]
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Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fentanyl: A narcotic opioid drug that is used in the treatment of pain. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH] Flumazenil: A potent benzodiazepine receptor antagonist. Since it reverses the sedative and other actions of benzodiazepines, it has been suggested as an antidote to benzodiazepine overdoses. [NIH] Flunitrazepam: Benzodiazepine with pharmacologic actions similar to those of diazepam. The United States Government has banned the importation of this drug. Steps are being taken to reclassify this substance as a Schedule 1 drug with no accepted medical use. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Flupenthixol: This tranquilizer seems to be a dopamine-receptor blocker. It works primarily on the D2 receptors, with some effects on the D1 receptors. Craving in some cocaine addicts becomes manageable but is not eliminated. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Food Deprivation: The withholding of food in a structured experimental situation. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Forensic Medicine: The application of medical knowledge to questions of law. [NIH] Fourth Ventricle: An irregularly shaped cavity in the rhombencephalon, between the medulla oblongata, the pons, and the isthmus in front, and the cerebellum behind. It is continuous with the central canal of the cord below and with the cerebral aqueduct above, and through its lateral and median apertures it communicates with the subarachnoid space.
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[NIH]
Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Functional magnetic resonance imaging: A noninvasive tool used to observe functioning in the brain or other organs by detecting changes in chemical composition, blood flow, or both. [NIH]
Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gait: Manner or style of walking. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma-hydroxybutyrate: Anxiolytic. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestures: Movement of a part of the body for the purpose of communication. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [NIH] Gluconeogenesis: The process by which glucose is formed from a non-carbohydrate source.
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[NIH]
Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Gonorrhoea: Infection due to Neisseria gonorrhoeae transmitted sexually in most cases, but also by contact with infected exudates in neonatal children at birth, or by infants in households with infected inhabitants. It is marked in males by urethritis with pain and purulent discharge, but is commonly asymptomatic in females, although it may extend to produce suppurative salpingitis, oophoritis, tubo-ovarian abscess, and peritonitis. Bacteraemia occurs in both sexes, resulting in cutaneous lesions, arthritis, and rarely meningitis or endocarditis. Formerly called blennorrhagia and blennorrhoea. [EU] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into
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three groups: neutrophils, eosinophils, and basophils. [NIH] Granulomas: Small lumps in tissues caused by inflammation. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Habituation: Decline in response of an organism to environmental or other stimuli with repeated or maintained exposure. [NIH] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Hallucinogen: A hallucination-producing drug, a category of drugs producing this effect. The user of a hallucinogenic drug is almost invariably aware that what he is seeing are hallucinations. [NIH] Haloperidol: Butyrophenone derivative. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH]
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Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heroin Dependence: Strong dependence, both physiological and emotional, upon heroin. [NIH]
Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes
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simplex or to herpes zoster. [EU] Herpes virus: A member of the herpes family of viruses. [NIH] Herpes Zoster: Acute vesicular inflammation. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Homeless Persons: Persons who have no permanent residence. The concept excludes nomadic peoples. [NIH] Homeless Youth: Runaway and homeless children and adolescents living on the streets of cities and having no fixed place of residence. [NIH] Homicide: The killing of one person by another. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horseradish Peroxidase: An enzyme isolated from horseradish which is able to act as an antigen. It is frequently used as a histochemical tracer for light and electron microscopy. Its antigenicity has permitted its use as a combined antigen and marker in experimental immunology. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydromorphone: An opioid analgesic made from morphine and used mainly as an analgesic. It has a shorter duration of action than morphine. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels
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are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypodermic: Applied or administered beneath the skin. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Ibogaine: One of several indole alkaloids extracted from Tabernanthe iboga, Baill. It has a complex pharmacological profile and interacts with multiple systems of neurotransmission. Ibogaine has psychoactive properties and appears to modulate tolerance to opiates. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Illusions: The misinterpretation of a real external, sensory experience. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH]
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Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impulsive Behavior: An act performed without delay, reflection, voluntary direction, or obvious control in response to a stimulus. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incarceration: Abnormal retention or confinement of a body part; specifically : a constriction of the neck of a hernial sac so that the hernial contents become irreducible. [EU] Incision: A cut made in the body during surgery. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infant Behavior: Any observable response or action of a neonate or infant up through the age of 23 months. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infection Control: Programs of disease surveillance, generally within health care facilities, designed to investigate, prevent, and control the spread of infections and their causative microorganisms. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU]
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Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Institutionalization: The caring for individuals in institutions and their adaptation to routines characteristic of the institutional environment, and/or their loss of adaptation to life outside the institution. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interindividual: Occurring between two or more individuals. [EU] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intervention Studies: Epidemiologic investigations designed to test a hypothesized causeeffect relation by modifying the supposed causal factor(s) in the study population. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraocular: Within the eye. [EU] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a
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gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]
Jealousy: An irrational reaction compounded of grief, loss of self-esteem, enmity against the rival and self criticism. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Juvenile Delinquency: The antisocial acts of children or persons under age which are illegal or lawfully interpreted as constituting delinquency. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratoconjunctivitis: Simultaneous inflammation of the cornea and conjunctiva. [NIH] Keratoconjunctivitis Sicca: Drying and inflammation of the conjunctiva as a result of insufficient lacrimal secretion. When found in association with xerostomia and polyarthritis, it is called Sjogren's syndrome. [NIH] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lacrimal: Pertaining to the tears. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Length of Stay: The period of confinement of a patient to a hospital or other health facility. [NIH]
Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine.
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Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Litter: Appliance consisting of an oblong frame over which is stretched a canvas or other material, used for carrying an injured or disabled person. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]
Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Local Government: Smallest political subdivisions within a country at which general governmental functions are carried-out. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU]
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Locus Coeruleus: Bluish region in the superior angle of the fourth ventricle floor, corresponding to melanin-like pigmented nerve cells which lie lateral to the pontomesencephalic central gray (griseum centrale). It is also known as nucleus pigmentosus pontis. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lysergic acid: A compound close in chemical structure to LSD-25 but without hallucinogenic effects; one of the direct chemical predecessors of LSD-25. Sometimes LSD-25 is erroneously called by this name. [NIH] Lysergic Acid Diethylamide: Semisynthetic derivative of ergot (Claviceps purpurea). It has complex effects on serotonergic systems including antagonism at some peripheral serotonin receptors, both agonist and antagonist actions at central nervous system serotonin receptors, and possibly effects on serotonin turnover. It is a potent hallucinogen, but the mechanisms of that effect are not well understood. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH]
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Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mandatory Testing: Testing or screening required by federal, state, or local law or other agencies for the diagnosis of specified conditions. It is usually limited to specific populations such as categories of health care providers, members of the military, and prisoners or to specific situations such as premarital examinations or donor screening. [NIH] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Marital Status: A demographic parameter indicating a person's status with respect to marriage, divorce, widowhood, singleness, etc. [NIH] Mass Media: Instruments or technological means of communication that reach large numbers of people with a common message: press, radio, television, etc. [NIH] Maternal Deprivation: Prolonged separation of the offspring from the mother. [NIH] Maternal Exposure: Exposure of the female parent, human or animal, to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals that may affect offspring. It includes pre-conception maternal exposure. [NIH] Maximum Tolerated Dose: The highest dose level eliciting signs of toxicity without having major effects on survival relative to the test in which it is used. [NIH] Mazindol: Tricyclic anorexigenic agent unrelated to and less toxic than amphetamine, but with some similar side effects. It inhibits uptake of catecholamines and blocks the binding of cocaine to the dopamine uptake transporter. [NIH] Meconium: The thick green-to-black mucilaginous material found in the intestines of a fullterm fetus. It consists of secretions of the intestinal glands, bile pigments, fatty acids, amniotic fluid, and intrauterine debris. It constitutes the first stools passed by a newborn. [NIH]
Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH]
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Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Memantine: Amantadine derivative that has some dopaminergic effects. It has been proposed as an antiparkinson agent. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Health Services: Organized services to provide mental health care. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Meperidine: 1-Methyl-4-phenyl-4-piperidinecarboxylic acid ethyl ester. A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration. [NIH] Mesencephalic: Ipsilateral oculomotor paralysis and contralateral tremor, spasm. or choreic movements of the face and limbs. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metaphase: The second phase of cell division, in which the chromosomes line up across the equatorial plane of the spindle prior to separation. [NIH] Methamphetamine: A central nervous system stimulant and sympathomimetic with actions and uses similar to dextroamphetamine. The smokable form is a drug of abuse and is referred to as crank, crystal, crystal meth, ice, and speed. [NIH]
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Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiological: Pertaining to microbiology : the science that deals with microorganisms, including algae, bacteria, fungi, protozoa and viruses. [EU] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Minority Groups: A subgroup having special characteristics within a larger group, often bound together by special ties which distinguish it from the larger group. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]
Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other
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procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Morale: The prevailing temper or spirit of an individual or group in relation to the tasks or functions which are expected. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motivations: The most compelling inner determinants of human behavior; also called drives, urges, impulses, needs, wants, tensions, and willful cravings. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucilaginous: Pertaining to or secreting mucus. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myalgia: Pain in a muscle or muscles. [EU] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the
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heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myoglobin: A conjugated protein which is the oxygen-transporting pigment of muscle. It is made up of one globin polypeptide chain and one heme group. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle Sharing: Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease. [NIH] Needle-Exchange Programs: Organized services for exchange of sterile needles and syringes used for injections as a potential means of reducing the transmission of infectious diseases. [NIH]
Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH]
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Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephrology: A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]
Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroendocrinology: The study of the anatomical and functional relationships between the nervous system and the endocrine system. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurologist: A doctor who specializes in the diagnosis and treatment of disorders of the nervous system. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous
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system. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neuropharmacology: The branch of pharmacology dealing especially with the action of drugs upon various parts of the nervous system. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neurosciences: The scientific disciplines concerned with the embryology, anatomy, physiology, biochemistry, pharmacology, etc., of the nervous sytem. [NIH] Neurosecretory Systems: A system of neurons that has the specialized function to produce and secrete hormones, and that constitutes, in whole or in part, an endocrine organ or system. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]
Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] N-methyl: A synthetic amino acid. [NIH] N-methyl-D-aspartate: A synthetic amino acid. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH]
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Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Obsession: A recurrent, persistent thought, image, or impulse that is unwanted and distressing (ego-dystonic) and comes involuntarily to mind despite attempts to ignore or suppress it. Common obsessions involve thoughts of violence, contamination, and selfdoubt. [EU] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Ofloxacin: An orally administered broad-spectrum quinolone antibacterial drug active against most gram-negative and gram-positive bacteria. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oophoritis: Inflammation of an ovary. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operating Rooms: Facilities equipped for performing surgery. [NIH] Opioid Peptides: The endogenous peptides with opiate-like activity. The three major classes currently recognized are the enkephalins, the dynorphins, and the endorphins. Each of these families derives from different precursors, proenkephalin, prodynorphin, and proopiomelanocortin, respectively. There are also at least three classes of opioid receptors, but the peptide families do not map to the receptors in a simple way. [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Oral Health: The optimal state of the mouth and normal functioning of the organs of the
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mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Orderly: A male hospital attendant. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Osteosclerosis: An abnormal hardening or increased density of bone tissue. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxycodone: Semisynthetic derivative of codeine that acts as a narcotic analgesic more potent and addicting than codeine. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Paranoia: A psychotic disorder marked by persistent delusions of persecution or delusional jealousy and behaviour like that of the paranoid personality, such as suspiciousness, mistrust, and combativeness. It differs from paranoid schizophrenia, in which hallucinations or formal thought disorder are present, in that the delusions are logically consistent and that
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there are no other psychotic features. The designation in DSM III-R is delusional (paranoid) disorders, with five types : persecutory, jealous, erotomanic, somatic, and grandiose. [EU] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Particle: A tiny mass of material. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pelvic: Pertaining to the pelvis. [EU] Pemoline: A central nervous system stimulant used in fatigue and depressive states and to treat hyperkinetic disorders in children. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perceived risk: Estimate or evaluation of risk as observed through personal experience or personal study, and personal evaluation of consequences. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pergolide: A long-acting dopamine agonist which is effective in the treatment of Parkinson's disease and hyperprolactinemia. It has also been observed to have antihypertensive effects.
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[NIH]
Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] Personnel Management: Planning, organizing, and administering all activities related to personnel. [NIH] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmacist: A person trained to prepare and distribute medicines and to give information about them. [NIH] Pharmacodynamic: Is concerned with the response of living tissues to chemical stimuli, that is, the action of drugs on the living organism in the absence of disease. [NIH] Pharmacogenetics: A branch of genetics which deals with the genetic components of variability in individual responses to and metabolism (biotransformation) of drugs. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenazopyridine: A local anesthetic that has been used in urinary tract disorders. Its use is limited by problems with toxicity (primarily blood disorders) and potential carcinogenicity. [NIH]
Phencyclidine: A hallucinogen formerly used as a veterinary anesthetic, and briefly as a general anesthetic for humans. Phencyclidine is similar to ketamine in structure and in many of its effects. Like ketamine, it can produce a dissociative state. It exerts its pharmacological action through inhibition of NMDA receptors (receptors, N-methyl-Daspartate). As a drug of abuse, it is known as PCP and Angel Dust. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phenylpropanolamine: A sympathomimetic that acts mainly by causing release of norepinephrine but also has direct agonist activity at some adrenergic receptors. It is most
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commonly used as a nasal vasoconstrictor and an appetite depressant. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Plague: An acute infectious disease caused by Yersinia pestis that affects humans, wild rodents, and their ectoparasites. This condition persists due to its firm entrenchment in sylvatic rodent-flea ecosystems throughout the world. Bubonic plague is the most common form. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma Volume: Volume of plasma in the circulation. It is usually measured by indicator dilution techniques. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyarthritis: An inflammation of several joints together. [EU] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH]
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Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Post-traumatic stress disorder: A psychological disorder that develops in some individuals after a major traumatic experience such as war, rape, domestic violence, or accident. [NIH] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Preferred Provider Organizations: Arrangements negotiated between a third-party payer (often a self-insured company or union trust fund) and a group of health-care providers (hospitals and physicians) who furnish services at lower than usual fees, and, in return, receive prompt payment and an expectation of an increased volume of patients. [NIH] Prejudice: A preconceived judgment made without adequate evidence and not easily alterable by presentation of contrary evidence. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prescription drug abuse: Using two or more drugs interchangeably in an attempt to counteract the adverse effects of one with the other or to potentiate the effects of one with the other, so that an interdependent habit requiring both is formed. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU]
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Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Preventive Medicine: A medical specialty primarily concerned with prevention of disease and the promotion and preservation of health in the individual. [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Professional Practice: The use of one's knowledge in a particular profession. It includes, in the case of the field of biomedicine, professional activities related to health care and the actual performance of the duties related to the provision of health care. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prone: Having the front portion of the body downwards. [NIH] Pro-Opiomelanocortin: A precursor protein, MW 30,000, synthesized mainly in the anterior pituitary gland but also found in the hypothalamus, brain, and several peripheral tissues. It incorporates the amino acid sequences of ACTH and beta-lipotropin. These two hormones, in turn, contain the biologically active peptides MSH, corticotropin-like intermediate lobe peptide, alpha-lipotropin, endorphins, and methionine enkephalin. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed
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and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostitution: The practice of indulging in promiscuous sexual relations for money. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Conformation: The characteristic 3-dimensional shape of a protein, including the secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Proxy: A person authorized to decide or act for another person, for example, a person having durable power of attorney. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychology, Social: The branch of psychology concerned with the effects of group membership upon the behavior, attitudes, and beliefs of an individual. [NIH] Psychometrics: Assessment of psychological variables by the application of mathematical procedures. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychomotor Performance: The coordination of a sensory or ideational (cognitive) process
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and a motor activity. [NIH] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Psychotropic Drugs: A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents). [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Assistance: Financial assistance to impoverished persons for the essentials of living through federal, state or local government programs. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the
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medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptivity: The condition of the reproductive organs of a female flower that permits effective pollination. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH]
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Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reference point: The midpoint of a line connecting the centers of the two end faces of the acoustic test fixture. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Rehabilitative: Instruction of incapacitated individuals or of those affected with some mental disorder, so that some or all of their lost ability may be regained. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal amyloidosis: A disease of unknown etiology characterized by the abnormal deposition of amyloid, a translucent homogenous glycoprotein, in various organs and tissues of the body. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory Paralysis: Complete or severe weakness of the muscles of respiration. This condition may be associated with motor neuron diseases; peripheral nerve disorders; neuromuscular junction diseases; spinal cord diseases; injury to the phrenic nerve; and other disorders. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines
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with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rhabdomyolysis: Necrosis or disintegration of skeletal muscle often followed by myoglobinuria. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk-Taking: Undertaking a task involving a challenge for achievement or a desirable goal in which there is a lack of certainty or a fear of failure. It may also include the exhibiting of certain behaviors whose outcomes may present a risk to the individual or to those associated with him or her. [NIH] Risperidone: A selective blocker of dopamine D2 and serotonin-5-HT-2 receptors that acts as an atypical antipsychotic agent. It has been shown to improve both positive and negative symptoms in the treatment of schizophrenia. [NIH] Robotics: The application of electronic, computerized control systems to mechanical devices designed to perform human functions. Formerly restricted to industry, but nowadays applied to artificial organs controlled by bionic (bioelectronic) devices, like automated insulin pumps and other prostheses. [NIH] Role Playing: The adopting or performing the role of another significant individual in order to gain insight into the behavior of that person. [NIH] Role-play: In this method, a conflict is artificially constructed, and the trainee is given a strategic position in it. [NIH] Rural Population: The inhabitants of rural areas or of small towns classified as rural. [NIH] Safe Sex: Sex behavior that prevents or decreases the spread of sexually transmitted diseases or pregnancy. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Salpingitis: 1. Inflammation of the uterine tube. 2. Inflammation of the auditory tube. [EU] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or
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computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sedatives, Barbiturate: Those derivatives of barbituric or thiobarbituric acid that are used as hypnotics or sedatives. The structural class of all such derivatives, regardless of use, is barbiturates. [NIH] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selection Bias: The introduction of error due to systematic differences in the characteristics between those selected and those not selected for a given study. In sampling bias, error is the result of failure to ensure that all members of the reference population have a known chance of selection in the sample. [NIH] Selegiline: A selective, irreversible inhibitor of Type B monoamine oxidase. It is used in newly diagnosed patients with Parkinson's disease. It may slow progression of the clinical disease and delay the requirement for levodopa therapy. It also may be given with levodopa
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upon onset of disability. (From AMA Drug Evaluations Annual, 1994, p385) The compound without isomeric designation is Deprenyl. [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Self Administration: Administration of a drug or chemical by the individual under the direction of a physician. It includes administration clinically or experimentally, by human or animal. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Sexual Partners: Married or single individuals who share sexual relations. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Sicca: Failure of lacrimal secretion, keratoconjunctivitis sicca, failure of secretion of the
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salivary glands and mucous glands of the upper respiratory tract and polyarthritis. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sign Language: A system of hand gestures used for communication by the deaf or by people speaking different languages. [NIH] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Single Parent: A natural, adoptive, or substitute parent of a dependent child, who lives with only one parent. The single parent may live with or visit the child. The concept includes the never-married, as well as the divorced and widowed. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep Deprivation: The state of being deprived of sleep under experimental conditions, due to life events, or from a wide variety of pathophysiologic causes such as medication effect, chronic illness, psychiatric illness, or sleep disorder. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smiling: A facial expression which may denote feelings of pleasure, affection, amusement, etc. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Behavior: Any behavior caused by or affecting another individual, usually of the same species. [NIH] Social Class: A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income. [NIH]
Social Conditions: The state of society as it exists or in flux. While it usually refers to society as a whole in a specified geographical or political region, it is applicable also to restricted strata of a society. [NIH]
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Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Problems: Situations affecting a significant number of people, that are believed to be sources of difficulty or threaten the stability of the community, and that require programs of amelioration. [NIH] Social Sciences: Disciplines concerned with the interrelationships of individuals in a social environment including social organizations and institutions. Includes Sociology and Anthropology. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Socialization: The training or molding of an individual through various relationships, educational agencies, and social controls, which enables him to become a member of a particular society. [NIH] Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrometer: An apparatus for determining spectra; measures quantities such as wavelengths and relative amplitudes of components. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU]
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Spike: The activation of synapses causes changes in the permeability of the dendritic membrane leading to changes in the membrane potential. This difference of the potential travels along the axon of the neuron and is called spike. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spirochete: Lyme disease. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Standardize: To compare with or conform to a standard; to establish standards. [EU] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Sterile: Unable to produce children. [NIH] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Streptomycin: O-2-Deoxy-2-(methylamino)-alpha-L-glucopyranosyl-(1-2)-O-5- deoxy-3-Cformyl-alpha-L-lyxofuranosyl-(1-4)-N,N'-bis(aminoiminomethyl)-D-streptamine. Antibiotic substance produced by the soil actinomycete Streptomyces griseus. It acts by inhibiting the initiation and elongation processes during protein synthesis. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU]
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Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substrate: A substance upon which an enzyme acts. [EU] Sulbactam: A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of
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another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]
Systemic: Affecting the entire body. [NIH] Talc: A native magnesium silicate. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Technology Transfer: Spread and adoption of inventions and techniques from one geographic area to another, from one discipline to another, or from one sector of the economy to another. For example, improvements in medical equipment may be transferred from industrial countries to developing countries, advances arising from aerospace engineering may be applied to equipment for persons with disabilities, and innovations in science arising from government research are made available to private enterprise. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutic Community: Psychotherapeutic technique which emphasizes socioenvironmental and interpersonal influences in the resocialization and rehabilitation of the patient. The setting is usually a hospital unit or ward in which professional and nonprofessional staff interact with the patients. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases,
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palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Tranquilizing Agents: A traditional grouping of drugs said to have a soothing or calming effect on mood, thought, or behavior. Included here are the anti-anxiety agents (minor tranquilizers), antimanic agents, and the antipsychotic agents (major tranquilizers). These drugs act by different mechanisms and are used for different therapeutic purposes. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH]
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Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Translating: Conversion from one language to another language. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Triazolam: A short-acting benzodiazepine used in the treatment of insomnia. Some countries temporarily withdrew triazolam from the market because of concerns about adverse reactions, mostly psychological, associated with higher dose ranges. Its use at lower doses with appropriate care and labeling has been reaffirmed by the FDA and most other countries. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urethritis: Inflammation of the urethra. [EU]
478 Drug Abuse
Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urine Testing: Checking urine to see if it contains glucose (sugar) and ketones. Special strips of paper or tablets (called reagents) are put into a small amount of urine or urine plus water. Changes in the color of the strip show the amount of glucose or ketones in the urine. Urine testing is the only way to check for the presence of ketones, a sign of serious illness. However, urine testing is less desirable then blood testing for monitoring the level of glucose in the body. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventral Tegmental Area: A region in the mesencephalon which is dorsomedial to the substantia nigra and ventral to the red nucleus. The mesocortical and mesolimbic dopaminergic systems originate here, including an important projection to the nucleus accumbens. Overactivity of the cells in this area has been suspected to contribute to the positive symptoms of schizophrenia. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH]
Dictionary 479
Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] War: Hostile conflict between organized groups of people. [NIH] Weight Lifting: A sport in which weights are lifted competitively or as an exercise. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Xylazine: An adrenergic alpha-agonist used as a sedative, analgesic, and muscle relaxant in veterinary medicine. [NIH]
481
INDEX A Abdomen, 413, 421, 446, 448, 458, 473, 479 Abdominal, 395, 405, 413, 458, 460 Abdominal Pain, 395, 413, 460 Aberrant, 413, 425 Abscess, 176, 213, 413, 440 Acculturation, 273, 332, 351, 413 Acetaldehyde, 320, 325, 413 Acetylcholine, 413, 424 Acoustic, 91, 413, 467 Acquired Immunodeficiency Syndrome, 29, 161, 246, 325, 347, 413 Acute renal, 239, 341, 413 Adaptation, 223, 279, 413, 446 Adenine, 413 Adenosine, 321, 413, 422 Adjustment, 83, 89, 120, 279, 413 Adolescence, 14, 16, 24, 40, 46, 58, 59, 66, 138, 160, 198, 368, 383, 414 Adolescent Behavior, 153, 414 Adolescent Medicine, 143, 144, 254, 414 Adrenal Glands, 414, 416 Adrenal Medulla, 315, 414, 423, 436, 456 Adrenergic, 414, 416, 417, 433, 436, 460, 474, 479 Adverse Effect, 414, 462, 471 Affinity, 81, 88, 127, 414, 431, 432, 472 Age Groups, 126, 414 Aged, 80 and Over, 414 Agonist, 15, 17, 19, 22, 37, 39, 75, 108, 129, 414, 422, 433, 449, 454, 456, 459, 460, 479 Airway, 248, 414 Airway Obstruction, 248, 414 Akathisia, 414, 418 Alertness, 414, 422 Alimentary, 414, 459 Alkaloid, 314, 414, 422, 425, 426, 453, 456 Alleles, 160, 415 Allergen, 415, 470 Allium, 188, 415 Alternative medicine, 415 Alum, 415, 425 Amalgamation, 135, 415 Amino Acid Sequence, 103, 415, 416, 420, 463 Amino Acids, 216, 415, 420, 456, 459, 462, 464, 474, 477 Ammonia, 415, 474, 477
Amniotic Fluid, 415, 450 Amphetamine, 44, 45, 94, 108, 111, 115, 191, 257, 259, 298, 318, 324, 325, 376, 415, 432, 450 Amygdala, 143, 415, 419, 448, 475 Amyloid, 5, 415, 467 Amyloidosis, 5, 218, 341, 415 Anabolic, 158, 209, 215, 317, 416 Anal, 25, 37, 57, 58, 64, 112, 151, 341, 416, 436, 438, 449 Analgesic, 48, 231, 409, 416, 422, 425, 443, 447, 448, 451, 453, 457, 458, 479 Analog, 416, 432 Analogous, 84, 416 Anaphylatoxins, 416, 426 Anatomical, 109, 416, 418, 445, 455, 469 Anemia, 371, 416 Anesthesia, 414, 416, 447 Anesthetics, 416, 419, 436 Animal model, 14, 29, 32, 39, 45, 57, 83, 91, 111, 117, 126, 130, 416 Anionic, 93, 416 Antagonism, 37, 416, 422, 449 Antecedent, 112, 416 Anthropology, 12, 89, 416, 472 Anti-Anxiety Agents, 416, 465, 476 Antiarrhythmic, 319, 416 Antibacterial, 416, 457, 472, 474 Antibiotic, 416, 422, 423, 459, 472, 473, 474 Antibodies, 4, 14, 47, 202, 219, 224, 229, 313, 323, 416, 417, 441, 444, 449, 453, 461 Antibody Affinity, 81, 417 Anticonvulsant, 417, 422 Antidepressant, 5, 417, 438 Antidepressive Agents, 417, 465 Antidote, 417, 438 Antiemetic, 417, 418 Antigen, 81, 414, 417, 419, 426, 436, 443, 444, 445, 450, 470 Antigen-Antibody Complex, 417, 426 Antihypertensive, 417, 459 Anti-inflammatory, 155, 417, 439 Antipsychotic, 5, 203, 321, 417, 455, 468, 476 Antithrombotic, 318, 418 Antitussive, 418, 432, 457 Anus, 416, 418, 422
482 Drug Abuse
Anxiety, 6, 15, 99, 109, 115, 127, 138, 198, 280, 406, 414, 416, 418, 458 Anxiety Disorders, 198, 418, 458 Anxiolytic, 15, 134, 418, 439 Applicability, 19, 110, 134, 418 Approximate, 54, 418 Aqueous, 324, 418, 420, 447 Aromatic, 418, 460 Arrhythmia, 416, 418 Arterial, 418, 428, 439, 443, 464 Arteries, 312, 418, 421, 428, 452 Articular, 201, 418 Artifacts, 32, 98, 418 Artificial Organs, 418, 468 Aspartate, 418, 447 Aspiration, 182, 418 Asymptomatic, 367, 418, 440 Ataxia, 155, 371, 406, 418, 475 Atrium, 418, 419, 428, 478 Atrophy, 371, 418 Attenuated, 83, 108, 419, 432 Atypical, 149, 419, 468 Audiovisual Aids, 396, 419 Auditory, 98, 419, 468 Auricular, 271, 419 Autonomic, 413, 418, 419, 429, 456, 474 Autonomic Nervous System, 419, 429, 474 Autosuggestion, 419, 444 Avidity, 417, 419 B Bacteria, 416, 417, 419, 420, 435, 440, 452, 457, 472, 477, 478 Bacterial Physiology, 413, 419 Bactericidal, 419, 437 Bacteriophage, 419, 477 Bacteriostatic, 415, 419 Bacterium, 419, 426 Bacteriuria, 419, 478 Barbiturates, 318, 419, 469 Basal Ganglia, 418, 419, 425, 448, 457 Basal Ganglia Diseases, 418, 419, 425 Base, 14, 51, 95, 114, 140, 310, 312, 314, 321, 360, 413, 419, 430, 431, 447, 475 Behavior Therapy, 300, 329, 420 Behavioral Sciences, 19, 25, 114, 420 Benchmarking, 104, 420 Benign, 420, 441, 455 Benzene, 420 Benzodiazepines, 9, 15, 318, 342, 420, 438 Beta-Endorphin, 149, 420 Beta-Lactamases, 420, 474 Beta-pleated, 415, 420
Bile, 420, 439, 447, 448, 450, 473 Bile Pigments, 420, 447, 450 Biochemical, 17, 32, 83, 109, 415, 420, 470 Biological Markers, 190, 191, 234, 420 Biological Psychiatry, 17, 49, 158, 183, 266, 420 Biological Sciences, 101, 420 Biomedical Engineering, 91, 96, 421 Biophysics, 420, 421 Biopsy, 5, 421 Biosynthesis, 314, 421 Biotransformation, 421, 460 Bipolar Disorder, 165, 421 Bivalent, 317, 421 Bladder, 421, 464, 477, 478 Blennorrhoea, 421, 440 Blood Platelets, 421, 470 Blood pressure, 407, 409, 417, 421, 423, 424, 439, 443, 444, 452, 472 Blood vessel, 421, 423, 424, 425, 428, 436, 441, 447, 448, 449, 459, 471, 473, 475, 476, 478 Blood Volume, 72, 421 Blood-Brain Barrier, 216, 421, 448 Body Fluids, 156, 204, 311, 421, 472 Bone Marrow, 420, 421, 444, 449 Bone scan, 421, 468 Bowel, 416, 421, 422, 432, 446 Bowel Movement, 422, 432 Brain Stem, 325, 422, 424 Branch, 28, 137, 345, 403, 414, 422, 430, 435, 439, 449, 456, 459, 460, 464, 465, 472, 475 Breakdown, 422, 432, 439 Breast Feeding, 396, 422 Broad-spectrum, 15, 422, 457 Butorphanol, 129, 422 C Caffeine, 9, 47, 55, 65, 271, 409, 422 Calcium, 422, 426, 471 Cannabidiol, 422 Cannabinoids, 23, 259, 422 Cannabinol, 422 Cannabis, 33, 199, 271, 410, 422, 475 Carbamazepine, 306, 422 Carbohydrate, 422, 439, 462 Carcinogenic, 420, 422, 446, 473 Carcinogens, 423, 457 Cardiac, 416, 422, 423, 428, 435, 436, 454, 473 Cardiovascular, 10, 40, 201, 271, 415, 423, 429, 470
Index 483
Cardiovascular disease, 10, 423 Cardiovascular System, 423, 429 Case report, 149, 192, 201, 202, 423, 425 Catecholamine, 417, 423, 433, 460 Caudal, 423, 432, 444, 457, 462 Caudate Nucleus, 419, 423, 457 Causal, 25, 285, 423, 436, 446 Cause of Death, 423, 430 Cefoxitin, 146, 423 Cell Differentiation, 423, 471 Cell Division, 371, 419, 423, 430, 450, 451, 461, 463 Cell membrane, 423, 431, 437, 461 Cell proliferation, 423, 471 Central Nervous System Infections, 423, 441 Cerebellar, 142, 155, 418, 423, 467 Cerebellum, 423, 438, 462, 467 Cerebral hemispheres, 419, 422, 424 Cerebrovascular, 153, 156, 419, 423, 424, 475 Cerebrum, 424, 477 Chancroid, 367, 424 Character, 93, 312, 322, 424, 430 Chemical Warfare, 424, 430 Chemical Warfare Agents, 424, 430 Chemoreceptor, 418, 424 Chemotactic Factors, 424, 426 Chemotherapy, 424, 433 Child Behavior, 105, 424 Child Care, 351, 424 Child Welfare, 7, 424 Chlamydia, 367, 424 Cholesterol, 420, 424, 429, 473 Choline, 91, 424 Cholinergic, 417, 424, 456 Chorea, 417, 424 Chromaffin System, 425, 435 Chromosomal, 425, 468 Chromosome, 425, 448, 468 Chronic renal, 341, 425, 461 Circulatory system, 425, 435 Clinical Medicine, 425, 462 Clinical study, 425, 428 Coal, 420, 425, 426 Coca, 314, 425 Codeine, 65, 425, 432, 457, 458 Cofactor, 425, 464 Cognition, 32, 91, 425, 455 Cognitive Therapy, 329, 335, 425 Coke, 314, 426 Colchicine, 5, 426
Communicable disease, 310, 426 Communication Barriers, 382, 426 Community Health Centers, 197, 426 Comorbidity, 50, 76, 78, 84, 126, 131, 158, 165, 167, 199, 210, 231, 237, 258, 426 Competency, 34, 110, 290, 426 Complement, 23, 83, 123, 416, 426, 470 Complementary and alternative medicine, 269, 270, 276, 426 Complementary medicine, 270, 426 Complete remission, 427, 467 Compulsion, 159, 427 Computational Biology, 359, 370, 427 Computed tomography, 244, 427, 468 Computer Simulation, 32, 427 Computerized axial tomography, 427, 469 Computerized tomography, 427 Concept Formation, 71, 427 Conception, 427, 428, 438, 450 Concomitant, 5, 31, 129, 427 Condoms, 3, 4, 346, 427 Confounding, 98, 427 Confusion, 427, 432, 455 Congestion, 418, 427 Conjugated, 427, 430, 454 Conjunctiva, 427, 445, 447 Connective tissue, 421, 427, 438, 439, 449 Consciousness, 407, 416, 427, 430, 431, 433 Constipation, 418, 427, 460 Constitutional, 242, 428 Constriction, 428, 445, 447, 468 Consultation, 39, 42, 110, 132, 428 Consumption, 8, 11, 31, 55, 62, 79, 84, 88, 94, 115, 159, 332, 376, 382, 428, 432, 467 Contamination, 74, 428, 442, 457 Continuum, 81, 350, 428 Contraception, 368, 428 Contraindications, ii, 428 Control group, 11, 16, 43, 46, 67, 99, 428, 466 Controlled clinical trial, 27, 428 Controlled study, 82, 117, 428 Convulsion, 115, 410, 428 Coordination, 34, 363, 395, 407, 424, 428, 464 Cor, 428, 439, 463 Coronary, 209, 423, 428, 429, 452 Coronary heart disease, 209, 423, 428 Coronary Thrombosis, 429, 452 Cortex, 100, 221, 418, 429, 436, 437, 458, 463, 465, 467 Cortical, 429, 437, 469, 475
484 Drug Abuse
Corticosteroids, 429, 439 Cost-benefit, 35, 161, 429 Cost-Benefit Analysis, 35, 429 Crack Cocaine, 12, 66, 106, 243, 293, 338, 429 Cranial, 201, 423, 429, 441 Craniocerebral Trauma, 419, 429, 441, 475 Creatine, 321, 429 Creatinine, 5, 429 Creatinine clearance, 5, 429 Criminology, 20, 271, 429 Criterion, 159, 429 Critical Care, 258, 429 Cues, 72, 84, 107, 429 Cultured cells, 99, 429 Curative, 429, 456, 476 Cutaneous, 146, 163, 430, 440 Cyclic, 422, 430, 469 Cysteine, 430, 474 Cytidine, 321, 430 Cytochrome, 104, 254, 255, 430 Cytogenetics, 430, 468 Cytosine, 321, 430 Cytotoxic, 430, 471 D Data Collection, 25, 57, 78, 83, 138, 340, 362, 364, 430, 438 Databases, Bibliographic, 359, 430 Death Certificates, 351, 430 Deception, 199, 430 Decision Making, 30, 328, 380, 430 Decontamination, 74, 430 Degenerative, 430, 442, 453 Deletion, 109, 430 Delirium, 417, 430 Delivery of Health Care, 426, 431, 441 Delusions, 431, 458, 465 Dementia, 413, 417, 431 Dendrites, 431, 455 Dendritic, 431, 451, 473 Density, 302, 303, 431, 457, 458 Dental Care, 173, 341, 431 Dentate Gyrus, 431, 443 Dentists, 341, 431 Depersonalization, 431, 458, 469 Depolarization, 431, 471 Deprivation, 82, 111, 431 Derealization, 431, 458 Designer Drugs, 246, 257, 431 Desipramine, 301, 303, 305, 306, 314, 431 Detoxification, 3, 22, 60, 88, 99, 163, 227, 277, 291, 432
Developing Countries, 432, 475 Dextroamphetamine, 415, 432, 451, 452 Dextromethorphan, 88, 110, 432 Dextrorphan, 110, 432 Diabetes Mellitus, 5, 93, 269, 432, 440, 442 Diagnostic procedure, 309, 432 Diencephalon, 432, 444, 476 Diethylproprion, 314, 432 Diffusion, 432 Digestion, 414, 420, 421, 432, 446, 448, 473 Digestive system, 307, 432 Dilatation, 432, 463 Dilution, 191, 432, 437, 461 Discrimination, 10, 14, 21, 48, 95, 127, 259, 382, 432 Disease Progression, 432, 479 Disinfectant, 432, 437 Disorientation, 341, 427, 430, 432, 433 Disparity, 53, 433 Disposition, 103, 191, 433 Dissociation, 81, 131, 288, 414, 433 Dissociative Disorders, 433 Distal, 310, 433, 463, 464 Diuresis, 422, 433 Dizziness, 406, 433, 458 Domestic Violence, 13, 335, 433, 462 Dopa, 106, 433, 447 Dopamine, 12, 17, 19, 39, 44, 45, 58, 59, 93, 99, 103, 106, 108, 139, 156, 175, 191, 218, 255, 301, 302, 315, 320, 321, 324, 415, 417, 425, 432, 433, 438, 447, 450, 453, 459, 460, 468 Doping, 234, 433 Drinking Behavior, 9, 433 Drive, ii, vi, 59, 133, 265, 433 Dronabinol, 55, 433, 475 Drug Delivery Systems, 93, 433 Drug Interactions, 61, 104, 347, 434 Drug Resistance, 434 Drug Tolerance, 94, 95, 127, 434, 476 Dyes, 415, 434 Dynorphins, 434, 457 Dyskinesia, 418, 434 Dysplasia, 371, 434 Dyspnea, 434, 458 Dystonia, 418, 434 Dystrophy, 371, 434 E Eating Disorders, 166, 182, 263, 335, 434 Edema, 434, 455 Educational Status, 16, 434 Effector, 413, 426, 434, 455, 456
Index 485
Effector cell, 434, 455, 456 Elasticity, 18, 79, 280, 434 Electroencephalography, 227, 434 Electrolyte, 140, 431, 434, 472 Electrons, 420, 434, 446, 447, 458, 466 Electrophysiological, 47, 435 Emaciation, 413, 435 Emboli, 215, 435 Embolus, 216, 435, 445 Embryology, 435, 456 Empirical, 7, 20, 30, 67, 89, 167, 175, 177, 435 Encephalitis, 29, 435 Encephalitis, Viral, 435 Endemic, 206, 435, 473 Endocarditis, 55, 139, 198, 199, 341, 435, 440 Endocardium, 435 Endocrine Glands, 435 Endocrine System, 20, 435, 455 Endocrinology, 21, 435 Endophthalmitis, 175, 214, 435 Endorphins, 435, 457, 463 Endothelial cell, 421, 435, 436 Endotoxins, 426, 436 End-stage renal, 425, 436, 461 Enhancers, 121, 436 Enkephalin, 249, 420, 436, 463 Entorhinal Cortex, 436, 443 Environmental Exposure, 420, 436, 457 Environmental Health, 205, 209, 358, 360, 436 Enzymatic, 314, 422, 426, 436, 443, 467 Enzyme, 4, 269, 420, 434, 436, 440, 443, 453, 464, 471, 474, 479 Enzyme-Linked Immunosorbent Assay, 4, 436 Epidemiologic Studies, 25, 420, 436 Epinephrine, 414, 433, 436, 456, 477 Ergot, 436, 449 Erythrocyte Volume, 421, 436 Erythrocytes, 416, 421, 436, 437, 470 Escalation, 12, 84, 94, 116, 138, 437 Esophagus, 432, 437, 460, 473 Essential Tremor, 371, 437 Ethanol, 79, 315, 318, 437 Ethnic Groups, 28, 58, 126, 332, 364, 437 Euphoria, 72, 108, 314, 437 Evoke, 437, 473 Excitatory, 84, 437, 440 Exhaustion, 416, 437 Exocytosis, 315, 437
Expiratory, 436, 437 Expiratory Reserve Volume, 436, 437 Extracellular, 106, 415, 437, 452, 472 Extracellular Space, 437, 452 Extraction, 311, 437 Extrapyramidal, 18, 414, 418, 433, 437 Extremity, 267, 437 F Facial, 437, 471 Family Characteristics, 138, 198, 437 Family Planning, 28, 359, 384, 437 Family Relations, 53, 115, 437 Fat, 70, 421, 428, 429, 435, 437, 439, 448 Father-Child Relations, 39, 437 Fathers, 39, 437 Fatigue, 395, 406, 438, 459 Fatty acids, 438, 450 Fentanyl, 103, 438 Fetus, 348, 438, 450, 462 Fibrosis, 269, 371, 438, 469 Fixation, 438, 470 Flatus, 438, 439 Flumazenil, 10, 438 Flunitrazepam, 10, 438 Fluoxetine, 303, 438 Flupenthixol, 302, 438 Focus Groups, 9, 10, 39, 260, 438 Food Deprivation, 37, 438 Forearm, 421, 438 Forensic Medicine, 257, 353, 438 Fourth Ventricle, 438, 449, 476 Frontal Lobe, 71, 439 Functional magnetic resonance imaging, 48, 98, 439 Fungi, 435, 439, 452 G Gait, 408, 439 Gallbladder, 413, 432, 439 Gamma-hydroxybutyrate, 110, 439 Ganglia, 413, 419, 439, 455, 474 Gas, 191, 415, 432, 436, 438, 439, 443, 456, 478 Gastrin, 439, 443 Gastrointestinal, 429, 436, 437, 439, 470, 474 Gastrointestinal tract, 437, 439, 470 Gelatin, 439, 440 Gene, 99, 124, 130, 160, 249, 338, 372, 373, 415, 420, 439, 457 Gene Expression, 130, 372, 439 General practitioner, 183, 189, 266, 341, 439
486 Drug Abuse
Genetics, 33, 48, 57, 94, 157, 190, 191, 194, 396, 430, 439, 460 Gestation, 439, 460 Gestures, 439, 471 Gland, 414, 425, 439, 449, 458, 463, 464, 469, 473, 474, 476 Glucocorticoids, 223, 439 Gluconeogenesis, 439 Glucose, 5, 371, 432, 439, 440, 442, 446, 468, 478 Glucose Intolerance, 432, 440 Glutamate, 127, 432, 440 Glutathione Peroxidase, 440, 470 Glycine, 127, 440 Glycogen, 424, 439, 440 Glycoprotein, 341, 440, 467 Gonad, 440 Gonadal, 49, 440, 473 Gonorrhea, 116, 367, 440 Gonorrhoea, 249, 440 Gout, 426, 440 Governing Board, 440, 462 Grade, 14, 24, 120, 196, 277, 279, 290, 440 Graft, 440, 443 Gram-negative, 424, 440, 457 Gram-positive, 440, 457 Granulocytes, 440, 471, 479 Granulomas, 163, 441 H Habitual, 129, 317, 424, 441 Habituation, 340, 441 Haematoma, 441 Haemorrhage, 201, 441 Half-Life, 99, 320, 325, 441 Hallucinogen, 441, 449, 460 Haloperidol, 108, 302, 321, 441 Haptens, 23, 414, 441 Headache, 167, 197, 207, 212, 214, 266, 422, 441, 445 Headache Disorders, 441 Health Behavior, 24, 164, 231, 441 Health Care Costs, 297, 441 Health Education, 141, 177, 260, 346, 347, 396, 441 Health Expenditures, 441 Health Policy, 12, 13, 46, 113, 332, 442 Health Promotion, 46, 124, 333, 349, 378, 442 Health Status, 60, 297, 441, 442 Heart attack, 423, 442 Heme, 430, 442, 454 Hemodynamics, 72, 442
Hemoglobin, 416, 437, 442, 447 Hemoglobinuria, 371, 442 Hemorrhage, 429, 441, 442, 465, 473 Hemostasis, 442, 470 Hepatitis A, 142, 349, 396, 442 Hepatocytes, 442 Hepatovirus, 442 Hereditary, 440, 442, 453, 468 Heredity, 439, 442 Heroin Dependence, 22, 75, 88, 298, 300, 306, 442 Herpes, 102, 367, 442, 443 Herpes virus, 102, 443 Herpes Zoster, 443 Heterogeneity, 134, 414, 443 Hippocampus, 71, 111, 431, 443, 448, 474 Histamine, 416, 417, 443 Homeless Persons, 273, 443 Homeless Youth, 178, 443 Homicide, 118, 443 Homogeneous, 136, 428, 443 Homologous, 415, 421, 443, 470, 475 Hormonal, 49, 94, 419, 443 Hormone, 80, 111, 420, 429, 436, 439, 443, 446, 463, 469, 471, 476 Horseradish Peroxidase, 436, 443 Host, 29, 48, 116, 419, 443, 444, 479 Hydrogen, 420, 422, 440, 443, 452, 458, 460 Hydromorphone, 79, 409, 443 Hydrophobic, 417, 443 Hyperbilirubinemia, 443, 447 Hypersensitivity, 415, 443, 470 Hypertension, 275, 423, 428, 441, 443 Hypnotic, 5, 269, 444 Hypodermic, 310, 444 Hypotension, 418, 444 Hypothalamic, 49, 80, 247, 444 Hypothalamus, 80, 111, 419, 432, 436, 444, 448, 463, 476 I Iatrogenic, 212, 444 Ibogaine, 149, 444 Id, 267, 274, 386, 387, 394, 402, 404, 444 Illusions, 262, 444, 469 Immune function, 24, 48, 444 Immune response, 415, 417, 441, 444, 470, 474, 479 Immune Sera, 444 Immune system, 333, 352, 380, 434, 444, 449, 454, 478, 479 Immunity, 269, 413, 444, 477
Index 487
Immunization, 202, 313, 323, 380, 396, 444, 463, 470 Immunoassay, 436, 444 Immunoglobulin, 416, 444, 453 Immunologic, 424, 444 Immunology, 21, 114, 150, 414, 443, 444 Impairment, 31, 99, 183, 260, 340, 364, 418, 430, 434, 445, 451, 465 Impulsive Behavior, 58, 92, 445 In situ, 311, 445 In vitro, 18, 19, 29, 93, 103, 209, 445 In vivo, 15, 18, 19, 59, 74, 93, 103, 106, 109, 111, 249, 313, 323, 445, 452 Incarceration, 38, 131, 282, 445 Incision, 445, 446 Indicative, 334, 445, 459, 478 Induction, 417, 445, 447 Infant Behavior, 424, 445 Infant, Newborn, 414, 445 Infarction, 429, 445, 452 Infection Control, 169, 333, 445 Influenza, 351, 445 Informed Consent, 4, 445 Infusion, 70, 445 Ingestion, 56, 445, 461 Inhalation, 212, 248, 445, 461 Initiation, 12, 14, 45, 59, 63, 70, 84, 90, 138, 161, 173, 196, 199, 200, 446, 473, 476 Inotropic, 433, 446 Inpatients, 147, 228, 236, 242, 446 Insight, 366, 446, 468 Insomnia, 275, 407, 446, 477 Institutionalization, 317, 446 Insulin, 5, 446, 468 Insulin-dependent diabetes mellitus, 446 Interindividual, 103, 446 Intermittent, 70, 446, 449 Internal Medicine, 25, 48, 61, 165, 173, 174, 203, 241, 297, 435, 446, 455 Intervention Studies, 61, 269, 446 Intestinal, 104, 446, 450 Intestine, 104, 421, 446, 447 Intoxication, 146, 149, 155, 189, 255, 366, 431, 446, 479 Intracellular, 341, 422, 445, 446, 466, 469, 470, 471 Intramuscular, 446, 459 Intraocular, 435, 446 Intrinsic, 15, 19, 111, 414, 446 Invasive, 330, 444, 446, 449 Involuntary, 419, 424, 428, 437, 446, 454 Ion Channels, 23, 446, 456, 475
Ionizing, 436, 446, 450 Ions, 420, 433, 434, 443, 446 Ischemia, 418, 447 J Jaundice, 395, 443, 447 Jealousy, 447, 458 Joint, 35, 101, 201, 204, 253, 327, 379, 418, 447, 474 Juvenile Delinquency, 40, 447 K Kb, 358, 447 Keratoconjunctivitis, 447, 470 Keratoconjunctivitis Sicca, 447, 470 Ketamine, 127, 134, 447, 460 Kidney Disease, 307, 341, 358, 371, 447 L Labile, 426, 447 Lacrimal, 447, 470 Large Intestine, 432, 446, 447, 466, 471 Latent, 32, 36, 112, 447, 462 Length of Stay, 36, 447 Lens, 447, 467 Lesion, 447, 448, 475 Leucine, 420, 447 Leukemia, 371, 447 Levo, 88, 433, 447 Levodopa, 433, 447, 469 Levorphanol, 432, 448 Library Services, 402, 448 Ligament, 448, 464 Ligands, 15, 58, 93, 448 Limbic, 111, 415, 448 Limbic System, 415, 448 Linkage, 49, 56, 60, 89, 135, 153, 159, 206, 286, 448 Lipid, 424, 446, 448 Lithium, 417, 448 Litter, 22, 448 Liver, 104, 111, 206, 349, 380, 395, 413, 416, 420, 432, 439, 440, 442, 448, 453, 468, 477 Liver cancer, 395, 448 Liver scan, 448, 468 Local Government, 252, 448, 465 Localization, 103, 448 Localized, 70, 99, 188, 415, 424, 438, 441, 445, 448, 453, 458, 461 Locomotion, 448, 461 Locomotor, 23, 70, 83, 111, 448 Locus Coeruleus, 80, 449 Longitudinal Studies, 46, 332, 362, 449 Longitudinal study, 14, 24, 32, 56, 117, 180, 449
488 Drug Abuse
Long-Term Care, 26, 62, 449 Lymph, 182, 425, 436, 449 Lymph node, 182, 449 Lymphatic, 445, 449, 473, 476 Lymphatic system, 449, 473, 476 Lymphocyte, 4, 163, 315, 413, 417, 449, 450 Lymphocyte Count, 163, 413, 449 Lymphoid, 417, 429, 449 Lymphoma, 371, 449 Lysergic acid, 342, 449 Lysergic Acid Diethylamide, 342, 449 Lytic, 449, 470 M Magnetic Resonance Imaging, 449, 469 Malabsorption, 371, 450 Malignant, 371, 413, 448, 450, 455 Malnutrition, 418, 450, 453 Mandatory Testing, 125, 450 Manic, 417, 421, 448, 450, 465 Manic-depressive psychosis, 450, 465 Marital Status, 368, 450 Mass Media, 46, 450 Maternal Deprivation, 111, 450 Maternal Exposure, 74, 450 Maximum Tolerated Dose, 434, 450 Mazindol, 305, 450 Meconium, 85, 450 Mediate, 99, 111, 433, 450 Mediator, 433, 450, 470 Medical Records, 296, 450 Medicament, 415, 450 MEDLINE, 359, 370, 371, 450 Medullary, 432, 450, 466 Meiosis, 421, 450, 475 Melanin, 80, 449, 450, 460, 477 Melanocytes, 451 Melanoma, 371, 451 Memantine, 88, 451 Membrane, 423, 426, 427, 431, 437, 440, 446, 451, 452, 454, 461, 471, 473, 474, 477 Memory, 31, 32, 71, 92, 97, 115, 129, 269, 407, 430, 431, 451 Meninges, 423, 429, 451 Meningitis, 440, 451 Mental Disorders, 65, 158, 173, 176, 295, 308, 451, 463, 464, 465 Mental Processes, 31, 433, 451, 464 Mental Retardation, 329, 372, 385, 451 Mentors, 35, 48, 49, 61, 69, 92, 98, 123, 131, 451 Meperidine, 431, 451 Mesencephalic, 449, 451, 467
Mesolimbic, 45, 59, 127, 175, 417, 451, 478 Meta-Analysis, 118, 194, 222, 252, 451 Metabolite, 110, 410, 421, 432, 451 Metaphase, 421, 451 Methionine, 420, 452, 463, 474 Methylphenidate, 44, 45, 65, 203, 324, 325, 452 MI, 8, 18, 37, 55, 85, 96, 101, 111, 144, 179, 299, 315, 348, 411, 452 Microbe, 452, 476 Microbiological, 244, 452 Microbiology, 199, 229, 244, 413, 419, 452 Microdialysis, 59, 106, 117, 452 Microorganism, 425, 452, 479 Migration, 273, 362, 452 Minority Groups, 84, 452 Mitochondrial Swelling, 452, 454 Mobility, 385, 452 Mobilization, 327, 452 Modeling, 12, 32, 58, 64, 77, 89, 96, 110, 121, 161, 349, 452 Modification, 4, 22, 120, 348, 352, 431, 452, 466 Modulator, 106, 452 Molecule, 37, 417, 420, 426, 433, 434, 452, 458, 466, 471, 478 Monitor, 5, 73, 125, 346, 429, 452, 456 Monoamine, 415, 417, 432, 453, 469 Monoamine Oxidase, 415, 417, 432, 453, 469 Monoclonal, 23, 81, 453 Monoclonal antibodies, 23, 81, 453 Morale, 9, 104, 453 Morphine, 22, 74, 83, 93, 99, 311, 422, 425, 443, 451, 453, 454, 457 Motility, 453, 470 Motion Sickness, 453, 454 Motivations, 53, 453 Motor Activity, 453, 465 Movement Disorders, 417, 453, 475 Mucilaginous, 450, 453 Mucins, 453, 468 Muscle Fibers, 453 Muscle relaxant, 416, 453, 479 Muscular Atrophy, 371, 453 Muscular Dystrophies, 434, 453 Myalgia, 341, 445, 453 Myocarditis, 197, 453 Myocardium, 452, 453, 454 Myoglobin, 341, 454 Myotonic Dystrophy, 371, 454
Index 489
N Naive, 129, 454 Naloxone, 22, 27, 88, 420, 454 Naltrexone, 75, 88, 117, 298, 454 Narcolepsy, 314, 432, 452, 454 Narcosis, 454 Narcotic, 214, 240, 266, 290, 413, 422, 438, 448, 451, 453, 454, 458 Nasal Mucosa, 445, 454 Nausea, 341, 395, 407, 417, 433, 454, 458 NCI, 1, 307, 357, 454 Necrosis, 224, 435, 445, 452, 454, 468 Needle Sharing, 60, 346, 347, 348, 350, 351, 454 Needle-Exchange Programs, 237, 454 Needs Assessment, 43, 277, 454 Neonatal, 74, 282, 440, 454 Neoplasia, 371, 454, 455 Neoplasms, 413, 423, 455, 475 Neoplastic, 449, 455 Nephrology, 5, 140, 234, 341, 455 Nephropathy, 231, 341, 447, 455 Nephrosis, 455 Nephrotic, 5, 341, 455 Nephrotic Syndrome, 5, 341, 455 Nerve, 315, 414, 416, 418, 431, 449, 450, 453, 455, 462, 467, 469, 473, 477 Nerve Endings, 315, 455 Nervous System, 10, 81, 115, 324, 325, 333, 341, 371, 410, 413, 415, 419, 420, 422, 423, 425, 429, 432, 434, 439, 448, 449, 450, 451, 452, 453, 455, 456, 459, 462, 463, 470, 474, 475 Networks, 11, 12, 71, 106, 110, 116, 282, 292, 360, 396, 455 Neural, 29, 30, 59, 70, 71, 72, 80, 111, 216, 415, 431, 453, 455 Neuroanatomy, 129, 130, 448, 455 Neuroeffector Junction, 455 Neuroendocrine, 48, 455 Neuroendocrinology, 48, 455 Neuroleptic, 321, 414, 417, 455 Neurologic, 99, 216, 416, 455 Neurologist, 71, 455 Neuronal, 71, 80, 111, 454, 455 Neurons, 80, 126, 139, 223, 425, 431, 437, 439, 448, 453, 455, 456, 474, 475 Neuropeptide, 99, 456 Neuropharmacology, 29, 71, 100, 456 Neurophysiology, 30, 126, 431, 456 Neurosciences, 59, 101, 155, 165, 262, 456 Neurosecretory Systems, 435, 456
Neurotoxicity, 149, 432, 456 Neurotransmitters, 130, 456, 463 Niacin, 456, 477 Nicotine, 9, 10, 22, 23, 33, 39, 44, 45, 47, 50, 65, 70, 93, 107, 126, 134, 318, 342, 456 Nitrogen, 414, 438, 456, 477 N-methyl, 88, 127, 210, 432, 456, 460 N-methyl-D-aspartate, 88, 127, 210, 432, 456, 460 Nonverbal Communication, 456, 465 Norepinephrine, 314, 324, 414, 431, 433, 456, 460 Nuclear, 49, 188, 419, 435, 437, 448, 454, 456 Nuclear Family, 437, 456 Nuclei, 415, 434, 448, 449, 456, 461 Nucleic acid, 430, 456, 457 Nucleus, 59, 80, 99, 103, 218, 419, 430, 449, 450, 457, 463, 475, 478 Nucleus Accumbens, 59, 80, 99, 103, 457, 478 O Observational study, 15, 457 Obsession, 427, 457 Ocular, 219, 245, 457 Ofloxacin, 74, 457 Oncogene, 371, 457 Oophoritis, 440, 457 Opacity, 431, 457 Operating Rooms, 182, 457 Opioid Peptides, 109, 434, 435, 457 Opium, 453, 457 Opportunistic Infections, 413, 457 Optic Chiasm, 444, 457 Oral Health, 396, 457, 458 Oral Hygiene, 366, 458 Orderly, 65, 458 Orthostatic, 418, 458 Osteomyelitis, 247, 458 Osteosclerosis, 222, 458 Overdose, 80, 116, 181, 248, 458 Ovum, 439, 458, 463, 479 Oxidation, 421, 430, 440, 458 Oxycodone, 273, 458 Oxygenation, 72, 458 P Palliative, 458, 476 Pancreas, 413, 432, 446, 458 Pancreatic, 371, 458 Pancreatic cancer, 371, 458 Panic, 127, 158, 458 Panic Disorder, 127, 158, 458
490 Drug Abuse
Paranoia, 115, 458 Parenteral, 103, 214, 218, 244, 459 Paresthesias, 458, 459 Parietal, 71, 459 Parietal Lobe, 459 Parkinsonism, 418, 448, 459 Paroxysmal, 371, 441, 459 Partial remission, 459, 467 Particle, 459, 477 Pathogenesis, 341, 379, 459 Pathologic, 421, 428, 443, 459 Patient Advocacy, 396, 459 Patient Education, 378, 400, 402, 411, 459 Pelvic, 459, 464 Pemoline, 305, 306, 459 Penicillin, 416, 459 Penis, 427, 459 Peptide, 37, 80, 420, 457, 459, 462, 463, 464 Perceived risk, 67, 459 Perception, 24, 113, 332, 431, 459, 469 Perfusion, 272, 459 Pergolide, 266, 304, 459 Perinatal, 85, 151, 224, 225, 227, 332, 333, 396, 460 Peritonitis, 440, 460 Personality Disorders, 246, 290, 350, 460 Personnel Management, 330, 460 Petechiae, 441, 460 PH, 146, 239, 244, 460 Pharmacist, 255, 460 Pharmacodynamic, 71, 81, 110, 129, 460 Pharmacogenetics, 103, 460 Pharmacokinetic, 23, 71, 80, 110, 225, 460 Pharmacologic, 28, 104, 266, 416, 438, 441, 460, 476 Pharmacotherapy, 14, 17, 27, 130, 200, 306, 321, 460 Pharynx, 445, 460 Phenazopyridine, 74, 460 Phencyclidine, 81, 110, 127, 210, 225, 244, 318, 409, 460 Phenotype, 420, 460 Phenyl, 319, 451, 460 Phenylalanine, 314, 460, 477 Phenylpropanolamine, 314, 460 Phospholipases, 461, 471 Phospholipids, 437, 461 Physiologic, 414, 421, 433, 441, 461, 466 Physiology, 71, 72, 86, 100, 101, 102, 220, 349, 420, 435, 455, 456, 461 Pigment, 451, 454, 461 Pilot Projects, 49, 93, 116, 117, 461
Pilot study, 8, 11, 89, 112, 177, 461 Plague, 22, 461 Plants, 414, 420, 424, 425, 440, 456, 461, 468, 476 Plasma, 74, 149, 417, 421, 423, 439, 440, 442, 461, 470, 479 Plasma cells, 417, 461 Plasma Volume, 421, 461 Platelet Activation, 461, 471 Pleomorphic, 457, 461 Poisoning, 191, 204, 248, 431, 436, 446, 454, 461 Polyarthritis, 447, 461, 471 Polycystic, 371, 461 Polymorphism, 191, 254, 461 Polypeptide, 415, 454, 462, 464 Polysaccharide, 417, 462 Pons, 422, 438, 462 Posterior, 416, 418, 423, 458, 462 Postnatal, 59, 462 Postoperative, 103, 451, 462 Postsynaptic, 321, 455, 462, 471, 474, 475 Post-traumatic, 138, 441, 453, 462 Post-traumatic stress disorder, 138, 462 Potentiate, 10, 462 Potentiation, 462, 471 Practicability, 462, 477 Practice Guidelines, 297, 369, 386, 462 Preclinical, 14, 17, 20, 23, 48, 107, 129, 152, 462 Precursor, 245, 288, 314, 424, 433, 434, 435, 436, 447, 456, 460, 462, 463, 477 Predisposition, 94, 314, 323, 462 Preferred Provider Organizations, 50, 462 Prejudice, 330, 462 Prenatal, 85, 91, 164, 227, 378, 462 Prescription drug abuse, 9, 171, 181, 203, 206, 212, 217, 228, 229, 230, 250, 462 Presynaptic, 455, 462, 463, 474, 475 Presynaptic Terminals, 455, 463 Preventive Medicine, 42, 46, 113, 173, 219, 231, 252, 353, 401, 463 Primary Prevention, 45, 161, 205, 281, 285, 463 Probe, 37, 104, 225, 452, 463 Problem Solving, 349, 463 Professional Practice, 20, 463 Progesterone, 463, 473 Program Evaluation, 105, 331, 367, 463 Progression, 28, 61, 97, 106, 112, 126, 132, 138, 199, 231, 416, 463, 469
Index 491
Progressive, 15, 313, 423, 425, 431, 434, 437, 441, 453, 454, 461, 463 Projection, 72, 456, 463, 467, 478 Prone, 57, 175, 463 Pro-Opiomelanocortin, 435, 457, 463 Prophase, 421, 463, 475 Proportional, 77, 436, 463 Prospective study, 204, 449, 463 Prostate, 371, 464 Prostitution, 219, 464 Protein C, 415, 419, 464, 477 Protein Conformation, 415, 464 Protein S, 338, 371, 372, 464, 473 Proteins, 29, 47, 415, 417, 423, 426, 452, 456, 459, 461, 464, 466, 470, 476 Proteinuria, 5, 455, 464 Proteolytic, 426, 464 Protocol, 22, 28, 49, 108, 361, 365, 379, 464 Protozoa, 452, 464 Proximal, 433, 462, 464 Proxy, 126, 464 Psychic, 464, 469 Psychology, Social, 332, 464 Psychometrics, 133, 332, 464 Psychomotor, 65, 108, 314, 422, 430, 455, 464 Psychomotor Performance, 108, 464 Psychopathology, 32, 62, 64, 85, 117, 134, 155, 166, 232, 235, 286, 465 Psychosis, 80, 115, 155, 417, 465 Psychotherapy, 193, 200, 238, 260, 425, 465 Psychotomimetic, 415, 432, 465 Psychotropic, 4, 10, 325, 465 Psychotropic Drugs, 4, 5, 465 Puberty, 414, 465 Public Assistance, 239, 465 Public Policy, 55, 78, 205, 239, 287, 289, 313, 323, 347, 359, 465 Publishing, 6, 48, 51, 78, 87, 138, 330, 465 Pulmonary, 218, 275, 421, 428, 465, 478 Pulmonary Artery, 421, 465, 478 Pulse, 361, 409, 452, 465 Purpura, 441, 465 Purulent, 413, 435, 440, 465 Pyogenic, 458, 465 Pyramidal Tracts, 437, 465 Q Quality of Life, 61, 87, 132, 297, 466 R Race, 4, 67, 124, 133, 168, 261, 350, 368, 433, 452, 466 Radiation, 429, 436, 446, 450, 466, 469, 479
Radioactive, 421, 430, 441, 443, 448, 453, 456, 466, 469 Radiological, 156, 233, 466 Radiology, 466 Random Allocation, 466 Randomization, 49, 58, 298, 466 Randomized clinical trial, 87, 132, 167, 296, 297, 466 Rape, 158, 335, 462, 466 Reality Testing, 465, 466 Receptivity, 112, 466 Receptors, Serotonin, 466, 470 Recombinant, 23, 466, 478 Rectum, 418, 422, 432, 438, 439, 447, 464, 466 Recurrence, 421, 450, 467 Red Nucleus, 418, 467, 478 Refer, 1, 426, 433, 435, 438, 439, 442, 448, 454, 455, 465, 467 Reference point, 74, 467 Refraction, 467, 472 Refractory, 134, 467 Regeneration, 81, 467 Regimen, 347, 434, 460, 467 Rehabilitative, 327, 367, 467 Reliability, 13, 56, 73, 74, 87, 125, 134, 236, 242, 467 Remission, 237, 246, 273, 421, 450, 467 Renal amyloidosis, 5, 467 Research Design, 19, 85, 90, 389, 467 Resolving, 122, 467 Respiration, 424, 452, 467 Respiratory Paralysis, 413, 467 Retinal, 433, 457, 467 Retinoblastoma, 371, 468 Retrospective, 24, 73, 77, 155, 468 Rhabdomyolysis, 225, 239, 341, 468 Ribose, 413, 430, 468 Rigidity, 407, 459, 461, 468 Risk-Taking, 366, 468 Risperidone, 305, 468 Robotics, 127, 468 Role Playing, 368, 468 Role-play, 311, 312, 322, 468 Rural Population, 251, 468 S Safe Sex, 349, 468 Saliva, 68, 311, 468 Salivary, 432, 458, 468, 471 Salivary glands, 432, 468, 471 Salpingitis, 440, 468 Saponins, 468, 473
492 Drug Abuse
Satellite, 33, 283, 363, 468 Scans, 91, 98, 468 Schizoid, 469, 479 Schizophrenia, 132, 144, 164, 241, 250, 302, 321, 458, 468, 469, 478, 479 Schizotypal Personality Disorder, 431, 469, 479 Sclerosis, 371, 469 Second Messenger Systems, 456, 469 Secretion, 439, 443, 446, 447, 453, 469, 470 Sedative, 5, 10, 18, 33, 65, 425, 438, 469, 479 Sedatives, Barbiturate, 419, 469 Sediment, 469, 478 Segmental, 74, 469 Segmentation, 469 Seizures, 242, 341, 408, 422, 431, 459, 469 Selection Bias, 253, 469 Selegiline, 295, 469 Selenium, 218, 317, 470 Self Administration, 14, 19, 127, 470 Self Care, 365, 470 Self-Help Groups, 159, 272, 470 Semen, 464, 470 Sensitization, 70, 83, 92, 94, 111, 181, 470 Septic, 154, 470 Sequencing, 124, 470 Serologic, 4, 444, 470 Serotonin, 58, 106, 314, 318, 324, 417, 431, 438, 449, 453, 460, 466, 468, 470, 477 Serum, 4, 5, 111, 416, 426, 444, 460, 470 Sex Characteristics, 414, 465, 470 Sex Determination, 371, 470 Sexual Partners, 4, 6, 470 Sexually Transmitted Diseases, 3, 219, 231, 382, 383, 384, 468, 470 Shock, 411, 470, 477 Sicca, 198, 470 Side effect, 5, 104, 108, 315, 317, 414, 418, 450, 471, 476 Sign Language, 349, 471 Signal Transduction, 23, 99, 109, 130, 471 Signs and Symptoms, 467, 471 Single Parent, 73, 471 Skeletal, 341, 453, 468, 471 Skeleton, 447, 471 Skull, 429, 471, 475 Sleep Deprivation, 82, 471 Small intestine, 443, 446, 471 Smiling, 349, 471 Smooth muscle, 416, 422, 443, 453, 471, 474
Social Behavior, 54, 147, 243, 471 Social Class, 75, 471 Social Conditions, 123, 329, 429, 471 Social Environment, 62, 466, 472 Social Problems, 36, 472 Social Sciences, 64, 75, 472 Social Support, 11, 38, 62, 66, 274, 282, 292, 293, 472 Socialization, 121, 472 Socioeconomic Factors, 128, 472 Sodium, 320, 325, 440, 472, 474 Solvent, 245, 311, 420, 437, 472 Soma, 472 Somatic, 29, 414, 448, 450, 459, 472 Specialist, 347, 396, 472 Species, 18, 91, 94, 424, 426, 436, 450, 452, 453, 466, 471, 472, 474, 477, 479 Specificity, 14, 42, 70, 255, 414, 472 Spectrometer, 93, 472 Spectrum, 5, 69, 121, 343, 365, 367, 472, 474 Spike, 127, 473 Spinal cord, 385, 422, 423, 424, 451, 455, 466, 467, 473, 474 Spirochete, 473, 475 Spleen, 416, 449, 473 Sporadic, 468, 473 Staging, 468, 473 Standardize, 94, 473 Stasis, 155, 473 Sterile, 246, 454, 473 Sterilization, 346, 473 Steroid, 209, 215, 468, 473 Stimulant, 45, 93, 108, 115, 299, 324, 325, 331, 415, 422, 432, 443, 451, 452, 459, 473 Stimulus, 10, 14, 15, 84, 433, 434, 445, 446, 459, 473, 476 Stomach, 413, 432, 437, 439, 443, 454, 460, 471, 473 Streptomycin, 181, 473 Striatum, 99, 143, 457, 473 Stroke, 127, 156, 174, 247, 275, 308, 358, 423, 473 Stupor, 341, 454, 473 Subacute, 277, 445, 473 Subarachnoid, 438, 441, 473 Subclinical, 445, 469, 474 Subcutaneous, 5, 434, 459, 474 Subiculum, 443, 474 Subspecies, 472, 474 Substance P, 451, 469, 473, 474 Substrate, 59, 111, 436, 474
Index 493
Sulbactam, 146, 474 Sulfur, 317, 452, 474 Support group, 350, 384, 409, 410, 411, 474 Suppression, 94, 315, 318, 474 Suppurative, 435, 440, 474 Sweat, 406, 474 Sweat Glands, 474 Sympathetic Nervous System, 12, 419, 474 Sympathomimetic, 153, 249, 415, 432, 433, 436, 451, 456, 460, 474 Symphysis, 464, 474 Synapses, 455, 456, 473, 474 Synaptic, 249, 456, 471, 474, 475 Synaptic Transmission, 456, 475 Syphilis, 249, 367, 475 Systemic, 245, 415, 421, 431, 436, 442, 445, 475, 477 T Talc, 182, 475 Tardive, 418, 475 Technology Transfer, 28, 43, 234, 252, 339, 363, 475 Telangiectasia, 371, 475 Temporal, 72, 415, 441, 443, 475 Temporal Lobe, 415, 475 Tetrahydrocannabinol, 422, 433, 475 Thalamic, 71, 418, 475 Thalamic Diseases, 418, 475 Therapeutic Community, 254, 286, 293, 475 Therapeutics, 23, 39, 49, 59, 61, 218, 256, 324, 341, 453, 475 Thermal, 433, 476 Third Ventricle, 444, 476 Threshold, 106, 443, 476 Thrombosis, 464, 473, 476 Thrombus, 429, 445, 476, 478 Thymus, 257, 444, 449, 476 Thyroid, 476, 477 Thyroxine, 460, 476 Tolerance, 94, 109, 117, 129, 134, 195, 315, 317, 422, 440, 444, 476 Tomography, 106, 162, 226, 476 Tooth Preparation, 413, 476 Topical, 384, 437, 476 Toxic, iv, 314, 420, 436, 437, 444, 450, 456, 470, 476 Toxicity, 79, 80, 93, 257, 315, 434, 450, 460, 476 Toxicology, 23, 73, 76, 80, 110, 127, 147, 223, 225, 256, 257, 259, 264, 273, 298, 360, 476
Toxins, 417, 435, 436, 445, 453, 476 Tranquilizing Agents, 465, 476 Transcription Factors, 80, 249, 476 Transduction, 23, 471, 477 Transfer Factor, 444, 477 Translating, 103, 477 Translational, 30, 96, 477 Transmitter, 103, 413, 433, 446, 450, 456, 474, 477 Transplantation, 140, 234, 425, 444, 477 Trauma, 38, 55, 131, 145, 256, 261, 288, 293, 431, 454, 477 Treatment Failure, 104, 477 Triazolam, 15, 65, 237, 477 Tricyclic, 417, 431, 450, 477 Trigger zone, 418, 477 Tryptophan, 300, 470, 477 Tubercle, 457, 477 Tuberculosis, 351, 361, 367, 382, 383, 428, 477 Tuberous Sclerosis, 371, 477 Tyrosine, 276, 314, 433, 477 U Unconscious, 411, 416, 444, 477 Urea, 474, 477 Urethra, 459, 464, 477, 478 Urethritis, 440, 477 Urinalysis, 96, 209, 478 Urinary, 259, 419, 460, 477, 478 Urinary tract, 419, 460, 478 Urine Testing, 68, 241, 478 Urogenital, 440, 478 Uvea, 435, 478 V Vaccine, 349, 351, 415, 464, 478 Vascular, 201, 261, 441, 445, 476, 478 Vasculitis, 203, 341, 478 Vasodilator, 433, 443, 478 VE, 4, 296, 304, 347, 349, 478 Vector, 86, 330, 477, 478 Vein, 446, 456, 468, 478 Venereal, 475, 478 Venous, 153, 155, 464, 478 Venous Thrombosis, 153, 478 Ventral, 80, 143, 444, 457, 462, 478 Ventral Tegmental Area, 80, 478 Ventricle, 415, 423, 428, 443, 457, 465, 478 Vertebrae, 473, 478 Veterinary Medicine, 359, 478, 479 Viral, 11, 29, 349, 395, 435, 445, 477, 479 Viral Hepatitis, 395, 479 Viral Load, 11, 479
494 Drug Abuse
Virulence, 419, 476, 479 Viscera, 472, 479 Vitro, 18, 93, 104, 479 Vivo, 18, 93, 104, 479 W War, 338, 424, 462, 479 Weight Lifting, 158, 479 White blood cell, 417, 449, 461, 479
Withdrawal, 10, 11, 22, 29, 80, 88, 99, 134, 146, 197, 207, 302, 303, 317, 318, 321, 431, 451, 479 Womb, 348, 479 X Xenograft, 416, 479 X-ray, 427, 456, 466, 469, 479 Xylazine, 264, 272, 479
Index 495
496 Drug Abuse
