Substance Abuse - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

SUBSTANCE ABUSE 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 2004 by ICON Group International, Inc. Copyright 2004 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., 1960Substance 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: 0-597-84081-4 1. Substance 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: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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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 substance 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 SUBSTANCE ABUSE ................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Substance Abuse ........................................................................... 7 E-Journals: PubMed Central ....................................................................................................... 72 The National Library of Medicine: PubMed ................................................................................ 73 CHAPTER 2. NUTRITION AND SUBSTANCE ABUSE ....................................................................... 117 Overview.................................................................................................................................... 117 Finding Nutrition Studies on Substance Abuse ........................................................................ 117 Federal Resources on Nutrition ................................................................................................. 119 Additional Web Resources ......................................................................................................... 119 CHAPTER 3. ALTERNATIVE MEDICINE AND SUBSTANCE ABUSE ................................................. 121 Overview.................................................................................................................................... 121 National Center for Complementary and Alternative Medicine................................................ 121 Additional Web Resources ......................................................................................................... 126 General References ..................................................................................................................... 128 CHAPTER 4. DISSERTATIONS ON SUBSTANCE ABUSE ................................................................... 129 Overview.................................................................................................................................... 129 Dissertations on Substance Abuse ............................................................................................. 129 Keeping Current ........................................................................................................................ 161 CHAPTER 5. CLINICAL TRIALS AND SUBSTANCE ABUSE .............................................................. 163 Overview.................................................................................................................................... 163 Recent Trials on Substance Abuse ............................................................................................. 163 Keeping Current on Clinical Trials ........................................................................................... 167 CHAPTER 6. PATENTS ON SUBSTANCE ABUSE .............................................................................. 169 Overview.................................................................................................................................... 169 Patents on Substance Abuse ...................................................................................................... 169 Patent Applications on Substance Abuse .................................................................................. 182 Keeping Current ........................................................................................................................ 202 CHAPTER 7. BOOKS ON SUBSTANCE ABUSE ................................................................................. 203 Overview.................................................................................................................................... 203 Book Summaries: Federal Agencies............................................................................................ 203 Book Summaries: Online Booksellers......................................................................................... 209 The National Library of Medicine Book Index ........................................................................... 212 Chapters on Substance Abuse .................................................................................................... 213 Directories.................................................................................................................................. 215 CHAPTER 8. MULTIMEDIA ON SUBSTANCE ABUSE ....................................................................... 217 Overview.................................................................................................................................... 217 Video Recordings ....................................................................................................................... 217 Audio Recordings....................................................................................................................... 221 Bibliography: Multimedia on Substance Abuse......................................................................... 223 CHAPTER 9. PERIODICALS AND NEWS ON SUBSTANCE ABUSE .................................................... 225 Overview.................................................................................................................................... 225 News Services and Press Releases.............................................................................................. 225 Newsletters on Substance Abuse ............................................................................................... 228 Newsletter Articles .................................................................................................................... 228 Academic Periodicals covering Substance Abuse ...................................................................... 229 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 231 Overview.................................................................................................................................... 231 U.S. Pharmacopeia..................................................................................................................... 231

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Commercial Databases ............................................................................................................... 232 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 237 Overview.................................................................................................................................... 237 NIH Guidelines.......................................................................................................................... 237 NIH Databases........................................................................................................................... 239 Other Commercial Databases..................................................................................................... 251 APPENDIX B. PATIENT RESOURCES ............................................................................................... 253 Overview.................................................................................................................................... 253 Patient Guideline Sources.......................................................................................................... 253 Associations and Substance Abuse ............................................................................................ 274 Finding Associations.................................................................................................................. 275 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 277 Overview.................................................................................................................................... 277 Preparation................................................................................................................................. 277 Finding a Local Medical Library................................................................................................ 277 Medical Libraries in the U.S. and Canada ................................................................................. 277 ONLINE GLOSSARIES................................................................................................................ 283 Online Dictionary Directories ................................................................................................... 290 SUBSTANCE ABUSE DICTIONARY........................................................................................ 291 INDEX .............................................................................................................................................. 355

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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 substance 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 substance 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 substance 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 substance 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 substance 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 substance 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 SUBSTANCE ABUSE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on substance 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 substance 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 “substance 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: •

Impact of Drug Abuse on the Renal Community Source: American Kidney Fund Newsletter for Health Professionals. 7(1): 1, 5-6. 1990. Summary: Drug abuse in outpatient dialysis centers affects patients, caregivers, and center services, and it is highly likely to continue to affect renal practice in the next five years and beyond. This article discusses the impact of drug abuse on the renal community. The author identifies five drug-related issues: a higher incidence of addiction among renal patients; diminishing resources for increased needs; a breakdown in family and community support; erosion of patient solidarity; and the threat of violence. The author discusses the impact of each of these issues and emphasizes that now is the time for the renal community to start talking about the problems of drug abuse and implementing strategies to address these problems.

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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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Assessing Substance Abuse Problems in Deaf and Hard of Hearing Individuals Source: American Annals of the Deaf. 143(1): 14-19. March 1998. Summary: Professionals who provide services to individuals who are deaf and hard of hearing may encounter situations related to abuse of alcohol and other drugs. This article provides an overview of chemical dependency, assessment issues, and considerations unique to the deaf and hard of hearing population. Getting access to an agency that can provide an appropriate chemical dependency assessment for a person who is deaf or hard of hearing is difficult because there are no formalized assessment tools normed or specifically designed to use with such individuals. Additionally, most assessors are unfamiliar with how to work with people who are deaf and hard of hearing, less likely to be fluent in American Sign Language, and unaware of appropriate treatment options. The authors describe a chemical dependency assessment tool developed by the Minnesota Chemical Dependency Program for Deaf and Hard of Hearing Individuals. They also report a case study that illustrates application of the assessment process. 1 table. 6 references.

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Renal Disease and Psychoactive Substance Abuse and Dependence Source: American Kidney Fund Newsletter for Health Professionals. 7(1): 1-4. 1990. Summary: Psychoactive substance use disorders, more commonly referred to as alcohol and drug addiction, are important but under-diagnosed and under-treated causes of renal disease. These disorders also complicate the treatment of many patients with endstage renal disease who are undergoing chronic dialysis and/or who are being considered for transplantation. This article discusses renal disease and psychoactive substance abuse and dependence. The author explores definitions of substance dependence and abuse, misconceptions about addiction, renal complications of substance use, issues for dialysis programs, and issues for transplant programs. The author stresses that health providers can decrease enabling behavior that helps perpetuate addiction by confronting patients about addiction and encouraging patients to enter treatment for substance abuse. 9 references.

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Patients who are Substance Abusers Source: New York State Dental Journal (NYSDJ). 68(5): 24-27. May 2002.

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Contact: Available from Dental Society of the State of New York. 7 Elk Street, Albany, NY 12207. (518) 465-0044. Summary: Substance abuse cuts across all social groups. This article offers the dentist background information regarding drug abuse in the United States. The authors define common terms, discuss the rationale for identifying substance abusers (including possible drug interactions), provide a list of 'telltale signs' for recognizing a chemical abuse problem, and suggest ways to approach a suspected abuse problem. The authors recommend that dentists become familiar with agencies, private practitioners or health care facilities in their community to which they may refer patients; lists of referral sources should be handy and printed out, as for any other consult or referral situation. One sidebar lists the psychosomatic effects associated with various illicit drug groups. 4 figures. 13 references. •

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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Deaf Culture and Alcohol and Substance Abuse Source: Journal of Substance Abuse. 9(2): 103-110. 1992. 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).

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Substance Abuse and HIV in Native Communities: How Substance Abuse Programs Are Addressing HIV Source: SEASONS. Contact: National Native American AIDS Prevention Center, 436-14th St Ste1020, Oakland, CA, 94612, (510) 444-2051, http://www.nnaapc.org. Summary: This article describes counseling and education programs that have been developed and implemented by substance abuse counselors in various Native American communities. It discusses programs at the Seminole Nation of Oklahoma, the Pascua Yaqui Tribe, Friendship House in San Francisco, and the Hoopa Reservation. It features information from interviews with an HIV/AIDS educator in each program.

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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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Talking to Your Kids About Substance Abuse Source: Diabetes Self-Management. 19(5): 54, 56, 58, 60, 63. September-October, 2002. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Website: www.diabetes-self-mgmt.com. Summary: This article on talking to kids about substance abuse is written for the parents of children and adolescents with diabetes. The author presents the bad news as the ease with which teens can get hold of drugs and alcohol and the common behaviors of experimenting with smoking and drinking. The good news is that parents can work toward keeping their children from abusing substances such as cigarettes, alcohol, or drugs. The author reviews the rationale of why teens experiment with smoking, drinking and illegal drugs, then considers that additional risks to adolescents with diabetes. The article then outlines strategies to begin conversations with adolescents and to maintain ways to stay involved with the child's life. The author encourages parents to model positive behavior for their children and to include other resources (family members, community organizations) that will reiterate the same messages about substance abuse. The article concludes with a list of signs and symptoms of potential substance abuse. One sidebar reviews safety tips for teens with diabetes; another lists substance abuse resources for readers needing additional information.

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Nutritional Status of Substance Abusers with Mandible Fractures Source: Journal of Oral and Maxillofacial Surgery. 58(2): 153-157. February 2000. Contact: Available from W.B. Saunders Company. Periodicals Department, P.O. Box 628239, Orlando, FL 32862-8239. (800) 654-2452. Summary: This article reports on a study undertaken to assess the validity of patient self report in identifying illegal substance abuse and to identify nutritional deficiencies in substance abusers presenting for treatment of mandible fractures. To address the research purposes, a prospective cohort study was conducted of patients presenting for treatment of mandible (lower jaw) fractures. A urine drug screen was used to determine the validity of patient self report of substance abuse. For purposes of assessing nutritional status, 2 categories of substance abusers were identified: illegal and legal (alcohol). The nutritional status was measured using various laboratory markers. The sample was composed of 93 subjects. Urine drug studies were available for 32 patients. Of the 22 patients who denied illegal drug use, 12 (55 percent) had a positive drug screen. Of the 10 patients reporting a positive history of illicit drug use, 7 (70 percent) had a positive urine drug screen. A positive correlation was found between alcohol

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exposure and serum aspartate aminotransferase, mean corpuscular volume, and lactate dehydrogenase. Positive drug screens also were associated with increased serum ferritin levels. The results of this study suggest that patient self report of illicit drug use may be unreliable. The findings also suggest that legal and illegal substance abusers presenting for treatment of mandible fractures have minimal nutritional deficiencies. 2 tables. 31 references. •

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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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.

Federally Funded Research on Substance Abuse The U.S. Government supports a variety of research studies relating to substance 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

2 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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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 substance 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 substance abuse. The following is typical of the type of information found when searching the CRISP database for substance abuse: •

Project Title: ADOLESCENT SUBSTANCE ABUSE PERFORMANCE MEASURES Principal Investigator & Institution: Lee, Margaret T.; None; Brandeis University 415 South Street Waltham, Ma 024549110 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-MAY-2006 Summary: (provided by applicant): This revised application is submitted in response to PA-01-097: Drug Abuse Health Services Research for a R21 Exploratory/Developmental study. The proposed study will develop performance measures for adolescent substance abuse services, and test the feasibility of the measures using administrative data. Steps are needed to increase the accountability for delivery of services that will lead to positive outcomes for adolescents. This is the role of substance abuse performance measures. The feasibility of both new measures and several that have been previously developed for adults by the Washington Circle Group (WCG) will be tested and linkage of process to treatment outcomes for adolescents will be examined. The specific aims of the proposed research are to: (1) Develop new performance measures for adolescents based on effective treatment processes, (2) Test the feasibility of both these newly developed measures and those previously developed by the WCG for adolescents, using state administrative data, and (3) Explore the relationship of treatment processes to substance abuse treatment outcomes for adolescents, using a state database. The data source will be from the Oklahoma Department of Mental Health and Substance Abuse Services (DMHSAS). Descriptive analyses are planned to compare adolescents who receive the established recommended treatment as specified by the performance measure to those who do not. Multivariate analyses will be conducted to determine the relationship between process measures and substance abuse treatment outcomes for adolescents. The significance of the proposed study is that it will extend the work on performance measures conducted by the WCG to the adolescent population. By the completion of the proposed project, we plan to have identified and specified a set of substance abuse performance measures for adolescents that are based on effective treatment processes. In addition, we will have determined which measures can be calculated using a state database such as the Oklahoma DMHSAS data. The relationships between each of seven specific treatment processes to treatment outcomes will be evaluated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ADOPTION AND IMPLEMENTATION OF ADOLESCENT EBT STATE-WIDE Principal Investigator & Institution: Henggeler, Scott W.; Professor and Director; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425

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Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): The overriding purpose of this study is to examine the statewide adoption and implementation of an evidence-based adolescent substance abuse treatment by practitioners working within the state substance abuse treatment system (South Carolina Department of Alcohol and Other Drug Abuse Services, DAODAS) and the state mental health system (South Carolina Department of Mental Health, DMH). Impetus for this project comes from several significant challenges in providing and transporting effective (i.e., evidence-based) substance abuse treatments to adolescents in real world practice settings (IOM, 1998). In light of these challenges, it seems reasonable to consider the viability of additional strategies for providing effective substance abuse treatment to adolescents. One possibility, and the focus of the present study, is to provide substance abuse treatment through the existing and more extensive network of mental health providers. Mental health providers might be relatively amenable to the adoption of evidence-based practices for a number of reasons. Substance abuse counselors, however, might be equally amenable when given access to the resources needed to implement an evidence-based practice (e.g., training, resources, ongoing consultation). Therefore, in collaboration with DAODAS and DMH, this study will provide an equal and voluntary statewide opportunity for DAODAS and DMH practitioners who treat marijuana abusing adolescents to receive training in contingency management as well as to have access to resources that facilitate the implementation of this evidence-based practice. Primary aims include: Aim 1: Evaluate the predictors of voluntary attendance at a contingency management (CM) workshop, based on demographic, professional training, organizational (e.g., culture, climate, structure), and service sector (substance abuse vs. mental health) measures collected from practitioners at the 33 DAODAS provider organizations and the 17 DMH community mental health centers prior to receiving an opportunity to be trained in this evidence-based treatment of adolescent marijuana abuse. Aim 2: Determine the predictors of CM implementation during the 6 months following CM training among those practitioners who attended the CM workshop, based on demographic, professional training, organizational (e.g., culture, climate, structure), and service sector (substance abuse vs. mental health) measures. Aim 3: Conduct exploratory analyses to assess whether barriers to workshop attendance and practitioner implementation of CM following such attendance contribute variance above that of the aforementioned variables. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AFTERCARE FOR ADOLESCENTS WITH SUBSTANCE USE DISORDERS Principal Investigator & Institution: Kaminer, Yifrah; Associate Professor; Psychiatry; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2007 Summary: (provided by applicant): Adolescent Alcohol and Other Substance Use Disorders (AOSUD) continue to present as a major public health problem. Regional studies reveal that between 7-10%of adolescents are in need of treatment. Little is known empirically about the effectiveness of various treatment methods and techniques for adolescents with AOSUD, mainly due to restricted resources including a limited number of clinical investigators in this area. There is a pressing need to mentor more clinical investigators who will concentrate on effective treatment and aftercare for adolescents. This proposal to meet three complementary objectives, 1) develop and implement a mentor ship program for new clinical investigators interested in the treatment and aftercare of adolescents with AOSUD; 2) conduct a clinical trial focusing

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on treatment and aftercare for adolescents with AOSUD; and 3) further advance the applicant's skills in research methodology and data analysis in order to become both a better independent clinical investigator and a more effective mentor. The applicant is an experienced child and adolescent psychiatrist who has demonstrated 1) a long-term commitment as a career clinical scientist in the assessment and treatment of adolescent AOSUD; 2) academic productivity by publishing, teaching, and training in this domain nationally and internationally; and 3) an ability to obtain research funding. This award will allow the applicant protected time to pursue quality mentoring of future clinical investigators while conducting clinical research that will optimize long-term scientific contributions of both the mentor and trainees. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AMERICAN WOMEN AND SUBSTANCE ABUSE 1865-1980 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 05-FEB-1999; Project End 31-JAN-2004 Summary: The proposed project builds on Dr. Musto's perspective on U.S. narcotics policy during the 19th and 20th Centuries, gained over the course of his long career studying American drug use. The project will provide a picture of American women's experience with psychoactive substances between 1865 and 1980 that will be useful as a context for present day policy planning and public discourse. The thesis upon which the analysis will be based and around which the material will be organized is that there is a powerful dynamic between changing images of drugs and changing roles and images of women, and that this dynamic is, in turn, affected by the large social and intellectual currents that give special character to given "ages" in our history. Some of the basic issues that must be analyzed in order to test this thesis include the role of gender and class as factors in incidence and prevalence of drug abuse among women; the impact of drug use on women's roles as wives, mothers, and sexual partners; the relationship between drug use and women's health issues; and finally the role that women have played in defining the policy debate on drug abuse. The project researchers will collect, organize, and analyze materials that respond to the subsets of the larger proposition from as great a variety of primary and secondary sources as possible, with an emphasis on the former. With a few important exceptions, the existing historical literature on the history of substance abuse among American women has relied primarily on secondary sources. Particularly with respect to debates on the narcotics problem, which are often highly politicized, primary sources in the form of unpublished archival material must be consulted where available in order to produce as unbiased an account as possible of both the actors' motivations and the actual state of the drug problem. After completion of this basic research, the full texts of hundreds of the most important historical documents will be prepared for publication on CD-ROM. Dr. Musto will also produce a print volume of analysis and commentary on these documents. It is hoped that the CDROM project will form a basic resource for both historical research and policy planning. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: AMERSA ANNUAL NATIONAL CONFERENCE Principal Investigator & Institution: Samet, Jeffrey H.; Professor of Medicine; Assn/Medical Educ & Res in Subs Abuse & Research in Substance Abuse Providence, Ri 029083246

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Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): The Annual National Conference of the AMERSA is the major meeting for health professional educators focused on substance abuse. The annual scientific meeting gives physicians and other health professionals the opportunity to increase their knowledge of new educational programs in the substance abuse area. It facilitates the process of networking of faculty from multiple disciplines working in the substance abuse field. AMERSA will hold its 26th annual national conference on November 7-9, 2002 at the Hilton in Alexandria, VA. Meetings in subsequent years are scheduled in the Washington, D.C. area on November 6-8, 2003, November 4-6, 2004, November 10-12, 2005 and November 9-11, 2006. For the 2002 meeting, this proposal aims to strengthen the high quality and diversity of the conference through speaker fees to attract preeminent speakers, provision of continuing education gratis to participants, and outreach efforts to diverse, multidisciplinary health professionals. The primary mission of AMERSA is to encourage the development of educational programs in substance abuse and develop cadres of substance abuse health professional educators who will effectively facilitate the transfer of research to practice. AMERSA 1) provides leadership and improves training for all health care professions in the management of problems related to alcohol, tobacco and other drugs; 2) disseminates state-of-the-art information about substance abuse education and research, through means such as the National AMERSA conference and the organization?s journal, Substance Abuse; 3) provides mentoring for health professionals interested in becoming teachers, clinicians and researchers in the field; 4) promotes cultural competence and inclusiveness among health care professionals in their work with individuals affected by alcohol, tobacco and other drug problems; 5) promotes collaboration among multiple professions including, but not limited to, medicine, nursing, social work, psychology, dentistry, pharmacology, and public health; and 6) builds a national network of substance abuse experts who can advise local, national, and international organizations on health professional substance abuse education through representation of national forums. Plenary topics have been proposed for the 2002 meeting: Juvenile and Family Drug Courts, Tobacco Policy, Contingency Management and Community Reinforcement, Opioid Dependence in Pregnancy, Nicotine Dependence in Minority Populations and Buprenorphine -Early Reports on Primary Care Implementation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ANXIETY, DISINHIBITION, AND RISK FOR DRUG ABUSE Principal Investigator & Institution: Grillon, Christian; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 15-SEP-1999; Project End 31-JUL-2004 Summary: This application requests funding for a four-year study to investigate psychophysiological markers for substance abuse in children ages 13-17 who are at high risk for substance abuse by virtue of their parental history for this condition. The rationale for the present proposal is to search for psychophysiological abnormalities associated with the two main dimensions of personality linked to substance abuse, that is, negative affectivity/anxiety and disinhibited/antisocial behaviors. Theorists have proposed a biobehavioral model based on responses to aversive and appetitive stimuli to explain the neurophysiological basis of motivational behaviors and to account for childhood mental disorders. The model posits that motivational behaviors is influenced by an arousal system, and by a behavioral inhibition system (BIS), which processes signals related to aversive stimuli, and a behavioral activation system (BAS), which

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processes signal related to rewards. Psychopathology is assumed to result from an imbalance within these systems. The major hypothesis for which we have preliminary support is that distinct deficits in arousal and/or affective responses underlie the relationship between substance abuse and both anxiety and disinhibited/antisocial personality. Specifically we will examine the following in children of parents with 1) substance abuse only, 2) substance abuse and comorbid anxiety disorder, 3) substance abuse and antisocial personality disorder, and 3) no psychiatric disorders: 1. startle potentiation and autonomic nervous system (ANS) measures of arousal to threat of aversive stimuli; 2. ANS responses to reward and to the removal of reward; 3. Asymmetry of resting EEG; 4. the association between psychophysiological measures of BAS and BIS activity and temperamental characteristics associated with anxiety and disinhibited/antisocial behavior; 5. the effects of the gender of the offspring in the relationship between parental history and the offspring's psychophysiological, temperamental, and clinical characteristics; 6. phenotypic indices of vulnerability using combinations of clinical and psychophysiological measures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BRAIN FUNCTION IN SUBSTANCE-DEPENDENT ABUSED WOMEN (PILOT) Principal Investigator & Institution: Ernst, Frederick A.; Professor; Meharry Medical College 1005-D B Todd Blvd Nashville, Tn 37208 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2007 Summary: Substance dependence has had an enormous deleterious impact on the health and well-being of Americans. Understanding the process by which persons become vulnerable to substance abuse will be necessary to more effectively prevent and treat this pervasive problem in American society. It is well-known that childhood sexual abuse (CSA) is strongly related to various manifestations of psychopathology including dissociative disorders, anxiety disorders, personality disorders, and substance abuse. However, the empirical study of this relationship is difficult because of the private, very personal, and traumatic nature of the childhood experiences associated with CSA. Current methods of screening for CSA in treatment programs for chemical dependence depend largely on the Addictions Severity Index (ASI) and are believed to be inadequate. Part of this proposed pilot investigation seeks to test the validity of the ASI for the identification of CSA by comprehensive interview methods and through the use psychometric and neuropsychological measures that are likely to indirectly detect adult manifestations of CSA experiences. An additional aim of the proposed investigation is to study prefrontal cortical functioning in eighty women, 40 blacks and 40 whites, from the treatment programs of the Meharry Alcohol and Drug Abuse Program. Forty women with reported histories of CSA will be compared to 40 women who report no history of CSA. It is hypothesized that substance-dependent women with histories of CSA will reveal more severely impaired prefrontal function than women reporting no history of CSA when matched on potential confounding variables including race, SES, age, substance abused, and length and severity of substance dependence. The Emotional Stroop Task, a modified version of the original Stroop, the Trails A and B, a Stop-Signal Test, a Negative Priming Task, and Directed Forgetting will form a battery of tests to yield a composite measure of prefrontal function. Data will be analyzed by MANOVA with Race and Sexual Abuse History as independent variables and prefrontal function as a dependent variable. The validity of the ASI is expected to reveal a significant frequency of false negatives when compared to comprehensive interview. No racial difference in the extent of CSA history or its effect on prefrontal function is expected and

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subjects with histories of CSA are expected to reveal relatively impaired prefrontal functioning irrespective of race. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BRIEF COUPLES THERAPY IN DRUG ABUSE TREATMENT Principal Investigator & Institution: Fals-Stewart, William S.; Senior Research Scientist; None; State University of New York at Buffalo Suite 211 Ub Commons Amherst, Ny 14228 Timing: Fiscal Year 2001; Project Start 25-JUN-2001; Project End 31-MAY-2006 Summary: (Applicant's Abstract) Behavioral Couples Therapy (BCT) is associated with positive outcomes for couples in which one of the partners abuses drugs or alcohol, both in terms of reduced psychoactive substance use and improved relationship functioning. However, a major practical limitation of the use of BCT with substance-abusing patients is that it has been delivered either as an adjunct to an intensive outpatient treatment regimen, typically requiring 15-20 couples sessions along with individual sessions or group counseling, or is offered as the primary or only intervention. A recent survey of substance abuse treatment programs strongly suggests that, despite its effectiveness, a very small minority use BCT (or other couples-based treatments). Nearly all program administrators interviewed noted they would be unwilling to provide BCT or other couples treatment as (a) a primary intervention or (b) over the course of so many sessions if it were used as an adjunct intervention to other treatments. Nearly all programs noted they would use a couples-based intervention as an adjunct to other services if it was brief, shown to be effective in reducing substance use and improving other psychosocial outcomes, and could be integrated into existing treatments (e.g., individual counseling, group counseling). Thus, the mandate for investigators is to develop an abbreviated version of BCT that retains the effectiveness of standard BCT and could therefore be more attractive and more widely implemented within the substance abuse treatment community. Thus, the PRIMARY OBJECTIVE of the proposed study is to conduct a randomized clinical trial with 214 married or cohabiting drug-abusing patients and their nonsubstance-abusing partners to examine the comparative clinical efficacy, in terms of 1-year posttreatment drug-using behavior, relationship functioning, and other psychosocial outcomes, or Abbreviated BCT (i.e., ABCT) versus (a) standard BCT, (b) Individual-Based Treatment, and (c) a Psychoeducational Attention Control Treatment. The SECONDARY OBJECTIVE is to compare the cost-benefit and cost-effectiveness of the treatment conditions. Pilot data indicate ABCT is as clinically effective as standard BCT, but is far less costly to deliver, primarily due to the significantly reduced number of sessions required to deliver ABCT. This Stage II study extends pilot studies conducted by the investigators with ABCT by (a) recruiting more participants, (b) including substance-abusing women and their nonsubstance-abusing partners, (c) recruiting a more homogeneous patients sample (i.e., primary cocaine-abusing patients) of which a smaller proportion are mandated to treatment by the legal system, and (d) using a longer posttreatment follow-up period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BRIEF INTERVENTION IN AT-RISK FIRST-TIME MOTHERS Principal Investigator & Institution: Ondersma, Steven J.; Assistant Professor; None; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2001; Project Start 25-APR-2001; Project End 31-MAR-2006

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Summary: (Applicant's Abstract) CANDIDATE. The applicant is a child clinical psychologist with a background in child maltreatment, including work with mothers of drug-exposed infants. His goal is to validate interventions that facilitate readiness to change in parents at risk of child maltreatment, especially those at risk due to substance abuse. The proposed K23 award will make possible close supervision from Dr. Schuster and the advisory team, observation of state of the art programs, graduate coursework, and applied experience, through which the applicant will gain advanced skills in (a) research methodology and data analysis, especially regarding clinical trials; (b) substance abuse and motivational models; (c) culturally sensitive and ethical research with a vulnerable population; and (d) the measurement of attachment in infancy, as well as an increased record of scholarly productivity. ENVIRONMENT. Wayne State University is a Carnegie I research institution. Access to WSU's many senior researchers, including Dr. Schuster's productive clinical research division and faculty with expertise in perinatal substance abuse, longitudinal research, child maltreatment, and attachment, is available. The applicant has extraordinary support from his institute's director and from WSU's Vice President for Research, and will be freed of all teaching or clinical duties. RESEARCH PLAN. The above training will inform and be continued through the research plan, which is based on a model hypothesizing readiness to change as a mediator of the relationship between risk/protective factors and child maltreatment, especially in a services-rich environment. Intensive, barrier-free early intervention programs aimed at child maltreatment prevention (especially those targeting substance-abusing and other high-risk populations) have faced significant problems with engagement and retention, causing reductions in overall effectiveness and less efficient use of resources. To address the gaps between (a) availability of/need for services and service utilization, and (b) need for and readiness for change, theory and technique from the substance abuse field - including brief motivational interventions, the use of operant behavioral principles, and a "check-up" model - will be applied via a brief intervention with first-time parents in an urban Detroit hospital. Following a development and pilot phase, a small-scale clinical trial will assess the impact of a brief motivational intervention on maltreatment, attendance at community programs, and risk-related change. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CAREER TRAINING IN ADOLESCENT ALCOHOL TREATMENT RESEARCH Principal Investigator & Institution: Deas, Deborah V.; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 01-AUG-1997; Project End 31-JUL-2003 Summary: APPLICANT'S ABSTRACT: The current proposal is a request for a K08 Mentored Clinical Scientist Development Award. The candidate, Dr. Deborah DeasNesmith, is a child/adolescent psychiatrist in the field of adolescent substance abuse at the Medical University of South Carolina, Center for Drug and Alcohol Programs. In order for the candidate to develop into a sophisticated, independent researcher, she must receive additional didactic and experiential research training in treatment research which is not possible in her current faculty position due to the vast amount of clinical and teaching responsibilities required. The long-term objectives of the proposal are to: acquire expertise in research-related skills as well as acquire skills in theory, development and execution of manual-guided therapies for adolescents; and to gain expertise in the delivery of an assessment battery, and cognitive behavioral (CBT) and 12-step facilitation (TSF) therapy to adolescent substance abusers in a clinical trial. The

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proposed research plan addresses the need for systematic exploration of the effectiveness of psychosocial interventions in the treatment of adolescent substance abusers. The project integrates the ~candidate's skills and expertise in the area of adolescent substance abuse with a training plan designed to develop skill in nonpharmacologic treatment interventions and in adolescent treatment outcome research. The proposed research is a randomized clinical trial which will compare two standard approaches used in the treatment of adult alcoholics (CBT and TSF), in treatmentseeking adolescents who abuse alcohol. The hypothesis being tested is that treatmentseeking adolescent alcohol abusers will have better treatment outcome over a six month period with cognitive behavioral therapy intervention than with a 12-step facilitation therapy intervention. The specific aims are to modify existing CBT and TSF therapy manuals to suit adolescent alcohol abusers as well as gain training in the use of these manuals; to pilot test and revise manuals if necessary and conduct a 12-week randomized trial of weekly individual CBT or TSF in 84 (42/group) adolescents presenting for outpatient treatment of alcohol abuse/dependence. The study involves a randomized clinical trial assigning substance abusing adolescents to one of two 12-week individual psychotherapy groups. The proposed research is divided into several phases which will take place over the 5 year training period. Phase I will consist of manual development/revision for substance abusing adolescents; in Phase 2, the manual and research assessment battery will be pilot tested for feasibility and acceptability; and in Phase 3, the subjects will be randomly assigned to one of the two treatment conditions, and treatment will begin. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CAUSAL EFFECTS OF COMMUNITY-BASED TREATMENTS FOR YOUTHS Principal Investigator & Institution: Mccaffrey, Daniel F.; Rand Corporation 1700 Main St Santa Monica, Ca 90401 Timing: Fiscal Year 2003; Project Start 05-APR-2003; Project End 31-MAR-2006 Summary: (provided by applicant): The number of substance abuse program admissions for youths in the United States has been rising dramatically, increasing by 46 percent from 1993 to 1998. Despite this growth, little is known about the effectiveness of community-based treatment services for adolescents. Previous studies find that some adolescent outcomes improve after treatment and that outcomes vary across service modalities. These studies, however, are descriptive. They do not examine whether the services youths receive cause the observed functional improvements, or whether these improvements instead are caused by factors unrelated to treatment services, like maturation, the natural course of adolescent psychosocial problems or pretreatment differences in groups. Determining the causal effect attributable to adolescent services is more complex, but policy relevant: unless we know the relative improvement attributable to a particular form of treatment, time-in-treatment or source of referral, we can neither evaluate the relative cost-effectiveness of alternative services nor determine the value in funding such services. The proposed study estimates the causal effects of community-based adolescent services using data collected in NIDA's Drug Abuse Treatment Outcomes Studies for Adolescents (DATOS-A). Innovative statistical methods are planned to distinguish pretreatment group differences from differential treatment effects in the explanation of 12-month post treatment outcomes of youths receiving different service modalities. The study has four specific aims: 1) estimate the causal effects of outpatient, residential and short-term inpatient services on the outcomes of those adolescents most likely to enter each program; 2) for each modality,

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estimate the causal effects of treatment length; 3) compare the effectiveness of courtreferred services to those provided without legal pressure; and 4) develop and evaluate statistical methods required for aims 1 to 3, and compare findings using our new methods to those produced using methods more standard in substance abuse treatment services research. This study will provide the most rigorous and conclusive assessment of the comparative effectiveness of community-based adolescent substance abuse programs yet conducted. In addition, it will develop and disseminate more relevant and robust causal modeling approaches to substance abuse treatment services research than are currently used in our field. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CHILD PSYCHOPATHOLOGY, ADVERSITY & DEVELOPING DRUG ABUSE Principal Investigator & Institution: Molnar, Beth; Maternal and Child Health; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2003; Project Start 06-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Comorbidity of addictive and mental disorders has been shown to be pervasive, with more than half (54%) of those aged 15-54 in the National Comorbidity Survey who had one diagnosable disorder having at least one cooccurring disorder. Less is known about comorbidity in youth or the degree to which it is affected by environmental factors. This proposal describes a two-year, multi-level investigation of the roles that mental disorders and adverse family, school, and community environments play in increasing risk of children and adolescents' misuse of alcohol and other drugs. The primary objective is to identify preventable antecedents of youth substance use disorders, using a developmental psychopathology approach. These investigations will be accomplished through secondary analyses of a multi-level study of 3000 youth and their communities, gathered by the Project on Human Development in Chicago Neighborhoods (PHDCN) from 1995-2001. Comorbidity between mental and addictive disorders among the youth will be described; additionally, the developmental risk processes that gave rise to the disorders themselves on the pathway to subsequent substance problems will be investigated. This proposal is being submitted by a new investigator, trained in social/psychiatric epidemiology. Youth, 9-18 years of age at baseline, and a caregiver were interviewed at home three times. Community characteristics were measured in 1995 and 2001 from independent samples and from videotapes of subjects' neighborhoods. Multilevel statistical methods will be used including discrete time survival analysis, hierarchical linear modeling, and individual growth modeling. This sample is uniquely suited to address the proposed aims, given (1) the longitudinal nature of the study; (2) the ability to compare neighborhoods and schools using an ecological framework and measurement of contextual features; and (3) comprehensive assessments of individual mental health and substance use behaviors. The use of existing data sets represents an opportunity to address these questions in a cost-effective manner. In his 1999 report on mental health, former U.S. Surgeon General Satcher asserted that little is known about the role of mental disorders in increasing the risk of misuse of alcohol and other drugs by youth. By addressing this research silence in a scientifically sound, multi-level study design, the products of the proposed research will be important contributions toward improving the planning and efficacy of health promotion and substance abuse prevention programs at the individual and local community level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CHILD WELFARE, DRUG ABUSE AND INTERGENERATIONAL RISK Principal Investigator & Institution: Mccallion, Philip; None; State University of New York at Albany 1400 Washington Ave Albany, Ny 12222 Timing: Fiscal Year 2003; Project Start 05-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): We seek to establish a program of research on Child Welfare, Drug Abuse and Intergenerational Risk (CWDAIR) based in the School of Social Welfare (SSW) at the University at Albany. The goal is to advance research on the development and delivery of coordinated, evidence-based and theoretically-oriented services for parents in the child welfare system with addiction and co-occurring problems including HIV/AIDS. The focus on substance abuse in conjunction with HIV/AIDS within child welfare families is timely, appropriate, and significant since children in these families face significant barriers to healthy development. Improved and more integrated services for parents will reduce the risk of drug abuse and other negative outcomes in the next generation. The CWDAIR Program has two specific aims: first, to build an infrastructure for conducting interdisciplinary research on drug abuse and HIV/AIDS in child welfare families, including the development and support of interdisciplinary research teams based in SSW; and second, to develop collaborative partnerships with state agency leaders and professionals from child welfare, HIV/AlDS, and substance abuse services to improve the design of services to address substance abuse and co-occurring problems among high risk parents. The research program will support high impact collaborative research leading to R01, R03 and K awards, better services for high-risk families, and reduced intergenerational transfer of risk. In order to achieve Program aims, a capacity-building infrastructure development is planned. Specifically the CWDAIR Program will: (1) launch an intensive faculty development program of seminars and training focused upon crosscutting child welfare, HIV/AIDS and substance abuse interventions; critical collaboration issues; improved services to racially and ethnically diverse families; and state of the art methodologies (2) provide methodological and computer support, training, and pilot project supports to foster the development of fundable research projects, especially involving junior faculty and doctoral students (3) support two initial pilot projects designed with interdisciplinary and community consultation, (4) seed a mini-grants program designed to further develop collaborative research projects among community practitioners, faculty from other disciplines within and beyond the University at Albany and SSW faculty, (5) design and implement an infrastructure evaluation system that identifies key lessons learned, informs subsequent stages of infrastructure and blended research development and (6) advance dissemination and communication through web-pages, listservs, research briefs, presentations and publications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CHOLESTEROL AND FATTY ACIDS IN COCAINE ADDICTION RELAPSE Principal Investigator & Institution: Buydens-Branchey, Laure B.; Acting Associate Chief of Staff; Narrows Institute for Biomedical Res Inc Biomedical Research, Inc. New York, Ny 11209 Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 31-JUL-2005 Summary: (provided by applicant): The goal of this project is to determine whether our preliminary findings of significant associations between low circulating levels of cholesterol and of some polyunsaturated fatty acids (PUFAs) and the relapse rate of

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detoxified cocaine addicts can be replicated in a larger population sample. Attempts will be also made to determine whether some factors such as poor nutritional habits contribute to the presence of altered cholesterol values or fatty acid profiles in some patients. The role of cholesterol and PUFAs has not been investigated in addictive disorders but our data can be understood in light of recent literature suggesting the existence of associations between low cholesterol levels and a number of psychiatric disorders including depression, suicide and violence. Cholesterol does not cross the blood-brain barrier but it has been suggested that it could be a marker for changes in PUFAs. There is mounting evidence that low levels of some PUFAs are also associated with a variety of psychiatric disorders. Some PUFAs are main components of neuronal synaptic membranes and influence neuronal function. Preclinical studies have demonstrated that PUFAs influence the function of dopamine and 5-HT that play a role in reward mechanisms. One hundred and twenty cocaine addicts admitted to a Substance Abuse Inpatient Unit will be studied. While on the ward, they will undergo assessments of cholesterol and its subfractions and of the entire fatty acids series. After discharge, they will be transferred to a Substance Abuse clinic where follow-up assessments will be conducted for 12 months. The primary outcome measures will be time to relapse as determined monthly by qualitative urine and selfreported use. Psychosocial functioning, cocaine craving and dietary intake will also be monitored monthly. Cholesterol and fatty acids will be determined every 3 months. If our preliminary findings are confirmed, the use of fatty acids supplements or changes in dietary habits could have a significant potential in the prevention of relapse in a subgroup of cocaine addicts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLINICAL INVESTIGATION OF DRUG ABUSE DISORDERS Principal Investigator & Institution: Brady, Kathleen T.; Professor of Psychiatry; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 15-AUG-1999; Project End 31-JUL-2004 Summary: This mid-career investigator award application is designed to support the continued efforts of Dr. Kathleen T. Brady, M.D., Ph.D. in conducting and mentoring patient-oriented drug abuse research. Dr. Brady has been continuously funded to conduct patient-oriented research with substance abusing individuals since completing her psychiatric residency training in 1989. Her particular areas of interest are in psychiatric comorbidity with substance use disorders and the pharmacotherapy of substance use disorders. She is currently funded as the PI on four (Concurrent Treatment of PTSD and Cocaine Dependence, Naltrexone Use in a Community Setting, Sertraline Treatment of Comorbid Alcoholism and PTSD, and Valproate in Relapse Prevention) and the Co-PI on two (Amlodipine in Cocaine Dependence and Buspirone in Methadone Maintained Individuals with GAD) patient-oriented substance abuse research projects. Dr. Brady has a strong track record in mentoring beginning clinical researchers. She is currently the director of the Addiction Psychiatry Fellowship Program and the co-director of a NIDA-funded post-doctoral research fellowship training program. Dr. Brady is a faculty member in the Center for Drug and Alcohol Programs (CDAP) which is an active and productive clinical and research training environment. CDAP provides a variety of education and training-related activities to faculty and students. There are currently eleven faculty at CDAP conducting eighteen funded, patient oriented research projects. The candidate's immediate career goals include the initiation of pilot work to support the competing renewals of existing

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projects and assisting two junior faculty with the submission of K awards. Her longterm career goals are to continue work in patient-oriented substance abuse research in new directions which build on existing studies. Investigation of CRF antagonists in the treatment of substance use disorders in a clinical setting and the development of a human laboratory model for the measurement of risk-tasking and impulsivity are two areas of preliminary investigation which would be developed during the award period. The candidate would also use the time and funding provided through this award to expand her activities in mentoring fellows and junior faculty in patient-oriented research. This award will allow Dr. Brady to be relieved from a number of clinical and administrative duties in order to refocus her career to center on clinical research and clinical research training activities. 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 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

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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 RESEARCH TO IMPROVE DRUG ABUSE TREATMENT ENTRY Principal Investigator & Institution: O''toole, Thomas P.; Medicine; 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) This is a request for a Mentored Patient-Oriented Career Development Award. Over the five years of the award, the candidate will conduct one observational study and two clinical trials of hospital-based interventions to improve drug abuse treatment entry and retention among medicine inpatients. Primary mentorship will be provided by Drs. George Bigelow and Daniel Ford. Additional mentoring and tutorial assistance will be provide by Drs. Maxine Stitzer, Laura Morlock, and Carlo DiClemente. The goals for this career development project are to better understand the role of the medical hospitalization on motivation for treatment and readiness for change and to assess whether clinical interventions can improve subsequent treatment entry and retention. Specific aims are to (1) identify factors within an acute hospitalization episode that influence a person's motivation for and actual entry into treatment. (2) Determine whether hospital-based clinical interventions improve treatment entry and retention upon hospital discharge. (3) Determine whether these interventions effect subsequent health utilization and management of concurrent HIV infection. Three sub-studies will be conducted on a cohort of substance abusing patients admitted to the medicine service at Johns Hopkins Hospital: (a) an observational, longitudinal study of substance abusing medicine inpatients; (2) a randomized clinical trials of peer mentor-structured transitional support and (3) a quasiexperimental study of concurrently administered substance abuse treatment. This program of research and training will provide important information on the acute medical hospitalization for substance abusing patients and how it can best be structured to improve health care and substance abuse outcomes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CLINICAL TRIALS NETWORK, OHIO VALLEY NODE Principal Investigator & Institution: Somoza, Eugene C.; Medical Director; Psychiatry; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: The Cincinnati Addiction Research Center (CinARC) proposes to form the Ohio Valley Node of the NIDA Clinical Trials Network (CTN) and to function as its Regional Research and Training Center (RRTC). The Ohio Valley Node would initially encompass the University of Cincinnati-based RRTC and six community-based treatment programs (CTPs) in Ohio, Indiana, Kentucky, and West Virginia. It would thus contribute a mid-western and Appalachian presence to the CTN, enhancing the network's geographical and cultural diversity. The goal of this proposal is to facilitate the CTN's evaluation and implementation of effective substance abuse treatments in community settings by operating a highly efficient and effective node that includes diverse treatment programs and patient populations. The Ohio Valley Node RRTC is primarily composed of the research team that has successfully conducted clinical trials for the Cincinnati NIDA Medication Development Research Unit (MDRU) since 1995.

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The RRTC team thus has extensive experience in conducting both single- and multi-site substance abuse trials in cooperation with NIDA and other NIDA-funded centers and has been recognized by NIDA for excellence in conducting clinical trials. The initial six CTPs of the Ohio Valley Node bring a rich variety of substance abuse services, treatment modalities, and patient populations to the CTN. Together, they treat almost 18,000 substance abuse patients per year from a population pool of 6.8 million persons. The CTPs have been highly involved in the development of this proposal and are committed to the goals of the CTN. The success of a CTN node is largely contingent upon establishing collaborative relationships among its RRTC and CTPs. The organizational and management plan of the Ohio Valley Node has been designed to enable the RRTC to provide the infrastructure, scientific leadership, and support functions necessary for successful operation while ensuring that the RRTC and CTPs are able to work collaboratively at a variety of levels. Parallel functional areas have been built into the RRTC, CTP, and node structures to facilitate communication between CTP and RRTC staff, to encourage the flow of experience-based insights from the CTPs to the RRTC, and to foster the transfer of technology from the RRTC to the CTPs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COCAINE AND CHEST PAIN: ER PATIENT CARE AND OUTCOMES Principal Investigator & Institution: Booth, Brenda M.; Professor of Psychiatry; Psychiatry and Behavioral Scis; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, Ar 72205 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2005 Summary: (provided by applicant) Little is known about the clinical picture of cocaine users presenting with chest pain in the ED from the substance abuse or health services perspective. Almost all of the research on cocaine users presenting to the ED with chest pain has been conducted from the perspective of the ED physician and hence has focused on cardiac outcomes and mortality. Before we can develop interventions for this high-risk group of cocaine users, we need to understand who is at greatest risk for poor outcome and who is least likely to enter treatment in order to target interventions for those most in need. Likewise, we need to know where and when high-risk individuals intersect with the health care system to determine the optimal timing and setting for interventions. We propose a prospective observational study to provide the foundation for subsequent intervention research. We propose to study a consecutive cohort (N=300) of individuals presenting to the Hurley Medical Center ED, Flint, MI with chest pain and recent cocaine use and to follow them longitudinally for a year after their ED presentation with interviews at 3, 6, and 12 months. The specific aims of the study are: (1) To develop a comprehensive portrait of a consecutive cohort of cocaine users presenting to the ED with chest pain; (2) To identify specific locations where study participants interact with the health service system in the year following their ED visit and to identify the key patient characteristics associated with types of service use; (3) To identify access barriers to engaging in treatment and use of other services including primary care; (4) To measure one-year outcomes for this Cohort and to identify key socio-demographic and clinical characteristics of cocaine-using individuals with poor or good outcomes in the year after their ED visit for chest pain; and (5) To identify the timing and service setting for future interventions, based on findings from Specific Aims 1-4. The proposed study will study barriers to obtaining treatment, including access (multi-dimensional measures including accessibility, availability, acceptability, and affordability of treatment services), motivation (readiness to change), and need for treatment, including severity of cocaine dependence, comorbid conditions including

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other substance dependence, and comorbid medical conditions. Therefore, this proposed longitudinal observational study will identify key observational data and directions for future work to develop interventions in the ED or elsewhere to enhance treatment engagement, linkages to primary care, and changes in drug use for this understudied population already experiencing potentially harmful medical consequences of their drug use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COCAINE SELF ADMINISTRATION AND RELAPSE IN MICE:GENE DEL Principal Investigator & Institution: Middaugh, Lawrence D.; Professor; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: (provided by applicant): Most information about the neurobiology of substance abuse derives from experiments on rats. These models address several phenomena characteristic of substance abusing humans (e.g., self administration of drugs abused by humans, uncontrolled use of drugs, relapse upon presentation of interoceptive or exteroceptive cues related to the drug, etc) and have established the mesoaccumbens dopaminergic system as one of the important mediators of the reinforcing effects of drugs. Many of the findings have been confirmed in monkeys and more recently in mice. The desirability of using the mouse species in substance abuse research is prompted by the development of mutant mice which lack genes for specific proteins (i.e. "Gene Knockouts") important for neurotransmission in reward circuitry, as well as several well characterized inbred and transgenic strains. Technologies commonly used in substance abuse research on the rat such as jugular catheterization for i.v. self-administration and installation of indwelling cannulas for in vivo microdialysis have recently been down sized for use on mice. Using these techniques, the scant literature indicates that, like rats, mice self-administer most drugs which are abused by humans and the drugs appear to elicit similar increases in DA transmission in the anteroventral striatum as reported for rats. Notably absent from current literature using mice, however, are experiments to evaluate the effects of drug conditioned stimuli on behavior directed toward drug administration, models of relapse, and the effects of self administered drugs on DA systems. Thus, the proposed experiments will determine; 1) the extent to which cues present during lover responding for i.v. cocaine will maintain the behavior; 2) if the cocaine or cocaine conditioned cues will reinstate lever responding after extinction; and 3) if self-administered cocaine, and perhaps cocaine conditioned cues, will enhance extracellular DA consistent as seen in rats. The proposed experiments will initially be conducted on B6 mice, a strain which has been shown to self-administer i.v. cocaine. Additional experiments will be conducted on mutant mice with deletion of the DA D1 receptor gene to evaluate the role of the DA D1 receptor in the mediation of lever responding maintained by cocaine and cocaine conditioned stimuli, as well as reinstatement of 'cocaine-seeking behavior." These studies will significantly advance the use of the mouse species as a model for drug abuse and contribute toward establishing appropriate therapies for addiction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COGNITIVE SEQUELAE OF METHAMPHETAMINE ABUSE Principal Investigator & Institution: Salo, Ruth E.; Psychiatry; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 95616

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Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-MAY-2006 Summary: (provided by applicant): This application is to support a period of advanced training in multidisciplinary approaches to the study of substance abuse with a focus on methamphetamine [MA]. The candidate will acquire new knowledge in the fields of addiction psychiatry, pharmacology, neuroanatomy and neuropsychological assessment, providing the foundation to develop an independent research program that will examine the cognitive and neural sequelae of stimulant abuse. Additional training is needed to achieve this goal, as the study of substance abuse is new to the candidate and requires specialized knowledge related to the substances themselves as well as the behavioral results of long-term abuse. The candidate will work with a small group of talented mentors who will provide a solid background in addiction medicine, neurological research and cognitive assessment of substance abusers. The candidate will attend advanced courses in pharmacology, neuroanatomy, and participate in clinical rotations at substance abuse clinics (yrs 1-3) and neurobehavioral clinics (4-5). UC Davis is uniquely suited for the training and research goals of the candidate. The UC Davis School of Medicine offers advanced courses in pharmacology, neuroanatomy and clinical rotations, and staffs an ongoing program of neurobehavioral rounds and MRI/CT scan reading. The candidate's immediate goal is to assess cognitive performance in a group of MA dependent subjects, substance abusing controls, and focal lesion patients compared to healthy controls and to correlate the cognitive data with clinical symptomatology associated with substance abuse. The candidate will employ a focused battery of cognitive tasks that have been validated as measures of frontostriatal functioning and are believed to recruit the anterior cingulate [ACC], prefrontal cortex [PFC] and the basal ganglia, brain regions noted to be damaged following long-term MA abuse. This project will complement ongoing imaging studies of neural damage in stimulant abusers at UC Davis. The specific aims of the research proposed in this project are to measure: 1) the ability to suppress response conflict; 2) cognitive flexibility; 3) explicit and implicit memory processes; and 4) to correlate the cognitive findings with clinical symptomatology associated with stimulant abuse. The candidate's long-term career goal is to use the experience gained during this award to develop an independent research program that applies the approaches of cognitive neuroscience and clinical neuropsychiatry to the study of substance abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CONFERENCE: CHOICE, BEHAVIORAL ECONOMICS, AND ADDICTION Principal Investigator & Institution: Vuchinich, Rudy E.; Professor; Health Behavior; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2002 Summary: (Provided by applicant): Funds are requested for a conference on analyses of substance abuse and addiction that are based on theoretical and empirical developments in economic science and in behavioral economics within psychological science. Although this work has produced significant advances in knowledge regarding substance abuse and addiction, it has not yet had commensurate impact on the field as a whole. One primary goal of the conference is to promote the dissemination of this knowledge. The conference participants will be a mix of established and young, promising basic, clinical, economic, public health, and public policy scientists and scholars who either work in behavioral economics or economics or who are knowledgeable of this work and of its important implications for understanding substance abuse and addiction. The overall objective of the conference is to create a

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context for open presentation, discussion, and critique of theoretical, empirical, and applied issues concerning economic and behavioral economic perspectives on addiction, which will facilitate progress in the area. The specific aims include (a) the articulation of shared and distinctive elements of the four major theories in this area, (b) the development of empirical interpretations of theoretical concepts that have not yet been empirically evaluated, (c) the identification of issues that may provide empirical evaluations of the relative merits of the different theoretical perspectives, (d) the articulation of the full range of applied implications of this body of work for clinical, public health, and public policy initiatives, and to facilitate the translation of these basic science developments into an applied research agenda, and (e) publishing the conference proceedings in a book that will facilitate progress in this area by dissemination in the scholarly, research, and professional substance abuse and addiction communities. The conference will be held from 3/30/01 to 4/1/01 at the Pickwick Hotel and Conference Center in Birmingham, AL, which is adjacent to the campus of the University of Alabama at Birmingham. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CONSEQUENCES OF COMORBID DRUG ABUSE AND MENTAL DISORDERS Principal Investigator & Institution: Havassy, Barbara E.; Director; Langley Porter Psychiatric Institute; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 30-SEP-1997; Project End 31-JUL-2004 Summary: (Applicant's Abstract) This proposal concerns the impact of comorbid drug abuse and mental disorders on individuals and service systems. Using a longitudinal design, this study will contrast two samples of comorbid adults recruited during an acute care episode in county service systems. One sample will be drawn from the substance abuse treatment system (n=125), and one will be drawn from the mental health treatment system (n=125). To control for differences not related to comorbidity, an equal number of non-comorbid subjects will be recruited, bringing the sample total to 500 subjects, 250 from substance abuse and 250 from mental health treatment. Data on key demographic and severity of alcohol and drug use variables will be obtained at treatment entry, and a diagnostic assessment will be performed. Psychosocial data on alcohol and drug use, risk factors for HIV/AIDS, prevalence of violence, and quality of life will be obtained for a prospective 24 month community follow-up period. Service use and cost data will be obtained from substance abuse, mental health, public health, and forensic services for a period of 24 months prospectively and 24 months retrospectively from time of recruitment. We will test the null hypothesis that the two samples are from the same population on key entry variables. The samples will also be contrasted on the psychosocial, service use, and cost variables. If the samples are found to be from the same population on key entry variables, then differences in psychosocial status, service use, and costs will suggest differences in treatment service systems rather than differences between the clients of these systems. If the samples are significantly different on key entry variables, it will imply the presence of unique comorbid groups. Both similarities and differences between the two samples will be of utmost value. Findings that the comorbid samples are from the same population can guide coordination or integration of services. Findings that they are from different populations can lead to increased precision in distinguishing types of comorbid disorders in treatment systems and should enhance development of services, tailored to the needs of unique comorbid groups.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CONTEXT AND EFFECTIVENESS OF TWO MODELS OF SVC DELIVERY Principal Investigator & Institution: Grella, Christine E.; Associate Research Psychologist; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 20-AUG-1998; Project End 31-JUL-2003 Summary: (Applicant's Abstract) The goal of this 5-year project is to evaluate the comparative effectiveness of the integrated and parallel models for organizing service delivery to dually-diagnosed individuals, within the environmental context of the Los Angeles County treatment systems for mental illness and substance abuse. A total of 400 subjects will be randomly assigned to receive either integrated treatment from outpatient mental health and residential drug treatment programs that jointly deliver dual-diagnosis treatment or concurrent mental health and residential drug treatment delivered by separate programs on a parallel basis. Primary treatment outcomes include retention and completion, service utilization, drug and alcohol use, psychiatric status, criminal behavior, and psychosocial functioning; secondary outcomes include physical health status, HIV risk, and housing status. The study will also identify client characteristics that influence treatment outcomes, either independently or in interaction with different models of service delivery, and examine the influence of program and staff characteristics on client outcomes. The treatment outcome study will be embedded within a study of the environmental context of the mental health and substance abuse treatment systems in Los Angeles County. Interviews will be conducted with county administrators, administrators of programs participating in the treatment outcome study, and administrators of programs that are not in the study for comparison purposes. In addition, surveys will be conducted with staff in these same programs. Focus groups will be conducted with members of key community stakeholder groups and changes in the mental health and substance abuse treatment service systems will be monitored throughout the study. These data will provide a multilevel context in which to evaluate the implementation and effectiveness of the two models of service delivery. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COST EFFECTIVE TREATMENT FOR DUALLY DIAGNOSED HOMELESS Principal Investigator & Institution: Milby, Jesse B.; Professor; Psychology; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2001; Project Start 25-APR-2001; Project End 31-MAR-2006 Summary: (Applicant's Abstract) Substance abuse in homeless persons is associated with multiple health risks and presents daunting challenges to agencies providing services. Proposed research with this vulnerable population is based on two previous randomized controlled studies showing an innovative behavioral day treatment's (BDT+) effectiveness in a community setting with different comparison groups. The second demonstrated superiority of abstinent contingent housing and work compared to BDT alone, while controlling for alternative explanations of treatment effectiveness. This study determines if BDT+ for dually diagnosed, homeless substance abusers can be successfully transported to a new site. It develops training materials and methods for new staff to implement BDT at the University of Texas, Houston Recovery Campus. Expected products are: treatment manual, 35mm slides, video tapes etc., and brief

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observation scales to assess fidelity of each transported BDT+ component. Objective criteria and methods assure BDT+ components have been implemented with measured specified fidelity. Implementation is studied via a 2 group randomized control comparison with usual care. From a population meeting criteria from previous studies, 100 each will be assigned to either BDT+ or an existing Riverside General Hospital Day Treatment (RGHDT) control. Assessments at baseline, 1, 2, 6 and 12 months use instruments and measures employed in original studies. Outcomes include alcohol and drug abuse, homelessness, employment and HIV/A1DS risk behaviors, and a cost effectiveness analysis. Successful implementation is ultimately defined by hypothesized, superior outcomes for BDT+. If BDT+ can be replicated, products and methods would permit transport to other settings. Results will provide important knowledge and technology for transporting complex psychosocial treatment and how to most effectively treat this dysfunctional population, knowledge which has important clinical, economic, public health and public housing policy implications. 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,

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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 •

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: DEVELOPMENT AND PREVENTION OF SUBSTANCE USE PROBLEMS Principal Investigator & Institution: Dodge, Kenneth A.; Professor and Director; Public Policy Studies; Duke University Durham, Nc 27706 Timing: Fiscal Year 2003; Project Start 20-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): The goal of this project is to understand the role that conduct disorder plays in the development of substance-use problems in young adulthood. To reach this goal, the proposed project will amplify two ongoing, federally funded, multi-site, longitudinal studies. The Child Development Project (CDP) is a prospective study of 585 youth (50% female; 19% minority) from three sites, who have been followed since age four years and are now 19 years old (with 84% retention of

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original sample). The Fast Track (FT) Project is a prevention experiment in which 892 early-starting conduct-problem youth (31% female; 55% minority) from four sites were identified in first grade and randomly assigned to receive a ten-year intervention or not and have been followed through age 18 (83% retention of sample). Findings indicate that youth assigned to the FT intervention display 40% fewer diagnoses of conduct disorder in high school than controls. FT also includes a normative-representative sample of 387 youth (50% female; 49% minority) who are being followed to study how conduct disorder develops. To date, substance use in both the CDP and FT has been measured but not in depth. For both studies, new data collection for the proposed project will include detailed measurement of participants' use, dependence, and abuse of illicit substances, alcohol, and tobacco in early adulthood. Three aims will be addressed. The first aim is to understand how early conduct disorder leads to substance-use problems. A transactional-developmental model will be tested that posits risk and protective factors in the domains of child behavior, socio-cultural contexts, parenting, peer relations, schooling, and social cognitions. Findings that emerge from the CDP will be replicated with the FT normative sample. The second aim is to understand resilience to substance-use development among conduct-problem children. The FT high-risk control group, known to be at elevated risk for substance use, will be examined to identify protective factors that account for resilience to substance use. The hypothesis will be tested that professional services moderate risk; specifically, services that aggregate deviant children in groups will enhance risk, whereas individual services that focus on family process will decrease risk. The third aim is to test the efficacy of the FT intervention in preventing substance-use problems in early adulthood and the role of reduced conduct disorder as a mediator of this effect. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEVELOPMENT OF SUBSTANCE USE IN GIRLS Principal Investigator & Institution: Loeber, Rolf; Associate Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 15-FEB-2000; Project End 31-JAN-2005 Summary: The long-term development of substance use and abuse in girls and women are poorly understood. In at least two ways, females compared to males appear more vulnerable to substance abuse and dependence: a speedier development from onset of use to abuse, and a higher propensity to develop comorbid conditions. In addition, females and males with an early onset of substance use are more likely to become substance abusers. The main goal of the proposed research is to investigate the early phases in this development process. Specifically, we propose to study precursors to the onset of early substance use (i.e., mainly alcohol and tobacco use), the transition to onset of use, and the transition to regular use in an inner-city community sample of 2,484 preadolescent girls. The girls, together with their parent and school teacher, will be assessed yearly and will be followed up over a period of five years. The sample will be made up of approximately 50 percent African-American and 50 percent Caucasian girls. The proposed study will be a substudy linked to and benefitting from the NIMHfunded study on the same girls, which has as its main object the study of the development of antisocial and delinquent behavior. The present proposal has three foci: 1). To identify the developmental precursors to the onset and regular use of substances; 2). To examine behavior problems which interact with early substance use; and 3) To elucidate the risk and protective factors predictive of the precursors of early substance use and predictive of the early use. The proposed study will be the foundation upon which follow-ups beyond the current five-year period can be built in order to better

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understand the long-term antecedents, risk and protective factors for substance abuse and dependence in females. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEVELOPMENTAL PATHWAYS OF ADOLESCENT DRUG ABUSE Principal Investigator & Institution: Winters, Ken C.; Associate Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): This independent scientist award (K02) is proposed for the applicant to acquire necessary skills for enhancing work on the developmental pathways of adolescent drug use behaviors including substance use disorders (SUD), with a particular focus on long-term pathways. The intensive period of study afforded by a K02 will permit the applicant to gain scientific skills via coursework, workshops and consultations with experts in the field. Specifically, the career development plan will enhance the analysis of current data and the development of future studies of existing prospective samples by focusing on the acquisition of a thorough foundation in (a) advanced statistical modeling techniques and related methodological issues; (b) the theoretical underpinnings and relevant models associated with young adulthood, the development period from the late teens through the twenties; and (c) the role of innovative brief intervention strategies as relapse prevention strategies for youth who are recovering from a prior substance use disorder. The enhanced statistical skills will be applied to prospective longitudinal data sets at the University of Minnesota, as well as other national data sets. The local data represent two youth groups: an at-risk group and a substance use disorder (SUD) group. The at-risk group consists of teenagers who were diagnosed with ADHD, Conduct Disorder (CD)/Oppositional Defiant Disorder (ODD) or both during childhood. Some of these youth have either developed an SUD during adolescence whereas others are at-risk for developing a later-onset SUD. The second data set, the SUD group, consists of adolescents who were diagnosed with and treated for a SUD as a teenager and for whom ADHD and CD/ODD are common comorbidities. This latter group is relevant to the study of the course of SUD as the youth age toward young adulthood. Both samples have normal groups matched on age, gender, race, and SES fo use in comparative analyses. Based on empirical findings to date, the specific hypotheses focus on externalizing disorders (e.g. ADHD and CD/ODD) as possible predictors, consequences, or moderators of the developmental pathways of adolescent drug use behaviors. Select personal (psychological distress) and environmental (drug use by peers, parenting practices, and treatment experiences) factors will be considered in hypothesis testing as well. The aims of this award will advance research on the cause and consequences of adolescent substance use disorders by clarifying the role of disruptive behaviors, and the award will help enhance the investigator's skills in researching the long-term course of adolescents who are either atrisk for developing an SUD or have experienced an adolescent-onset SUD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DISADVANTAGED YOUTH AND ALCOHOL ABUSE PREVENTION Principal Investigator & Institution: Schinke, Steven P.; Professor; None; Columbia Univ New York Morningside 1210 Amsterdam Ave, Mc 2205 New York, Ny 10027 Timing: Fiscal Year 2001; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: This study will develop and test intervention strategies to prevent alcohol and other substance abuse among high-risk youth. The study has three aims: 1)

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Develop intervention strategies to prevent alcohol and other substance abuse among high-risk youth. 2) Test the strategies in a randomized trial with high-risk youth in community settings. 3) Develop and deliver booster sessions to extend and expand intervention effects. 4) Longitudinally evaluate the strategies through follow-up data collections. 5) Analyze relationships among individual-level variables for youth and parent participants. The proposed study will occur in three phases. In a 10-month preparation phase, the investigators will develop intervention and measurement protocols, draw a representative sample of community organizations for study participation, and recruit and train intervention delivery agents. A 12-month implementation phase will initiate field operations of a clinical trial, including pretesting, intervention delivery, process data collection, and posttesting. A follow-up phase in the last years of the study will involve follow-up testing, booster session delivery, and data analysis. The study's alcohol and other substance abuse prevention strategy includes skills interventions that will engage groups of high-risk youths in community settings, and parent-enhanced skills intervention that will help family members sustain youths' risk reduction efforts. By engaging parents in the skills-based intervention, the prevention protocol will tap natural resources in youths' environments to nurture and sustain their efforts to avoid problems with alcohol and other substance abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DOMS EARLY REINTERVENTION (ERI) EXPERIMENT Principal Investigator & Institution: Dennis, Michael L.; Senior Research Psychologist; Chestnut Health Systems 1003 Martin Luther King Dr Bloomington, Il 61701 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2003 Summary: While most clinicians view substance use as a chronic relapsing condition that may require multiple episodes of care, most research to date has focused on single episodes of care. Recent emphasis on outcome based contracts and/or capitated cost contracts has stimulated interest in better managing clients "across" multiple admissions and/or in a continuum of care model. In the treatment of other chronic illnesses quarterly, semi-annual or annual check-ups are often integral parts of aftercare which check for early indications of relapse and attempt early re-intervention before the condition and consequences worsen. The specific aims of this study are to determine the relative effectiveness of an Early Re-Intervention (ERI) protocol in terms of its ability to: 1) reduce the time to treatment re-entry and increase the rates of early treatment reentry, and, 2) improve long-term outcomes related to a) substance use, HIV risk behaviors, illegal activity, b) training- and employment-related behaviors, and c) utilization of expensive services (e.g., inpatient substance abuse treatment, inpatient mental health treatment, emergency room admissions, hospital nights, days in jail, days of their children being in foster care or institutions). To evaluate ERI, 800 new clients with substance use disorders will be recruited from two central intake units, one located in Chicago and another in Central Illinois. Clients will be blocked into one of five severity groups (based on drug dependence, alcohol dependence, and frequency of use) then randomly assigned to either quarterly outcome monitoring (OM) with 20-30 minute assessments for 18 months or quarterly OM plus ERI. Response of participants in the ERI condition will be used to determine the participants linkage assistance needs every quarter. ERI Linkage Managers will provide the qualified participants with linkage assistance including feedback on their current substance use and need for treatment, motivational discussions to convince them to consider returning to treatment, and then direct assistance in helping them make and keep a readmission appointment.

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Through feedback, social reinforcement, and assistance to access care, ERI is expected to reduce the time to readmission, increase the rate of early treatment re-admissions, and consequently, improve long-term outcomes. Significant findings in favor of the ERI protocol would provide a better understanding of the clinical value of outcome monitoring and a straightforward, replicable protocol for improving the long-term effectiveness of drug treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DRUG ABUSE TREATMENT COSTS OF MEDICAID CLIENTS IN AN HMO Principal Investigator & Institution: Lynch, Frances; Kaiser Foundation Research Institute 1800 Harrison St, 16Th Fl Oakland, Ca 94612 Timing: Fiscal Year 2001; Project Start 01-FEB-1999; Project End 31-JAN-2002 Summary: The dramatic growth in health maintenance organizations (HMO) enrollment has heightened concern about the adequacy of treatment available for persons with substance abuse problems. This topic is of particular interest to the growing number of states that are now replacing fee-for- service with capitated health care systems for Medicaid clients, many of whom have severe substance abuse problems. If true, this could disrupt continuity of care and lead to poorer outcomes for Medicaid clients with substance abuse problems. The broad purpose of this study is to provide a better understanding of substance abuse treatment for Medicaid clients in HMOs in order to improve care for Medicaid enrollees. The specific aims are: 1. To describe enrollment duration, service use, and cost care of Medicaid funded enrollees seeking treatment of chemical dependency; 2. To compare enrollment duration, service use, and cost of care of chemically dependent Medicaid clients with hose of non-Medicaid HMO enrollees; and 3. To develop a risk adjustment model designed to improve the prediction of chemical dependency treatment costs for the Medicaid population. Decision makers could use information from this study to set policies to improve the retention of Medicaid clients in HMOs and for setting per member per month payment rates for capitated Medicaid programs. Policy makers especially need cost data on sub-groups of the Medicaid population such as children and youth. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DRUG ATTITUDES AND BEHAVIOR ON THE US/MEXICO BORDER Principal Investigator & Institution: Spence, Richard T.; Research Scientist; Ctr for Social Work Research; University of Texas Austin 101 E. 27Th/Po Box 7726 Austin, Tx 78712 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2005 Summary: (provided by applicant) The objective of this study is to improve knowledge and understanding of disparities in drug use and related attitudes, perceptions, and behaviors concerning drug use and drug treatment utilization among Hispanic and non Hispanic populations living in proximity to the U.S./Mexico border. This is a geographic area in which the mainstream culture is heavily bicultural, a pattern which is expected to typify an increasingly large segment of the West and Southwest regions of the United States during the next decade. Knowledge gained in this study is expected to benefit service planners who would anticipate need for current and future service strategies to better respond to the problems and needs of Hispanic and bicultural populations. Specific aims are 1) to describe the prevalence of substance use, abuse, and dependence, and the demographic and social correlates of use among households living on the border, and to measure the changes in prevalence that have occurred during the

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past six years since a similar study was done; 2) to investigate the role of acculturation in explaining differences in substance use within the Hispanic border community; and 3) to determine border residents' attitudes and behaviors related to the utilization of treatment services and the correlates of these attitudes and behaviors. These questions will be addressed through an in-person survey of 1200 adults living in households: 400 from the El Paso metropolitan area, 400 from the Rio Grande Valley metropolitan area, and 400 from colonias (rural, unincorporated communities often characterized by lack of basic public services). 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 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

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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

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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 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

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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 •

Project Title: EFFICACY OF GROUP MOTIVATIONAL INTERVIEWING Principal Investigator & Institution: Santa Ana, Elizabeth J.; Psychology; State University of New York at Albany 1400 Washington Ave Albany, Ny 12222 Timing: Fiscal Year 2003; Project Start 20-AUG-2003; Project End 31-JUL-2004 Summary: (provided by applicant): Poor compliance with aftercare treatment among dually diagnosed patients is a costly and pervasive health problem that limits the effectiveness of inpatient detoxification. Current strategies for improving compliance with aftercare treatment are minimally effective. The proposed project intends to improve current strategies by examining the impact of adding group motivational interviewing (GMI) to the standard treatment program of an inpatient psychiatric hospital for individuals with coexisting psychiatric and substance use disorders. The project aims to significantly improve compliance with aftercare treatment (e.g. AA/NA, outpatient therapy) and reduce substance use over standard inpatient treatment alone. The study specifically addresses Healthy People 2010 objectives to reduce the treatment gap for individuals with coexisting substance use and psychiatric problems and to reduce past-month use of alcohol and illicit substances by specifically targeting patientlevel barriers and motivation. Ample evidence shows that motivational interviewing (MI) significantly reduces substance abuse and increases treatment engagement. As such, MI holds great promise for use in the inpatient setting and may represent a significant upgrade in the treatment services provided. However, MI is traditionally delivered one-on-one. The project seeks to demonstrate the efficacy of GMI in a group format. Until this is accomplished, MI will remain underutilized in inpatient or substance abuse treatment settings that rely on group therapy. The consequence is that motivational interviewing continues to go undelivered in inpatient settings despite the fact that this intervention may result in substantial benefits for patients, their families, and the community at large. Inpatients meeting eligibility criteria will be allocated to GMI + Standard Treatment (ST) or to ST alone using block randomization. Following admission, screening, and informed consent procedures, a group containing 5-6 participants will be invited to complete pretreatment questionnaires. Patients assigned to receive GMI + ST will be invited to return the following two days to attend two 90minute group sessions delivered in the style of motivational interviewing. Patients receiving ST alone will be invited to return the following two days for a nonexperimental group activity to control for therapist attention effects. All participants and collaterals will be contacted at a one and three month follow-up period after discharge to evaluate compliance with aftercare treatment and rate of alcohol and other drug consumption. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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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 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

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Project Title: GAMBLING AND SUBSTANCE USE AMONG YOUTH IN THE U.S. Principal Investigator & Institution: Welte, John W.; Senior Research Scientist; State University of New York at Buffalo Suite 211 Ub Commons Amherst, Ny 14228 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2007 Summary: (provided by applicant): The recent expansion of gambling opportunities in the U.S. has been intended for adults, yet gambling extends to young people. In fact, existing research shows that adolescents and young adults are more likely to be classified as problem gamblers than older adults. Gambling among young people is also linked with substance use and delinquency. In spite of the increasing concern about youthful gambling, there have been no large representative U.S. studies of gambling and related behaviors among youth. The present study will be among the first. Our aims are: 1) to determine the prevalence and demographic patterns of gambling behaviors and pathological gambling among U.S. youth, 2) to examine the relationship of youth gambling to social and ecological factors such as neighborhood disadvantage, permissiveness of gambling laws, availability of gambling modalities, and the influence of peer gambling, 3) to examine the relationship between youth gambling and alcohol, tobacco and marijuana use, as well as conduct disorder and risky sexual behavior. We will conduct a computer-assisted telephone survey to interview 2500 U.S. residents aged 14 to 21. We will use a sample of phone numbers which is carefully stratified geographically to represent every area of the country. When contacting a household that contains more than one person aged 14-21, we will select the respondent at random. Tract-level and block-level census data will be used to characterize each respondent's neighborhood. A state-level data set will characterize the permissiveness of each state's gambling laws. Data analyses will examine the demographic and regional patterns of gambling behavior and pathology among U.S. youth. Further analyses will predict gambling behavior and pathology from geographic variables including permissiveness of state gambling laws and neighborhood social disadvantage, and examine the comorbidity between pathological gambling and substance abuse as well as conduct disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GREAT LAKES REGIONAL NODE Principal Investigator & Institution: Schuster, Charles R.; Director, Substance Abuse; Psychiatry & Behav Neuroscis; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: Recognizing the need for and value in bridging the gap between clinical research and treatment, this initiative shall establish a consortium of academic substance abuse researchers and community treatment programs to serve as the Great Lakes Regional Node (GLRN) for the NIDA National Drug Abuse Treatment Clinical Trials Network (CTN). This consortium involves substance abuse clinical researchers from the three major research universities in the State of Michigan (Wayne State University; University of Michigan; and Michigan State University) in collaboration with a variety of substance abuse Community Treatment Programs (CTPs). The CTPs have been selected to assure diversity in therapeutic modalities employed, demographic and psychiatric characteristics of patients served, and the nature of the drug problems being treated. The CTN has two principal goals: first, to determine whether treatment interventions with demonstrated efficacy in rigorously controlled clinical trials are both useful and effective in CTPs. Because the CTN will have access to large samples of patients to participate in controlled clinical trials of treatment interventions, the process

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of evaluation can be rapid. Such large scale testing also will allow secondary analyses of outcome data to identify predictors for matching patients to effective treatment. The second goal of the CTN is to improve the quality of care available in CTPs by facilitating the adoption of research-based treatment interventions. The proposed GLRN assembles a group of academic researchers with long standing expertise in the evaluation of the efficacy and usefulness of behavioral, pharmacologic, and combined treatments for a variety of substance abuse problems, and with parallel expertise in the data management of large scale clinical trials. In many instances, the CTPs and these academic centers already have established research collaborations that will facilitate the rapid implementation of new research protocols. The inclusion of other CTPs without this background will allow us to investigate the process of introducing research and collaboration into a CTP to determine the problems encountered and their solutions. To this end we have enlisted the aid of researchers with a history of process evaluation for technology transfer. We also document the Node's capability to implement currently approved CTN concept proposals, as well as to implement new proposals in areas relating to behavioral therapy, pharmacotherapy and health services delivery research. In summary we believe that the GLRN has a very strong research team, the administrative infrastructure to manage the program, and enthusiastic CTPs anxious to participate in the NIDA CTN. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EMPLOYMENT

HIGHLY

ACTIVE

ANTIRETROVIRAL

THERAPY

AND

Principal Investigator & Institution: Bernell, Stephanie L.; Public Health; Oregon State University Corvallis, or 973391086 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-JAN-2004 Summary: (PROVIDED BY APPLICANT): The objective of this research is to examine the employment consequences of HIV, focusing on the labor market behavior of HIV positive individuals who use and who do not use highly active antiretroviral therapy (HAART). Like all workers, HIV positive individuals leave the state of employment and unemployment for very different reasons. This study examines the causes of job loss and job acquisition, concentrating primarily on the contribution of HAART and secondarily on the effect of mental health and substance abuse problems. This study uses data from the HIV Cost and Services Utilization Study (HCSUS) and employs discrete choice models of analysis. The specific aims of this research are to (1) examine the effect of HAART on the probability of leaving employment, (2) assess the effect of HAART on the probability of leaving unemployment, and (3) identify whether persons dually diagnosed as HIV positive and having mental health and/or substance abuse problems have differential labor market outcomes than those without mental health or substance abuse problems. Understanding the influence of HAART on the labor market behavior of HIV positive individuals is of fundamental significance to pubic sector policymakers as well as employers in all parts of the economy. On an individual level, it is likely that many people with HIV are still denied opportunities in the workplace due to their HIV status. On a national level, if HAART results in better employment outcomes, it is likely that individuals will remain privately insured for a longer period of time and will be less reliant on federal and state programs (SSI, Medicaid, Medicare, etc,). Furthermore, by having a clearer understanding of the employment outcomes of those who are dually diagnosed with HIV and mental health and/or substance abuse problems, this project will provide new information on the effects of recent policy revisions, including employment-based mental health insurance parity mandates.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HIV RISK REDUCTION FOR BLACK DRUG USING WOMEN Principal Investigator & Institution: Jemmott, Loretta S.; None; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 25-SEP-2001; Project End 31-AUG-2006 Summary: The broad objective of this proposal is to identify effective culturally sensitive interventions to reduce the risk of sexually transmitted diseases (STDs), including HIV, among inner-city African American women who abuse substances. We will randomly assign 869 African American substance abusing women from an inpatient detoxification program serving a low-income community in Philadelphia, PA to one of two conditions: (a) a 2- session skill-building HIV risk-reduction intervention or (b) a 2-session general health promotion intervention concerning health issues unrelated to sexual behavior, which will serve as the control group. The women will also receive booster interventions at the 3- and 6-month follow-up sessions. The interventions will include films, roleplaying, and interactive activities led by a specially trained facilitator. The approach draws on Bandura's social cognitive theory, Fishbein and Ajzen's theory of reasoned action, its extension, the theory of planned behavior; focus groups with substance abusing African American women; and the applicant's previous HIV risk-reduction research with inner-city African American populations, including substance abusing women. The primary outcome measures are self-reported frequency of sexual intercourse, unprotected sexual intercourse, and condom use. Secondary outcome measures include STDs, condom coupon redemption, and theoretically relevant variables hypothesized to mediate intervention effects, including intentions, beliefs, and self-efficacy. We will use audio computer-assisted self- interviewing (audio-CASI) to collect data before, immediately postintervention, and at 3-, 6-, 12-, and 18-month follow-up. We will perform ligase chain reaction tests to detect STDs in urine specimens collected at baseline and 6-, 12-, and 18-month follow- up. To address the Specific Aims, we will analyze the data with generalized estimating equations (GEE). We will test (a) the effects of the interventions on unprotected sexual intercourse, condom coupon redemption, STD incidence, and mediators of sexual behavior and (b) whether intervention effects are systematically different depending on key moderator variables, including participants' history of substance abuse, history of drug treatment, HIV serostatus, sexual abuse history, relationship status, and depression. The results of this project will contribute to the development of efficient and effective HIV prevention programs for inner-city African American women who abuse substances. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HIV RISK, DRUGS, AND VIOLENCE Principal Investigator & Institution: Ellickson, Phyllis L.; Rand Corporation 1700 Main St Santa Monica, Ca 90401 Timing: Fiscal Year 2001; Project Start 20-FEB-1999; Project End 31-JUL-2002 Summary: A number of recent studies have noted associations between violence, substance use, and risk of infection with HIV. However, the prevalence patterns, and predictors of their co-occurrence are unknown. Nor are the reasons for their association well understood. The proposed studies use data from a panel of over 3600 young adults of diverse social and economic backgrounds to explore these issues, employing both cross- sectional and longitudinal approaches. Study 1 will estimate the prevalence of high-risk sexual activity, injection drug use, and various types of violence, victimization,

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and substance use among heterosexual adults aged 23-24. Rates for various patterns of co-occurrence among these problems will also be estimated and the characteristics of persons with multiple problems will be determined. Studies 2 and 3 will explore the basis for co-occurring problems in adulthood: the first will focus on concurrent relationships and predictors; the second will examine prospective predictors. These studies will identify the common and unique predictors of violence, victimization, substance use, HIV sexual risk and risk for HIV from injection drug use to test whether multiple problems might be co-morbid outcomes of a risk-enhancing personality or environment. They all explore possible direct relationships between HIV risk and other high-risk problems. They examine whether problems with violence and use of drugs make a unique contribution to HIV risk, over and above the influence of other personal and environmental factor, and whether substance use and violence mediate the impact of other factors on HIV risk. Importantly, each of these predictors and their relationships to HIV risk are tested at early adolescence, late adolescence, and young adulthood, allowing us to determine whether early substance use or early experience with violence and sexual activity makes a contribution to adult HIV risk independent of other adult and adolescent predictive factors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HIV TESTING AMONG ADOLESCENTS WITH SUBSTANCE ABUSE Principal Investigator & Institution: Pugatch, David L.; Assistant Professor; Rhode Island Hospital (Providence, Ri) Providence, Ri 02903 Timing: Fiscal Year 2001; Project Start 15-AUG-1998; Project End 31-JUL-2003 Summary: (Applicant's Abstract) HIV infection remains a threat to the health of adolescents with substance abuse in the United States. Recent advances in HIV therapeutics make the early identification of HIV infected adolescents through HIV testing a high priority for public health. Unfortunately, HIV testing faces numerous challenges among adolescents with substance abuse. This mentored clinical scientist development award will prepare David Pugatch, M.D. to design and implement studies with the ultimate goal of increasing HIV testing behaviors in this high risk adolescent population. The award will also prepare Dr. Pugatch for academic leadership in the field of adolescent HIV infection, with a special emphasis on the behavioral issues facing adolescents with substance abuse. Dr. Pugatch is a board-certified pediatrician in his first year on the full-time faculty as the medical director of the adolescent HIV/AIDS program at the Brown University School of Medicine. Dr. Pugatch's special interest in adolescents with substance abuse, as well as his clinical contact with this population, places him in a unique position to complete important studies to elucidate the barriers and facilitating determinants of HIV testing among substance abusing adolescents. Under the direction of on site mentors, Dr. Larry K. Brown and Dr. Timothy P. Flanigan, Dr. Pugatch will undertake advanced training in the behavioral science of health belief models, clinical trial design as it relates to behavioral interventions, community health approaches to HIV prevention, and statistical training adequate to provide the knowledge to carry out these proposed studies. The research project proposed by Dr. Pugatch will examine the barriers and facilitating determinants of HIV testing in adolescents with substance abuse, ages 15 through 25 years. The project will recruit adolescents from inpatient and outpatient substance abuse treatment programs, and from an agency serving homeless/runaway youth. Specifically, the project will: 1) study the applicability of the transtheoretical model of change to HIV testing behaviors in adolescents with substance abuse; 2) develop a behavioral intervention based upon these findings to increase HIV testing behaviors among this population. The results of

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Substance Abuse

this research may have broad implications for increasing HIV testing behaviors among adolescents with substance abuse as well as other groups of adolescents at high risk for HIV infection. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HIV/AIDS RISK IN CLINICALLY DISTURBED ADOLESCENTS Principal Investigator & Institution: Donenberg, Geri R.; Associate Professor; Psychiatry; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2001; Project Start 10-SEP-1999; Project End 31-MAY-2004 Summary: Adolescents are among the fastest growing population at risk for HIV/AIDS, and psychiatrically disturbed teens are at especially high risk. Little is known about the specific HIV/AIDS risk determinants in troubled teens, or the mechanisms by which psychopathology and substance abuse influence risk for infection in youth. The current project explores HIV/AIDS risk determinants among 360 ethnically diverse mentally ill teenagers seeking outpatient mental health services. Study aims are to (a) determine rates of risky sexual behavior and drug use among troubled youth and compare these rates to rates among teens in the general population; (b) test and compare the utility of two theoretical models in explaining AIDS-risk--the Information-Motivation-Behavior model and a Social-Personal model; and (3) test and compare the two models for theoretically important subgroups of youth (internalizing, externalizing, substance abusing). In a final integrative analysis, we will develop a profile for youth at greatest AIDS-risk based on the strongest predictors from both theoretical models. We will recruit teens from two clinics associated with the same hospital network and we will reassess them at 6- and 9-months after the first interview. Teens and caregivers will complete a combination of interviews and questionnaires to assess AIDS information, motivation, and behavioral skills, and personal attributes, relationship concerns, and adolescent AIDS-risk behavior. Family context will be examined via two structured videotaped interaction tasks and questionnaires, and we will assess adolescent psychopathology and substance abuse via questionnaires and a structured diagnostic interview (i.e., the Diagnostic Interview Schedule for Children). Thus, we will use multiple methods to predict AIDS-risk behavior. We will use structural equation modeling to test the associations specified in the models and identify causal factors associated with disturbed teens at risk for AIDS. The long-term significance of this research is to guide the development of specially targeted AIDS prevention programs for clinically disturbed youth. AIDS prevention programs are most effective when they are tailored to specific population needs. Thus, HIV/AIDS risk determinants identified in this study can be used to develop specially targeted programs for troubled youth, and interventions that are effective in a clinical setting may be applied to teens with mental health problems in school-based settings. This study is a first step in an overall program of research designed to develop effective AIDS prevention programs for troubled adolescents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: IMPACT OF SUBSTANCE ABUSE TREATMENT ON MARITAL VIOLENCE Principal Investigator & Institution: Stuart, Gregory L.; Butler Hospital (Providence, Ri) 345 Blackstone Blvd Providence, Ri 02906 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2005

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Summary: APPLICANT'S ABSTRACT: This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) from NIAAA. I am strongly committed to a career in patient-oriented research. I believe that the educational opportunities in which I will be able to participate as a result of a K23 award will lead to further development of the skills necessary to become a productive, independent researcher. The proposed training experiences will include: collaboration with excellent mentors (Dr. Richard Brown"Dr. Kenneth Leonard, and Dr. Robert Stout), active participation in the Brown University Center for Alcohol and Addiction Studies academic activities, advanced courses in multivariate statistics, and regular presentations at national conferences. The reduction of marital violence is a health priority for the US. There is extensive theoretical and empirical evidence linking alcohol and drug abuse and marital violence. Marital violence is over represented in individuals seeking treatment for alcohol and drug abuse. The efficacy of treatments designed to address marital violence is questionable, with research suggesting that treatment for marital violence is relatively ineffective. It has been suggested that maritally violent individuals who abuse alcohol and drugs require substance abuse treatment before addressing their violent behavior. However, the extent to which treatment for alcohol and drug abuse (which does not include interventions specifically targeting marital violence) will ameliorate subsequent marital violence is currently unknown. Given the high comorbidity of marital violence and alcohol and drug abuse, it is critical to assess the extent to which substance abuse treatment for alcohol dependent patients impacts marital violence. The proposed study assesses the impact of substance abuse treatment for alcohol dependent patients on marital violence and psychological abuse. Alcohol and drug use and abuse, marital violence, psychological abuse, and marital satisfaction will be assessed in a sample of alcohol dependent patients receiving substance abuse treatment. These variables will be assessed at pretreatment and at 6-month and 12month follow-up. At each assessment point we will also contact the patients' partners to obtain collateral data regarding the patients' use of substances, marital violence, and psychological abuse, as well as to collect data on these variables in the partners. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPACT OF TERMINATING SUBSTANCE ABUSE DISABILITY BENEFIT Principal Investigator & Institution: Orwin, Robert G.; Senior Study Director; Westat, Inc. 1650 Research Blvd Rockville, Md 208503195 Timing: Fiscal Year 2001; Project Start 01-JUN-2000; Project End 31-MAY-2004 Summary: Effective Jan. 1, 1997, the Contract with America Advancement Act (PL 104121) terminated the Social Security Administration's Disability Insurance (DI) and Supplemental Security Income (SSI) benefits for persons diagnosed with drug or alcohol addiction, also known as DA and A recipients. The law ended Medicaid eligibility as well, leading to many chronic substance abuse patients losing Medicaid reimbursement for addiction treatment and general health care needs. The legislation raised two sets of interrelated concerns. The first was for the well-being of the substance abusers who lost their mandate for treatment, insurance for treatment, insurance for general health care, monthly income, and their relationships with their representative payees. The second was for the larger effects on others in society. Several studies have been conducted or are currently in progress that address the issue of how the benefits termination affected recipients. However, no rigorous evaluation of the net impact of the law using actual resource utilization and labor force participation data has yet been attempted. The proposed study fills that gap with a quasi-experimental evaluation of the economic

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Substance Abuse

impact of the policy change in Washington State. Using records extracted and recombined from existing datasets, the analytic methodology combines an enhanced interrupted time series analysis with 1) recent developments in the multilevel random regression modeling of longitudinal outcome data, and 2) contemporary economic valuation methods for resource utilization and productivity. Specific aims are: 1. Estimate the net impact of the law on service utilization and labor force participation among the DA and A population as a whole and its component subgroups. Service utilization data will include mental health services, general medical services, substance abuse services, use of the criminal justice system, and cash benefits. Subgroups will include former benefit classification (SSI, DI, or both), urban v. rural, age, gender, education, ethnicity, criminal justice background, previous employment history, substance abuse diagnosis, substance abuse treatment history, psychiatric comorbidity, medical comorbidity, and SSI/DI requalification status. 2. Based on the findings from Aim 1, estimate the economic impact of the benefits termination on federal, state and local government resources, for the population as a whole and subgroups. This will be accomplished through the use of cost data from Washington State and current economic valuation models that assign unit cost estimates to each of the resource utilization and productivity activities that were modeled in Aim 1. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPACTS OF MANAGED CARE ON SA SERVICE LINKAGES Principal Investigator & Institution: Morrissey, Joseph P.; Professor; Psychiatry; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2001; Project Start 20-FEB-2000; Project End 31-JAN-2003 Summary: This three year project will focus on an important issue affecting the delivery of substance abuse services across the nation: the implementation of managed care funding mechanisms on the service relationships involving outpatient substance abuse services. Some recent findings suggest that the introduction of managed care funding practices decreases the number and/or intensity of relationships among providers of care for persons with mental health and substance abuse disorders. Many of these studies however involve intra rather than interorganizational relationships, of which we know little. Findings also show that substance abuse services are most effective for persons with both mental health and substance abuse disorders if they receive services for both disorders concomitantly and receive an appropriate number of them. Managed care, with its practices of decreasing service use and defining provider networks, may have the consequence of disrupting the local service system of care. This study is focused on understanding which service relationships are implicated by the introduction or the intensification of managed care payment practices for providers serving persons with substance abuse and mental health disorders. This study will use in-person surveys to collect data from approximately 420 service providers in 60 sites across the US. In each of 60 sites at least one outpatient substance abuse organization, determined from a different study currently underway, is identified along with an appropriate respondent. This person is asked to identify up to six other local providers of care of mental health, vocational, and primary health care in their organization's service network for persons with substance abuse disorders along with attributes of their organization or service program. In addition, these other identified organizations are also interviewed and asked a similar set of questions. Interorganizational network methods and dyadic analysis of the relationships over time between these substance abuse providers and other local providers of supportive care will be used to determine

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the impact of managed care on these service linkages controlling for important environmental, organizational, or contextual factors. The project will use a longitudinal data design to build appropriate relational models. Findings will be related and communicated to program managers and directors who are engaged in providing appropriate and responsive care to this vulnerable population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPROVING INTERVENTIONS FOR DRUG ABUSE-PARTNER VIOLENCE Principal Investigator & Institution: Connelly, Cynthia D.; Children's Hospital Research Center 3020 Children's Way, Mc 5074 San Diego, Ca 92123 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-MAY-2007 Summary: (Provided by Applicant) The applicant is requesting five years of funding through the Mentored Career Development Award (K01) program to establish an independent program of substance abuse research focused on improving the identification and intervention for substance abuse, intimate partner violence (IPV) and co-occurring affective disorders (AD) in early intervention settings. The applicant?s strong background of academic, research and nurse clinical training in substance abuse, violence, family health, and health services research provides an excellent foundation for this work. The proposed training goals provide additional instruction and mentoring in 1) the complex linkage between ATOD, IPV, and AD and engagement and treatment strategies for early preventive intervention, 2) longitudinal data analysis and modeling techniques, 3) cultural issues and health disparities that complicate early intervention efforts among diverse populations, and 4) training in the ethical conduct of research. This training will prepare the applicant to pursue a research career in prevention science targeting substance abuse among women of childbearing age. In Phase I secondary data analysis will be conducted on longitudinal data provided by two large samples of postpartum women to examine the role of ATOD, IPV and AD on engagement and participation with an early intervention: home visitation. Subgroup analyses based on age, race/ethnicity and combinations of ATOD, IPV and AD will be examined. In Phase II, existing protocols for provider education and training in assessment including instrumentation, interpretation, and triage will be critically examined in two model programs. Phase III will use findings from Phases I and II as well as mentoring from experts in specific content areas to inform the development of strategies and preliminary protocols to strengthen early preventive interventions addressing these specific issues and to pilot test these protocols. Phase III will identify characteristics that impact implementation at the provider, family, and program level and will generate preliminary data to inform research and program development. The data will form the basis for a R01 application to prospectively test the effectiveness of strategies designed to improve provider education and practice related to ATOD, IPV, and AD among women of childbearing age. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INCREASING TREATMENT ADHERENCE THROUGH SOCIAL ENGAGEMENT Principal Investigator & Institution: Davidson, Larry; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 15-SEP-2000; Project End 31-AUG-2005

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Substance Abuse

Summary: (adapted from investigator's abstract): Lack of adherence to medication and outpatient treatment along with substance abuse are two of the most troubling factors to emerge as persons with psychotic disorders have returned to the community. These factors have combined to produce a new cohort of patients who experience poor clinical and functional outcomes and a "revolving door," cycle of recurrent inpatient and detox admissions followed by continued drug use. Primarily young and in urban settings, these patients are more likely to be from ethnic minority communities and to be disaffiliated from traditional mental health services. This study evaluates the effectiveness of an innovative approach to increasing medication and outpatient treatment adherence among this population that combines a peer-run engagement program with intensive community-based clinical care. Based on input from dually diagnosed patients, including those of African-American and Latino origin, this approach is informed by a theoretical model in which adherence is hypothesized to be mediated by social support, self-efficacy, and degree of collaboration and cultural sensitivity present in treatment relationships between patients and their mental health providers. Aims include evaluations of this theoretical model and of the effectiveness of the social engagement intervention as compared to standard care with and without a medication compliance skills training module in increasing medication and outpatient treatment adherence and level of functioning and decreasing psychiatric symptoms, substance abuse, and the rate and duration of readmissions in the first 3 and 9 months following hospitalization. To achieve these aims, a controlled clinical trial will be conducted involving 360 adults with co-occurring psychotic and substance use disorders recruited during hospitalization over a 36-month period. Process measures will be employed to ensure fidelity of the interventions in each of the three conditions. The theoretical model informing the intervention and its effectiveness will be assessed through interviews at baseline, 12 weeks, and 9 months follow-up post-discharge from index hospitalization on measures of social support, self-efficacy, degree of collaboration and cultural sensitivity present in treatment relationships, treatment adherence, clinical and functional status, substance abuse, and inpatient and detox service utilization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: JANE COLLABORATION

ADDAMS

SUBSTANCE

ABUSE

RESEARCH

Principal Investigator & Institution: Bennett, Larry W.; Assistant Professor; None; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2003; Project Start 10-FEB-2003; Project End 31-JAN-2008 Summary: (provided by applicant): The goal of this program is to strengthen the infrastructure for substance abuse research linked to the Jane Addams College of Social Work, University of Illinois at Chicago. The collaborative will address the impact of drugs and the societal response to drugs on women and their children to provide a fuller understanding of the link between substance abuse, criminal justice, and women, in accordance with the agenda set forth in Healthy People 2000. The specific aims of the collaboration are: (1) Develop a community-based, multidisciplinary substance abuse research program focused on the confluence of substance abuse, criminal justice, and women; (2) Provide an organizational focus which will support multi-disciplinary teams pairing senior faculty, junior faculty, and research assistants in pilot research efforts in the core area, leading to funded R01/R03 proposals for substance abuse research projects; (3) Increase active collaboration with Treatment Alternatives for Safe Communities (TASC), BRASS/HRDI, and other substance abuse providers to enhance the generation of practitioner-useful research, consistent with the mission of the Jane

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Addams College of Social Work; (4) Promote culturally competent and practice-useful substance abuse research through a Minority Researcher Development Program and a Community Scholar Program; (5) Utilize an Advisory Panel consisting of providers, consumers, and senior researchers to provide conceptual guidance and specific expertise, critique research proposals, and identify applications for research; and, (6) Support professional development plans, including multidisciplinary research seminars, conferences, technical assistance, and broad exposure to substance abuse research culture in order to prepare social work faculty to become fully collaborative and independent substance abuse researchers, and make pragmatic and distinguished contributions to the substance abuse field. Three pilot projects will support mentoring of faculty by senior substance abuse researchers and serve as platforms for fully developed research proposals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LONGITUDINAL FACTORIAL INVARIANCE OF SUBSTANCE ABUSE Principal Investigator & Institution: Preacher, Kristopher J.; Psychology; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): Overlapping cohorts are of critical importance in substance abuse research. The application of latent curve analysis (LCA) to the study of change in overlapping cohorts has become popular, yet potential problems with this new modeling paradigm have received relatively little scrutiny. If the fundamental assumption of invariance fails to hold, observed differences over time may be due to changes in measurement and not to changes in the construct itself. Despite its importance, longitudinal invariance is not well understood analytically and is rarely evaluated empirically, increasing the risk that invalid conclusions might be drawn from LCA applied to empirical data. Given the critical role invariance plays in LCA, this will be the focus of the proposed project. The project is organized around three central aims. Aim 1 is to review and integrate the literature on factorial invariance, with an emphasis on cohort-sequential LCA. Aim 2 will draw upon the results of Aim t to inform the design and implementation of a computer simulation to empirically study measurement invariance in cohort-sequential designs under conditions commonly encountered substance use research. Aim 3 is to synthesize the findings of Aims 1 and 2 and apply them to empirical data sets studying the relation between stress and substance use in children of alcoholics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MARIJUANA/BLUNTS: USE, SUBCULTURES AND MARKERS Principal Investigator & Institution: Dunlap, Eloise E.; Principal Investigator; National Development & Res Institutes Research Institutes, Inc. New York, Ny 10010 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (provided by applicant): During the 1990s, youths across the nation (especially in inner-cities) have increasingly disdained crack, but expanded their interest in marijuana. Limited ethnographic findings from other projects strongly suggest that the renewed interest in marijuana might reflect an emerging practice of blunt smoking (marijuana wrapped with a cigar shell and smoked via deep inhalation) and that a new subcultural pattern is emergent. The project has the following aims: Aim A: (Use Practices) To analyze the use patterns, conduct norms, subcultures, and variations in

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Substance Abuse

youthful marijuana and blunt use; to identify how these are related to use of other illegal drugs and tobacco products. Aim B: (Social Settings) To analyze the social, economic, and physical contexts (both private and public) where youths create and maintain (both legally and illegally) their regular consumption of marijuana, tobacco, and blunts. Aim C: (Markets) To scientifically document the interaction of retail markets associated with blunt use regarding access to various tobacco products with marijuana and other illegal drug markets. Aim D: (Integrate Qualitative and Quantitative Analysis) To establish the findings by developing quantitative instruments, and analyzing data about types of smoking behaviors among larger samples of youths. The project will interview, observe and follow over the course of five years (an omnibus longitudinal ethnography), focal subjects recruited at ages 11-26 from Harlem and the Lower East Side of New York City; focal subjects will beta selected to represent diverse age groups, ethnicities, and substance use patterns. This ethnography will delineate current blunt use practices, impacts upon lifestyles, maturation, and the evolution of youthful drug subcultures. The project includes two modest quantitative analyses. A secondary analysis of a New York City School Survey and Peer Group Questionnaires will help establish the prevalence of marijuana and/or blunt use patterns among New York City youths within ethnicity and age groups and show whether the experiences of ethnographic focal subjects are typical A vigorous publication agenda will integrate qualitative and quantitative findings across time and subjects' lives and identify policy implications of this preferred substance use pattern among many youths coming of age in first decade of the 21st Century. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MATERNAL LIFESTYLE STUDY PHASE 4 Principal Investigator & Institution: Korones, Sheldon B.; Pediatrics; University of Tennessee Health Sci Ctr Memphis, Tn 38163 Timing: Fiscal Year 2003; Project Start 19-AUG-2002; Project End 31-MAR-2006 Summary: (provided by applicant): Prenatal substance exposure continues to be a major public health problem that affects millions of children and places enormous financial and social burdens on society. The Maternal Lifestyle Study (MLS) is an interagency collaboration involving the National Institute of Child Health and Human Development, the National Institute on Drug Abuse, the Administration on Children, Youth and Families, and the Center for Substance Abuse Treatment. MLS is being conducted in four University sites: Miami, Tennessee at Memphis, Wayne State, and Brown; and it is the largest clinical prospective longitudinal study to date of prenatal drug exposure and child outcome. The follow-up cohort includes 658 exposed and 730 comparison children who have been studied through 7 years of age with 71% retention. This application is to continue the follow-up through age 11. One aim is to study the effects of prenatal cocaine/opiate exposure on immediate child outcomes that start in infancy (e.g. attention, relationship to parent, neuromotor, physiologic reactivity, arousal/regulation, and medical status) as well as latent effects on domains of function that emerge later and become salient as children reach school age (e.g. cognition, antisocial behavior, substance use onset, psychopathology, neuroendocrine function, and health disorders). This includes determining the effects of heavy cocaine exposure and controlling for exposure to other drugs (alcohol, marijuana, and tobacco), medical (e.g. physical growth) and environmental factors, gender, minority status, and study site. The second aim is to study a broader conceptualization of the consequences of maternal drug use that includes determining how drug effects, and the effects of the postnatal environment combine to affect child outcome, including specific aspects of the

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environment unique to the drug culture. As a major longitudinal study, MLS is important to the field of developmental science by contributing to our understanding of developmental processes in normal and at-risk children. MLS will also contribute to the field by addressing health indicators related to Healthy People 2010. Understanding the consequences of prenatal cocaine exposure and risky environments is crucial for treatment and public policy. 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: MEDICAL IMPLICATIONS

COMORBIDITY

IN

ALCOHOLICS:

SERVICE

Principal Investigator & Institution: Moore, Charles D.; Kaiser Foundation Research Institute 1800 Harrison St, 16Th Fl Oakland, Ca 94612 Timing: Fiscal Year 2001; Project Start 01-JUN-2000; Project End 31-MAY-2005

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Summary: APPLICANT'S ABSTRACT: While many studies have demonstrated the effectiveness of substance abuse treatment, research is sparse regarding substance abuse patients' medical conditions and patterns of pre-treatment medical services utilization as they impact medical services utilization and outcome. The proposed work for this K23 application examines pre-treatment medical services utilization, medical conditions and medications, and their impact on medical services utilization and outcome at one year as well as longer-term (7 year) trajectories. This application interacts with an NIAAA grant on a long-term follow-up of individuals admitted to an HMO's substance abuse treatment program; it addresses analyses not proposed in that application. The applicant, Charles Moore, M.D., M.B.A. is a clinician and subregional Chief of Mental Health and Substance Abuse Services for the HMO, and has been extensively involved in the original study. He has raised many of the questions that the research team has developed in the past few years. The conceptual model of the original grant--which examines individual factors, treatment characteristics, and extra-treatment factors among a sample of 1204 individuals who entered an HMO's substance abuse treatment program--is broadened here to include pretreatment medical utilization patterns and pretreatment medical conditions as they impact treatment retention, treatment outcome, medical utilization, and cost. The proposed work addresses such research questions as: What is the impact of individual characteristics (including type of pretreatment medical conditions), treatment and extra-treatment characteristics on "appropriate use" (i.e., outpatient, preventive health services)? Furthermore, is this impact dose related? It will also examine whether high pre-treatment utilization (inpatient and ER) and chronic co-morbid medical conditions are related to a) shorter stays in index treatment; and, b) rates of abstinence and numbers of days abstinent posttreatment. Kaiser Permanente has on-going computerized data to document the dates, diagnoses and settings of all health care utilization received and costs. The analysis will first focus on baseline and 12 month data. In the later years of the application, analysis will include the 5 year follow-up and longer-term utilization data, in close collaboration with the work of the larger study as well. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MIDCARRER MENTORING AWARD: ADOLESCENT SUICIDE RESEARCH Principal Investigator & Institution: Spirito, Anthony; Professor of Psychiatry; Ctr for Alcohol & Addict Studs; Brown University Providence, Ri 02912 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: (Adapted from the Applicant's Abstract): This application for the K24 midcareer mentoring award in patient-oriented research is organized into 3 sections. In the first section, I describe my history of conducting patient-oriented research in 2 major areas: pediatric psychology and adolescent suicide. I have conducted research in the areas of pediatric asthma, sleep disorders, cancer, cystic fibrosis and developed a brief measure of coping which is widely used. I have also had a number of state, private, and federal grants to study the behavioral and psychological characteristics of adolescent suicide attempters. The last few years this programmatic research has been focused on how to improve treatment compliance and use structured treatment protocols for this high risk population. My career objectives are to conduct treatment research with high risk adolescent populations; in particular, adolescents with suicidal behavior and substance abuse problems. This award will contribute to my career objectives by relieving me of patient care duties and providing the time for additional training in substance abuse treatment. Opportunities for memorizing, which are ample due to

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Brown's strong postdoctoral training programs, are described in the second section. Three junior faculty are specifically identified to work under me on the proposed research project: a comprehensive, integrated, theoretically-based treatment protocol for the most high risk group of suicide attempters with comorbid substance abuse. In addition, two postdoctoral fellows will also work on this comprehensive intervention. In section three, the treatment program is presented. The premise of this protocol is that these high risk adolescents with comorbid substance abuse and suicidal behavior need multiple training opportunities in different circumstances - individual and family - to be able to effectively develop and positively appraise their problem-solving and affect management skills. An individual 14 session therapy protocol focusing on problemsolving and affect management is complemented by a 14 session family therapy protocol. These sessions will be conducted at the clinic or in home-based sessions. Similar skills are emphasized in both the individual and family sessions to reinforce skill retention. A substance use treatment protocol will be developed in the first 18 months of this application, piloted for an additional 6 months, and then integrated into the comprehensive treatment protocol. This integrated substance abuse/suicidal behavior treatment protocol will then be compared to the standard treatment protocol in a group of 50 adolescents with comorbid substance abuse/dependence and psychiatric symptomatology, including suicidal behavior, with outcome assessed at 6 and 12 month follow-up. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOTIVATIONAL INTERVIEWS FOR INCARCERATED TEENS Principal Investigator & Institution: Stein, Lynda a R.; Ctr for Alcohol & Addict Studs; Brown University Providence, Ri 02912 Timing: Fiscal Year 2001; Project Start 16-AUG-2000; Project End 31-JUL-2004 Summary: A significant proportion of teens involved in the juvenile justice system abuse substances. Multiple drug use increases the likelihood of remaining a youth involved in crime. Many teens involved in crime use alcohol or drugs prior to the commission of delinquent acts. A substantial number of delinquent youths who are offered treatment are unmotivated for intervention. The objective of this research is to investigate ways to enhance motivation for treatment and effectively reduce substance abuse among juvenile offenders. Motivational intervention (MI) as preparation for residential treatment and for persons (including teens) with little motivation to change has been effective in reducing substance abuse. Thus, MI designed for delinquent youths who are required to attend substance abuse treatment may prove efficacious. In this proposed randomized trial, a one-way design (MI + Standard Care [SC] vs. Attention Control [AC] + SC) will be used to determine whether MI enhances subsequent treatment participation and reduces substance-related problems post discharge in substance using, delinquent youths. Teens will also receive a booster session of MI or AC prior to discharge. SC includes skills training and psycho-educational components; AC provides relaxation training. Participants will be followed at 3 months post discharge. Primary outcome variables include alcohol and marijuana use, as well as related behaviors (illegal activity, sex or injures while drunk or high). It is hypothesized that in comparison to teens receiving AC, youths receiving MI will participate more (by therapist and teen ratings) in SC and will show the lowest levels of heavy substance use and related problems after discharge. It is hypothesized that effects found post discharge will be mediated by stage of change, drug effect expectancies, self-efficacy and treatment participation. This study will extend previous research by evaluating the use of MI with ethnically diverse substance abusing teens in a correctional facility, and by

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Substance Abuse

expanding outcome measures to include alcohol and marijuana-related risk behavior (such as injuries and illegal activity when drunk or high) in this population. The development of effective interventions for substance using juvenile offenders has the potential to reduce substance abuse and crime in this population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MULTIMEDIA ADDICTION SEVERITY INDEX FOR ADOLESCENTS Principal Investigator & Institution: Lord, Sarah E.; Director, College Health Programs; Inflexxion, Inc. Newton, Ma 02464 Timing: Fiscal Year 2003; Project Start 01-JUL-2001; Project End 31-MAY-2006 Summary: (provided by applicant): This proposed project develops and tests an interactive, multimedia (CD-ROM) adolescent alcohol and other drug assessment instrument called the Multimedia Addiction Severity Index for Adolescents (ASI-AMV). This tool is intended for use with adolescents (aged 13-18 years) at the outset of substance abuse treatment or upon entry into the juvenile justice system to guide treatment planning. The numbers of adolescents with diagnosed substance abuse problems is distressing both in treatment facilities and in the criminal justice system. Reported statistics do not include youth with substance abuse issues who are institutionalized or otherwise in trouble but have not been identified as misusing substances. Adolescent alcohol and other drug use frequently occurs in a constellation with other risky behaviors. The financial and societal costs of alcohol and/or drug abuse by adolescents are high. Early substance abuse can significantly delay attainment of normative developmental tasks, and estimated health and criminal costs for a lifetime of heavy drug abuse are staggering. Such considerations highlight the importance of early assessment and treatment for adolescents who are struggling with substance use issues. In Phase I, a paper-version scripted flowchart of the ASI-A-MV was created. Phase II will entail production of the ASI-A-MV CD-ROM, usability testing of the program to ensure functionality, and a clinical field trial to finalize a scoring system and determine reliability and validity of the ASI-A-MV. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NATIONAL INFRASTRUCTURE

AAPI

SUBSTANCE

ABUSE

RESEARCH

Principal Investigator & Institution: Wong, Frank Y.; Associate Professor; National Asian Pac Amer Fam Ag Sub Abuse Families against Substanc Abuse Los Angeles, Ca 90012 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): The National Asian Pacific American Families Against Substance Abuse (NAPAFASA) in consultation with the NIDA AAPI Researcher and Scholar Workgroup proposes a series of conferences over a five-year period that will address substance use/abuse among AAPIs. Using a regional approach, the conferences will bring together researchers and service providers from the diverse AAPI sub-groups and geographic regions to build a national substance abuse research infrastructure for AAPIs. The specific aims of the proposed series of conferences intend to: 1. establish a substance abuse research initiative that focuses on AAPIs; 2. encourage AAPI participation in career development programs with particular emphasis on the development of behavioral and social science researchers focusing on AAPI substance use/abuse; 3. establish a communication system amongst the researchers, service providers, and the AAPI communities to disseminate pertinent substance abuse

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research findings; 4. develop a mechanism for substance abuse research and data collection collaboration between AAPI behavioral and social scientists and AAPI community-based service organizations; and 5. disseminate substance abuse research information related to training, networking, and funding opportunities. The overall goals of the proposed series of conferences to be conducted over a five-year period are to: 1. develop substance abuse prevention and treatment research that is culturally competent; 2. develop methodologies that are appropriate for AAPI sub-groups that will be more targeted to the needs of these groups and contribute to the research methodology including a multicultural drug terminology lexicon that can be used in other studies with urban and semi-urban AAPI populations; 3. increase the numbers of AAPI research projects in the behavioral and social sciences by increasing the number of scientists with competence in AAPI substance abuse issues and AAPI community-based service providers with competence in research methodology, terminology, and practices; 4. establish a substance abuse services utilization database for AAPIs; and 5. establish data for the epidemiology of substance use/abuse in the AAPI populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NETWORK THEORY TO TAILOR PROJECT TOWARDS NO DRUG USE Principal Investigator & Institution: Valente, Thomas W.; Associate Professor; 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): This study proposes to use network analysis theory to tailor a nationally recognized effective substance abuse prevention program, Towards no Drug Use (TND). Network analysis theory will be used to identify group leaders and group members. TND will then be adapted to be used by these groups, completing the exercises and lessons in TND within these naturally occurring groups to determine if the effectiveness of TND can be improved by harnessing the power of peer influence. Recent evidence from an earlier trial has shown that this network approach to health promotion can be effective. The shortcoming to this prior work, however, has been that it has been implemented with a novel prevention program for which prior effectiveness had not been demonstrated. Thus this study provides the opportunity to test the network adaptation on an existing evidence-based program. This study will randomly assign 46 continuing high school classrooms (N=800) to receive TND or TNDNetworked and compare outcomes on substance abuse behavior at one and two year intervals. The two TND curricula will be similar with the exception that all group activities in TND-Networked will be conducted with groups based on students' selection of peer leaders. It is expected that TND-Networked will be more effective than TND by resulting in lower incidence and prevalence of smoking, marijuana, and hard drug use. This study will also use the network data to test hypotheses concerning peer influence. Specifically, we will test whether peer influence, measured with social network analysis, mediates the influence of TND. This study also proposes to conduct basic research on the role of social network influences on substance abuse behavior among these high-risk youth. We propose to study the ethnic composition of friendships choices, and investigate whether this facilitates or impedes substance abuse. It is linked with Project 1 in that it uses the baseline data from Project 1 and will investigate whether associative memories are affected differentially in the two conditions, and whether they vary by network choices. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEUROPHYSIOLOGY IN CHILDREN AT HIGH RISK FOR ALCOHOLISM Principal Investigator & Institution: Porjesz, Bernice; Associate Professor; Psychiatry; Suny Downstate Medical Center 450 Clarkson Ave New York, Ny 11203 Timing: Fiscal Year 2001; Project Start 01-JUL-1982; Project End 31-AUG-2006 Summary: (provided by applicant): For the past twenty years it has been repeatedly observed that the P3(00) component of the event-related potential (ERP) is not only significantly lower in alcoholics, but also in young offspring of alcoholics at high risk (HR) for developing alcoholism. These observations suggested that reduced amplitudes of the P3 component in HR individuals might antecede the development of alcohol dependence. There is some evidence that reduced P3 voltage in childhood and adolescence in HR individuals is associated with externalizing disorders (conduct disorder, attention deficit hyperactivity, oppositional defiant disorder and adult antisocial behavior) and increased substance use, and may predict later substance and alcohol abuse. A meta-analysis of all HR studies concluded that the low amplitude P3 in HR individuals provides a reliable phenotypic marker of alcoholism, and it has been postulated to be indicative of increased Central Nervous System (CNS) disinhibition. Thus P3 as a potential vulnerability marker may provide insight into some causative pathophysiology process involved in the development of alcohol dependence. Here it is hypothesized that the P3 amplitude may index some CNS vulnerability (e.g. disinhibition) which may result in any one of a number of adverse conditions, such as alcohol dependence, drug abuse, antisocial personality, attention deficit hyperactivity disorder, conduct disorder, oppositional disorder, etc. The research strategy used to date has been based on a familial high-risk model, because it is well known that children of alcoholics are at high risk to develop alcohol dependence. In the present renewal a complementary strategy is proposed based on a "neurophysiological high-risk" model. In this model, individuals are hypothesized to be at high-risk based solely on their extreme scores on neurophysiological features (e.g. visual P3 amplitude), well established to be associated with a number of clinical conditions such as alcohol dependence, substance abuse, etc. Several scientific issues will be examined with the use of this novel approach, using innovative neurophysiological assays and methods. Specifically, electrophysiological measures (P3 and other measures) will be recorded in a large randomly ascertained sample of adolescents (15-17). The P3b amplitude provides a quantitative variable that typically yields a normal distribution in the general population. This distribution will be divided into the lower, upper and middle third. These three groups based on P3b amplitude will provide the basis for subsequent dependent variables, such as other EEG/ERP experiments, the clinical data to be collected (externalizing symptoms, other psychiatric symptoms, alcohol use, drug use, family history of psychiatric disorders, etc.). It is hypothesized that those individuals at the low end of the P3 amplitude distribution will manifest more evidence of electrophysiological disinhibition, externalizing traits, and substance use. Moreover, it is proposed that individuals with low P3b amplitude will manifest significantly greater prevalence of externalizing traits, alcohol and drug abuse compared to subjects with high P3b amplitude when retested four years later (ages 19-21). Retesting will begin in the last year of this application, and will continue in the future. The identification of individuals with neuroelectric deficits will have great utility in prevention initiatives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEW PSYCHOMETRIC METHODS FOR SUBSTANCE ABUSE RESEARCH 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 01-AUG-1976; Project End 31-JUL-2006 Summary: (provided by applicant) This is a request for a K05 Senior Scientist Research Career Award (RCA) as a competing continuation of #5 K05 DA00017. The specific aims of the proposed five-year research program are the following: 1. Develop new psychometric methods for drug abuse research; 2. Apply these newly developed methods to important drug abuse data sets; 3. Generate practical improvements in methodology; 4. Create nontechnical papers and tutorials to improve methodology in drug abuse research; and 5. Advise drug abuse and health researchers and government agencies on methodology. The research program is directed towards the development of new multivariate psychometric and statistical techniques that hold special promise for improving the quality of psychosocial, social, behavioral, epidemiological, and functional imaging health-related research on drug use and abuse. Methods for robustly analyzing experimental and nonexperimental drug abuse data that may contain selectivity, outlier cases, arbitrary distributions, errors in measurement, nonstandard sampling plans, small samples, dependent observations, etc. will be developed. Special attention is given to structural equation models that may involve latent variables in mediation and moderator relations. Optimal small sample, missing data, robust, multilevel nonnormal, bootstrap, functional imaging, supercomputer research methods are a special focus. While no data will be gathered under this grant, the newly developed techniques will be extensively evaluated for their practical relevance to drug abuse research by addressing important substantive issues in drug abuse on highquality data obtained in association with NIDA/UCLA program project grant P01 DA01070, via collaboration with brain mapping researchers and nationally active substance abuse researchers working on their own projects, as well as by cooperation with NIDA and other health-related agencies. Methods that are developed under this grant also will be widely disseminated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: OUTCOME OF CRA WITH HOMELESS STREET YOUTH Principal Investigator & Institution: Slesnick, Natasha; Research Associate Professor; Psychology; University of New Mexico Albuquerque Controller's Office Albuquerque, Nm 87131 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2005 Summary: (provided by applicant): Substance abuse among homeless youth is twice the rate for school youth. In addition to being at greater risk for AIDS, homeless youth also report a broader range of substance-related problems, generally at higher levels of severity. A majority of homeless youth, however, do not receive substance abuse treatment. A recent study indicated that only 30 percent of homeless youth utilize even basic shelter services. Simply increasing ongoing substance abuse treatment for this population will not address the multiple problems these youth face. Few such interventions exist, and of the programs in operation, none have documented treatment outcome. In addition, few assessment instruments have documented validity or reliability with this population. The purpose of this study is to adapt a highly effective intervention for homeless adults to meet the special needs of homeless youth. Development of a manual guided therapy based upon the Community Reinforcement

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Approach (CRA) will be followed by recruitment and randomization to one of two interventions: (1) service as usual (no treatment control), and (2) CRA individual therapy and HIV intervention. The first 30 participants into the project will be asked to participate in a test-retest study of several of the assessment instruments. The efficacy of CRA and HIV intervention tailored for homeless youth will be evaluated and documented 3 and 6 months after treatment, and will include measures of substance use, HIV risk behaviors, negative affect, social stability, and related problem behaviors. Differential treatment response as a function of ethnicity, sexual orientation, and gender will be investigated to better understand the intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PATHWAYS TO SUBSTANCE ABUSE AND DEPENDENCE Principal Investigator & Institution: Dierker, Lisa C.; Psychology; Wesleyan University Middletown, Ct 06459 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): This proposal represents a request for a NIDA Research Scientist Development Award (K01) to provide training and research experience that will integrate complex developmental theory surrounding the etiology of substance abuse and dependence with newly emerging statistical methods. The candidate's goal is to advance her growth as an independent investigator and to apply appropriate and powerful quantitative methods to the refinement of substance theory that may optimally guide the development of intervention efforts. Thus, the applicant seeks additional training in the technical aspects of newly developed quantitative methods and in the consideration of state-of-the-art statistical procedures in the planning and design phases of longitudinal research aimed at uncovering the heterogeneity of developmental pathways to substance use disorder. The combination of training and supervised research provides the groundwork for the candidate's ability to independently bridge different disciplines and to ultimately function as an independent researcher and as the leading member of a multidisciplinary research team. The proposed research project will apply state-of-the-art statistical methods to the analysis of newly available longitudinal and cross-sectional data that include measurement of the widest array of individual and contextual risk factors available to date. The goal will be to identify multiple and prominent risk pathways that will guide the theoretical characterization of individual differences in risk for substance abuse and dependence. To achieve this goal, the following specific aims will be addressed: 1) Distinguish between substance use trajectories leading to substance use disorder vs. less severe levels of use 2) Identify prominent and unique risk constellations/pathways that predict the most severe outcome trajectories 3) Determine the attributable risk associated with each of the prominent risk pathways in order to evaluate the potential for reduction of substance abuse and dependence Existing data from three data sets will be utilized that include both nationally representative and case-control samples. Multiple statistical techniques for studying both growth and mediational effects will be used including group based semi-parametric techniques, tree-based methods, and diverse latent class approaches. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PERSISTENT TRAUMATIC BRAIN INJURY

NEUROPSCHIATRIC

DISORDERS

IN

MILD

Principal Investigator & Institution: Strickland, Tony L.; Professor; Charles R. Drew University of Med & Sci 1621 E 120Th St Los Angeles, Ca 90059

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Timing: Fiscal Year 2002; Project Start 25-SEP-2002; Project End 31-JUL-2005 Summary: The primary goal of this project is to determine if the presence of substantial abuse is associated with differential patterns of sustained neuropsychiatric disorders in mild traumatic brain injury (MTBI) patients. Traumatic brain injury (TBI) represents a major pubic health concern in the United States and worldwide. Neurocognitive and neuropsychiatric sequelae secondary to MTBI usually resolve within 90 days, however, for a significant minority of patients symptoms persist and can be severe. Incidence estimates of TBI based on U.S. studies are about 200 per 100,000 per year, thus yielding approximately 470,000 cases of brain injury annually. The most common causes of TBI include motor vehicle accidents, falls, assaults, firearm injuries, and sports. The majority of TBI is classified as mild. Toxicology studies of TBI patients reveal that they were often under the influence at the time of their acquired brain traumas. However, importantly, the relative contribution of acquired brain trauma versus substance-induced persistent neuropsychiatric pathology is incompletely understood. Understanding differential patterns of neuropsychiatric outcomes in minority patients is particularly important, because of the increased prevalence of intentional and unintentional injuries in the groups. Due to a dramatic surge in alcohol and other drugs in the past decade, there is a pressing need to study the associated neuropsychiatric aspects, particularly when substance abuse is combined with acquired brain trauma. It is now well-established that substance abuse, especially the abuse of alcohol and stimulants, can lead to hypertensive encephalopathy and ischemic brain hemorrhage, and that depression and other neuropsychiatric symptomatology are common (Bigler, 2001; Pulse Watch, 2000; Strickland, et al., 1998). Despite that alcohol and stimulants can induce significant cerebral pathology, little is known about differences in the magnitude of neuropsychiatric impairment, duration of symptoms, or the specific brain region(s) adversely impacted when substance abuse co-occurs with MTBI. Existing information is even less complete regarding differences in neurobehavioral outcomes secondary to ethnic, cultural, and socioeconomic influences. To strengthen our understanding of differences in neuropsychiatric and quality of life (QOL) outcomes in MTBI patients, this proposed project utilizes a five-year, between- and within-subject, repeated-measures design to investigate these parameters in a sample of 200 subjects. Fifty MTBI subjects positive for substance abuse will be evaluated within thirty days of injury (Time 1), and three months later (Time 2). Fifty non-MBTI and non-substance abusing subjects will be evaluated (Time 1), and three months later (Time 2). The proposed study has the following specific aims: 1. To determine if severity and duration of neuropsychiatric impairment in MTBI is associated with the presence of substance abuse. 2. To compare severity of neuropsychiatric and neuropsychological functioning between MTBI and substance abuse subjects over time (three months after initial assessment). 3. To identify and describe factors that are associated with improvement in neuropsychiatric symptoms via evaluation of primary or secondary analyses (such as interventions, demographics, or socioeconomics). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHARMACOLOGY OF ADDICTION RISK FACTORS Principal Investigator & Institution: Donovan, Stephen J.; Research Psychiatrist; Psychiatry; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: This resubmission of my INDEPENDENT SCIENTIST AWARD (K-02) will maintain me as a research scientist and mentor in the substance abuse treatment research I began under my K-20. As a psychopharmacologist, child psychiatrist, and

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addiction psychiatrist, I have been investigating early intervention to prevent career addiction. As a former high school teacher, I established, during my K-20, a referral network from which to recruit high-risk subjects. The Career Development and Research Plans hypothesize pathological affective (i.e. non predatory) aggression is a major psychopharmacologically relevant problem in antisocial spectrum disorders, including substance abuse. The Research Plan operationalizes criteria for a hypothetical subtype of affective aggression characterized by irritable mood swings. The Research Plan tests divalproex (i.e. mood stabilizer) efficacy in this subtype via three six-week randomized clinical trials, first in adolescents, then in children and finally in adults. Research Plan revisions incorporate IRG suggestions to use the referral network to supplement tracking of medication compliance and to follow-up children long after they have returned to the community. The Career Development Plan is more detailed in this resubmission. Part One will develop screening criteria for other affective (i.e. nonpredatory) aggressive storms (e.g. impulsive, paranoid, depressive) and refine them using response to specific pharmacological agents (e.g stimulants, low dose antipsychotics, SSRI's, respectively). Part Two proposes to impute medication effectiveness if efficacious medication alters intermediate steps in the antisocial trajectory. These "surrogate outcomes" include educational tracking into aggressive classes, predominance of coercive family interaction, and (for irritable affective aggression), marijuana use. If efficacious medication alters these surrogates, it is probably making a difference. If not, we must rethink our causal, models. Developing these ideas requires protected time to study epidemiology/biostatistics and work with my collaborators. A course of study at the School of Public Health was developed after consultation with Drs. Ezra Susser and Peter Jensen. Dr. Pardes' letter clarifies that Columbia's ability to support this Career Development Plan is contingent on continued financial support from NIDA-K. Concrete plans for participation in research ethics seminars are provided. Mentoring is via 2 NIH Training Fellowships at Columbia: Dr. Kleber's Substance Abuse Training Fellowship and the Psychiatric Epidemiology Training Program. I mentor child psychiatrists seeking advanced training in addiction and teacher to pre and post doctoral students interested in substance abuse intervention and randomized clinical trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHYSICIAN SCIENTIST TRAINING IN SUBSTANCE ABUSE RESEARCH Principal Investigator & Institution: Rounsaville, Bruce J.; Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (Applicant's Abstract) Using the revised Mentored Clinical Scientist Development Program Award (MCSDPA) mechanism, the Substance Abuse Division, Department of Psychiatry at Yale University School of Medicine requests a 5 year renewal period for our Physician Scientist Training Program, which has been providing intensive training in research methods for clinical and preclinical investigation on drug abuse. We request 6 positions for faculty level physicians to spend 3-5 years at Yale's Substance Abuse Treatment Unit obtaining clinical and research training under the mentorship of a team of investigators whose interests range from molecular neurobiology to psychiatric epidemiology. With over 30 externally funded research projects, the central theme of our research program is the development and evaluation of innovative pharmacological and behavioral treatments for substance abusers. Our multidisciplinary program enables us to conduct research that moves rapidly and in

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both directions from preclinical projects ("bench") to clinical studies ("bedside"). The training goal for this program is to provide physician scientists at the junior faculty level with an opportunity to devote virtually fulltime effort during the initial phase of their careers to learning research skills and conducting research projects as a start to careers as independent clinician scientists. After initial work conducted with the support of this program, they will be guided to develop scientifically meritorious research proposals (using, for example, R03 or R01 mechanisms) which will provide support for research that extends beyond the period of this program. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

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 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

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Project Title: PREPUBERTAL COMORDITY: GENDER & DEVELOPMENTAL HETEROTYPY Principal Investigator & Institution: Costello, Elizabeth J.; Professor; Psychiatry; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001; Project Start 21-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): This application responds to RFA: MH-01-002, "Research on Depression Comorbid with Externalizing Problems in Children." The application does two things: first, it brings the strengths of an already-collected longitudinal data set to addressing two of the questions set out in the RFA (page 2): (1) are comorbid conditions etiologically distinct from non-comorbid depressive conditions? and (2) do different patterns of comorbidity represent different subtypes? Second, it requests funding for further follow up of the same sample to address 5 other questions raised by the RFA: (3)does variation in developmental paths depend on age at onset of the comorbid disorder? (4)which children with comorbid conditions are at risk for substance abuse outcomes? (5) what are the mechanisms of risk? (6) what is the developmental course for comorbid children who go on to develop problems with substance abuse? and (7) what predicts long-term difficulties, for peer relationships and success in school, and substance use, abuse, and dependence, rather than more transient problems? The application builds on the Great Smoky Mountains Study (GSMS), a longitudinal epidemiologic study now in its eighth year of data collection. One quarter of the sample is American Indian. The sample has been followed since 1993 to examine the development of psychiatric and substance abuse disorders. To address questions 1 and 2 of the RFA, we are requesting funding for additional statistical and data management support to work on data already collected. Both dimensional and diagnostic data will be used. To answer questions 3 through 7 requires longitudinal data extending into late adolescence. By the end of 2002 we shall have collected data on the 11 year-old cohort (N =497) through age 19 and 20, using existing funds. We are requesting funding to interview the 9 year-old cohort (N=508) as they reach age 19 and 20, in 2003 and 2004. Our third request is for funding to carry out a structured family psychiatric history interview with the parents, in order to be able to co-address family genetic questions about the development of depression/DBD comorbidity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PREVENTING HIV AND OTHER STDS AMONG DRUG-INVOLVED WOMEN Principal Investigator & Institution: El-Bassel, Nabila; Associate Professor; None; Columbia Univ New York Morningside 1210 Amsterdam Ave, Mc 2205 New York, Ny 10027 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: (Applicant's Abstract) Urban minority women are currently among the fastest growing populations with HIV/AIDS in the nation. The vast majority of cumulative female AIDS cases are African-American (56 percent) or Latina (20 percent), living in inner city communities with high rates of substance abuse. This application seeks funding to establish a Social Work Research Development (SWRD) Program at the Columbia University School of Social Work (CUSSW) to develop the social work profession's capacity to conduct intervention research on HIV and other STDs among drug-involved women, their sex partners, and their children. The Social Intervention Group (SIG) at CUSSW in collaboration with the HIV Center for Clinical and Behavioral Studies, and several other Columbia University research centers, National Development

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and Research Institutes, Inc., state authorities and community-based service agencies, proposes to establish a SWRD Program in order to train junior social work faculty in research on the overlapping issues of HIV and substance abuse among women, their main partners, and their children. Our strategic plan to enhance faculty research includes: 1) developing structured mentorship relationships for junior faculty; 2) facilitating pilot studies and grant proposals; 3) providing access to expert scientific consultations; 4) establishing ongoing seminars and scientific work-groups; 5) providing administrative, technical, and clerical support; 6) promoting meaningful, multidisciplinary collaborations with other research centers and 7) facilitating dissemination and diffusion of findings to providers, policy makers, students, and consumers. To establish an enduring infrastructure for faculty substance abuse research, the SWRD program will create: a) an Executive Board to direct the proposed SWRD program, b) a scientific advisory board, c) a panel of mentors, d) a research resources unit, e) a panel of scientific consultants, and f) a community collaborators board. In addition to increasing the number of social work faculty and graduate students, who are trained in substance abuse research, the SWRD program aims to promote high quality, interdisciplinary research, which will advance the design of theoretically sound, contextually specific HIV interventions for different populations of drug-involved women and enhance knowledge and strategies for maintaining behavioral change as well as for diffusing HIV and relapse prevention interventions into communities. The SWRD Program will be directed by Dr. Nabila El-Bassel and codirected by Drs. Steven Schinke and Mary McKay, all CUSSW faculty with strong programs of federally funded research related to substance abuse and HIV. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREVENTING SUBSTANCE ABUSE IN SPECIAL EDUCATION STUDENTS Principal Investigator & Institution: Wells, Jennifer J.; Research Scientist; Oregon Center for Applied Science 1839 Garden Ave Eugene, or 97403 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-MAY-2002 Summary: (provided by investigator): The overall goal of this project is to create an interactive program designed to prevent use and abuse of illicit substances among youth with mental retardation and developmental disabilities (IMRDD). Young people with MRDD want to be like, and be accepted by their non-disabled peers. Research has shown that MRDD youth are more apt to use illicit substances in response to social (i.e., peer) pressure than their non-disabled peers. Additionally, approximately half of individuals with MRDD who use substances (including alcohol) may be characterized as substance abusers. Individuals with MRDD that abuse substances suffer the same health-related, social, economic, and emotional consequences as people without MRDD. This project will develop four stand-alone gender-specific CD-ROM substance abuse prevention programs for youth with MRDD at middle school and high school age levels. Within each program, the social and behavioral skills required for (a) recognition of, (b) response to, and (c) retreat from substance use risk situations will be taught via an interactive text-free program that incorporates graphic, animation, and video components. Direct Instruction (DI) methodology will be employed to facilitate mastery of program content for all program users. Forty MRDD high school males in a pre/post test design will evaluate the program. PROPOSED COMMERCIAL APPLICATIONS: This program fills a unique need: Substance abuse prevention for youth with mental retardation and developmental disabilities (MRDD). This product will be attractive to

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people with MRDD, and anyone serving this population (e.g., schools, health clinics, parents, services for at-risk youth, training centers, vocational and residential services. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PTSD AND SUBSTANCE USE/ABUSE IN YOUTH Principal Investigator & Institution: Wu, Ping; Epidemiology; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2003; Project Start 10-SEP-2003; Project End 31-MAY-2006 Summary: (provided by applicant): This R01 application is in response to the recent RFA, the Impact of Child Psychopathology & Childhood Interventions on Subsequent Drug Abuse, and is to study the relationship between Post-traumatic Stress Disorder (PTSD) and substance use/abuse in youth. With the 9/11 terrorist attack on the World Trade Center, subsequent terrorist threats and documented elevated rates of PTSD in youth, it is important to understand the relationship between PTSD and subsequent substance use/abuse, if we are to provide adequate prevention and intervention to this population, particularly in light of possible future terrorist attacks. The proposed study is based on secondary data analysis of 4 existing data sets with information about PTSD and substance use/abuse in youth. Two of the data sets are from two New York City Board of Education School Surveys conducted at 6 months (grades 6 - 12, N=4,690) and 18 months (grades 6-12, projected N=4,000) after 9/11. Two others are longitudinal data sets from community samples. The Children in the Community (CIC, N=717) sample, with children randomly selected from two upstate New York counties in 1975 at mean age of 5, followed-up 5 times, including as young adults. Also, a sub-sample from the Boricua Youth Study, those ages who were 10 to 15 at the baseline interview (N=1,300), and re-interviewed twice at 12 month intervals. This study will examine: (1) whether or not PTSD (or PTSD symptoms) after 9/11 are associated with increased substance use and abuse in youth; (2) whether or not youth use substances to self-medicate their PTSD symptoms after 9/11; (3) whether or not youth exposure to trauma and related PTSD (or symptoms) has an impact on later substance use and abuse; (4) whether or not the relationship between PTSD (or symptoms) and substance use/abuse differ by sociodemographic factors, such as gender, ethnicity, and family SES; and (5) whether or not the relationship between PTSD (or symptoms) and substance use/abuse can be explained by the existence of other comobid psychiatric disorders, such as major depression and anxiety. It is hoped that the findings from this project will provide useful information for clinicians and policy makers, so as to improve service delivery for youth with PTSD and substance use/abuse after traumatic events. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PUBLIC POLICY, SUBSTANCE ABUSE AND PSYCHIATRIC DISORDERS Principal Investigator & Institution: Saffer, Henry; Research Associate; National Bureau of Economic Research Cambridge, Ma 02138 Timing: Fiscal Year 2001; Project Start 01-JUN-2000; Project End 31-MAY-2003 Summary: (Applicant's abstract): The empirical work outlined in this proposal will examine the interaction between substance abuse related public policies, substance abuse outcomes and mental health problems including psychiatric disorders. The significance of research on substance abuse is highlighted by the mortality, illness, employment costs, and other costs associated with their consumption. The significance of research involving mental health problems and psychiatric disorders is emphasized

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by their prevalence and costs. Recent research has shown that psychiatric disorders affect 28% of the noninstitutionalized US population in any given year. There has also been an increasing interest in the use of policy for the control of substance problems. For example, there are an increasing number of localities, which are seeking to ban outdoor alcohol and cigarette advertising and an increased recognition that taxes can be used to control alcohol and cigarette consumption. Although the link between substance abuse and psychiatric disorders is well established, no study of the effects of public policy on substance abuse explicitly accounts for the role of psychiatric disorders. The primary issue, which will be studied, is whether individuals who are diagnosed with various psychiatric disorders or who have reported symptoms associated with mental health problems are equally responsive to the current and proposed menu of policy options as those without these disorders and problems. The substances, which will be examined, include alcohol, illicit drugs, and tobacco. The research will employ the National Comorbidity Study (NCS) which is the only survey to administer a structured psychiatric interview to a representative national sample of over 8000 people in the United States. The NCS will be augmented with an extensive series of substance abuse policy variables. These policy variables will be appended to the individual records at the county level or the state level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REDUCING BARRIERS TO DRUG ABUSE TREATMENT SERVICES Principal Investigator & Institution: Siegal, Harvey A.; Professor; Community Health; Wright State University Colonel Glenn Hwy Dayton, Oh 45435 Timing: Fiscal Year 2003; Project Start 20-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): In 1998 more than 13 million people had a potentially diagnosable substance abuse disorder (NHSDA, 1998). Substance abuse treatment is considered as an effective response to these disorders. Despite the benefits of substance abuse treatment, only a relatively small proportion of those in need of treatment receive any service. Many of those initiating treatment leave before the therapeutic benefit can be realized (IOM, 1990) Many people needing services face a range of barriers to treatment linkage and engagement. These barriers include internal or psychological ones such as denial of problem, lack of self-efficacy that services could be accessed, embarrassment, and fears of what treatment might entail. External barriers, such as transportation difficulties and childcare needs, may impose limitations to treatment entry and, importantly treatment engagement. While barriers to treatment linkage and engagement have been well documented, few interventions to removing them have been studied. The broad goal of this study is to assess the effectiveness of two interventions to facilitate treatment linkage and treatment engagement. The study's two interventions will be a Motivationally based one and Strengths-Based Case Management. Each has proven effective in either moving substance abusers towards treatment and retaining them once in service. A three-armed controlled clinical trial research design will be used to test the effectiveness of these interventions in the context of a community wide Central Intake Unit (CIU) and several community-based specialty substance abuse providers. Treatment Linkage and Engagement will be the outcome measures. We hypothesize that those receiving either of the interventions will be more likely to Link with treatment than those in the control condition. We further hypothesize that the case management condition will have better outcomes for treatment linkage and engagement than the motivational condition. The study will recruit a sample of 690 treatment seeking people and use a longitudinal design, obtaining data at 3 points. Research goals are to examine the interaction of individual factors, Community

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Treatment Program factors, and study-delivered interventions on the outcomes of treatment linkage and engagement. The study's parallel qualitative/ethnographic aims will describe how the processes of linkage and engagement occur at the individual level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RELAPSE AMONG SEVERELY MENTALLY ILL ALCOHOL ABUSERS Principal Investigator & Institution: Bradizza, Clara M.; None; State University of New York at Buffalo Suite 211 Ub Commons Amherst, Ny 14228 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2006 Summary: The long-term goal of this proposed research is to develop effective methods for reducing posttreatment alcohol involvement among severely mentally ill (SMI) alcohol-abusing individuals. The specific aims of this research proposal are to test specific hypotheses summarized in a conceptual path model: 1. To examine the direct and indirect effects of psychiatric symptomatology on posttreatment alcohol involvement in schizophrenic individuals. Alcohol involvement outcome will be assessed by several variables including relapse to alcohol use, percent days abstinent, drinks per drinking day, and negative consequences due to alcohol use. It is anticipated that psychiatric symptoms will have both a direct influence on posttreatment alcohol involvement and an indirect effect through the dual-diagnosis treatment and coping skills factors. 2. To examine the direct and indirect effects of alcohol and other substance use problems on posttreatment alcohol involvement. It is predicted that alcohol and other substance use problems will have both a direct influence on alcohol involvement outcomes and an indirect effect through the dual- diagnosis treatment and coping skills factors. 3. To examine the direct and indirect effects of dual-diagnosis treatment on posttreatment alcohol involvement outcomes. It is predicted that dual-diagnosis treatment will have a direct influence on alcohol involvement outcomes and also an indirect effect through the coping skills factor. 4. To examine the direct influence of general and alcohol- specific coping skills on posttreatment alcohol involvement outcomes. It is predicted that poorer coping skills will lead to worse alcohol involvement outcomes. 5. To conduct exploratory analyses examining the moderating effects of gender, ethnic background, antipsychotic medications, and alcohol medications on the association between predictor variables derived from our mediational path model and alcohol involvement outcomes. A longitudinal design will be used to assess multiple measures of key constructs at treatment entry, and every two months thereafter for a period of six months. Key constructs include background characteristics, psychiatric symptomatology, alcohol and other substance use problems, treatment, coping skills, and alcohol involvement outcomes. Importantly, the results of this study will be used to gain an understanding of factors leading to posttreatment alcohol involvement among SMI individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RISKY FAMILIES EMBEDDED IN RISKY ENVIRONMENTS Principal Investigator & Institution: Robles, Rafaela R.; Senior Scientist; None; Universidad Central Del Caribe Bayamon, Pr 009606032 Timing: Fiscal Year 2002; Project Start 20-JUN-2002; Project End 31-MAY-2007 Summary: (provided by applicant): This application requests five years of funding to continue our efforts to understand the factors that are sustaining the high prevalence of HIV infection, HIV risk behaviors and high incidence of AIDS among Puerto Rican drug users. The overall study goal is to develop and test models that assess the effects of

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parental drug use and depression, adolescent substance use and psychopathology, as well as HIV risk behaviors, and the mediating effects of cultural, familial/ extra-familial and personal factors on transitions and turning points that define the movement from early to late adolescence. Drug using (n=375) and non-drug using parents (n=375) and one of their offspring (n=750), 13 to 15 years of age, residing in poor neighborhoods comprise the group of study participants. This application proposes a prospective study design with a nested ethnography. Data will be collected by multiple assessment strategies: interview protocols and structured psychiatric interviews using the Spanish version of the Diagnostic Interview Schedule for Children Version 2.1 (DISC 2.1) to assess substance use/ abuse, depression and conduct disorders among adolescents at baseline and in year 2, 3 and 4. The Spanish version of the substance abuse and depression scales of the Composite International Diagnostic Interview (CIDI) will assess substance abuse and depression among parents at baseline and in year 2 and 3. These diagnostic data, along with annual interviews of parents and adolescents will cover a critical and wide range of topics related to participants' life events and transitions; such as school and work experience, drug and alcohol use/ abuse, criminal behavior, coping mechanisms (e.g., social support, self-esteem and mastery), and depressive symptomatology. These data and the information collected through the in-depth interviews conducted by our ethnographic team will provide specific information with which to assess adolescent transitions, especially substance use/ abuse and HIV risk behaviors and adaptation to their expected roles as they move from early to late adolescence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SCREENING FOR COMORBIDITY IN SUBSTANCE ABUSE CLINICS Principal Investigator & Institution: Blanco, Carlos; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 10032 Timing: Fiscal Year 2003; Project Start 20-SEP-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Despite our increased understanding of the determinants of substance abuse the treatment of addictive disorders continues to be a major public health problem. Even powerful treatments such as methadone maintenance for opiate dependence have high failure rates and, when patients stay in treatment, they often continue to use psychoactive substances. One reason for this poor outcome may be the high prevalence of comorbid psychiatric disorders in this population. Fortunately, a number of studies has shown the outcome of these patients can improve when their comorbidity is treated. Therefore, increasing the diagnostic accuracy and referral for treatment of this group of patients represents a promising strategy for the treatment of substance abuse disorders. As a first step in that process, this R03 proposal focuses on the adaptation and initial testing of the Patient Health Questionnaire (PHQ) for the diagnosis of psychiatric comorbidity in substance abuse patients, but it is not intended itself to change providers' behaviors. The PHQ is a brief, self-administered instrument that has been extensively studied in a variety of community-based, primary care medical settings. It has been found to accurately identify common psychiatric disorders and has been well accepted due its ease of use and low time demands on patients and staff. It is hoped that the adapted PHQ (Patient Health Questionnaire-Substance Abuse Version; PHQ-SA) will become a patient- and clinician-friendly tool for counselors and other frontline staff to identify patients who could benefit from referral for psychiatric care. Data from this study will help plan future intervention studies that will use our increased ability to diagnose comorbidity to

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provide appropriate referral and treatment strategies for substance abuse patients in community-based treatment settings. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SEROTONIN, IMPULSE CONTROL, AND SUBSTANCE ABUSE Principal Investigator & Institution: Moeller, Frederick G.; Associate Professor; Psychiatry and Behavioral Scis; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: This application is a re-submission of an Independent Scientist Award (K02). The candidate is Frederick G. Moeller, M.D. He is an associate professor in the Department of Psychiatry and Behavioral Sciences. Environment: He is a member of the Psychiatry Department's Substance Abuse Research Center, and has several established investigators in the area of substance abuse, laboratory measurement of behavior and neurochemistry with whom he collaborates. His Human and wet laboratories occupy approximately 2,000 square feet of space. Research Projects: The research plan draws heavily from currently funded grants R01 DA08425, and R01 AA10828 on which the author is the principal investigator. The overall aim of this proposal is to study the relationship between drug use, serotonin, and impulsive/aggressive behaviors. Once the underlying biochemistry of these behaviors is determined, this will allow development of treatments for impulsivity, which leads to behaviors such as drug use or impulsive sexual behaviors that increase the risk for HIV transmission. The proposed research is grouped into four experiments. Experiment I will determine if combining two treatments which can decrease impulsive behavior (the serotonin reuptake inhibitor citalopram and behavior modification through monetary contingencies) will improve response to treatment in cocaine dependence. Experiment II will measure ethanol induced aggressive responding in subjects with Antisocial Personality Disorder (ASP) and matched controls. Experiment III will measure serotonin (5-HT) function using a neuroendocrine challenge and relate this measure to impulsive and aggressive behaviors in the laboratory and in the clinic. Experiment IV will determine if changes impulsivity in the laboratory parallel clinical response to treatment for cocaine dependence. The candidate's immediate career goals are to continue ongoing research on serotonin, substance abuse and impulse control. Long term career goals are to develop as a researcher in the area of the biology of impulse control and substance abuse. This will be done by defining the serotonergic receptors involved in impulse control through collaboration with experts in preclinical serotonin research, and impulsivity. Novel laboratory methods for measurement of impulsivity will be developed and validated in impulsive patient populations, and neurophysiology techniques will be used as an additional measure of 5-HT. Research Career Development Program: The research career development consists of new and expanded collaborations with scientists in the field of basic science of serotonin function, impulsivity, and laboratory measurement of human behavior. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SOFTAD SUBSTANCE USE OUTCOMES FOLLOWING TAD Principal Investigator & Institution: Curry, John F.; Associate Professor; Psychiatry; Duke University Durham, Nc 27706 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-MAY-2008

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Summary: (provided by applicant): Substance abuse is a major public health problem among adolescents in the United States, associated with serious negative outcomes including high-risk sexual behavior and the leading causes of adolescent death: accidents, homicide and suicide. Substance use disorders (SUD's) are one of the three most common forms of adolescent psychiatric disturbance. Prevention of such disorders is a public health priority. The National Institute on Drug Abuse (NIDA) and the National Institute of Mental Health (NIMH) recently released RFA: DA-03-007, calling for investigations into the impact of child psychopathology and childhood interventions on subsequent drug abuse. This project, Substance use Outcomes Following Treatment for Adolescent Depression (SOFTAD) is an extended follow-up of adolescents who have completed the NIMH Treatment for Adolescents with Depression Study (TADS). We developed and are coordinating TADS, a 12-site study comparing cognitive behavior therapy (CBT), fluoxetine (FLX), combined CBT and FLX acutely to one another and to placebo, and longitudinally to one another in 432 adolescents with Major Depressive Disorder (MDD). TADS is the first adolescent MDD treatment study to include measures of substance use and abuse. We propose to enhance the measurement of substance use outcomes and related family factors and to extend the follow-up period from TADS treatment to five years in order to address critical questions emphasized in RFA: DA-03-007. These include the impact of treating MDD (and of specific treatments) on subsequent substance use outcomes, the identification of moderators and mediators of successful outcome in the affective and substance use domains, and the longitudinal relationship between adolescent MDD and substance use or abuse in a clinical sample. Approximately 300 adolescents will be followed and assessed every six months. Selfreport, parent-report and diagnostic interview measures will be collected. The major hypothesis, that successful treatment of MDD will reduce subsequent substance use problems, and additional questions, will be tested using chi-square, logistic regression, and structural equation modeling. SOFTAD will be coordinated by the Duke Clinical Research Institute (DCRI), the same organization coordinating TADS, thus realizing substantial efficiencies and cost savings. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

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

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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 •

Project Title: SUBSTANCE ABUSE IN ADHD GIRLS Principal Investigator & Institution: Wilens, Timothy E.; Associate Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 05-MAY-2002; Project End 31-DEC-2006 Summary: This is the first resubmission of an R01 application, 1 R01 DA14419-01, that is a response to a PA (97-043) encouraging research on the origins and pathways to substance abuse (SA). A mixed body of evidence suggests that SA is frequently preceded by childhood attention-deficit/hyperactivity disorder (ADHD) and associated comorbid disorders. The aim of this proposal is to test hypotheses about the cooccurrence of SA in ADHD adolescent girls growing up and their high-risk siblings. We are proposing to study a group of girls available from an NIMH funded five year, family-based, controlled follow-up study of girls with ADHD currently underway with a focus on SA. At baseline assessment, we ascertained 140 ADHD and 120 normal control girls from psychiatric and non-psychiatric settings with 464 and 402 first degree biological relatives, respectively. We now propose a five-year study that will re-examine the probands and families five years after their baseline assessment with a particular emphasis on SA, thus capturing these adolescents as they are beginning to pass through the risk for SA. We have two Main Aims: 1) To characterize SA in ADHD girls growing up, and 2) To determine predictors of SA in ADHD girls growing up. In our preliminary work, we have begun to address issues related to the overlap of SA and ADHD in boys and girls that are the focus of the proposed work. We view the proposed extension of our work as an essential step for several reasons: this work will be the first, prospective high risk family-based study of SA in ADHD girls; we will have extensive information on a well characterized group of children ascertained from medical and psychiatric settings spanning five years; and psychiatric comorbidity within ADHD was not excluded allowing analysis of its influence on later SA. Given the high prevalence of ADHD, its related comorbid disorders, and its frequent persistence into adulthood, the proposed study will shed light on ADHD adolescent and young adult females at highest risk for SA. Since ADHD is treatable and identifiable in early years, these data will provide valuable information to formulate prevention interventions. Thus, the research,

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approach, and goals of this R01 application are consistent with those underscored in the PA and by the Institute of Medicine as being of the highest research priority. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SUBSTANCE ABUSE IN FIRST EPISODE MANIA Principal Investigator & Institution: Strakowski, Stephen M.; Associate Professor; Psychiatry; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221 Timing: Fiscal Year 2001; Project Start 15-JUL-1999; Project End 31-MAR-2004 Summary: Up to 60% of people with bipolar disorder abuse drugs and alcohol, and, in contrast to the general population, bipolar patients are far more likely to meet criteria for substance dependence than abuse. Despite numerous studies documenting this frequent co- occurrence, it is unclear why substance dependence rates are so high in bipolar disorder. It is likely that more than one mechanism accounts for these elevated rates of substance dependence, which confounds studies of this problem. Therefore, one approach to clarify why substance dependence is so common in bipolar disorder is to define subgroups of patients with different mechanisms leading to this co-occurrence and then study how these subgroups differ. With this in mind, we propose that three patient groups defined by age at onset, course of illness, and life-events, will account for the excess of substance dependence in bipolar disorder: 1) patients in whom bipolar disorder initiates substance dependence, 2) patients in whom substance dependence initiates bipolar disorder; and 3) patients in whom both bipolar and substance use disorders develop as a result of a common risk factor (stressful life-events). The first major objective of this proposal, then, is to determine whether these patient groups can be identified in a sample of bipolar patients recruited at the time of their first manic episode, and to determine whether different substances of abuse are more commonly associated with each group. The second major objective is to determine whether these groups demonstrate different clinical outcome and familial rates of substance use and affective disorders. This study is novel in that it examines specific a priori-defined subgroups of bipolar patients with co-occurring substance dependence using prospective outcome, family history, and life events methodology to clarify why these two disorders so commonly co-occur. The study is further strengthened by a hypothesis driven design in a first-episode patient sample thereby eliminating the confounds of illness chronicity and prior treatment. The results of this study could have immediate impact on how treatment of this patient population is developed. 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 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

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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: SUBSTANCE USE AMONG CHILDREN OF HISPANIC SCHOOL DROPOUTS Principal Investigator & Institution: Aloise-Young, Patricia A.; Psychology; Colorado State University Fort Collins, Co 80523 Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 31-AUG-2007 Summary: (Provided by Applicant): School dropout and drug use contribute to the health disparities that exist between different constituencies within the US. Wide ranging negative health, economic and social outcomes result both from school failure and from substance use, and they disproportionately affect disadvantaged, minority adolescents. In order to break this cycle, data are needed on the mechanisms of the intergenerational transmission of risk for school failure and substance use. To that end, the focus of the present study is the identification of characteristics that might put the children of Hispanic school dropouts at risk for school failure and drug abuse. Specifically, the primary aims of the proposed project are to study: 1: the relation between parental educational factors and parent involvement in child's schooling (i.e., school visitation, enrichment activities, and encouragement of child's school success) 2: the interrelations between parental educational factors, the parent's involvement in the child's schooling and the child's early use of cigarettes, alcohol, and inhalants 3: the relation between parental involvement in the child's schooling and the child's academic performance 4: the relation between parental drug use, parenting practices, and children's substance use The parents included in the proposed study have been participating in the Mexican American dropout project (funded by NIDA; Chavez, PI) and data on drug use and school variables are available for the parents since they were

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adolescents. In the current study, participants from the Mexican American dropout project and their children will be measured at three time points, when the children are in the third, fourth, and fifth grades. Longitudinal data analyses will be conducted using structural equation modeling, latent transition analysis, and latent growth modeling. The career development plan includes provisions for the PI to obtain training in those advanced statistical techniques. The career development plan is designed to enable the PI to learn about an analytic technique through readings, workshops, etc. and then to utilize this knowledge in the analysis of real data. The PI is a developmental psychologist with postdoctoral training in substance use prevention research. The PI has recently returned to academia following a career interruption and she believes that the acquisition of these statistical skills is integral to her ability to develop an externally funded research program in developmental epidemiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SUBSTANCE USE AND TREATMENT WITHIN A TRANSGENDER SAMPLE Principal Investigator & Institution: Lombardi, Emilia L.; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 20-APR-2001; Project End 31-MAR-2003 Summary: (Applicant's Abstract) Discrimination against transgendered individuals can make their access to health services highly problematic. More specifically, substance use treatment programs may not be sensitive to transgendered individuals who have drug use problems. Because of this, the needs of transgendered individuals may go unmet. As indicated in a resolution recently passed by the American Public Health Association (March, 2000), a knowledge base must be built to aid substance use service providers in developing policies to increase their effectiveness when working with transgendered men and women. This study will examine (a) factors that influence transgendered men and women's substance use, (b) problems that may hinder their access to substance use treatment, and (c) problems they may face within such programs. I will distribute confidential, self-administered questionnaires to transgendered men and women in Los Angeles and San Francisco (two areas with large concentrations of transgendered men and women). The recruitment strategy will utilize outreach and treatment organizations serving transgendered individuals, advertising in local newspapers and magazines, and respondent driven sampling. The chief analytic task is to examine relationships between people's experiences of discrimination and physical/verbal abuse due to being transgendered, their experience in substance use treatment and other health services, and their substance use history. As this is an exploratory study, much of the analysis will be bivariate. Hypotheses: 1. Experience of physical/verbal abuse and discrimination will be positively associated with substance use. 2. Experience of physical/verbal abuse and discrimination will be negatively associated with participation in treatment. 3. Experience of physical/verbal abuse and discrimination will be negatively associated with treatment engagement. 4. Receiving transgender-specific services will be positively associated with participation in treatment. 5. Receiving transgender-specific services will be positively associated with treatment engagement. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SUBSTANCE USE: FAMILY, FRIEND, AND COMMUNITY FACTORS Principal Investigator & Institution: Sterk, Claire E.; Professor and Chair; Behavioral Scis & Hlth Educ; Emory University 1784 North Decatur Road Atlanta, Ga 30322

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Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2006 Summary: (Applicant's Abstract) The specific aim of this application for a K02 award is to advance the applicant's quantitative skills, which in turn will allow her to build on the qualitative and quantitative skills she already has as well as on the largely qualitative contributions she has made to the substance abuse field. Much of her work in the substance abuse field has been qualitative in nature or been limited to less advanced quantitative approaches. Ultimately, the candidate anticipates that an extensive knowledge of advanced qualitative and quantitative skills will allow her to continue to make contributions to the field. In the research plan, the applicant proposes to build on her ongoing research on intergenerational substance abuse among mothers and daughters. Although research on familial, friend, and community factors on substance abuse exists, many questions remain regarding the complex relationship between risk and protective factors at all three of these levels. In the proposed research, the candidate aims: (1) to determine familial patterns of substance use, abuse and dependence among cocaine-dependent young adults (ages 18-25), their parents and their siblings. This includes the role of specific family members, familial aggregation, familial use patterns of specific drugs, and the development of familial substance use; (2) to explore the association between cocaine dependence and comorbid psychopathology, particularly depression, anxiety, antisocial personality disorder, and post-traumatic stress syndrome; (3) to examine the role of specific community factors in the development of substance use, abuse, and dependence. These factors involve local drug market forces, such as the availability, price and purity of cocaine and other drugs; community norms regarding substance use, and other relevant community characteristics; and (4) to investigate the dynamics of risk and protective factors at the individual, familial, and community levels. The development and training component of the application includes course work in advanced statistical techniques. This further training will allow the applicant to continue to build on her existing expertise and to continue to make contributions to the field by adding quantitative approaches to her largely qualitative work. The requested release time from teaching and administrative responsibilities will allow the candidate to enhance her research career. 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

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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 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: TRANSPORTING TREATMENT FOR HOMELESS COCAINE ABUSERS Principal Investigator & Institution: Schumacher, Joseph E.; Medicine; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 20-SEP-2001; Project End 31-AUG-2005 Summary: (Applicant's Abstract) Substance abuse in homeless persons is associated with multiple health risks and presents daunting challenges to agencies providing services. Proposed research with this vulnerable population is based on 2 previous randomized controlled studies showing an innovative behavioral day treatment's (BDT+) effectiveness in a community setting with different comparison groups. The second demonstrated superiority of abstinent contingent housing and work compared to BDT alone, while controlling for alternative explanations of treatment effectiveness. This study determines if BDT+ for dually diagnosed, homeless substance abusers, can be successfully transported to a new site. It develops training materials and methods for new staff to implement BDT at the University of Texas, Houston Recovery Campus. Expected products are: treatment manual, 35mm slides, videotapes etc., and brief observation scales to assess fidelity of each transported BDT+ component. Objective criteria and methods assure BDT+ components have been implemented with measured specified fidelity. Implementation is studied via a 2 group randomized control comparison with usual care. From a population meeting criteria from previous studies, 100 each will be assigned to either BDT+ or an existing Riverside General Hospital Day Treatment (RGHDT) control. Assessments at baseline, 1, 2, 6 and 12 months use instruments and measures employed in original studies. Outcomes include alcohol and drug abuse, homelessness, employment and HIV/AIDS risk behaviors, and a cost effectiveness analysis. Successful implementation is ultimately defined by hypothesized, superior outcomes for BDT+. If BDT+ can be replicated, products and methods would permit transport to other settings. Results will provide important knowledge and technology for transporting complex psychosocial treatment and how to most effectively treat this dysfunctional population, knowledge which has important clinical, economic, public health and public housing policy implications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TREATMENT OF ALCOHOL PROBLEMS FOR VIOLENCE PRONE YOUTH Principal Investigator & Institution: Gil, Andres G.; Associate Professor and Associate Direct; School of Social Work; Florida International University Division of Sponsored Research and Training Miami, Fl 33199 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): "Treatment of Alcohol Problems for Violence Prone Youth" is a five-year research project designed to develop and test a school-based alcohol abuse/violent behavior intervention with a multicultural sample of violence prone alternative school youth with alcohol and substance use problems. Adolescent alcohol and drug use/abuse and juvenile violence are pressing social problems in America. Moreover, an extensive literature has documented significant associations between substance use/abuse and juvenile violence. Compared with the general population of adolescents, juvenile offenders are more likely to use alcohol, tobacco, and other drugs, are more likely to have substance use problems, and use substances at earlier ages. The proposed study is a randomized clinical trial evaluating the efficacy of a school-based intervention (Guided Self-Change). Key features of the study include manualized treatments, theory-driven hypotheses, a randomized controlled trial design, and a culturally/ethnically diverse sample of youth with co-occurring problems of substance abuse and violent behaviors. Participants (n=800) will be randomly assigned to two conditions: a brief intensive school-based intervention (GSC) or standard care (SC and referral] provided by Communities in Schools of Miami. The school-based intervention will consist of 5-7 weekly individual sessions of GSC. Participants will be assessed immediately before and after intervention and at 3- and 6-month follow-up. Primary hypotheses include: 1) adolescents assigned to GSC will demonstrate significantly greater reductions in alcohol and other drug involvement thanadolescents assigned to SC; and 2) adolescents assigned to GSC will demonstrate significantly greater reductions in violent behavior and attitudes than those assigned to SC. Our second aim is to examine processes of change associated with response to the GSC intervention. Analyses will involve: 1) measuring the degree to which participants demonstrate pretreatment/post-treatment changes in selected domains (i.e., stresscoping skills, social skills, adolescent-parent communication skills, motivation to change) directly reflecting each of the intervention components; and 2) examining whether changes in these domains predict participants? ultimate response to intervention. A third aim is to examine contextual variables, representing significant subgroups of adolescents that may predict differential treatment. These include family and neighborhood substance use and violence, and peer and adult social support. Finally, the fourth aim is to examine treatment response by factors related to race/ethnicity and gender. These factors include acculturation level, acculturation stress, discrimination, and cultural mistrust for race/ethnic factors, and psychopathology and abuse experiences for gender factors. 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 3

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

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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 “substance 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 substance abuse in the PubMed Central database: •

Addiction and the brain: the role of neurotransmitters in the cause and treatment of drug dependence. by Tomkins DM, Sellers EM.; 2001 Mar 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=80880

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Drug supply and drug abuse. by Copeman M.; 2003 Apr 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=153673

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Pharmacokinetics and bactericidal rates of daptomycin and vancomycin in intravenous drug abusers being treated for gram-positive endocarditis and bacteremia. by Rybak MJ, Bailey EM, Lamp KC, Kaatz GW.; 1992 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188844

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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=abstr act&artid=162572

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Teicoplanin pharmacokinetics in intravenous drug abusers being treated for bacterial endocarditis. by Rybak MJ, Lerner SA, Levine DP, Albrecht LM, McNeil PL, Thompson GA, Kenny MT, Yuh L.; 1991 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245081

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The need for a drug abuse documentation center in India. by Kumar RP.; 1990 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=225437

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The Substance Abuse Index and Abstracts - A Guide to Drug, Alcohol and Tobacco Research. by Anderson SM.; 1989 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=227503

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 4 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. 6 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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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 substance abuse, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “substance abuse” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for substance abuse (hyperlinks lead to article summaries): •

A comparison of pathological gamblers with and without substance abuse treatment histories. Author(s): Ladd GT, Petry NM. Source: Experimental and Clinical Psychopharmacology. 2003 August; 11(3): 202-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12940499&dopt=Abstract

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A comparison of substance abuse among female offender subtypes. Author(s): Phillips JA, Nixon SJ, Pfefferbaum B. Source: J Am Acad Psychiatry Law. 2002; 30(4): 513-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12539906&dopt=Abstract

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A history of induced abortion in relation to substance abuse during subsequent pregnancies carried to term. Author(s): Darroch JE, Finer LB, Henshaw SK, Jones RK. Source: American Journal of Obstetrics and Gynecology. 2003 August; 189(2): 617-8; Author Reply 618. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14524368&dopt=Abstract

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A model of recovery from substance abuse and dependence for Korean adolescents. Author(s): Hyun MS, Kools S, Kim SA. Source: Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc. 2003 January-March; 16(1): 25-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790305&dopt=Abstract

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A national study of the substance abuse treatment workforce. Author(s): Mulvey KP, Hubbard S, Hayashi S. Source: Journal of Substance Abuse Treatment. 2003 January; 24(1): 51-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646330&dopt=Abstract

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A phenomenological exploration of spirituality among African American women recovering from substance abuse. Author(s): Wright VL. Source: Archives of Psychiatric Nursing. 2003 August; 17(4): 173-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14508773&dopt=Abstract

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A simple cost-benefit analysis of brief interventions on substance abuse at Naval Medical Center Portsmouth. Author(s): Storer RM. Source: Military Medicine. 2003 September; 168(9): 765-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14529255&dopt=Abstract

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Acceptability of sexually transmitted infection screening among women in short-term substance abuse treatment. Author(s): Lally MA, Alvarez S, Macnevin R, Cenedella C, Dispigno M, Harwell JI, Pugatch D, Flanigan TP. Source: Sexually Transmitted Diseases. 2002 December; 29(12): 752-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12466715&dopt=Abstract

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Accessibility of addiction treatment: results from a national survey of outpatient substance abuse treatment organizations. Author(s): Friedmann PD, Lemon SC, Stein MD, D'Aunno TA. Source: Health Services Research. 2003 June; 38(3): 887-903. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12822917&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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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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Analytical aspects of volatile substance abuse (VSA). Author(s): Gaulier JM, Tonnay V, Faict T, Sayer H, Marquet P, Lachatre G. Source: J Forensic Sci. 2003 July; 48(4): 880-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12877311&dopt=Abstract

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Animal models of periadolescent substance abuse. Author(s): Smith RF. Source: Neurotoxicology and Teratology. 2003 May-June; 25(3): 291-301. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12757826&dopt=Abstract

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Ante- and postpartum substance abuse treatment and antiretroviral therapy among HIV-infected women on Medicaid. Author(s): Warner LA, Wei W, McSpiritt E, Sambamoorthi U, Crystal S. Source: J Am Med Womens Assoc. 2003 Summer; 58(3): 143-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12948105&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. 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

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Asian American and Pacific Islander mental health and substance abuse agencies: organizational characteristics and service gaps. Author(s): Chow J. Source: Administration and Policy in Mental Health. 2002 September; 30(1): 79-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12546258&dopt=Abstract

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Assessing substance abuse treatment need: a statewide hospital emergency department study. Author(s): Rockett IR, Putnam SL, Jia H, Smith GS. Source: Annals of Emergency Medicine. 2003 June; 41(6): 802-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12764335&dopt=Abstract

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Assessment of efficacy of long-term opioid therapy in pain patients with substance abuse potential. Author(s): Nedeljkovic SS, Wasan A, Jamison RN. Source: The Clinical Journal of Pain. 2002 July-August; 18(4 Suppl): S39-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479253&dopt=Abstract

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Attitudes of staff towards mothers affected by substance abuse. Author(s): Raeside L. Source: British Journal of Nursing (Mark Allen Publishing). 2003 March 13-26; 12(5): 30210. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682598&dopt=Abstract

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Background and overview of mental health and substance abuse treatment systems: meeting the needs of women who are pregnant or parenting. Author(s): Grella CE. Source: J Psychoactive Drugs. 1996 October-December; 28(4): 319-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9017555&dopt=Abstract

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Behavioral characteristics related to substance abuse and risk-taking, sensationseeking, anxiety sensitivity, and self-reinforcement. Author(s): Wagner MK. Source: Addictive Behaviors. 2001 January-February; 26(1): 115-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11196285&dopt=Abstract

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Behavioral health care dot-com and beyond: computer-mediated communications in mental health and substance abuse treatment. Author(s): Budman SH. Source: The American Psychologist. 2000 November; 55(11): 1290-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11280939&dopt=Abstract

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Behavioral health issue brief: mental health and substance abuse parity: year end report-2002. Author(s): Delaney T, Crean E. Source: Issue Brief Health Policy Track Serv. 2002 December 31; : 1-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12875267&dopt=Abstract

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Behavioral health issue brief: minimum mandated benefits and mandated offerings for mental health and substance abuse: year end report-2002. Author(s): Delaney T, Crean E. Source: Issue Brief Health Policy Track Serv. 2002 December 31; : 1-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12875270&dopt=Abstract

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Behavioral self-regulation: correlates and 2 year follow-ups for boys at risk for substance abuse. Author(s): Dawes MA, Tarter RE, Kirisci L. Source: Drug and Alcohol Dependence. 1997 May 2; 45(3): 165-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9179518&dopt=Abstract

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Behavioural effects of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionatereceptor antagonists and their relevance to substance abuse. Author(s): Jackson A, Mead AN, Stephens DN. Source: Pharmacology & Therapeutics. 2000 October; 88(1): 59-76. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11033384&dopt=Abstract

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Benefit determination under managed care for substance abuse treatment clients. Author(s): McNeese-Smith DK, Crook MW, Marinelli-Casey P, Williams L, Rawson R. Source: Care Manag J. 2001-2002 Winter; 3(2): 55-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12455215&dopt=Abstract

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Benefits of linking primary medical care and substance abuse services: patient, provider, and societal perspectives. Author(s): Samet JH, Friedmann P, Saitz R. Source: Archives of Internal Medicine. 2001 January 8; 161(1): 85-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11146702&dopt=Abstract

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Benzodiazepine treatment of anxiety or insomnia in substance abuse patients. Author(s): Ciraulo DA, Nace EP. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2000 Fall; 9(4): 276-9; Discussion 280-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11155783&dopt=Abstract

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Benzodiazepine use in posttraumatic stress disorder among veterans with substance abuse. Author(s): Kosten TR, Fontana A, Sernyak MJ, Rosenheck R. Source: The Journal of Nervous and Mental Disease. 2000 July; 188(7): 454-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10919705&dopt=Abstract

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Beyond CAGE. A brief clinical approach after detection of substance abuse. Author(s): Samet JH, Rollnick S, Barnes H. Source: Archives of Internal Medicine. 1996 November 11; 156(20): 2287-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8911235&dopt=Abstract

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Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: predictors and substance abuse outcomes. Author(s): Chassin L, Pitts SC, Prost J. Source: Journal of Consulting and Clinical Psychology. 2002 February; 70(1): 67-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11860058&dopt=Abstract

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Biopsychosocial characteristics and treatment outcomes of pregnant cocainedependent women in residential and outpatient substance abuse treatment. Author(s): Comfort M, Kaltenbach KA. Source: J Psychoactive Drugs. 1999 July-September; 31(3): 279-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10533975&dopt=Abstract

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Bloodborne sexually transmitted infections in patients presenting for substance abuse treatment in Jamaica. Author(s): Dowe G, Smilkle MF, Thesiger C, Williams EM. Source: Sexually Transmitted Diseases. 2001 May; 28(5): 266-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11354264&dopt=Abstract

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Bridging the gap in San Francisco: the process of integrating harm reduction and traditional substance abuse services. Author(s): Gleghorn A, Rosenbaum M, Garcia BA. Source: J Psychoactive Drugs. 2001 January-March; 33(1): 1-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11332995&dopt=Abstract

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Bridging the gap: a hybrid model to link efficacy and effectiveness research in substance abuse treatment. Author(s): Carroll KM, Rounsaville BJ. Source: Psychiatric Services (Washington, D.C.). 2003 March; 54(3): 333-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610240&dopt=Abstract

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Bridging the research-practice gap in adolescent substance abuse treatment: the case of brief strategic family therapy. Author(s): Robbins MS, Bachrach K, Szapocznik J. Source: Journal of Substance Abuse Treatment. 2002 September; 23(2): 123-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12220610&dopt=Abstract

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Brief motivational interviewing interventions targeting substance abuse in the acute care medical setting. Author(s): Dunn C. Source: Semin Clin Neuropsychiatry. 2003 July; 8(3): 188-96. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12874739&dopt=Abstract

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Burnout in substance abuse counselors. Impact of environment, attitudes, and clients with HIV. Author(s): Shoptaw S, Stein JA, Rawson RA. Source: Journal of Substance Abuse Treatment. 2000 September; 19(2): 117-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10963923&dopt=Abstract

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Cardiovascular manifestations of substance abuse part 1: cocaine. Author(s): Frishman WH, Del Vecchio A, Sanal S, Ismail A. Source: Heart Disease. 2003 May-June; 5(3): 187-201. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783633&dopt=Abstract

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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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Changes in managed care activity in outpatient substance abuse treatment organizations, 1995-2000. Author(s): Alexander JA, Lemak CH, Campbell CI. Source: The Journal of Behavioral Health Services & Research. 2003 October-December; 30(4): 369-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14593661&dopt=Abstract

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Changing prevalence of prenatal substance abuse in Utah. Author(s): Buchi KF, Zone S, Langheinrich K, Varner MW. Source: Obstetrics and Gynecology. 2003 July; 102(1): 27-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12850602&dopt=Abstract

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Characteristics of effective school-based substance abuse prevention. Author(s): Gottfredson DC, Wilson DB. Source: Prevention Science : the Official Journal of the Society for Prevention Research. 2003 March; 4(1): 27-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12611417&dopt=Abstract

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Charitable Choice regulations applicable to states receiving Substance Abuse Prevention and Treatment Block Grants, Projects for Assistance in Transition from Homelessness formula grants, and to public and private providers receiving discretionary grant funding from SAMHSA for the provision of substance abuse services providing for equal treatment of SAMHSA program participants. Final rule. Author(s): Substance Abuse and Mental Health Services Administration, HHS. Source: Federal Register. 2003 September 30; 68(189): 56429-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14518496&dopt=Abstract

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Chronic pain, substance abuse and addiction. Author(s): Compton P, Athanasos P. Source: Nurs Clin North Am. 2003 September; 38(3): 525-37. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14567207&dopt=Abstract

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Clinical aspects of substance abuse in persons with schizophrenia. Author(s): Negrete JC. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 February; 48(1): 14-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12635559&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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Clinical supervision: a working model for substance abuse acute care settings. Author(s): Rizzo MD. Source: The Health Care Manager. 2003 April-June; 22(2): 136-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785551&dopt=Abstract

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Clozapine treatment in patients with prior substance abuse. Author(s): Kelly DL, Gale EA, Conley RR. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 March; 48(2): 111-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12655909&dopt=Abstract

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Common ground: a framework for selecting core quality measures for mental health and substance abuse care. Author(s): Hermann RC, Palmer RH. Source: Psychiatric Services (Washington, D.C.). 2002 March; 53(3): 281-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11875220&dopt=Abstract

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Continuity of care and clinical effectiveness: outcomes following residential treatment for severe substance abuse. Author(s): Greenberg GA, Rosenheck RA, Seibyl CL. Source: Medical Care. 2002 March; 40(3): 246-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11880797&dopt=Abstract

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Coping styles and response to high versus low-structure individual counseling for substance abuse. Author(s): Thornton C, Gottheil E, Patkar A, Weinstein S. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2003 January-February; 12(1): 29-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623738&dopt=Abstract

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Correlates of stages of change for substance abuse among psychiatric outpatients. Author(s): Carey KB, Purnine DM, Maisto SA, Carey MP. Source: Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors. 2002 December; 16(4): 283-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503900&dopt=Abstract

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Cost sharing for substance abuse and mental health services in managed care plans. Author(s): Hodgkin D, Horgan CM, Garnick DW, Merrick EL. Source: Medical Care Research and Review : Mcrr. 2003 March; 60(1): 101-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12674022&dopt=Abstract

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Costs and effectiveness of substance abuse treatments for homeless persons. Author(s): Schumacher JE, Mennemeyer ST, Milby JB, Wallace D, Nolan K. Source: The Journal of Mental Health Policy and Economics. 2002 March; 5(1): 33-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12529568&dopt=Abstract

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Creating meaning and value in substance abuse education. Author(s): Barnes HN. Source: Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse. 2002 December; 23(4): 203-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12555770&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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Culturally competent treatment of African American clients among a national sample of outpatient substance abuse treatment units. Author(s): Howard DL. Source: Journal of Substance Abuse Treatment. 2003 March; 24(2): 89-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745026&dopt=Abstract

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Dancing with strangers: will U.S. substance abuse practice and research organizations build mutually productive relationships? Author(s): Rawson RA, Marinelli-Casey P, Ling W. Source: Addictive Behaviors. 2002 November-December; 27(6): 941-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12369477&dopt=Abstract

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Datapoints: moving from inpatient to residential substance abuse treatment in the VA. Author(s): Humphreys K, Horst D. Source: Psychiatric Services (Washington, D.C.). 2002 August; 53(8): 927. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12161662&dopt=Abstract

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Datapoints: perceived benefits of substance abuse treatments. Author(s): Mojtabai R. Source: Psychiatric Services (Washington, D.C.). 2003 June; 54(6): 780. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12773590&dopt=Abstract

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Deception in prison assessment of substance abuse. Author(s): Richards HJ, Pai SM. Source: Journal of Substance Abuse Treatment. 2003 March; 24(2): 121-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745029&dopt=Abstract

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Decision making in adolescents with behavior disorders and adults with substance abuse. Author(s): Ernst M, Grant SJ, London ED, Contoreggi CS, Kimes AS, Spurgeon L. Source: The American Journal of Psychiatry. 2003 January; 160(1): 33-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505799&dopt=Abstract

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Demographic variables and microCog performance: relationships for VA patients under treatment for substance abuse. Author(s): Lopez SJ, Ryan JJ, Sumerall SW, Lichtenberg JW, Glasnapp D, Krieshok TS, Van Fleet JN. Source: Psychological Reports. 2001 February; 88(1): 183-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293027&dopt=Abstract

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Depressive symptoms among amphetamine and cocaine users before and after substance abuse treatment. Author(s): Riehman KS, Iguchi MY, Anglin MD. Source: Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors. 2002 December; 16(4): 333-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503906&dopt=Abstract

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Determining predictors of attrition in an outpatient substance abuse program. Author(s): Sayre SL, Schmitz JM, Stotts AL, Averill PM, Rhoades HM, Grabowski JJ. Source: The American Journal of Drug and Alcohol Abuse. 2002; 28(1): 55-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11853135&dopt=Abstract

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Diagnostic cost groups (DCGs) and concurrent utilization among patients with substance abuse disorders. Author(s): Rosen AK, Loveland SA, Anderson JJ, Hankin CS, Breckenridge JN, Berlowitz DR. Source: Health Services Research. 2002 August; 37(4): 1079-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12236385&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. 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

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Differences in onset and persistence of substance abuse and dependence among whites, blacks, and Hispanics. Author(s): Reardon SF, Buka SL. Source: Public Health Reports (Washington, D.C. : 1974). 2002; 117 Suppl 1: S51-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435827&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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Disseminating substance abuse research findings for policy. Author(s): Jett KP. Source: J Psychoactive Drugs. 2003 May; 35 Suppl 1: 105. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12825751&dopt=Abstract

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Dissociation in adults with a diagnosis of substance abuse. Author(s): Benishek D, Wichowski HC. Source: Nurs Times. 2003 May 20-26; 99(20): 34-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800641&dopt=Abstract

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Does risperidone reduce concomitant substance abuse in cases of schizophrenia? Author(s): Gupta N, Basu D. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2001 November; 46(9): 862-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11761640&dopt=Abstract

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Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Author(s): Wilens TE, Faraone SV, Biederman J, Gunawardene S. Source: Pediatrics. 2003 January; 111(1): 179-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12509574&dopt=Abstract

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Drug testing athletes to prevent substance abuse: background and pilot study results of the SATURN (Student Athlete Testing Using Random Notification) study. Author(s): Goldberg L, Elliot DL, MacKinnon DP, Moe E, Kuehl KS, Nohre L, Lockwood CM. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 2003 January; 32(1): 16-25. Erratum In: J Adolesc Health. 2003 April; 32(4): 325. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12507797&dopt=Abstract

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DSM-IV alcohol and substance abuse and dependence in homeless youth. Author(s): Baer JS, Ginzler JA, Peterson PL. Source: J Stud Alcohol. 2003 January; 64(1): 5-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608478&dopt=Abstract

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Dual diagnosis and successful participation of adolescents in substance abuse treatment. Author(s): Wise BK, Cuffe SP, Fischer T. Source: Journal of Substance Abuse Treatment. 2001 October; 21(3): 161-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11728790&dopt=Abstract

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Dual diagnosis on “substance abuse”. Author(s): de Lima MS, Lorea CF, Carpena MP. Source: Substance Use & Misuse. 2002 June-August; 37(8-10): 1179-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12180560&dopt=Abstract

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Early and mid-adolescence risk factors for later substance abuse by African Americans and European Americans. Author(s): Gil AG, Vega WA, Turner RJ. Source: Public Health Reports (Washington, D.C. : 1974). 2002; 117 Suppl 1: S15-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435824&dopt=Abstract

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Early intervention strategies in substance abuse. Author(s): Kurz M. Source: Journal of Neural Transmission. Supplementum. 2003; (66): 85-96. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14582804&dopt=Abstract

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Early risk indicators of substance abuse among nurses. Author(s): West MM. Source: Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau. 2002; 34(2): 187-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12078545&dopt=Abstract

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Economic grand rounds: the costs of parity mandates for mental health and substance abuse insurance benefits. Author(s): Sing M, Hill SC. Source: Psychiatric Services (Washington, D.C.). 2001 April; 52(4): 437-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11274485&dopt=Abstract

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Effect of centralized intake on outcomes of substance abuse treatment. Author(s): Rohrer JE, Vaughan MS, Cadoret RJ, Carswell C, Patterson A, Zwick J. Source: Psychiatric Services (Washington, D.C.). 1996 November; 47(11): 1233-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8916242&dopt=Abstract

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Effect of primary medical care on addiction and medical severity in substance abuse treatment programs. Author(s): Friedmann PD, Zhang Z, Hendrickson J, Stein MD, Gerstein DR. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 2003 January; 18(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534757&dopt=Abstract

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Effectiveness of case management in substance abuse treatment. Author(s): Saleh SS, Vaughn T, Hall J, Levey S, Fuortes L, Uden-Holmen T. Source: Care Manag J. 2002 Summer; 3(4): 172-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847933&dopt=Abstract

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Effectiveness of high versus low structure individual counseling for substance abuse. Author(s): Gottheil E, Thornton C, Weinstein S. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2002 Fall; 11(4): 279-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12584871&dopt=Abstract

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Effectiveness of intervention into substance abuse disorders in women with comorbid depression. Author(s): Mynatt S. Source: Journal of Psychosocial Nursing and Mental Health Services. 1999 May; 37(5): 16-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10340226&dopt=Abstract

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Effectiveness of school-based family and children's skills training for substance abuse prevention among 6-8-year-old rural children. Author(s): Kumpfer KL, Alvarado R, Tait C, Turner C. Source: Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors. 2002 December; 16(4 Suppl): S65-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12502278&dopt=Abstract

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Effectiveness of substance abuse treatment programming for women: a review. Author(s): Ashley OS, Marsden ME, Brady TM. Source: The American Journal of Drug and Alcohol Abuse. 2003; 29(1): 19-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12731680&dopt=Abstract

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Effects of childhood physical abuse on course and severity of substance abuse. Author(s): Westermeyer J, Wahmanholm K, Thuras P. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2001 Spring; 10(2): 101-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11444153&dopt=Abstract

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Ego atrophy in substance abuse: addiction from a socio-cultural perspective. Author(s): Fine J, Juni S. Source: American Journal of Psychoanalysis. 2001 September; 61(3): 293-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11605232&dopt=Abstract

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Emergency department use of persons with comorbid psychiatric and substance abuse disorders. Author(s): Curran GM, Sullivan G, Williams K, Han X, Collins K, Keys J, Kotrla KJ. Source: Annals of Emergency Medicine. 2003 May; 41(5): 659-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12712033&dopt=Abstract

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Emerging issues in gender and ethnic differences in substance abuse and treatment. Author(s): Weiss SR, Kung HC, Pearson JL. Source: Curr Womens Health Rep. 2003 June; 3(3): 245-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12734036&dopt=Abstract

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Engaging the HIV-infected substance abuse--the classic academic approach to changing clinical practice: excruciatingly slow, extraneous, and/or effective? Author(s): Samet JH. Source: Medgenmed [electronic Resource] : Medscape General Medicine. 2001 March 30; 3(2): 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11549965&dopt=Abstract

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Enhancing readiness-to-change substance abuse in persons with schizophrenia. A four-session motivation-based intervention. Author(s): Carey KB, Purnine DM, Maisto SA, Carey MP. Source: Behavior Modification. 2001 July; 25(3): 331-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11428245&dopt=Abstract

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Estimating the costs of substance abuse: implications to the estimation of the costs and benefits of gambling. Author(s): Single E. Source: Journal of Gambling Studies / Co-Sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming. 2003 Summer; 19(2): 215-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766470&dopt=Abstract

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Etiology of adolescent substance abuse: a developmental perspective. Author(s): Tarter RE. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2002 Summer; 11(3): 171-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12202010&dopt=Abstract

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Evaluating selection out of health plans for Medicaid beneficiaries with substance abuse. Author(s): Normand SL, Belanger AJ, Frank RG. Source: The Journal of Behavioral Health Services & Research. 2003 January-February; 30(1): 78-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633005&dopt=Abstract

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Facility design, substance abuse also factors in forklift incidents. Author(s): Kusnetz E. Source: Occup Health Saf. 2000 March; 69(3): 8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10779967&dopt=Abstract

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Factors affecting mother-child visiting identified by women with histories of substance abuse and child custody loss. Author(s): Kovalesky A. Source: Child Welfare. 2001 November-December; 80(6): 749-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11817660&dopt=Abstract

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Factors affecting substance abuse treatment completion for women. Author(s): Kelly PJ, Blacksin B, Mason E. Source: Issues in Mental Health Nursing. 2001 April-May; 22(3): 287-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11885213&dopt=Abstract

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Factors affecting the initiation of substance abuse treatment in managed care. Author(s): Weisner C, Mertens J, Tam T, Moore C. Source: Addiction (Abingdon, England). 2001 May; 96(5): 705-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331029&dopt=Abstract

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Factors associated with level of care assignment in substance abuse treatment. Author(s): Gregoire TK. Source: Journal of Substance Abuse Treatment. 2000 April; 18(3): 241-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10742637&dopt=Abstract

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Factors associated with rehospitalization among veterans in a substance abuse treatment program. Author(s): Benda BB. Source: Psychiatric Services (Washington, D.C.). 2002 September; 53(9): 1176-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12221320&dopt=Abstract

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Factors predicting entry of injecting drug users into substance abuse treatment. Author(s): Zule WA, Desmond DP. Source: The American Journal of Drug and Alcohol Abuse. 2000 May; 26(2): 247-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10852359&dopt=Abstract

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Familial psychiatric illness and posttraumatic stress disorder: findings from a family study of substance abuse and anxiety disorders. Author(s): Dierker LC, Merikangas KR. Source: The Journal of Clinical Psychiatry. 2001 September; 62(9): 715-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11681768&dopt=Abstract

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Family and peer correlates of behavioral self-regulation in boys at risk for substance abuse. Author(s): Dawes M, Clark D, Moss H, Kirisci L, Tarter R. Source: The American Journal of Drug and Alcohol Abuse. 1999 May; 25(2): 219-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10395157&dopt=Abstract

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Family interventions to prevent substance abuse: children and adolescents. Author(s): Loveland-Cherry CJ. Source: Annu Rev Nurs Res. 2000; 18: 195-218. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10918937&dopt=Abstract

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Feasibility of multidimensional substance abuse treatment matching: automating the ASAM Patient Placement Criteria. American Society of Addiction Medicine. Author(s): Turner WM, Turner KH, Reif S, Gutowski WE, Gastfriend DR. Source: Drug and Alcohol Dependence. 1999 June 1; 55(1-2): 35-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10402147&dopt=Abstract

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Female substance abuse: characteristics and correlates in a sample of inpatient clients. Author(s): Dodge K, Potocky M. Source: Journal of Substance Abuse Treatment. 2000 January; 18(1): 59-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10636608&dopt=Abstract

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Fighting back against substance abuse: are community coalitions winning? Author(s): Hallfors D, Cho H, Livert D, Kadushin C. Source: American Journal of Preventive Medicine. 2002 November; 23(4): 237-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12406477&dopt=Abstract

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Fighting back or fighting themselves? Community coalitions against substance abuse and their use of best practices. Author(s): Green LW, Kreuter MW. Source: American Journal of Preventive Medicine. 2002 November; 23(4): 303-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12406485&dopt=Abstract

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Financial toll of substance abuse studied. Author(s): Pallarito K. Source: Modern Healthcare. 1995 February 20; 25(8): 18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10172212&dopt=Abstract

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Financing of substance abuse treatment services. Author(s): Horgan CM, Merrick EL. Source: Recent Dev Alcohol. 2001; 15: 229-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11449744&dopt=Abstract

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Finding poppa in substance abuse research. Author(s): Phares V. Source: Addiction (Abingdon, England). 2002 September; 97(9): 1119-20; Discussion 1120-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12199826&dopt=Abstract

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First person account: schizophrenia, substance abuse, and HIV. Author(s): Hummingbird. Source: Schizophrenia Bulletin. 1999; 25(4): 863-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10667754&dopt=Abstract

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Follow-up contact bias in evaluation of substance abuse treatment programs. Author(s): Rohrer JE, Vaughan MS, Cadoret R, Zwick J. Source: Administration and Policy in Mental Health. 1999 January; 26(3): 207-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10339835&dopt=Abstract

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For parents. Talking to your kids about substance abuse. Author(s): Butler D. Source: Diabetes Self Manag. 2002 September-October; 19(5): 54, 56, 58, 60, 63. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12561758&dopt=Abstract

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Gambling behavior in adolescent substance abuse. Author(s): Kaminer Y, Burleson JA, Jadamec A. Source: Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse. 2002 September; 23(3): 191-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444352&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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Gender differences in homeless persons with schizophrenia and substance abuse. Author(s): Brunette M, Drake RE. Source: Community Mental Health Journal. 1998 December; 34(6): 627-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9833202&dopt=Abstract

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Gender differences in income after substance abuse treatment. Author(s): Oggins J, Guydish J, Delucchi K. Source: Journal of Substance Abuse Treatment. 2001 April; 20(3): 215-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11516590&dopt=Abstract

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Gender differences in patients with schizophrenia and substance abuse. Author(s): Brunette MF, Drake RE. Source: Comprehensive Psychiatry. 1997 March-April; 38(2): 109-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9056130&dopt=Abstract

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Gender differences in predictors of initiation, retention, and completion in an HMObased substance abuse treatment program. Author(s): Green CA, Polen MR, Dickinson DM, Lynch FL, Bennett MD. Source: Journal of Substance Abuse Treatment. 2002 December; 23(4): 285-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495790&dopt=Abstract

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Gender differences in the relationship of homelessness to symptom severity, substance abuse, and neuroleptic noncompliance in schizophrenia. Author(s): Opler LA, White L, Caton CL, Dominguez B, Hirshfield S, Shrout PE. Source: The Journal of Nervous and Mental Disease. 2001 July; 189(7): 449-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11504322&dopt=Abstract

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Gender differences in victimization severity and outcomes among adolescents treated for substance abuse. Author(s): Titus JC, Dennis ML, White WL, Scott CK, Funk RR. Source: Child Maltreatment. 2003 February; 8(1): 19-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568502&dopt=Abstract

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Gender differences regarding peer influence and attitude toward substance abuse. Author(s): Rienzi BM, McMillin JD, Dickson CL, Crauthers D, McNeill KF, Pesina MD, Mann E. Source: Journal of Drug Education. 1996; 26(4): 339-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9071056&dopt=Abstract

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General and specific inheritance of substance abuse and alcoholism. Author(s): Goldman D, Bergen A. Source: Archives of General Psychiatry. 1998 November; 55(11): 964-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9819063&dopt=Abstract

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Genetic studies of substance abuse. Author(s): Vanyukov MM, Tarter RE. Source: Drug and Alcohol Dependence. 2000 May 1; 59(2): 101-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10891624&dopt=Abstract

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Genetics and substance abuse. Author(s): Wellington C. Source: Clinical Genetics. 1998 October; 54(4): 266. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9831336&dopt=Abstract

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Genetics of alcoholism and substance abuse. Author(s): Enoch MA, Goldman D. Source: The Psychiatric Clinics of North America. 1999 June; 22(2): 289-99, Viii. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10385934&dopt=Abstract

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Genotype-environment correlations and interactions in the etiology of substance abuse and related behaviors. Author(s): McGue M, Lykken DT, Iacono WG. Source: Nida Res Monogr. 1996; 159: 49-72; Discussion 73-80. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8784855&dopt=Abstract

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Geriatric patients on a substance abuse consultation service. Author(s): Weintraub E, Weintraub D, Dixon L, Delahanty J, Gandhi D, Cohen A, Hirsch M. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2002 May-June; 10(3): 337-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11994222&dopt=Abstract

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Group psychotherapy for adolescents comorbid for substance abuse and psychiatric problems: a relational constructionist approach. Author(s): Pressman MA, Kymissis P, Hauben R. Source: Int J Group Psychother. 2001 January; 51(1): 83-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191597&dopt=Abstract

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Group psychotherapy for persons with traumatic brain injury: management of frustration and substance abuse. Author(s): Delmonico RL, Hanley-Peterson P, Englander J. Source: The Journal of Head Trauma Rehabilitation. 1998 December; 13(6): 10-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9885315&dopt=Abstract

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Group psychotherapy of substance abuse in the era of managed mental health care. Author(s): Spitz HI. Source: Int J Group Psychother. 2001 January; 51(1): 21-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191593&dopt=Abstract

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Group treatment for substance abuse in schizophrenia. Author(s): Addington J, el-Guebaly N. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1998 October; 43(8): 843-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9806092&dopt=Abstract

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Group treatment of substance abuse for patients with schizophrenia or related disorders. Author(s): Cohen D, Tempier R. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1999 November; 44(9): 928. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10584171&dopt=Abstract

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Harmful effects of substance abuse: a Darwinian perspective. Author(s): Troisi A. Source: Funct Neurol. 2001; 16(4 Suppl): 237-43. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11996520&dopt=Abstract

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Health care challenges created by substance abuse: the whole is definitely bigger than the sum of its parts. Author(s): Abbott AA. Source: Health & Social Work. 2002 August; 27(3): 162-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12230040&dopt=Abstract

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Health care utilization of carpenters with substance abuse-related diagnoses. Author(s): Lipscomb HJ, Dement JM, Li L. Source: American Journal of Industrial Medicine. 2003 February; 43(2): 120-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12541266&dopt=Abstract

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Health care utilization of families of carpenters with alcohol or substance abuserelated diagnoses. Author(s): Lipscomb HJ, Dement JM, Li L. Source: American Journal of Industrial Medicine. 2003 April; 43(4): 361-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12645093&dopt=Abstract

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Health promotion in the city: a structured review of the literature on interventions to prevent heart disease, substance abuse, violence and HIV infection in US metropolitan areas, 1980-1995. Author(s): Freudenberg N, Silver D, Carmona JM, Kass D, Lancaster B, Speers M. Source: Journal of Urban Health : Bulletin of the New York Academy of Medicine. 2000 September; 77(3): 443-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10976617&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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Helping health care professionals confront substance abuse. Author(s): De Sanctis D. Source: Trustee : the Journal for Hospital Governing Boards. 1991 December; 44(12): 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10170873&dopt=Abstract

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High-risk sexual behaviors in a context of substance abuse: a focus group approach. Author(s): Nadeau L, Truchon M, Biron C. Source: Journal of Substance Abuse Treatment. 2000 December; 19(4): 319-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11166496&dopt=Abstract

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HIV and other infectious disease prevention activities at mental health and substance abuse treatment agencies in Alaska. Author(s): Brems C, Johnson ME, Watkins K. Source: Administration and Policy in Mental Health. 2003 March; 30(4): 355-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870560&dopt=Abstract

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HIV and substance abuse: the biggest challenge for many clinicians. Author(s): Sansovich D. Source: Hiv Clin. 2002 Fall; 14(4): 7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12434758&dopt=Abstract

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HIV testing among young adults and older adolescents in the setting of acute substance abuse treatment. Author(s): Pugatch DL, Levesque BG, Lally MA, Reinert SE, Filippone WJ, Combs CM, Flanigan TP, Brown LK. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2001 June 1; 27(2): 135-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11404535&dopt=Abstract

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HIV testing in the setting of inpatient acute substance abuse treatment. Author(s): Pugatch D, Levesque B, Greene S, Strong L, Flanigan T, Lally M. Source: The American Journal of Drug and Alcohol Abuse. 2001 August; 27(3): 491-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11506264&dopt=Abstract

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Hope as a predictor of entering substance abuse treatment. Author(s): Jackson R, Wernicke R, Haaga DA. Source: Addictive Behaviors. 2003 January-February; 28(1): 13-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12507524&dopt=Abstract

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Hormonal and behavioral homeostasis in boys at risk for substance abuse. Author(s): Dawes MA, Dorn LD, Moss HB, Yao JK, Kirisci L, Ammerman RT, Tarter RE. Source: Drug and Alcohol Dependence. 1999 June 1; 55(1-2): 165-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10402161&dopt=Abstract

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Hospital-based adolescent substance abuse treatment: comorbidity, outcomes, and gender. Author(s): Rivers SM, Greenbaum RL, Goldberg E. Source: The Journal of Nervous and Mental Disease. 2001 April; 189(4): 229-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11339318&dopt=Abstract

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How did the introduction of managed care for the uninsured in Iowa affect the use of substance abuse services? Author(s): Ettner SL, Argeriou M, McCarty D, Dilonardo J, Liu H. Source: The Journal of Behavioral Health Services & Research. 2003 January-February; 30(1): 26-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12645495&dopt=Abstract

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How expensive are unlimited substance abuse benefits under managed care? Author(s): Sturm R, Zhang W, Schoenbaum M. Source: The Journal of Behavioral Health Services & Research. 1999 May; 26(2): 203-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10230147&dopt=Abstract

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How is case management used with substance abuse cases? Author(s): Kalina CM, Haag AB, Tourigian R, Wassel ML. Source: Aaohn Journal : Official Journal of the American Association of Occupational Health Nurses. 2003 April; 51(4): 151-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729023&dopt=Abstract

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How some HIV clinics handle substance abuse. Author(s): Clements A, Gerse M, Mabry SH. Source: Aids Alert. 2001 August; 16(8): 95-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11547704&dopt=Abstract

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How to assess, treat, and monitor substance abuse/dependence in a multi-organ transplant program. Author(s): Paris W, Calhoun-Wilson G, Samara S, Nour B. Source: Nephrol News Issues. 2001 January; 15(2): 18-20. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12098830&dopt=Abstract

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Identifying and treating substance abuse. Author(s): Stuetz B. Source: Jaapa. 2001 July; 14(7): 56. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12516591&dopt=Abstract

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Identifying and treating substance abuse. Author(s): Zwerling A. Source: Jaapa. 2001 July; 14(7): 56. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11517822&dopt=Abstract

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Identifying substance abuse treatment gaps in substate areas. Author(s): McAuliffe WE, Woodworth R, Zhang CH, Dunn RP. Source: Journal of Substance Abuse Treatment. 2002 October; 23(3): 199-208. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392806&dopt=Abstract

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Impact of substance abuse on the course and treatment of bipolar disorder. Author(s): Salloum IM, Thase ME. Source: Bipolar Disorders. 2000 September; 2(3 Pt 2): 269-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11249805&dopt=Abstract

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Improving substance abuse prevention, assessment, and treatment financing for children and adolescents. Author(s): American Academy of Pediatrics. Committee on Child Health Financing and Committee on Substance Abuse. Source: Pediatrics. 2001 October; 108(4): 1025-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11581463&dopt=Abstract

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Improving the organization, management, and outcomes of substance abuse treatment programs. Author(s): Heinrich CJ, Lynn LE Jr. Source: The American Journal of Drug and Alcohol Abuse. 2002 November; 28(4): 60122. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492259&dopt=Abstract

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Increased early life stress and depressive symptoms in patients with comorbid substance abuse and schizophrenia. Author(s): Scheller-Gilkey G, Thomas SM, Woolwine BJ, Miller AH. Source: Schizophrenia Bulletin. 2002; 28(2): 223-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12693429&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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Individual and social/environmental predictors of alcohol and drug use 2 years following substance abuse treatment. Author(s): Walton MA, Blow FC, Bingham CR, Chermack ST. Source: Addictive Behaviors. 2003 June; 28(4): 627-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12726780&dopt=Abstract

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Initiation factors for substance abuse. Author(s): Al-Kandari FH, Yacoub K, Omu F. Source: Journal of Advanced Nursing. 2001 April; 34(1): 78-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11430610&dopt=Abstract

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In-patient treatment of substance abuse. Author(s): Greive P, Jaffe L. Source: The International Journal of Psycho-Analysis. 2002 February; 83(Pt 1): 253-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11915138&dopt=Abstract

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Insurance coverage of mental health and substance abuse services for children and adolescents: A consensus statement. American Academy of Pediatrics. Author(s): American Academy of Pediatrics. Source: Pediatrics. 2000 October; 106(4): 860-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11015538&dopt=Abstract

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Integrating harm reduction therapy and traditional substance abuse treatment. Author(s): Marlatt GA, Blume AW, Parks GA. Source: J Psychoactive Drugs. 2001 January-March; 33(1): 13-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11332996&dopt=Abstract

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Integrating health care for women diagnosed with HIV infection, substance abuse, and mental illness in Detroit, Michigan. Author(s): Andersen M, Smereck GA, Hockman E, Tinsley J, Milfort D, Shekoski C, Connelly C, Faber-Bermudez I, Schuman P, Emrich K, Paliwoda J, Harris C. Source: The Journal of the Association of Nurses in Aids Care : Janac. 2003 SeptemberOctober; 14(5): 49-58. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14571686&dopt=Abstract

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Integrating services for schizophrenia and substance abuse. Author(s): Hellerstein DJ, Rosenthal RN, Miner CR. Source: The Psychiatric Quarterly. 2001 Winter; 72(4): 291-306. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11525078&dopt=Abstract

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Integration and its discontents: substance abuse treatment in the Oregon Health Plan. Author(s): Laws KE, Gabriel RM, McFarland BH. Source: Health Aff (Millwood). 2002 July-August; 21(4): 284-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12117142&dopt=Abstract

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Internet recovery for substance abuse and alcoholism: an exploratory study of service users. Author(s): Hall MJ, Tidwell WC. Source: Journal of Substance Abuse Treatment. 2003 March; 24(2): 161-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745033&dopt=Abstract

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Intimate partner violence and substance abuse among minority women receiving care from an inner-city emergency department. Author(s): El-Bassel N, Gilbert L, Witte S, Wu E, Gaeta T, Schilling R, Wada T. Source: Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health. 2003 January-February; 13(1): 16-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12598055&dopt=Abstract

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Introduction to the special issue on the impact of childhood psychopathology interventions on subsequent substance abuse: pieces of the puzzle. Author(s): Glantz MD. Source: Journal of Consulting and Clinical Psychology. 2002 December; 70(6): 1203-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472297&dopt=Abstract

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Introduction. Integrating substance abuse treatment and prevention in the community. Author(s): Cuijpers P, Schippers GM. Source: Addictive Behaviors. 2002 November-December; 27(6): 847-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12369471&dopt=Abstract

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Judges', caseworkers', and substance abuse counselors' indicators of family reunification with substance-affected parents. Author(s): Karoll BR, Poertner J. Source: Child Welfare. 2002 March-April; 81(2): 249-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12014468&dopt=Abstract

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Jump start: a targeted substance abuse prevention program. Author(s): Harrington NG, Donohew L. Source: Health Education & Behavior : the Official Publication of the Society for Public Health Education. 1997 October; 24(5): 568-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9307894&dopt=Abstract

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Keeping an eye on HIV treatment: from substance abuse to side effects. IAPAC Sessions 2003. May 15-16, 2003, Chicago. Author(s): Mascolini M. Source: Iapac Mon. 2003 July; 9(7): 146-65. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12951957&dopt=Abstract

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Knowledge and attitudes of registered nurses toward perinatal substance abuse. Author(s): Selleck CS, Redding BA. Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing : Jognn / Naacog. 1998 January-February; 27(1): 70-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9475130&dopt=Abstract

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Knowledge transfer, policymaking and community empowerment: a consensus model approach for providing public mental health and substance abuse services. Author(s): Broner N, Franczak M, Dye C, McAllister W. Source: The Psychiatric Quarterly. 2001 Spring; 72(1): 79-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293203&dopt=Abstract

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Latino access to mental health, developmental disabilities, and substance abuse services in North Carolina. Author(s): Crowley MO. Source: N C Med J. 2003 May-June; 64(3): 127-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854308&dopt=Abstract

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Legal issues facing physicians: substance abuse in the workplace. Author(s): Clark HW, Johnson B. Source: Occupational Medicine (Philadelphia, Pa.). 2002 January-March; 17(1): 119-35, V. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11726341&dopt=Abstract

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Level of burden among women diagnosed with severe mental illness and substance abuse. Author(s): Brown VB, Melchior LA, Huba GJ. Source: J Psychoactive Drugs. 1999 January-March; 31(1): 31-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10332636&dopt=Abstract

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Lifetime physical and sexual abuse, substance abuse, depression, and suicide attempts among Native American women. Author(s): Bohn DK. Source: Issues in Mental Health Nursing. 2003 April-May; 24(3): 333-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623689&dopt=Abstract

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Lifetime use of mental health and substance abuse treatment services by incarcerated women felons. Author(s): Jordan BK, Federman EB, Burns BJ, Schlenger WE, Fairbank JA, Caddell JM. Source: Psychiatric Services (Washington, D.C.). 2002 March; 53(3): 317-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11875226&dopt=Abstract

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Linking substance abuse and serious mental illness service delivery systems: initiating a statewide collaborative. Author(s): Barreira P, Espey B, Fishbein R, Moran D, Flannery RB Jr. Source: The Journal of Behavioral Health Services & Research. 2000 February; 27(1): 10713. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10695245&dopt=Abstract

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Linking substance abuse services with general medical care: integrated, brief interventions with hospitalized patients. Author(s): Dunn CW, Ries R. Source: The American Journal of Drug and Alcohol Abuse. 1997 February; 23(1): 1-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9048144&dopt=Abstract

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Locations of facilities with special programs for older substance abuse clients in the US. Author(s): Schultz SK, Arndt S, Liesveld J. Source: International Journal of Geriatric Psychiatry. 2003 September; 18(9): 839-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12949852&dopt=Abstract

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Long-term evaluation of a substance abuse fellowship program in family medicine. Author(s): Graham AV, Davis AK, Coggan PG, Sherwood RA. Source: Family Medicine. 1997 March; 29(3): 194-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9085102&dopt=Abstract

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Long-term patterns of service use and cost among patients with both psychiatric and substance abuse disorders. Author(s): Hoff RA, Rosenheck RA. Source: Medical Care. 1998 June; 36(6): 835-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9630125&dopt=Abstract

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Losing the housing game. The leveling effects of substance abuse. Author(s): Devine JA, Wright JD. Source: The American Journal of Orthopsychiatry. 1997 October; 67(4): 618-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9361868&dopt=Abstract

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Maltreatment issues and outcomes of adolescents enrolled in substance abuse treatment. Author(s): Dennis ML, Stevens SJ. Source: Child Maltreatment. 2003 February; 8(1): 3-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568500&dopt=Abstract

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Maltreatment issues by level of adolescent substance abuse treatment: the extent of the problem at intake and relationship to early outcomes. Author(s): Funk RR, McDermeit M, Godley SH, Adams L. Source: Child Maltreatment. 2003 February; 8(1): 36-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568503&dopt=Abstract

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Managed care and access to substance abuse treatment services. Author(s): Alexander JA, Nahra TA, Wheeler JR. Source: The Journal of Behavioral Health Services & Research. 2003 April-June; 30(2): 161-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12710370&dopt=Abstract

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Management of substance abuse. Author(s): Barangan CJ, Alderman EM. Source: Pediatrics in Review / American Academy of Pediatrics. 2002 April; 23(4): 12331. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11927744&dopt=Abstract

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Mental illness and substance abuse. Author(s): Lancelot A, Sims J. Source: Nurs Times. 2001 September 27-October 3; 97(39): 36-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11935769&dopt=Abstract

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Methylphenidate and substance abuse: a review of pharmacology, animal, and clinical studies. Author(s): Huss M, Lehmkuhl U. Source: J Atten Disord. 2002; 6 Suppl 1: S65-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12685521&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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Models of standard and intensive outpatient care in substance abuse and psychiatric treatment. Author(s): Timko C, Sempel JM, Moos RH. Source: Administration and Policy in Mental Health. 2003 May; 30(5): 417-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12940684&dopt=Abstract

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Monitoring and reporting alcohol and drug use trends in California: the California Substance Abuse Research Consortium meetings. Author(s): Finnerty BA. Source: J Psychoactive Drugs. 2003 May; 35 Suppl 1: 119-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12825754&dopt=Abstract

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Motivation for treatment preceding and following a substance abuse program. Author(s): Cahill MA, Adinoff B, Hosig H, Muller K, Pulliam C. Source: Addictive Behaviors. 2003 January-February; 28(1): 67-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12507528&dopt=Abstract

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National spending on mental health and substance abuse treatment by age of clients, 1997. Author(s): Harwood HJ, Mark TL, McKusick DR, Coffey RM, King EC, Genuardi JS. Source: The Journal of Behavioral Health Services & Research. 2003 October-December; 30(4): 433-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14593666&dopt=Abstract

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Native American women in alcohol and substance abuse treatment. Author(s): Peterson S, Berkowitz G, Cart CU, Brindis C. Source: Journal of Health Care for the Poor and Underserved. 2002 August; 13(3): 36078. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12152506&dopt=Abstract

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Needed: mouse/human cross validation of reinstatement/relapse models (and drug reward models) to model human substance abuse vulnerability allelic variants. Author(s): Uhl GR. Source: Psychopharmacology. 2003 July; 168(1-2): 42-3. Epub 2003 April 29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719965&dopt=Abstract

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Negotiating case decisions in substance abuse managed care. Author(s): Sosin MR. Source: Journal of Health and Social Behavior. 2002 September; 43(3): 277-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12467253&dopt=Abstract

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Neurobehavioural consequences of substance abuse and HIV infection. Author(s): Basso MR, Bornstein RA. Source: Journal of Psychopharmacology (Oxford, England). 2000; 14(3): 228-37. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11106301&dopt=Abstract

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Neurologic complications of substance abuse. Author(s): Brust JC. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2002 October 1; 31 Suppl 2: S29-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394780&dopt=Abstract

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Neuropsychological predictors of the attainment of treatment objectives in substance abuse patients. Author(s): Teichner G, Horner MD, Harvey RT. Source: The International Journal of Neuroscience. 2001; 106(3-4): 253-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11264924&dopt=Abstract

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New anticonvulsants: a review of applications for the management of substance abuse disorders. Author(s): Gentry JR, Hill C, Malcolm R. Source: Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists. 2002 December; 14(4): 233-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630659&dopt=Abstract

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Nipping early risk factors in the bud: preventing substance abuse, delinquency, and violence in adolescence through interventions targeted at young children (0-8 years). Author(s): Webster-Stratton C, Taylor T. Source: Prevention Science : the Official Journal of the Society for Prevention Research. 2001 September; 2(3): 165-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11678292&dopt=Abstract

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Non-fatal suicidal behaviour in women--the role of spousal substance abuse and marital violence. Author(s): Pillay AL, van der Veen MB, Wassenaar DR. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2001 May; 91(5): 429-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11455809&dopt=Abstract

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Office-based intervention for adolescent substance abuse. Author(s): Levy S, Vaughan BL, Knight JR. Source: Pediatric Clinics of North America. 2002 April; 49(2): 329-43. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11993286&dopt=Abstract

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Olanzapine treatment for patients with schizophrenia and substance abuse. Author(s): Littrell KH, Petty RG, Hilligoss NM, Peabody CD, Johnson CG. Source: Journal of Substance Abuse Treatment. 2001 December; 21(4): 217-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11777671&dopt=Abstract

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Older adult patients with both psychiatric and substance abuse disorders: prevalence and health service use. Author(s): Prigerson HG, Desai RA, Rosenheck RA. Source: The Psychiatric Quarterly. 2001 Spring; 72(1): 1-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293198&dopt=Abstract

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Older offenders, substance abuse, and treatment. Author(s): Arndt S, Turvey CL, Flaum M. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2002 November-December; 10(6): 733-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427582&dopt=Abstract

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On substance abuse in Kuwait (1992-1997). Evidence from toxicological screening of patients. Author(s): Radovanovic Z, Pilcher CW, al-Nakib T, Shihab-Eldeen A. Source: Journal of Substance Abuse. 2000; 12(4): 363-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11452839&dopt=Abstract

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Oregon's transition to a managed care model for Medicaid-funded substance abuse treatment: steamrolling the glass menagerie. Author(s): D'Ambrosio R, Mondeaux F, Gabriel RM, Laws KE. Source: Health & Social Work. 2003 May; 28(2): 126-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12774534&dopt=Abstract

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Origins and consequences of child neglect in substance abuse families. Author(s): Dunn MG, Tarter RE, Mezzich AC, Vanyukov M, Kirisci L, Kirillova G. Source: Clinical Psychology Review. 2002 September; 22(7): 1063-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12238246&dopt=Abstract

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Outcomes and sample selection: the case of a homelessness and substance abuse intervention. Author(s): Sosin MR. Source: The British Journal of Mathematical and Statistical Psychology. 2002 May; 55(Pt 1): 63-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12034012&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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Outpatient treatment entry and health care utilization after a combined medical/substance abuse intervention for hospitalized medical patients. Author(s): O'Toole TP, Strain EC, Wand G, McCaul ME, Barnhart M. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 2002 May; 17(5): 334-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12047729&dopt=Abstract

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PA: Substance abuse subject licensed in 31 states: failure to comply with agreementsanctions result. Author(s): Tammelleo AD. Source: Nurs Law Regan Rep. 2002 December; 43(7): 3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12599747&dopt=Abstract

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Past anabolic-androgenic steroid use among men admitted for substance abuse treatment: an underrecognized problem? Author(s): Kanayama G, Cohane GH, Weiss RD, Pope HG. Source: The Journal of Clinical Psychiatry. 2003 February; 64(2): 156-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633124&dopt=Abstract

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Positron emission tomography and single-photon emission computed tomography in substance abuse research. Author(s): Volkow ND, Fowler JS, Wang GJ. Source: Semin Nucl Med. 2003 April; 33(2): 114-28. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756644&dopt=Abstract

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Precipitation and determination of the onset and course of schizophrenia by substance abuse--a retrospective and prospective study of 232 population-based first illness episodes. Author(s): Buhler B, Hambrecht M, Loffler W, an der Heiden W, Hafner H. Source: Schizophrenia Research. 2002 April 1; 54(3): 243-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11950549&dopt=Abstract

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Predictors of HIV risk among men seeking treatment for substance abuse in India. Author(s): Carey MP, Chandra PS, Carey KB, Neal DJ. Source: Archives of Sexual Behavior. 2003 August; 32(4): 339-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856895&dopt=Abstract

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Predictors of recovery following involuntary hospitalization of violent substance abuse patients. Author(s): Andre C, Jaber-Filho JA, Carvalho M, Jullien C, Hoffman A. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2003 January-February; 12(1): 84-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623743&dopt=Abstract

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Predictors of substance abuse treatment outcomes in Tennessee. Author(s): Kedia S, Williams C. Source: Journal of Drug Education. 2003; 33(1): 25-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12773023&dopt=Abstract

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PSTD, major depressive symptoms, and substance abuse following September 11, 2001, in a midwestern university population. Author(s): Cardenas J, Williams K, Wilson JP, Fanouraki G, Singh A. Source: Int J Emerg Ment Health. 2003 Winter; 5(1): 15-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12722486&dopt=Abstract

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Psychosocial aspects of substance abuse by clients with severe mental illness. Author(s): Drake RE, Wallach MA, Alverson HS, Mueser KT. Source: The Journal of Nervous and Mental Disease. 2002 February; 190(2): 100-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11889363&dopt=Abstract

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Psychotropic drug use and expenditures among medicaid beneficiaries with and without other mental health or substance abuse services. Author(s): Hennessy KD, Green-Hennessy S, Buck JA, Miller K. Source: The Journal of Nervous and Mental Disease. 2003 July; 191(7): 476-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12891096&dopt=Abstract

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Qualifications, training, and perceptions of substance abuse counselors who work with victims of incest. Author(s): Janikowski TP, Glover-Graf NM. Source: Addictive Behaviors. 2003 August; 28(6): 1193-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834662&dopt=Abstract

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Quality improvement and substance abuse: rethinking impaired provider policies. Author(s): Corsino BV, Morrow DH, Wallace CJ. Source: American Journal of Medical Quality : the Official Journal of the American College of Medical Quality. 1996 Summer; 11(2): 94-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8704503&dopt=Abstract

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Quality measurement and accountability for substance abuse and mental health services in managed care organizations. Author(s): Levy Merrick E, Garnick DW, Horgan CM, Hodgkin D. Source: Medical Care. 2002 December; 40(12): 1238-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12458305&dopt=Abstract

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Quality of treatment data. Reliability over time of self-reports given by clients in treatment for substance abuse. Author(s): Adair EB, Craddock SG, Miller HG, Turner CF. Source: Journal of Substance Abuse Treatment. 1996 March-April; 13(2): 145-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8880673&dopt=Abstract

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Quantitative EEG and substance abuse. Author(s): Drake ME Jr. Source: Clin Electroencephalogr. 1996; 27(4 Suppl): 3-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8902323&dopt=Abstract

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Randomization in a substance abuse treatment study: participants who consent vs those who do not. Author(s): Seraganian P, Brown TG, Tremblay J. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 July; 48(6): 388-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894613&dopt=Abstract

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Rationales, obstacles and strategies for local outcome monitoring systems in substance abuse treatment settings. Author(s): Brown TG, Topp J, Ross D. Source: Journal of Substance Abuse Treatment. 2003 January; 24(1): 31-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12646328&dopt=Abstract

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Recent advances against substance abuse. Author(s): Heading CE. Source: Idrugs. 2003 July; 6(7): 681-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12861473&dopt=Abstract

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Recognition of alcohol and substance abuse. Author(s): Mersy DJ. Source: American Family Physician. 2003 April 1; 67(7): 1529-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12722853&dopt=Abstract

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Rehabilitation unit staff attitudes toward substance abuse: changes and similarities between 1985 and 2001. Author(s): Basford JR, Rohe DE, Depompolo RW. Source: Archives of Physical Medicine and Rehabilitation. 2003 September; 84(9): 1301-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13680565&dopt=Abstract

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Relative contributions of parent substance use and childhood maltreatment to chronic homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood. Author(s): Stein JA, Leslie MB, Nyamathi A. Source: Child Abuse & Neglect. 2002 October; 26(10): 1011-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12398858&dopt=Abstract

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Release of behavioral health, developmental disabilities, HIV, and substance abuse information: guidelines for legal compliance. Author(s): Gordon EL. Source: Health Care Law Mon. 2000 December; : 3-16. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11924157&dopt=Abstract

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Reproductive ability for sale, do I hear $200?: private cash-for-contraception agreements as an alternative to maternal substance abuse. Author(s): Johnson JM. Source: Ariz Law Rev. 2001 Spring; 43(1): 205-43. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12449978&dopt=Abstract

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Residential adolescent substance abuse treatment: recommendations for collaboration between school health and substance abuse treatment personnel. Author(s): Wood RJ, Drolet JC, Fetro JV, Synovitz LB, Wood AR. Source: The Journal of School Health. 2002 November; 72(9): 363-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12557631&dopt=Abstract

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Retaining counseling staff at substance abuse treatment centers: effects of management practices. Author(s): Knudsen HK, Johnson JA, Roman PM. Source: Journal of Substance Abuse Treatment. 2003 March; 24(2): 129-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745030&dopt=Abstract

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Service enhancement to a dual-diagnosis population: mental illness/substance abuse (MISA). Author(s): Hayes RA, Andrews N, Baron-Jeffrey M, Conley C, Gridley K, Norman R, Wright G. Source: Quality Management in Health Care. 2003 July-September; 12(3): 133-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12891958&dopt=Abstract

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Substance abuse and welfare reform. Author(s): Nakashian M. Source: J Am Med Womens Assoc. 2002 Winter; 57(1): 36-7, 40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11905489&dopt=Abstract

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Substance abuse attitudes and policies in US rehabilitation training programs: a comparison of 1985 and 2000. Author(s): Basford JR, Rohe DE, Barnes CP, DePompolo RW. Source: Archives of Physical Medicine and Rehabilitation. 2002 April; 83(4): 517-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11932854&dopt=Abstract

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Substance abuse by pregnant women: legal and ethical concerns. Author(s): Tillett J, Osborne K. Source: The Journal of Perinatal & Neonatal Nursing. 2001 March; 14(4): 1-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11930519&dopt=Abstract

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Substance abuse in adolescents: a complex conundrum for the clinician. Author(s): Greydanus DE, Patel DR. Source: Pediatric Clinics of North America. 2003 October; 50(5): 1179-223. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14558685&dopt=Abstract

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Substance abuse in African American women. Author(s): Wingo LK. Source: J Cult Divers. 2001 Spring; 8(1): 21-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11855009&dopt=Abstract

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Substance abuse in heart transplant recipients: a 10-year follow-up study. Author(s): Hanrahan JS, Eberly C, Mohanty PK. Source: Progress in Transplantation (Aliso Viejo, Calif.). 2001 December; 11(4): 285-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11871277&dopt=Abstract

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Substance abuse in pregnancy and the child born alive. Author(s): Pickworth E. Source: Anglo Am Law Rev. 1998 October-November; 27(4): 472-93. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11936153&dopt=Abstract

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Suicidal thoughts related to psychoactive substance abuse among adolescents. Author(s): Licanin I, Music E, Laslo E, Berg-Kelly K, Masic I, Redzic A, Vejzagic A, Krosnjar S. Source: Med Arh. 2003; 57(4): 237-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14528719&dopt=Abstract

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Supervisor tolerance-responsiveness to substance abuse and workplace prevention training: use of a cognitive mapping tool. Author(s): Bennett JB, Lehman WE. Source: Health Education Research. 2002 February; 17(1): 27-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11890175&dopt=Abstract

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The impact of managed care on the use of outpatient mental health and substance abuse services in Puerto Rico. Author(s): Alegria M, McGuire T, Vera M, Canino G, Freeman D, Matias L, Albizu C, Marin H, Calderon J. Source: Inquiry. 2001-2002 Winter; 38(4): 381-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11887956&dopt=Abstract

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The importance of fulfilling unmet needs of rural and urban adolescents with substance abuse. Author(s): Mainous RO, Mainous AG 3rd, Martin CA, Oler MJ, Haney AS. Source: Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc. 2001 January-March; 14(1): 32-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11887679&dopt=Abstract

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The infected or substance abuse-impaired radiologist. Author(s): Smith JJ, Berlin L. Source: Ajr. American Journal of Roentgenology. 2002 March; 178(3): 567-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11856675&dopt=Abstract

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The influence of distance on utilization of outpatient mental health aftercare following inpatient substance abuse treatment. Author(s): Schmitt SK, Phibbs CS, Piette JD. Source: Addictive Behaviors. 2003 August; 28(6): 1183-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834661&dopt=Abstract

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The interactive effects of low self-control and commitment to school on substance abuse among college students. Author(s): Tibbetts SG, Whittimore JN. Source: Psychological Reports. 2002 February; 90(1): 327-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11899006&dopt=Abstract

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The origins of commitment for substance abuse in the United States. Author(s): Hall KT, Appelbaum PS. Source: J Am Acad Psychiatry Law. 2002; 30(1): 33-45; Discussion 46-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11931367&dopt=Abstract

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The use of microarrays to characterize neuropsychiatric disorders: postmortem studies of substance abuse and schizophrenia. Author(s): Lehrmann E, Hyde TM, Vawter MP, Becker KG, Kleinman JE, Freed WJ. Source: Current Molecular Medicine. 2003 August; 3(5): 437-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942997&dopt=Abstract

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To have and to hold: codependency as a mediator or moderator of the relationship between substance abuse in the family of origin and adult-offspring medical problems. Author(s): Harkness D. Source: J Psychoactive Drugs. 2003 April-June; 35(2): 261-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924749&dopt=Abstract

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Towards the integration of treatment systems for substance abusers: report on the second International Symposium on Substance Abuse Treatment and Special Target Groups. Author(s): Broekaert E, Vanderplasschen W. Source: J Psychoactive Drugs. 2003 April-June; 35(2): 237-45. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924746&dopt=Abstract

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Treatment for substance abuse in Australia: a comparison of public and private programs. Author(s): McNeese-Smith DK. Source: Int J Psychiatr Nurs Res. 2003 September; 9(1): 1025-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14533233&dopt=Abstract

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Under the influence of unconscious process: countertransference in the treatment of PTSD and substance abuse in women. Author(s): Cramer MA. Source: American Journal of Psychotherapy. 2002; 56(2): 194-210. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12125297&dopt=Abstract

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Understanding youth substance abuse: are there barriers? Author(s): Litt IF. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 2002 June; 30(6): 407-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12039509&dopt=Abstract

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Unsafe sex, substance abuse, and domestic violence: how do recently trained obstetricians-gynecologists fare at lifestyle risk assessment and counseling on STD prevention? Author(s): Haley N, Maheux B, Rivard M, Gervais A. Source: Preventive Medicine. 2002 June; 34(6): 632-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12052024&dopt=Abstract

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Unscheduled admissions and AMA discharges from a substance abuse unit. Author(s): Berg BJ, Dhopesh V. Source: The American Journal of Drug and Alcohol Abuse. 1996 November; 22(4): 58993. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8911595&dopt=Abstract

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Use ecology and drug use motivations of methamphetamine users admitted to substance abuse treatment facilities in Los Angeles: an emerging profile. Author(s): von MC, Brecht ML, Anglin MD. Source: Journal of Addictive Diseases : the Official Journal of the Asam, American Society of Addiction Medicine. 2002; 21(1): 45-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11831499&dopt=Abstract

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Use of substance abuse treatment services by persons with mental health and substance use problems. Author(s): Wu LT, Ringwalt CL, Williams CE. Source: Psychiatric Services (Washington, D.C.). 2003 March; 54(3): 363-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610245&dopt=Abstract

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Use of the MMPI-A to detect substance abuse in a juvenile correctional setting. Author(s): Stein LA, Graham JR. Source: Journal of Personality Assessment. 2001 December; 77(3): 508-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11781036&dopt=Abstract

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Utilization and cost impact of integrating substance abuse treatment and primary care. Author(s): Parthasarathy S, Mertens J, Moore C, Weisner C. Source: Medical Care. 2003 March; 41(3): 357-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618639&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

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Utilizing technology: the challenges and opportunities facing “substance abuse” professionals in rural communities. Author(s): Smith GL, Keliy KJ. Source: Substance Use & Misuse. 2002 April-June; 37(5-7): 805-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12117071&dopt=Abstract

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Validation of a system of classifying female substance abusers on the basis of personality and motivational risk factors for substance abuse. Author(s): Conrod PJ, Pihl RO, Stewart SH, Dongier M. Source: Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors. 2000 September; 14(3): 243-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10998950&dopt=Abstract

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Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Author(s): Knight JR, Sherritt L, Shrier LA, Harris SK, Chang G. Source: Archives of Pediatrics & Adolescent Medicine. 2002 June; 156(6): 607-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12038895&dopt=Abstract

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Variability of substance abuse. Global variability of substance abuse: is latitude a unique etiological factor? Author(s): Paschane D. Source: Int J Circumpolar Health. 1998 October; 57(4): 228-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9857579&dopt=Abstract

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Vasculitis owing to substance abuse. Author(s): Brust JC. Source: Neurologic Clinics. 1997 November; 15(4): 945-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9367974&dopt=Abstract

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Violence among individuals in substance abuse treatment: the role of alcohol and cocaine consumption. Author(s): Chermack ST, Blow FC. Source: Drug and Alcohol Dependence. 2002 March 1; 66(1): 29-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11850133&dopt=Abstract

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Violence and associated high-risk health behavior in adolescents. Substance abuse, sexually transmitted diseases, and pregnancy of adolescents. Author(s): Melzer-Lange MD. Source: Pediatric Clinics of North America. 1998 April; 45(2): 307-17. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9568011&dopt=Abstract

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Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. Author(s): Kilpatrick DG, Ruggiero KJ, Acierno R, Saunders BE, Resnick HS, Best CL. Source: Journal of Consulting and Clinical Psychology. 2003 August; 71(4): 692-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12924674&dopt=Abstract

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Violence and severe mental illness: the effects of substance abuse and nonadherence to medication. Author(s): Swartz MS, Swanson JW, Hiday VA, Borum R, Wagner HR, Burns BJ. Source: The American Journal of Psychiatry. 1998 February; 155(2): 226-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9464202&dopt=Abstract

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Violence, mental health, substance abuse-problems for women worldwide. Author(s): Wyshak G. Source: Health Care for Women International. 2000 October-November; 21(7): 631-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11813770&dopt=Abstract

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Voucher-based incentives. A substance abuse treatment innovation. Author(s): Higgins ST, Alessi SM, Dantona RL. Source: Addictive Behaviors. 2002 November-December; 27(6): 887-910. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12369474&dopt=Abstract

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Weight and eating concerns in outpatient men and women being treated for substance abuse. Author(s): Jackson TD, Grilo CM. Source: Eat Weight Disord. 2002 December; 7(4): 276-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12588055&dopt=Abstract

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Welfare reform and substance abuse: innovative state strategies. Author(s): Parra G. Source: Nhpf Issue Brief. 2002 March 7; (771): 1-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11915905&dopt=Abstract

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What drove private health insurance spending on mental health and substance abuse care, 1992-1999? Author(s): Mark TL, Coffey RM. Source: Health Aff (Millwood). 2003 January-February; 22(1): 165-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12528848&dopt=Abstract

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What general psychiatrists ask addiction psychiatrists: a review of 381 substance abuse consultations in a psychiatric hospital. Author(s): Greenfield SF, Hennessy G, Sugarman DE, Weiss RD. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2003 January-February; 12(1): 18-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623737&dopt=Abstract

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What is the relationship between schizophrenia and substance abuse? Author(s): Green AI. Source: The Harvard Mental Health Letter / from Harvard Medical School. 2000 October; 17(4): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11015759&dopt=Abstract

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Why should nurses care about substance abuse parity? Author(s): Bachman J. Source: Colo Nurse. 2002 June; 102(2): 19-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12080550&dopt=Abstract

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Women are less likely to be admitted to substance abuse treatment within 30 days of assessment. Author(s): Arfken CL, Borisova N, Klein C, di Menza S, Schuster CR. Source: J Psychoactive Drugs. 2002 January-March; 34(1): 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12003111&dopt=Abstract

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Women in jail: is substance abuse treatment enough? Author(s): Alemagno SA. Source: American Journal of Public Health. 2001 May; 91(5): 798-800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11344891&dopt=Abstract

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Women who smoke crack and their family substance abuse problems. Author(s): Boyd CJ, Holmes C. Source: Health Care for Women International. 2002 September-November; 23(6-7): 57686. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12418980&dopt=Abstract

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Workplace substance abuse prevention and help seeking: comparing team-oriented and informational training. Author(s): Bennett JB, Lehman WE. Source: Journal of Occupational Health Psychology. 2001 July; 6(3): 243-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11482635&dopt=Abstract

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CHAPTER 2. NUTRITION AND SUBSTANCE ABUSE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and substance abuse.

Finding Nutrition Studies on Substance 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 “substance 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 substance abuse: •

Demographics of substance abuse. Source: McMurtrey, J.J. Sherwin, R. Nutr-Today. Baltimore, Md. : Williams & Wilkins. Nov/December 1987. volume 6 (6) page 255-262. charts. 0029-666X

The following information is typical of that found when using the “Full IBIDS Database” to search for “substance abuse” (or a synonym): •

Adoption and implementation of new technologies in substance abuse treatment. Author(s): Institute for Behavioral Research, The University of Georgia, Athens, GA 30602, USA. [email protected] Source: Roman, Paul M Johnson, J Aaron J-Subst-Abuse-Treat. 2002 June; 22(4): 211-8 0740-5472

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American Indian and Alaska Native substance abuse: co-morbidity and cultural issues. Author(s): University of Arizona College of Public Health, Tucson, AZ, USA. Source: Gray, N Nye, P S Am-Indian-Alsk-Native-Ment-Health-Res. 2001; 10(2): 67-84 1533-7731

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Cocaine withdrawal severity and urine toxicology results from treatment entry predict outcome in medication trials for cocaine dependence. Author(s): Department of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia 19104, USA. [email protected] Source: Kampman, Kyle M Volpicelli, Joseph R Mulvaney, Frank Rukstalis, Margaret Alterman, Arthur I Pettinati, Helen Weinrieb, Robert M O'Brien, Charles P AddictBehavolume 2002 Mar-April; 27(2): 251-60 0306-4603

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Co-occurring psychosocial distress and substance abuse in community clients: initial validity and reliability of self-report measures. Author(s): Boston College Graduate School of Social Work, Chestnut Hill, MA 021673807, USA. Source: O'Hare, T Cutler, J Sherrer, M V McCall, T M Dominique, K N Garlick, K Community-Ment-Health-J. 2001 December; 37(6): 481-7 0010-3853

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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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Effect of opioid dependence pharmacotherapies on zidovudine disposition. Author(s): Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY 10461, USA. [email protected] Source: McCance Katz, E F Rainey, P M Friedland, G Kosten, T R Jatlow, P Am-J-Addict. 2001 Fall; 10(4): 296-307 1055-0496

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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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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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WebMDHealth: 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 SUBSTANCE ABUSE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to substance abuse. At the conclusion of this chapter, we will provide additional sources.

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 substance 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 “substance 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 substance abuse: •

A phenomenological exploration of spirituality among African American women recovering from substance abuse. Author(s): Wright VL. Source: Archives of Psychiatric Nursing. 2003 August; 17(4): 173-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14508773&dopt=Abstract

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A pilot trial of piracetam and ginkgo biloba for the treatment of cocaine dependence. Author(s): Kampman K, Majewska MD, Tourian K, Dackis C, Cornish J, Poole S, O'Brien C. Source: Addictive Behaviors. 2003 April; 28(3): 437-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12628617&dopt=Abstract

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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

•

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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Acupuncture for substance abuse. Author(s): Margolin A. Source: Current Psychiatry Reports. 2003 October; 5(5): 333-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13678552&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. 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

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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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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. 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

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Drug dependence studies and regulations: an overview of the past and present. Author(s): Harris LS. Source: Nihon Shinkei Seishin Yakurigaku Zasshi. 2001 November; 21(5): 171-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11797422&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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Integrating health care for women diagnosed with HIV infection, substance abuse, and mental illness in Detroit, Michigan. Author(s): Andersen M, Smereck GA, Hockman E, Tinsley J, Milfort D, Shekoski C, Connelly C, Faber-Bermudez I, Schuman P, Emrich K, Paliwoda J, Harris C. Source: The Journal of the Association of Nurses in Aids Care : Janac. 2003 SeptemberOctober; 14(5): 49-58. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14571686&dopt=Abstract

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Matching substance abuse aftercare treatments to client characteristics. Author(s): Brown TG, Seraganian P, Tremblay J, Annis H. 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.

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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 •

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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Psychosis and drug dependence: results from a national survey of prisoners. Author(s): Farrell M, Boys A, Bebbington P, Brugha T, Coid J, Jenkins R, Lewis G, Meltzer H, Marsden J, Singleton N, Taylor C. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2002 November; 181: 393-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411264&dopt=Abstract

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Reducing hospitalizations and arrests for substance abusers. Author(s): Groppenbacher J, Bemis Batzer G, White L. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2003 March-April; 12(2): 153-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12746090&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. 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

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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

•

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

•

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/

•

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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WebMDHealth: 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 substance 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

Alternative Medicine 127

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 Sleeplessness Source: Integrative Medicine Communications; www.drkoop.com Stress Source: Integrative Medicine Communications; www.drkoop.com Stroke Source: Integrative Medicine Communications; www.drkoop.com •

Alternative Therapy Meditation Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,717,00.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 Arctostaphylos Uva Ursi Source: Integrative Medicine Communications; www.drkoop.com Bearberry Source: Integrative Medicine Communications; www.drkoop.com

128 Substance Abuse

Beargrape Source: Integrative Medicine Communications; www.drkoop.com Eugenia Clove Alternative names: Cloves; Eugenia sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Uva Ursi Alternative names: Arctostaphylos uva ursi, Bearberry, Beargrape 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 SUBSTANCE ABUSE Overview In this chapter, we will give you a bibliography on recent dissertations relating to substance 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 “substance abuse” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on substance abuse, we have not necessarily excluded nonmedical dissertations in this bibliography.

Dissertations on Substance 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 substance 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: •

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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Life Events of Social Workers and Their Attitudes toward Substance Abuse by Hopkins, Susan, PhD from University of South Carolina, 1997, 99 pages http://wwwlib.umi.com/dissertations/fullcit/9815516

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Life Stressors, Anger and Internalization, and Substance Abuse among American Indian Adolescents in the Midwest: an Empirical Test of General Strain Theory by Chen, Xiaojin; PhD from Iowa State University, 2003, 133 pages http://wwwlib.umi.com/dissertations/fullcit/3085894

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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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Loss of Tolerance to Ethanol in a Male Alcoholic Population (genetic, Treatment, Substance Abuse) by Greene, John Alan, PhD from Boston College, 1986, 98 pages http://wwwlib.umi.com/dissertations/fullcit/8612170

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Management of Substance Abuse Testing in the Workplace by Lingenfelter, Wayne Michael, EDD from Pepperdine University, 1996, 166 pages http://wwwlib.umi.com/dissertations/fullcit/9715439

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Maternal Substance Abuse: Impact of Prenatal Care on Newborn Outcomes and Costs by Simantov, Elisabeth, PhD from City University of New York, 1998, 221 pages http://wwwlib.umi.com/dissertations/fullcit/9830762

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Medical Student Attitudes towards Substance Abuse: the Effectiveness of an Educational Program Involving Small Group and Discussion Formats of Patient Management Problems by Veach, Tracy Lee, EDD from University of Nevada, Reno, 1983, 123 pages http://wwwlib.umi.com/dissertations/fullcit/8400857

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Memory Performance in Substance Abusing Persons with Mental Retardation (substance Abuse) by Golden, Harriet, EDD from Columbia University Teachers College, 1993, 148 pages http://wwwlib.umi.com/dissertations/fullcit/9400560

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Mental Health and Substance Abuse Professionals' Attitudes toward Dually Diagnosed Clients in a Community-based Treatment Center by Bullock, Joseph Edward, Jr.; EDD from Virginia Polytechnic Institute and State University, 2002, 88 pages http://wwwlib.umi.com/dissertations/fullcit/3047968

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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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MMPI and SASSI Scores As Predictors of Sexual Abuse and Substance Abuse in Adolescent Psychiatric Inpatients by Fox, Marian R., PhD from The University of Toledo, 1992, 109 pages http://wwwlib.umi.com/dissertations/fullcit/9306716

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Mmpi Patterns in Codependency: before and after Treatment (substance Abuse) by Prouty, Kathleen Veronica, PhD from The University of Arizona, 1992, 175 pages http://wwwlib.umi.com/dissertations/fullcit/9220689

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Mother-child Relationships in a Residential Substance Abuse Setting by Telles, Vasiliky; Msw from California State University, Long Beach, 2002, 76 pages http://wwwlib.umi.com/dissertations/fullcit/1409284

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Motivational Factors for Nurses Attending Continuing Education Courses in the Prevention of Substance Abuse by Peloquin, Louise Mary, PhD from Walden University, 1996, 134 pages http://wwwlib.umi.com/dissertations/fullcit/9633602

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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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Object Representations of Substance Abusers As Predictors of Treatment Success by Hamowy, Alexander S.; PhD from Columbia University, 2002, 122 pages http://wwwlib.umi.com/dissertations/fullcit/3037711

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Observable Ramifications of Disrupted Homes on the Lives of Students: a Descriptive Study (dropouts, Substance Abuse, Teenage Parenthood) by Eberhardt, Jacques, EDD from Wayne State University, 1990, 164 pages http://wwwlib.umi.com/dissertations/fullcit/9118872

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Ongoing Substance Abuse and Its Effect on the Attachment Quality of Toddlers by Kelly, Kimberly Patrice; PhD from Fordham University, 2002, 188 pages http://wwwlib.umi.com/dissertations/fullcit/3061336

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Paranoid and Undifferentiated Types of Schizophrenia and Their Relationship to Types of Substance Abuse by Grillo-didomenico, Beatrice, PhD from Fordham University, 1998, 147 pages http://wwwlib.umi.com/dissertations/fullcit/9825880

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Parent and Chemically Misusing Adolescents Problem-solving: a Simulated Game Design (Substance Abuse) by Stokes-brewer, Carole Anne, PhD from The Union for Experimenting Colleges and Universities, 1986, 147 pages http://wwwlib.umi.com/dissertations/fullcit/8617906

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A Case Study of an Effective Substance Abuse Prevention Program for Adolescent Males with Emotional/behavioral Disorders by Clutterbuck, Owen Lee; EDD from University of Cincinnati, 2001, 211 pages http://wwwlib.umi.com/dissertations/fullcit/3000363

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A Case Study of Cocaine Usage by Student-Athletes and Substance Abuse Programs for Student-Athletes at NCAA Division I-A Universities by Atkinson, Eve, EDD from Temple University, 1991, 153 pages http://wwwlib.umi.com/dissertations/fullcit/9134913

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A Case Study of the Development of Oregon's 1985 Public Policy in Youth Substance Abuse by Grove, Sonja Carol, EDD from Portland State University, 1995, 211 pages http://wwwlib.umi.com/dissertations/fullcit/9608481

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A Cognitive Developmental Dilemma Based Model for Substance Abuse Prevention by Paisley, Robert Thomas, EDD from North Carolina State University, 1987, 142 pages http://wwwlib.umi.com/dissertations/fullcit/8712551

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A Comparison of Reported Substance Abuse Behavior and Coping Styles among Sexually Abused and Nonabused Female Clients (Women) by Jackson, Linda Garrett, EDD from Auburn University, 1992, 109 pages http://wwwlib.umi.com/dissertations/fullcit/9225359

132 Substance Abuse

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A Comparison of the Effects of a Gender-specific and Traditional Model of Substance Abuse Treatment Within the Therapeutic Community on Treatment Success by Harshman, William Leslie; PhD from Wayne State University, 1999, 199 pages http://wwwlib.umi.com/dissertations/fullcit/9954512

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A Comparison of Three Approaches Used in Selected School-based Substance Abuse Prevention Programs by Aiello, Nicholas Anthony, PhD from Fordham University, 1982, 186 pages http://wwwlib.umi.com/dissertations/fullcit/8213595

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A Construct Validation of Self-determination Instrument: Using Adult Substance Abuse Consumers in Residential Setting by Eke, Uju P., PhD from Wayne State University, 1996, 79 pages http://wwwlib.umi.com/dissertations/fullcit/9628888

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A Dependency System Based Program Design to Focus on Maltreated Children Subjected to Domestic Violence and Parental Substance Abuse by O'riley, Christine Ann; PsyD from Carlos Albizu University, 2002, 120 pages http://wwwlib.umi.com/dissertations/fullcit/3057618

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A Descriptive Study of Student Assistance Programs in the State of Texas (substance Abuse Prevention) by Wright, Marilyn Diane, PhD from University of North Texas, 1995, 114 pages http://wwwlib.umi.com/dissertations/fullcit/9529955

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A Descriptive Study of Substance Abuse Programs in Oregon's Public Universities by Roi, Marcia R., PhD from Oregon State University, 1993, 154 pages http://wwwlib.umi.com/dissertations/fullcit/9422176

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A Descriptive Study of the Moral Development of Selected Members of First Christian Church and Selected Residents of the Substance Abuse Program at the Veterans Administration Hospital by Thompson, Stephen W., EDD from New Orleans Baptist Theological Seminary, 1983, 123 pages http://wwwlib.umi.com/dissertations/fullcit/8320591

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A Developmental Substance Abuse Prevention Education Program Model for African-American Youth by Shaw, Sharon Elaine Webb, EDD from Peabody College for Teachers of Vanderbilt University, 1990, 241 pages http://wwwlib.umi.com/dissertations/fullcit/9027468

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A Followup Study of Adolescents: Career Maturity, Self-Concept, Personality, Anxiety and Participation in Substance Abuse Prevention Program (Ohio) by Rodebaugh, Helen Davis, PhD from The Ohio State University, 1986, 248 pages http://wwwlib.umi.com/dissertations/fullcit/8703606

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A Grounded Theory of Volition in Recovery from Substance Abuse by Speck, Kathryn Joan; PhD from The University of Nebraska - Lincoln, 2002, 203 pages http://wwwlib.umi.com/dissertations/fullcit/3045536

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A Historical Study of Adolescent Substance Abuse Primary Prevention Models and Strategies (Prevention) by Gibson, Michael Jay, EDD from Northern Illinois University, 1989, 157 pages http://wwwlib.umi.com/dissertations/fullcit/9020041

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A Longitudinal Study to Determine the Long-Term Effects of Prevention and Intervention Substance Abuse Strategies on At-Risk Fourth Grade Students and Their Families by Rentschler, David M., EDD from Widener University, 1996, 148 pages http://wwwlib.umi.com/dissertations/fullcit/9701173

Dissertations 133

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A Meta-analysis of Selected Adolescent Alcohol Education Studies (Drug Education, Substance Abuse Prevention) by Goldmon, Moses Vernon, EDD from The University of Tennessee, 1991, 97 pages http://wwwlib.umi.com/dissertations/fullcit/9221761

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A Model Program Manual for New Life Substance Abuse Treatment by Odono, Al, PhD from The Union Institute, 1996, 139 pages http://wwwlib.umi.com/dissertations/fullcit/9710011

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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 Parenting Curriculum Designed to Prevent and Reduce Substance Abuse Risk Factors by Millard, Joel Legrand, Dsw from The University of Utah, 1988, 133 pages http://wwwlib.umi.com/dissertations/fullcit/8818997

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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 Proposed Model for Early Identification of Substance Abuse among Adolescents by Traverse, George Frank, EDD from Baylor University, 1987, 116 pages http://wwwlib.umi.com/dissertations/fullcit/8721007

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A Qualitative Analysis of Jump Start Lexington: a Substance Abuse Prevention and Life Skills Intervention Program (Kentucky) by Mckissick-Melton, S. Charmaine; PhD from University of Kentucky, 2001, 154 pages http://wwwlib.umi.com/dissertations/fullcit/3028038

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A Structural Equation Model of Family-Life Variables in the Etiology and Progression of Substance Abuse and the Development of Problem Behaviors among Public School Adolescents in Abilene, Texas by Brand, Michael W., PhD from The University of Texas at Arlington, 1993, 212 pages http://wwwlib.umi.com/dissertations/fullcit/9328478

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A Study of African-american Female Substance Abusers by Williams, Art S.; PhD from Walden University, 1999, 137 pages http://wwwlib.umi.com/dissertations/fullcit/9998848

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A Study of Attitudinal, Behavioral, and Social Factors Related to Adolescent Substance Abuse by Tajiki, Maryam, EDD from University of San Francisco, 1988, 104 pages http://wwwlib.umi.com/dissertations/fullcit/8825370

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A Study of Former Substance Abusers Enrolled in a University Course on Substance Abuse by Senn, Karen Louise, EDD from Temple University, 1983, 295 pages http://wwwlib.umi.com/dissertations/fullcit/8311566

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A Study of Perceived Marital Power and Satisfaction of Couples in Counseling with Presenting Problems of Either Substance Abuse, Parent-child Conflict, or Communication (Marital Satisfaction) by Walker, James Randall, EDD from Southwestern Baptist Theological Seminary, 1991, 108 pages http://wwwlib.umi.com/dissertations/fullcit/9125073

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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

134 Substance Abuse

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 •

A Study of the Effect of a Teacher Training Program on the Implementation of an Elementary School Substance Abuse Education Curriculum in the Boston Public Schools by Handler, Shirley L., EDD from University of Massachusetts, 1989, 194 pages http://wwwlib.umi.com/dissertations/fullcit/8917360

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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 of the Effects of a Goal Oriented Counseling Program on the Self-concept and Perception of Environment and the Association of Dogmatism with These Variables among a Male Incarcerated Substance Abuse Population by Carway, John Patrick, PhD from St. John's University (New York), 1982, 127 pages http://wwwlib.umi.com/dissertations/fullcit/8305919

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A Study of the Identification and Referral Components of Substance Abuse Intervention Programs in Washington State's Public High Schools by Herberg, Todd Craig, EDD from Portland State University, 1989, 295 pages http://wwwlib.umi.com/dissertations/fullcit/9008542

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A Study of the Impact of an Interactive Video Disc and Role Playing Strategies on Student Learning and Attitudes about Substance Abuse As Taught by Preservice Teachers by Hrecz, Rita Arlene, PhD from The University of Iowa, 1991, 168 pages http://wwwlib.umi.com/dissertations/fullcit/9136932

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A Study of the Relationship of Substance Abuse to Child Abuse and Neglect by Thompson, Diane Lynch, PhD from University of South Carolina, 1981, 113 pages http://wwwlib.umi.com/dissertations/fullcit/8123443

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A Study of the Self-actualizing Characteristics in Cognitive Style of Participants in a Substance Abuse Rehabilitation Program. by Berman, Bennett Herbert, EDD from Wayne State University, 1974, 194 pages http://wwwlib.umi.com/dissertations/fullcit/7429784

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A Substance Abuse Awareness Prevention Program: Knowledge, Attitudes and Behaviors (Adolescent, Human Relations, Rural, Alcohol) by Scaggs, Linda Stoer, PhD from The Ohio State University, 1984, 321 pages http://wwwlib.umi.com/dissertations/fullcit/8504077

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A Substance Abuse Prevention Project among Youths in an Urban Baptist Church by Gable, Willie, Jr., Dmin from United Theological Seminary, 1998, 207 pages http://wwwlib.umi.com/dissertations/fullcit/9928755

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A Theoretical Contribution to the Understanding of Substance Abuse As a Manifestation of Unconscious Fantasy Process and Compromise Formations of Phallic-Oedipal Origin by Cattano, Joseph A., PhD from New York University, 1992, 242 pages http://wwwlib.umi.com/dissertations/fullcit/9237841

Dissertations 135

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A Theoretical Framework of Organizational Pluralism: an Analysis of the Organizational Dimensions of Substance Abuse Programs in Selected Private Sectarian Institutions of Higher Education in Texas (Sectarian Institutions) by Davis, Beth, PhD from University of North Texas, 1993, 343 pages http://wwwlib.umi.com/dissertations/fullcit/9326623

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A Woman's Place in the Home: a Case Study of the Staff at a Residential Treatment Program for Substance Abusing Women (Women Substance Abusers, Counselling Staff) by Reyes, Ann Albrecht, EDD from University of Cincinnati, 1992, 253 pages http://wwwlib.umi.com/dissertations/fullcit/9313821

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Abused Women in Recovery: a Qualitative Study of Women in Substance Abuse Recovery Who Were Abused, Either Physically or Sexually As Children by Walsh, Carmella Frances Ranelli; EDD from Morgan State University, 2002, 158 pages http://wwwlib.umi.com/dissertations/fullcit/3053040

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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 As a Functional Adaptation to a Deficit Ego (substance Abuse) by Mossler, Ronald Allen, PhD from University of California, Los Angeles, 1995, 184 pages http://wwwlib.umi.com/dissertations/fullcit/9521869

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Adolescent Information Acquisition, Locus-of-control, Lifestyle and Substance Abuse: a Social Market Segmentation for Health Communication Effectiveness by Atkyns, Robert L., PhD from Temple University, 1986, 367 pages http://wwwlib.umi.com/dissertations/fullcit/8627422

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Adolescent Substance Abuse from a Fluid and Crystallized Cognitive Abilities Perspective by Minehan, Janet Ann, EDD from University of Southern California, 1994 http://wwwlib.umi.com/dissertations/fullcit/f1557379

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Adolescent Substance Abuse Recovery: a Preliminary Investigation of Peer and Family Influences by Gazzini, Joseph Charles, PhD from The Union Institute, 1993, 296 pages http://wwwlib.umi.com/dissertations/fullcit/9412275

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Adolescent Substance Abuse Treatment Incorporating 'rites of Passage' by Mason, Michael Jon, PhD from Oregon State University, 1992, 273 pages http://wwwlib.umi.com/dissertations/fullcit/9311077

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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: towards an Integrated Model (social Learning, Social Control, Substance Abuse) by Goldsmith, Mary I. R., PhD from York University (Canada), 1991, 123 pages http://wwwlib.umi.com/dissertations/fullcit/NN72884

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Adolescents' Perceptions of Their Relationships with Their Fathers: a Comparison of Substance Abusers and Non-substance Abusers by Hansink, Raymond L., PhD from United States International University, 1993, 127 pages http://wwwlib.umi.com/dissertations/fullcit/9401107

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Adult Substance Abuse Treatment: the Incidence of Incest Histories among Clients and Their Perceptions Regarding Treatment by Glover, Noreen M., PhD from Southern Illinois University at Carbondale, 1995, 180 pages http://wwwlib.umi.com/dissertations/fullcit/9536541

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Alcohol Expectancies of College Students: a Comparison Study (Substance Abuse) by Paulus, Michael Dean, PhD from Rutgers the State University of New Jersey - New Brunswick, 1995, 125 pages http://wwwlib.umi.com/dissertations/fullcit/9537626

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Alexithymia and Levels of Emotional Development in a Substance Abuse Population by Walgren, Mischel B., PhD from University of Minnesota, 1995, 106 pages http://wwwlib.umi.com/dissertations/fullcit/9541371

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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 Organizational Change Within an Inpatient Substance Abuse Center by Prochaska, Fred, PhD from University of Pittsburgh, 1982, 159 pages http://wwwlib.umi.com/dissertations/fullcit/8303596

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An Analysis of Selected Clinical Variables of Substance Abusers Residing in Halfway Houses by Senegal, Marie Dinard, EDD from Texas Southern University, 1993, 122 pages http://wwwlib.umi.com/dissertations/fullcit/9433152

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An Analysis of Supervision Perceptions by Certified Substance Abuse Counselors (substance Abuse Counselors) by Freudenthal, Judy Ellen, EDD from Peabody College for Teachers of Vanderbilt University, 1991, 129 pages http://wwwlib.umi.com/dissertations/fullcit/9215377

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An Analysis of the Job Satisfaction of Substance Abuse Counselors Certified by the Commonwealth of Virginia by Evans, William Nelson, PhD from Virginia Polytechnic Institute and State University, 1993, 148 pages http://wwwlib.umi.com/dissertations/fullcit/9319769

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An Analysis of the Rehabilitative Effects of Social Support among Substance Abusers in a Transition Residence by Bridges, Jeffrey Keith, PhD from The University of Utah, 1986, 110 pages http://wwwlib.umi.com/dissertations/fullcit/8706385

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An Analysis of Variables That Impact Treatment Outcomes of Chemically Dependent Deaf and Hard of Hearing Individuals (substance Abuse, Disabilities) by GuthmannTernus, Debra Sue, EDD from University of Minnesota, 1995, 287 pages http://wwwlib.umi.com/dissertations/fullcit/9537833

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An Assessment of College Students Who Participate in Three Different Substance Abuse Programs by Thombs, Dennis Lee, PhD from University of Maryland College Park, 1990, 215 pages http://wwwlib.umi.com/dissertations/fullcit/9110362

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An Ecological Assessment of the School-based Substance Abuse Psychological Services for Native American Youth by Nielsen, Steven Kenneth, EDD from Northern Arizona University, 1994, 287 pages http://wwwlib.umi.com/dissertations/fullcit/9505474

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An Evaluation of a Developmentally-oriented Substance Abuse Curriculum for Urban Middle School Students by Beale, Leslie, EDD from Boston University, 1987, 261 pages http://wwwlib.umi.com/dissertations/fullcit/8727788

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An Evaluation of a Psychoeducational Group for Parents in Substance Abuse Treatment by Plasse, Beatrice Rogoff; DSW from City University of New York, 2000, 219 pages http://wwwlib.umi.com/dissertations/fullcit/9969717

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An Evaluation of an Educational Substance Abuse Prevention Program (Substance Abuse Prevention) by Cleckler, Paula Elizabeth Jones, EDD from University of Georgia, 1991, 191 pages http://wwwlib.umi.com/dissertations/fullcit/9133461

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An Evaluation of Child Welfare Inservice Training: the Relative Effectiveness of Substance Abuse Content in Improving Worker Knowledge and Attitudes by Mitchell, Welker Clark, PhD from Florida International University, 1995, 131 pages http://wwwlib.umi.com/dissertations/fullcit/9610892

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An Evaluation of Coping Ability As a Guide to the Treatment of Persons Diagnosed with Schizophrenia and Substance Abuse by Dumaine, Marian Lee, PhD from Florida International University, 1997, 186 pages http://wwwlib.umi.com/dissertations/fullcit/9811003

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An Evaluation of Day Care Treatment for Youth Polydrug Abuse by Feigelman, William T., PhD from State University of New York at Stony Brook, 1987, 266 pages http://wwwlib.umi.com/dissertations/fullcit/8723602

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An Evaluation of Public Substance Abuse Treatment Outcome: a Comparison of Intensive Day Treatment and Detox-Only Groups by Tandy, Cynthia Carole, PhD from University of Georgia, 1998, 125 pages http://wwwlib.umi.com/dissertations/fullcit/9836989

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An Evaluation of the Substance Abuse Prevention in Education Team Training Program by Felter, Carolyn Janet, PhD from The Louisiana State University and Agricultural and Mechanical Col., 1983, 108 pages http://wwwlib.umi.com/dissertations/fullcit/8318010

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An Evaluation Study of Women, Incorporated--A Substance Abuse Treatment Program for Females by Thornton, Shirley Ann, EDD from Boston University School of Education, 1981, 156 pages http://wwwlib.umi.com/dissertations/fullcit/8203909

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An Examination of Factors Influencing Early Adolescent Development: an Analysis Using Latent Variable Structural Equation Modeling (Substance Abuse) by Slocumb, Elaine Marguerite, PhD from The University of Connecticut, 1989, 169 pages http://wwwlib.umi.com/dissertations/fullcit/9003832

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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 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 Therapeutic and Personal Factors Related to Women Participating in Outpatient Substance Abuse Programs by Holbeck, Janice A.; PhD from Temple University, 2002, 165 pages http://wwwlib.umi.com/dissertations/fullcit/3057078

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An Integrated Analysis of Factors Affecting Treatment Outcome for Adolescent Substance Abusers by Hsieh, Sumin, PhD from University of Minnesota, 1997, 175 pages http://wwwlib.umi.com/dissertations/fullcit/9728955

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An Intensive Intervention for High-risk Students (substance Abuse Prevention, at Risk, Adolescents) by Kane-Ronning, Susan Dea, PhD from University of Oregon, 1994, 187 pages http://wwwlib.umi.com/dissertations/fullcit/9434783

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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 Investigation of Therapist Gender Bias in the Clinical Evaluation of Male and Female Substance Abusers by Ackerman, Iris Suzanne, PhD from New York University, 1993, 194 pages http://wwwlib.umi.com/dissertations/fullcit/9333703

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An Mmpi Typology of Incarcerated Substance Abusers Differentiated by Personality and Demographic Variables by Woodley, Charles Lynnwood, PhD from Texas A&M University, 1994, 215 pages http://wwwlib.umi.com/dissertations/fullcit/9520498

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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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Antisocial Personality Disorder (ASPD) and Substance Abuse Treatment Outcomes in a Post-prison Population by Mullaney, Donald K.; PhD from Barry University School of Social Work, 2002, 103 pages http://wwwlib.umi.com/dissertations/fullcit/3064157

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Assessing the Effects of Substance Abuse on Employment Status by Vechnak, Peter Bennett; PhD from The Pennsylvania State University, 2000, 75 pages http://wwwlib.umi.com/dissertations/fullcit/9998449

Dissertations 139

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Assessment of Life Skills Training in Communication, Appearance, Physical Fitness, and Health Maintenance As a Substance Abuse Prevention Program for Secondary School Students by Kavkewitz, Michael, PhD from University of Georgia, 1983, 120 pages http://wwwlib.umi.com/dissertations/fullcit/8314728

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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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Associations among Subclinical Attention Deficit Hyperactivity Disorder, Substance Abuse, and Depression in Young Adults by Nunes, Michael Anthony; MS from California State University, Fresno, 2002, 48 pages http://wwwlib.umi.com/dissertations/fullcit/1412220

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Attitudes of Alcohol/substance Abuse Practitioners toward Utilizing Computer-based Information and Communication Systems in Practice by Zysman, Shafer Harold, DSW from Adelphi University, School of Social Work, 1989, 220 pages http://wwwlib.umi.com/dissertations/fullcit/8917189

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Attitudes of Community Public High School and Area Vocational-technical School Administrators, Teachers, and Students toward the Student Substance Abuser by Marangoni, Lavonne M., PhD from University of Pittsburgh, 1989, 157 pages http://wwwlib.umi.com/dissertations/fullcit/8921398

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Attitudes of Nurses toward Substance Abuse in Nursing and in the General Population (Impaired Nurses) by Markey, Bernadine Theresa, PhD from The Pennsylvania State University, 1994, 198 pages http://wwwlib.umi.com/dissertations/fullcit/9518812

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Attitudes of Patients and Staff towards Treating Tobacco Dependence in Substance Abuse Treatment at the San Francisco VA Medical Center by Ceppi, Joanna Michelle; PsyD from The Wright Institute, 2002, 104 pages http://wwwlib.umi.com/dissertations/fullcit/3051899

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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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Basic Treatment Amenability in Substance Abuse Intervention: Client Variables Dictating the Direction of Substance Abuse Policy Within the Criminal Justice System by Downey, Kevin Joseph, PhD from Saint Louis University, 1997, 118 pages http://wwwlib.umi.com/dissertations/fullcit/9803764

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Behavioral Characteristics of Young Children Who Were Prenatally Substanceexposed (Substance Abuse, Crack Babies) by Heflin, L. Juane, PhD from University of North Texas, 1991, 145 pages http://wwwlib.umi.com/dissertations/fullcit/9213766

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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

140 Substance Abuse

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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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Burnout and Organizational Commitment among Staff of Publicly Funded Substance Abuse Treatment Programs by Liu, Hongji, PhD from University of Maryland Baltimore County, 1997, 209 pages http://wwwlib.umi.com/dissertations/fullcit/9736805

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Change in Motivation in Substance Abuse Treatment Clients by Claus, Ronald E.; PhD from University of Missouri - Saint Louis, 2003, 124 pages http://wwwlib.umi.com/dissertations/fullcit/3092282

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Changes in the Organization of VA Substance Abuse Treatment Programs: an Institutional Analysis by Floyd, Anthony Siddhartha, PhD from Stanford University, 1997, 133 pages http://wwwlib.umi.com/dissertations/fullcit/9810119

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Changing Attitudes about Substance Abuse: a Study to Assess the Impact of a Training Program for Social Work Students by Stein, Jack Bruce; PhD from Walden University, 1999, 248 pages http://wwwlib.umi.com/dissertations/fullcit/9941697

•

Characteristics of United States Air Force Members with Stepfamily and Divorce Conditions in Substance Abuse Services by Miller, Carl Scott; PhD from The University of Utah, 2002, 182 pages http://wwwlib.umi.com/dissertations/fullcit/3060730

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Child Welfare Workers' Knowledge and Attitudes toward Substance Abuse and the Latino Culture by Romero, Graciela; MSW from California State University, Long Beach, 2002, 92 pages http://wwwlib.umi.com/dissertations/fullcit/1409261

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Childhood Traumas, Substance Abuse and Sexual Experiences: a Comparison Study between Incarcerated Female Sex Offenders and Non-Sex Offenders by LaQue, Janie C.; PhD from University of Houston, 2002, 205 pages http://wwwlib.umi.com/dissertations/fullcit/3067745

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Children Born Exposed to PCP: A Biopsychosocial Study (Prenatal Chemical Exposure, Maternal Substance Abuse) by Drake, Francis Brett, PhD from University of California, Los Angeles, 1991, 264 pages http://wwwlib.umi.com/dissertations/fullcit/9134060

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Client Perceptions of Counselor Confrontations in Substance Abuse Counseling by Nakayama, Emilie Yukiko; PhD from University of Maryland College Park, 2002, 292 pages http://wwwlib.umi.com/dissertations/fullcit/3070547

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Client Readiness for Accepting Social Work Services in Substance Abuse by Yoon, Moon-ja, PhD from Wayne State University, 1984, 133 pages http://wwwlib.umi.com/dissertations/fullcit/8414537

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Clinical Social Workers' Beliefs about and Practice with Problem Drinkers (alcoholism, Substance Abuse) by Schmidt, Carolyn Lee, PhD from The Ohio State University, 1984, 178 pages http://wwwlib.umi.com/dissertations/fullcit/8426472

Dissertations 141

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Clinical Usefulness of the Basis-a Inventory with Substance Abusers by Bauman, Gary Sherman; PhD from Georgia State University, 2000, 126 pages http://wwwlib.umi.com/dissertations/fullcit/9991786

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Communication Influences on Selected Substance Abuse Behavior in Mexico City. by Rota, Josep, PhD from Michigan State University, 1978, 278 pages http://wwwlib.umi.com/dissertations/fullcit/7917775

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Community-Based Social Policy: a Case Study of the University City, Missouri Partnership for the Prevention of Substance Abuse by Edelman, Ira, PhD from University of Missouri - Saint Louis, 1996, 423 pages http://wwwlib.umi.com/dissertations/fullcit/9635473

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Comparative Analysis of Adult Male Substance Abusers Granted Probation in Los Angeles County (California) by Raschke, Phyllis Sherman, EDD from Pepperdine University, 1989, 101 pages http://wwwlib.umi.com/dissertations/fullcit/8918741

•

Comparing Supervisory Needs of Substance Abuse Counselors across Developmental Levels by Anderson, Christopher E.; PhD from The University of Iowa, 2002, 175 pages http://wwwlib.umi.com/dissertations/fullcit/3050766

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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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Conceptual and Moral Development of Substance Abuse Counselors: the Relationship to Counselor Level of Education, Experience and Recovery Status by Sias, Shari Mcclung; EDD from The College of William and Mary, 2002, 245 pages http://wwwlib.umi.com/dissertations/fullcit/3056676

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Concomitants of Success in a Perinatal Substance Abuse Treatment Program by Schulz, Linda Lao, PhD from George Mason University, 1998, 227 pages http://wwwlib.umi.com/dissertations/fullcit/9819740

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Continuity of Care for Chronically Mentally Ill Individuals with Substance Abuse Problems (Community Mental Health Treatment) by Semke, Jeanette Irene, PhD from University of Washington, 1991, 104 pages http://wwwlib.umi.com/dissertations/fullcit/9131708

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Coordination among Substance Abuse and Mental Health Services: Multiple Perspectives (Ontario) by Calderwood, Kimberly Anne; PhD from University of Toronto (Canada), 2001, 392 pages http://wwwlib.umi.com/dissertations/fullcit/NQ63797

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Correlates of Change in Day Treatment with Low-income Pregnant and Postpartum Women Substance Abusers by Hall, Mary Frances, PhD from Simmons College School of Social Work, 1997, 162 pages http://wwwlib.umi.com/dissertations/fullcit/9820259

•

Correlates of Substance Abuse among People with Blindness/visual Impairment by Brooks, Gene Iran; PhD from The University of Texas at Austin, 2000, 130 pages http://wwwlib.umi.com/dissertations/fullcit/3004224

•

Cost Effectiveness of the Public Provision of Substance Abuse Treatment in Maine by Machado, Matilde Pinto, PhD from Boston University, 1998, 226 pages http://wwwlib.umi.com/dissertations/fullcit/9802248

142 Substance Abuse

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Counselor Attributions of Client Attrition from Substance Abuse Treatment by Jorgensen, Barbara Stafford; PsyD from United States International University, 2003, 124 pages http://wwwlib.umi.com/dissertations/fullcit/3089077

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Criminal History, Use of Alcohol, Employment Status, and Demographic Characteristics As Factors Which Differentiate Substance Abusers Who Successfully Complete Treatment from Those Who Do Not by Fassett, Linda Young, EDD from Morgan State University, 1993, 115 pages http://wwwlib.umi.com/dissertations/fullcit/9329522

•

Crisis Psychiatric and Substance Abuse Services: Evaluation of a Community Program in an Urban Setting by Ligon, Jan Howard, PhD from University of Georgia, 1997, 109 pages http://wwwlib.umi.com/dissertations/fullcit/9726961

•

Delinquency and Substance Abuse in India and the United States: a Test of Strain, Control and Social Learning Perspectives by Kethineni, Sesha Rajani Kumari, PhD from Rutgers the State University of New Jersey - Newark, 1991, 254 pages http://wwwlib.umi.com/dissertations/fullcit/9201565

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Developing a Utility Index for Substance Abuse: Theory and Application by BuryMaynard, Denise, PhD from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1999, 287 pages http://wwwlib.umi.com/dissertations/fullcit/9933824

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Developing Instruments to Assess the Social Competence of Substance Abusers by Carr, Clifford Robin, EDD from University of California, Los Angeles, 1987, 124 pages http://wwwlib.umi.com/dissertations/fullcit/8719954

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Development of an Instrument to Identify Factors Associated with Adolescent Psychoactive Substance Abuse (Substance Abuse) by Sprabery, Carol Ann Forister, PhD from Mississippi State University, 1990, 124 pages http://wwwlib.umi.com/dissertations/fullcit/9120196

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Differences in the Well-Being of Family Caregivers of Adults with Mental Illness and a Co-Occurring Substance Abuse Disorder by MacMaster, Samuel Albro; PhD from Case Western Reserve University, 2001, 211 pages http://wwwlib.umi.com/dissertations/fullcit/3001112

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Differences in Therapists' Attitudes towards Mandated and Nonmandated Clients (Mandated Clients, Substance Abuse Clients) by Olshin, Sally, DSW from Adelphi University, School of Social Work, 1991, 184 pages http://wwwlib.umi.com/dissertations/fullcit/9130281

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Dual Symptomed Juvenile Offenders: a Study of Mental Health and Substance Abuse Symptoms Within Washington State Juvenile Rehabilitation Administration by Steele, Kaydee Bridget; PhD from Gonzaga University, 2000, 194 pages http://wwwlib.umi.com/dissertations/fullcit/9978104

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Dysfunctional Career Thoughts and Self-appraised Problem-solving Ability among Substance Abusers by Slatten, Marsha Lawanna, PhD from The Florida State University, 1999, 197 pages http://wwwlib.umi.com/dissertations/fullcit/9922669

Dissertations 143

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Effect of Counselor and Client Education in Nicotine Addiction on Substance Abusers' Readiness to Begin Smoking Cessation Treatment by Perine, Jessica Lee, PhD from Hofstra University, 1997, 123 pages http://wwwlib.umi.com/dissertations/fullcit/9804829

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Effect of Learning Style Preference on Drink Refusal Knowledge, Skill Acquisition, and Attrition for Substance Abusers in an Outpatient Drug and Alcohol Treatment Program by Currie, Edward Joseph, PhD from Mississippi State University, 1997, 106 pages http://wwwlib.umi.com/dissertations/fullcit/9818678

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Effects of Gender, Parental Support and Treatment Type on the Adolescent's Successful Completion of Substance Abuse Outpatient Treatment Program by Koh, Yun-Soon; PhD from The University of Wisconsin - Madison, 2002, 154 pages http://wwwlib.umi.com/dissertations/fullcit/3072807

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Ego Development and Substance Abuse: a Study of Hospitalized Adults by Colan, Neil Brian, EDD from Boston University, 1988, 167 pages http://wwwlib.umi.com/dissertations/fullcit/8901988

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Empowering Communities for the Prevention of Adolescent Substance Abuse (Substance Abuse Prevention, Community Mobilization) by Harachi-manger, Tracy, PhD from University of Washington, 1991, 170 pages http://wwwlib.umi.com/dissertations/fullcit/9203261

•

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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Evaluating the Impact of Voicemail Use and Bulletin Board Participation on Use of Substance Abuse Treatment Services by Mosavel, Maghboeba; PhD from Case Western Reserve University, 2002, 146 pages http://wwwlib.umi.com/dissertations/fullcit/3058358

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Evaluation of a Recovery-Based Curriculum in Literacy Education with Learning Disabled Substance Abusers by Swan, Gwendolyn C., EDD from Northern Arizona University, 1996, 102 pages http://wwwlib.umi.com/dissertations/fullcit/9625773

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Evaluation of an Interdisciplinary Programmed Substance Abuse Series for Industrial Nurses Using a Functional Approach. by De Dona, Frank Ettere, EDD from Wayne State University, 1975, 279 pages http://wwwlib.umi.com/dissertations/fullcit/7610937

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Evaluation of an Intersystem Network Model in the Treatment of the Mentally Ill Chemical Abusing Client (Substance Abuse) by Steinberg, Barbara A., PhD from Rutgers the State University of New Jersey - New Brunswick, 1990, 177 pages http://wwwlib.umi.com/dissertations/fullcit/9023135

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Evaluation of Substance Abuse Prevention Project: the Community Health Demonstration Project by Yuan, Jianping, PhD from The Pennsylvania State University, 1996, 169 pages http://wwwlib.umi.com/dissertations/fullcit/9702179

144 Substance Abuse

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Exploration of the Process of Adolescent Substance Abuse Treatment on a Residential Unit: a Case Study and Analysis by Wood, Ralph John; PhD from Southern Illinois University at Carbondale, 1999, 283 pages http://wwwlib.umi.com/dissertations/fullcit/9944474

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Factors Affecting Success in Self-help Groups Like Overeaters Anonymous (Substance Abuse, Binge Eating, Deviance, Rehabilitation) by Fischer, Henry Wallace, Iii, PhD from University of Delaware, 1986, 220 pages http://wwwlib.umi.com/dissertations/fullcit/8629260

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Factors Associated with Use, Dependence and Problem Consequences Application of a Common Process Model of Substance Abuse to Coffee and Tea by Graham, Kathryn Marie; PhD from The University of Western Ontario (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL40771

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Factors Influencing Psychologists' Interventions with Impaired Colleagues (Substance Abuse) by Dennings, Bruce Eldon, PhD from Texas A&M University, 1993, 127 pages http://wwwlib.umi.com/dissertations/fullcit/9403480

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Factors Predicting Middle School Students' Substance Abuse Policy Violations by Porch, William Bennett, PhD from Virginia Commonwealth University, 1992, 116 pages http://wwwlib.umi.com/dissertations/fullcit/9222504

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Factors Related to Human Service Delivery to Underserved Clients by Private Sector Nonprofit Social Service Organizations: An Ecological Study of National Outpatient Substance Abuse Treatment Units by Sookraj, Dixon Goreshwar, PhD from The Ohio State University, 1995, 232 pages http://wwwlib.umi.com/dissertations/fullcit/9534069

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Family Dynamic and Structural Factors As Correlates of Adolescent Substance Abuse: a Comparison of Families of Non-Substance Abusers and Substance Abusers by Malkus, Betty Mumford, PhD from University of Maryland College Park, 1991, 170 pages http://wwwlib.umi.com/dissertations/fullcit/9222727

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Family Planning, Family Structure, Social Support, Stress and Substance Abuse Factors Associated with Child Maltreatment Reabuse by Paarz, Karen Lynn, PhD from Temple University, 1998, 190 pages http://wwwlib.umi.com/dissertations/fullcit/9826188

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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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Female Inmates and Change: A Grounded Theory of Personal Change in a Women's Correctional Substance Abuse Treatment Unit by Schnackenberg, William J.; PhD from The University of Nebraska - Lincoln, 2001, 270 pages http://wwwlib.umi.com/dissertations/fullcit/3034390

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Female Survivors with Alcohol and Drug Dependence: Adult Attachment Styles by Gaylord-young, Cory; DNSC from The University of Tennessee Center for the Health Sciences, 2002, 79 pages http://wwwlib.umi.com/dissertations/fullcit/3067793

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Firm's Demand for Employment-Based Mental Health and Substance Abuse Benefits by Shinogle, Judith Ann; PhD from The Johns Hopkins University, 2001, 272 pages http://wwwlib.umi.com/dissertations/fullcit/3006348

Dissertations 145

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Gender Differences among Substance Abusers: New Wine in an Old Vessel by Davis, Diane Rae, PhD from The University of Texas at Austin, 1992, 239 pages http://wwwlib.umi.com/dissertations/fullcit/9225561

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Gender Differences in Behavioral and Psychosocial Correlates of Substance Abuse among Adolescents in Residential Treatment by Ellis, Rodney A., PhD from Florida International University, 1997, 233 pages http://wwwlib.umi.com/dissertations/fullcit/9724566

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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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Glue Sniffing and Volatile Substance Abuse by Schoolchildren and Adolescents by O'Connor, Denis J., PhD from University of Newcastle upon Tyne (United Kingdom), 1986, 412 pages http://wwwlib.umi.com/dissertations/fullcit/D-80582

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Grandmothers As Caregivers to Their Grandchildren Born with Positive Toxicological Screenings for Illicit Drugs: Degree of Burden and Their Coping Processes (Prenatal Substance Abuse, Drug Exposure, Infant Care) by Perrin, Allison S., EDD from University of San Francisco, 1991, 148 pages http://wwwlib.umi.com/dissertations/fullcit/9230591

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Group Prevention Programs Addressing Substance Abuse in Tenth- and Eleventhgrade Public School Students (Substance Abuse Prevention, Tenth-grade) by Flisser, Diane Elizabeth, EDD from Lehigh University, 1991, 247 pages http://wwwlib.umi.com/dissertations/fullcit/9129983

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'growing, Together': a Substance Abuse Prevention/education Program for Elementary School Age Children of Alcoholics and Their Parents by Knapp, Nancy Hay, EDD from University of Pennsylvania, 1987, 218 pages http://wwwlib.umi.com/dissertations/fullcit/8714941

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Healing the Soul Wound: the Retraditionalization of Native Americans in Substance Abuse Treatment by Edwards, Yvonne J.; PhD from California Institute of Integral Studies, 2002, 432 pages http://wwwlib.umi.com/dissertations/fullcit/3042866

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Histories and Current Functioning of Dually Diagnosed Clients: Implications for the Development of Psychoeducational Interventions (Substance Abuse) by Lehrman, Allan Jay, EDD from Temple University, 1994, 360 pages http://wwwlib.umi.com/dissertations/fullcit/9422661

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Holding Out for the Dream: Black Women, Substance Abuse and HIV/AIDS Infection (Immune Deficiency) by Johnson, Valerie Ann, PhD from Univ. of Calif., Berkeley with the Univ. of Calif., San Francisco, 1995, 214 pages http://wwwlib.umi.com/dissertations/fullcit/9602822

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How Attitudes about Drinking and Perceptions of Drinking Norms Are Related to Drinking Behavior in College Students (alcohol Use, Substance Abuse, Prevention) by Hamid, Idris Andrew, PhD from The University of Michigan, 1995, 99 pages http://wwwlib.umi.com/dissertations/fullcit/9527640

146 Substance Abuse

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Identification of the Initial Curriculum Components for the Preparation of Graduatelevel Substance Abuse Counselors by Whittinghill, William David; PhD from University of Florida, 2000, 152 pages http://wwwlib.umi.com/dissertations/fullcit/9984510

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Identifying Sets of Beliefs Instrumental in Maintaining Recovery from Substance Abuse (Coping) by Pilson, Barry, DSW from Tulane University, School of Social Work, 1996, 208 pages http://wwwlib.umi.com/dissertations/fullcit/9620870

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Illinois Department of Alcoholism and Substance Abuse Counselor Training Programs: an Impact Study (Alcoholism, Substance Abuse) by Lott, Sandra BrodersenSchneider Hinrichs, PhD from Illinois State University, 1989, 235 pages http://wwwlib.umi.com/dissertations/fullcit/9014751

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Images of God, Parents and Self in Substance Abuse Recovery (Spirituality, Twelve Step Program, Addiction) by Robinson, John Francis, PhD from University of California, Los Angeles, 1996, 251 pages http://wwwlib.umi.com/dissertations/fullcit/9626819

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Impact of Life Events, Trauma, Interpersonal Conflict and Substance Abuse on Pregnancy Outcomes of Inner City Women by Caldwell, Barbara Ann; PhD from Seton Hall University, College of Education and Human Services, 2002, 186 pages http://wwwlib.umi.com/dissertations/fullcit/3036922

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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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Impact of Welfare Reform on Substance Abusers' Medicaid Eligibility and Subsequent Effect on Access to and Utilization of Behavioral Health Services in Philadelphia, 1994--1999 (Pennsylvania) by Blitz, Cynthia Leigh; PhD from University of Pennsylvania, 2001, 108 pages http://wwwlib.umi.com/dissertations/fullcit/3003597

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In Pursuit of the 'True' Relationship: a Longitudinal Study of the Effects of Religiosity on Delinquency and Substance Abuse by Chard-Wierschem, Deborah Jo, PhD from State University of New York at Albany, 1998, 462 pages http://wwwlib.umi.com/dissertations/fullcit/9832253

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Instruction in the Effects of Alcohol and Narcotics in New York State Public Schools, 1884-1933 (Substance Abuse Education, State-required) by Yageric, Alice, PhD from State University of New York at Buffalo, 1995, 265 pages http://wwwlib.umi.com/dissertations/fullcit/9525640

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Interest of MSW Students and Field Instructors in Working with Elders, Substance Abusers and Elders with Drinking Problems by Durante, Joan Miller Brazer; PhD from Barry University School of Social Work, 2003, 137 pages http://wwwlib.umi.com/dissertations/fullcit/3086854

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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

Dissertations 147

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'Keep Coming Back--It Works!' a Study of Adolescent Peer Support Groups for Recovering Drug and Alcohol Users in a Rural Oregon High School (Substance Abuse Recovery) by Garcia, David Robert, PhD from University of Oregon, 1991, 274 pages http://wwwlib.umi.com/dissertations/fullcit/9205804

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Parental Knowledge, Services and Supports for ADHD Adolescents in a Substance Abuse Program by Franceschi, Cheryl Louise; MSW from University of Calgary (Canada), 2002, 134 pages http://wwwlib.umi.com/dissertations/fullcit/MQ72233

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Parental Substance Abuse, Children, Their Environment, and Their Families by Dalton, Bruce Owen, PhD from Rutgers the State University of New Jersey - New Brunswick, 1995, 207 pages http://wwwlib.umi.com/dissertations/fullcit/9618847

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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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Participatory Evaluation: an Innovative Framework for Evaluation of Substance Abuse Prevention Programs by Hall, Margruetta Bright, PhD from The Union Institute, 1997, 157 pages http://wwwlib.umi.com/dissertations/fullcit/9809298

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Pathways Taken by Adolescents Which Result in Psychiatric Hospitalization (Substance Abuse) by Marlow, Avis Jan, PhD from Texas Woman's University, 1994, 160 pages http://wwwlib.umi.com/dissertations/fullcit/9522024

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Perceived Differences in Social Interaction and Family Systems among Women Who Are in Substance Abuse Treatment, Incarcerated and Employed by Hardy, Barbara Nell; PhD from The University of Utah, 2000, 169 pages http://wwwlib.umi.com/dissertations/fullcit/9974853

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Perceptions of the Supervisory Relationship: Recovering and Non-recovering Substance Abuse Counselors (Supervisors) by Culbreth, John Robert, PhD from The University of North Carolina at Greensboro, 1996, 156 pages http://wwwlib.umi.com/dissertations/fullcit/9632129

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Posttraumatic Stress Disorder and Substance Abuse: Perspectives of Women in Recovery by Stam, Marjorie K.; PsyD from Massachusetts School of Professional Psychology, 2002, 124 pages http://wwwlib.umi.com/dissertations/fullcit/3056594

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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

148 Substance Abuse

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Predicting Recidivism Using Measures of Levels of Self-concept and Depression on Adolescent Substance Abusers by Williams, Carolyn Lee, PhD from University of Southern California, 1986 http://wwwlib.umi.com/dissertations/fullcit/f961125

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Predicting Substance Abuse in a Family Counseling Agency by Hudson, Sharon L., PhD from The University of Toledo, 1997, 103 pages http://wwwlib.umi.com/dissertations/fullcit/9721045

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Predicting Substance Abuse of High School Students Through Purpose in Life and Religiosity by Ezell, Racquel Jude; PhD from University of New Orleans, 2003, 221 pages http://wwwlib.umi.com/dissertations/fullcit/3093165

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Predicting Substance Abuse: an Explanatory Model of the Relationship between Parental Acceptance-rejection and Substance Abuse by Campo, Anthony Thomas, PhD from The University of Connecticut, 1985, 126 pages http://wwwlib.umi.com/dissertations/fullcit/8601214

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Predicting the Underreporting of Substance Abuse Symptoms in Adolescent Males in an Outpatient Substance Abuse Treatment Program by Ingersoll, Joel Benjamin; PhD from Fairleigh Dickinson University, 2003, 80 pages http://wwwlib.umi.com/dissertations/fullcit/3066661

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Predicting Treatment Completion in a Combined Outpatient Treatment Program for Polysubstance Abusers by Pike, Suzanne Graupner, PhD from Temple University, 1990, 85 pages http://wwwlib.umi.com/dissertations/fullcit/9100328

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Predictors of Woman Abuse by Male Substance Abusers by Bennett, Larry William, PhD from University of Illinois at Chicago, 1990, 240 pages http://wwwlib.umi.com/dissertations/fullcit/9107627

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Prenatal Drug Exposure: Learning and Behavior Performance at the Kindergarten Level (Maternal Substance Abuse) by Dixon, Gwendolyn, EDD from The University of Memphis, 1994, 68 pages http://wwwlib.umi.com/dissertations/fullcit/9521482

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Prevalence and Treatment of Substance Abuse among Adults in a Medicaid Population Pre and Post Managed Care by Leonard, Deanie Myers; PhD from The Johns Hopkins University, 2002, 212 pages http://wwwlib.umi.com/dissertations/fullcit/3028300

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Problem Drinking among the Faculty: Attitudes, Perceptions, and Responses of Coworkers toward Alcohol-impaired Colleagues (Substance Abuse) by Bolgiano, Christopher F., PhD from Bowling Green State University, 1994, 204 pages http://wwwlib.umi.com/dissertations/fullcit/9528160

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Project C.A.R.E. Substance Abuse Prevention Program: an Evaluation of Program Effectiveness (Alcohol Abuse) by Hostetler, Michelle Louise, PhD from The Pennsylvania State University, 1995, 153 pages http://wwwlib.umi.com/dissertations/fullcit/9612756

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Psychopathology and Substance Abuse among Adolescents with Psychiatric Disorders by Song, Li-yu, PhD from Case Western Reserve University, 1993, 168 pages http://wwwlib.umi.com/dissertations/fullcit/9406281

Dissertations 149

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Psychosocial Correlates of Drop Out in a Substance Abuse Treatment Program for Mothers by Colenso, Hilary Mary; PhD from New York University, 2002, 143 pages http://wwwlib.umi.com/dissertations/fullcit/3059409

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Ptsd Symptoms of Substance Abusers Who Have Been Sexually Abused and Substance Abusers Who Have Not Been Sexually Abused: a Retrospective, Descriptive and Comparative Study by Smith, Ethel Delores; DNS from Louisiana State Univ. Health Sciences Center School of Nursing, 2003, 140 pages http://wwwlib.umi.com/dissertations/fullcit/3087165

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Pulsar and the Prevention of Substance Abuse: the Experiences of Five Middle School Students by Martino-McAllister, Jeanne Marie; PhD from University of Virginia, 2003, 161 pages http://wwwlib.umi.com/dissertations/fullcit/3083091

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Racism, Grief, Chemical Abuse and Dependency, and African-american Males: towards a Conceptual Model of Pastoral Care (substance Abuse) by Wallace, Richard Marion, Jr., Thd from Luther Seminary, 1996, 321 pages http://wwwlib.umi.com/dissertations/fullcit/9629581

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Recovering College Students' Perspectives: Investigating the Phenomena of Recovery from Substance Abuse among Undergraduate Students by Woodford, Mark Stephen; PhD from University of Virginia, 2001, 255 pages http://wwwlib.umi.com/dissertations/fullcit/3022103

•

Recovery from Substance Abuse: the Role of Unsupportive Social Interactions by Schmitt, Michelle Marie; PhD from Virginia Commonwealth University, 2003, 177 pages http://wwwlib.umi.com/dissertations/fullcit/3082015

•

Rehabilitation Counselors' Attitudes toward Persons with Coexisting Mental Illness and Substance Abuse Disorders by Dunston-McLee, Cheryl Heulette; PhD from University of Maryland College Park, 2001, 156 pages http://wwwlib.umi.com/dissertations/fullcit/3035770

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Relationships between Sources of Coercion and Treatment Outcome in a Substance Abuse Treatment Program by Sosnowitz, Monica B., EDD from Rutgers the State University of New Jersey - New Brunswick, 1991, 120 pages http://wwwlib.umi.com/dissertations/fullcit/9125516

•

Religious Approaches to the Secondary and Tertiary Prevention of Substance Abuse: Their Efficacy in Reducing Risk Factors among Late Adolescents and Young Adults by Saunders, Donna Marie, PhD from Howard University, 1998, 138 pages http://wwwlib.umi.com/dissertations/fullcit/9911347

•

Reported Substance Abuse and Perceived Risk Factors among Adolescents in Selected Northeastern Ohio School Districts by Chordas, Ronald Karl, PhD from Kent State University, 1996, 140 pages http://wwwlib.umi.com/dissertations/fullcit/9708214

•

Responses to Partner Abuse: Modeling the Paths to Substance Abuse, Suicide Attempts, and Retaliative Partner Violence by Dawkins, Nicola Undine; PhD from Emory University, 2001, 259 pages http://wwwlib.umi.com/dissertations/fullcit/3009426

•

Retention of Substance Abuse Outpatients: the Role of Psychiatric Comorbidity in the Era of Welfare Reform by Brady, Thomas Moore; PhD from University of Illinois at Chicago, Health Sciences Center, 2002, 194 pages http://wwwlib.umi.com/dissertations/fullcit/3033407

150 Substance Abuse

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Risk Factors and Their Relationship to Substance Abuse for Seventh and Eleventh Grade Students: Implications for Educational Leaders (seventh-grade, Eleventhgrade) by Villa, H. Susan, EDD from University of San Francisco, 1992, 108 pages http://wwwlib.umi.com/dissertations/fullcit/9225795

•

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

•

Role of Parental Bond and Control on Adolescents' Substance Abuse by Thomas, George, PhD from University of Delaware, 1994, 222 pages http://wwwlib.umi.com/dissertations/fullcit/9540577

•

School-based Recovery Support: a Multiple Case Study of Recovering Adolescents' Perceptions of Home, School, and Peers (Substance Abuse) by Gibson, Richard Lee, PhD from Kansas State University, 1990, 140 pages http://wwwlib.umi.com/dissertations/fullcit/9108401

•

Schools, Drugs, and Failed Policies: an Exploration of the Potential of Federal and California State Drug Policies and Drug Prevention Programs to Reduce Student Drug Use (Substance Abuse) by Lark, Melody Leah, PhD from The Claremont Graduate University, 1996, 468 pages http://wwwlib.umi.com/dissertations/fullcit/9617445

•

Self Concept and Patterns of Substance Abuse in Female Adolescents with a History of Sexual Abuse by Neubauer, Lane B., PhD from Temple University, 1988, 208 pages http://wwwlib.umi.com/dissertations/fullcit/8902981

•

Self-efficacy and Substance Abuse: a Study of Situational Confidence (Inpatient Treatment, Treatment Programs) by Watson, Teri Suzanne, EDD from Memphis State University, 1992, 75 pages http://wwwlib.umi.com/dissertations/fullcit/9239635

•

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

•

Social Competence in Male College Students with Minor Alcohol-related Violations (substance Abuse) by Andrews, William Walter, Jr., EDD from University of Maine, 1994, 290 pages http://wwwlib.umi.com/dissertations/fullcit/9520696

•

Social Networks, Social Support and Substance Abuse: Testing Social Ability and Disability Theories of Deviance by Wortley, Norman Scot, PhD from University of Toronto (Canada), 1996, 500 pages http://wwwlib.umi.com/dissertations/fullcit/NN11891

•

Social Workers' Attitudes toward Drug-Addicted Mothers and Their Drug-Exposed Children (Substance Abuse) by Burgos-Ocasio, Hilda, PhD from The Ohio State University, 1995, 175 pages http://wwwlib.umi.com/dissertations/fullcit/9526002

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Socio-Environmental Factors in Substance Abuse in a Population of Homeless PolyAddicted African American Males by Dixon, Patricia, PhD from Temple University, 1995, 221 pages http://wwwlib.umi.com/dissertations/fullcit/9535737

Dissertations 151

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Spirituality and Sobriety: the Experience of Alcohol Use and Abuse among the Menominee Indians of Wisconsin (Substance Abuse) by Grant, Bruce Herman, PhD from The Catholic University of America, 1995, 198 pages http://wwwlib.umi.com/dissertations/fullcit/9514136

•

State, Sector, and Organization: the Transformation of Substance Abuse Services (Drug Policy, Service Organizations) by Burke, Anna Celeste, PhD from The University of Michigan, 1993, 282 pages http://wwwlib.umi.com/dissertations/fullcit/9319495

•

Stress and Substance Abuse among Law Students by Buick, William Potter; PhD from The University of Connecticut, 2000, 197 pages http://wwwlib.umi.com/dissertations/fullcit/9969069

•

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

•

Substance Abuse among Men Who Batter Their Mates: an Evaluation of the Clients' Behaviors While in Treatment for Battering (Wife Abuse, Emerge) by Seck, Magueye, PhD from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1995, 142 pages http://wwwlib.umi.com/dissertations/fullcit/9541288

•

Substance Abuse and HIV/AIDS: a Survey of Social Workers' Attitudes by Scheffler, Shelley, PhD from New York University, 1998, 213 pages http://wwwlib.umi.com/dissertations/fullcit/9828449

•

Substance Abuse and Mental Illness: Art Therapy in a Group Home Setting by Carl, Deborah Wefel; MA from Ursuline College, 2003, 139 pages http://wwwlib.umi.com/dissertations/fullcit/1414202

•

Substance Abuse and Nurses: a Study of Completers and Non-completers in an Alternative Diversion Program by Darbro, Nancy Mae; PhD from The University of New Mexico, 2003, 177 pages http://wwwlib.umi.com/dissertations/fullcit/3081213

•

Substance Abuse and Related Negative Behaviors of High School Students by Mermer, Donald, EDD from Yeshiva University, 1983, 182 pages http://wwwlib.umi.com/dissertations/fullcit/8404985

•

Substance Abuse Education Program for Sixth-grade Population by Burke, Barbara Anne, EDD from University of Massachusetts, 1986, 169 pages http://wwwlib.umi.com/dissertations/fullcit/8622654

•

Substance Abuse Education with Elite Athletes (Athletes, Sport Psychology) by Carr, Christopher Michael, PhD from Ball State University, 1992, 119 pages http://wwwlib.umi.com/dissertations/fullcit/9236375

•

Substance Abuse Prevention Approaches for Inner-city African American and Hispanic Youth (Inner City) by Forgey, Mary Ann, PhD from Columbia University, 1994, 370 pages http://wwwlib.umi.com/dissertations/fullcit/9427069

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Substance Abuse Prevention in the Workplace by Baker, Dana Michelle; Msn from Wilmington College Division of Nursing (Delaware), 2003, 96 pages http://wwwlib.umi.com/dissertations/fullcit/1411250

152 Substance Abuse

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Substance Abuse Prevention Programs for Children: a Theory-Oriented Evaluation by Mead, June Pressly, PhD from Cornell University, 1995, 302 pages http://wwwlib.umi.com/dissertations/fullcit/9527386

•

Substance Abuse Prevention, Student Attendance, Student Achievement, and Other Consequences of Teacher Training in Affective Education by Couture, John Raymond, EDD from University of Massachusetts, 1988, 134 pages http://wwwlib.umi.com/dissertations/fullcit/8822651

•

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

•

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

•

Substance Abuse Treatment and Recidivism: an Assessment of Predictive Factors from a Residential Program by Gibbs, Tyronne; PhD from Wayne State University, 2000, 181 pages http://wwwlib.umi.com/dissertations/fullcit/9966142

•

Substance Abuse Treatment: Substance Abuse Counselors' Belief Systems and How These Beliefs Impact Treatment by Crabb, Ann E.; PhD from Western Michigan University, 2002, 151 pages http://wwwlib.umi.com/dissertations/fullcit/3065398

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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

•

Substance Abuse: Its Relationship to Self-concept and Happiness. by Kochuba, Kathleen Frances, PhD from Boston College, 1978, 256 pages http://wwwlib.umi.com/dissertations/fullcit/7813782

•

Supervisor Referrals to Employee Assistance Programs (Substance Abuse) by Capece, Michael, PhD from University of Florida, 1991, 189 pages http://wwwlib.umi.com/dissertations/fullcit/9201958

•

Supportive Messages Perceived and Received in a Therapeutic Setting (Substance Abuse Treatment) by Barr, Jeanine Rice, PhD from University of Maryland College Park, 1994, 93 pages http://wwwlib.umi.com/dissertations/fullcit/9526172

•

Switching Tracks: Organizational Change in the Railroad Industry (substance Abuse) by Kennedy, Valerie Eva, PhD from Cornell University, 1995, 290 pages http://wwwlib.umi.com/dissertations/fullcit/9542504

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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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Teenage Substance Abuse: Life Change, Personality and Family Systems Parameters by Dillon, Charlotte Ann, PhD from Northwestern University, 1989, 266 pages http://wwwlib.umi.com/dissertations/fullcit/9002486

Dissertations 153

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The Analysis of a Substance Abuse Prevention Curriculum Using Social Deviance Theory by Stimmell, Tamara Lee, PhD from University of Pittsburgh, 1990, 163 pages http://wwwlib.umi.com/dissertations/fullcit/9120138

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The Analysis of Patient Status Following Substance Abuse Treatment and Utilization of Medical Care by Jones, French Allan, PhD from University of North Texas, 1988, 62 pages http://wwwlib.umi.com/dissertations/fullcit/8908923

•

The Characteristics of the Organization Culture of Six Effective Substance Abuse Programs: an Exploratory Study by Walton, Judith Patricia; PhD from Fielding Graduate Institute, 2003, 149 pages http://wwwlib.umi.com/dissertations/fullcit/3082491

•

The Comorbidity of Substance Abuse and Mental Illness Diagnoses among Delinquent Male Youth, Its Correlates and the Interventions That Are Typically Employed by Hooker, Richard J.; EDD from University of Cincinnati, 2001, 144 pages http://wwwlib.umi.com/dissertations/fullcit/3014906

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The Comparative Effectiveness of Satellite and Face-to-face Delivery for a Short-term Substance Abuse Education Program (Distance Education, Satellite Delivery) by Chen, Ivan M. C., PhD from University of Missouri - Kansas City, 1991, 170 pages http://wwwlib.umi.com/dissertations/fullcit/9126157

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The Construct of Substance Abuse Enabling Applied to Poor Performance Management: How Managers Deal with Poor Performing Employees by Parham, Creda Pamler Joe; PhD from Virginia Polytechnic Institute and State University, 2003, 93 pages http://wwwlib.umi.com/dissertations/fullcit/3082601

•

The Context of Transition Events across the Life Course: the Effects of Prior Event Sequencing on Adult Mental Health (Substance Abuse) by Jackson, Pamela Braboy, PhD from Indiana University, 1993, 489 pages http://wwwlib.umi.com/dissertations/fullcit/9418793

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The Defense Styles of Outpatient Substance Abusers Vs. Non Substance Abusers by Redick, Raymond Thomas; PsyD from Adler School of Professional Psychology, 2002, 89 pages http://wwwlib.umi.com/dissertations/fullcit/3049605

•

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/f309745

•

The Developmental Characteristics of Young Children Prenatally Substance-exposed (Substance Abuse) by Taylor, Diane Louise, PhD from University of North Texas, 1992, 95 pages http://wwwlib.umi.com/dissertations/fullcit/9311342

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The Disease Concept of Alcoholism: Correlates of Alcoholics Anonymous Membership (Substance Abuse) by White, Stephen Thomas, EDD from University of Maine, 1991, 194 pages http://wwwlib.umi.com/dissertations/fullcit/9218016

154 Substance Abuse

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The Effect of Chemical Dependency Counselors' Spiritual Well-Being on the Spiritual Well-Being of Their Clients (Substance Abuse) by Brooks, Clifford Wilson, Jr., EDD from The College of William and Mary, 1996, 125 pages http://wwwlib.umi.com/dissertations/fullcit/9623241

•

The Effect of Leisure Awareness on Attitude and Behavior of the Substance Abuser by Tom, Agnes M., PhD from Loyola University of Chicago, 1981, 151 pages http://wwwlib.umi.com/dissertations/fullcit/8119994

•

The Effect of Shared History of Alcoholism on Client Perceptions of Counselor Characteristics (Chemical Dependency, Substance Abuse) by Simmering, John August, PhD from Oklahoma State University, 1985, 74 pages http://wwwlib.umi.com/dissertations/fullcit/8603577

•

The Effect of the Teen Challenge Faith-based Program in Reducing Recidivism and Substance Abuse As Perceived by Adult Male Ex-offenders in Texas by Zimmer, Bolko; PhD from Texas A&M University, 2001, 141 pages http://wwwlib.umi.com/dissertations/fullcit/3033911

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The Effectiveness of Female-sensitive Substance Abuse Treatment by Dodge, Karen C. F., PhD from Florida International University, 1997, 299 pages http://wwwlib.umi.com/dissertations/fullcit/9732465

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The Effects of a 36-hour Marine Corps Substance Abuse Awareness Seminar on Supervisors' Knowledge and Perceptions of an Employee Alcoholism Program by Baker, Kay Louise, PhD from The American University, 1993, 224 pages http://wwwlib.umi.com/dissertations/fullcit/9422770

•

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

•

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 an Alcohol, Tobacco, and Other Drug Education/prevention Curriculum on Selected Risk Factors for Substance Abuse by Chard-Yaron, Sharon Deborah, EDD from United States International University, 1992, 248 pages http://wwwlib.umi.com/dissertations/fullcit/9307478

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The Effects of an Experimental Substance Abuse Curriculum on Sixth Graders in a Rural Setting by Daugherty, Thomas Edward, EDD from University of Cincinnati, 1984, 196 pages http://wwwlib.umi.com/dissertations/fullcit/8425374

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The Effects of Assertion Training and Decision-making Curricula on Likelihood of Adolescent Substance Abuse by Kerns, Andres, PhD from Arizona State University, 1993, 249 pages http://wwwlib.umi.com/dissertations/fullcit/9332983

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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

Dissertations 155

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The Effects of Guided Imagery and Twelve-step Programs on Depression and Anxiety in Substance Abuse Clients by Gleason, Deborah Rae, PhD from Wayne State University, 1996, 73 pages http://wwwlib.umi.com/dissertations/fullcit/9628893

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The Effects of High and Low Status Counseling Conditions on Substance Abusers' Perception of Counselor Credibility, Expertness, Attractiveness and Trustworthiness by Lining, Alfred Adolf, EDD from Indiana University, 1980, 130 pages http://wwwlib.umi.com/dissertations/fullcit/8103416

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The Effects of Substance Abuse and Violence in the Family of Origin on Courtship Experiences of College Students by Nutter, Lee, PhD from Case Western Reserve University, 1996, 150 pages http://wwwlib.umi.com/dissertations/fullcit/9723521

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The Effects of Substance Abuse upon Eighth-grade Connecticut Middle School Students: Its Impact upon Academic Achievement and the Social Behavior of the Students by Abelson, Kenneth Allan; EDD from University of Bridgeport, 2000, 367 pages http://wwwlib.umi.com/dissertations/fullcit/9957644

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The Effects of Training on Attitudes toward Substance Abuse of Graduate Students in School Counseling by Muldoon, John Patrick, PhD from University of South Carolina, 1998, 105 pages http://wwwlib.umi.com/dissertations/fullcit/9918961

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The Efficacy of the Social Norms Approach to Substance Abuse Prevention Applied to Fraternity Men: an Empirical Investigation by Carter, Colleen Ann, PhD from Georgia State University, 1998, 126 pages http://wwwlib.umi.com/dissertations/fullcit/9921350

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The Ethos of Power: Navajo Religious Healing of Alcohol and Substance Abuse by Garrity, John Francis, PhD from Case Western Reserve University, 1998, 255 pages http://wwwlib.umi.com/dissertations/fullcit/9833883

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The Experiences in a Jail Diversion Program of Women Clients Who Have a Severe and Persistent Mental Illness and a History of Substance Abuse by Cotton, Samuel Leslie; PhD from Columbia University, 2002, 265 pages http://wwwlib.umi.com/dissertations/fullcit/3048116

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The Helping Professions' Student and Faculty Beliefs about Substance Abuse and Reactions to a University Policy by Johnston-horn, Shirley, PhD from The University of Tulsa, 1994, 137 pages http://wwwlib.umi.com/dissertations/fullcit/9507881

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The Identification of Training Components for Substance Abuse Counselors: a Delphi Study by Klutschkowski, Franz, EDD from East Texas State University, 1992, 164 pages http://wwwlib.umi.com/dissertations/fullcit/9306921

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The Impact of a Substance Abuse Prevention Program: an Evaluation by Hogan, Julie Ann, PhD from University of Nevada, Las Vegas, 1998, 117 pages http://wwwlib.umi.com/dissertations/fullcit/9900370

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The Impact of Ancillary Services on Substance Abuse Treatment Outcomes by Reif, Sharon; PhD from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 2002, 273 pages http://wwwlib.umi.com/dissertations/fullcit/3052322

156 Substance Abuse

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The Impact of Maltreatment on Adolescent Substance Abuse by Hall, Nancy K.; PhD from Oregon State University, 2002, 96 pages http://wwwlib.umi.com/dissertations/fullcit/3029562

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The Impact of Resistance on Effectiveness of Substance Abuse Services Provided to Illinois Department of Corrections Work Release Center Referrals (client Resistance) by Ray, Karen Diane, PhD from Southern Illinois University at Carbondale, 1992, 136 pages http://wwwlib.umi.com/dissertations/fullcit/9239744

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The Influence of Multimedia-based Parent and Adolescent Interventions on Substance Abuse among Poor Youth by Ozanian, Alfred Joseph; PhD from Columbia University, 2003, 154 pages http://wwwlib.umi.com/dissertations/fullcit/3095600

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The Influence of the Selected Psychological and Sociological Factors on the Attitude of Inmates toward Treatment at Substance Abuse Facilities by Kwang, Pauline Sobe, EDD from Texas Southern University, 1997, 114 pages http://wwwlib.umi.com/dissertations/fullcit/9810247

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The Mental Health Adjustment of Younger Siblings of Adolescent Substance Abusers by Thompson, James Colby, EDD from University of Louisville, 1989, 98 pages http://wwwlib.umi.com/dissertations/fullcit/9026450

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The Myth of Adolescent Substance Abusers Having Social Skills Deficits by Tau, Emanuel, Psyd from United States International University, 1994, 81 pages http://wwwlib.umi.com/dissertations/fullcit/9505551

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The Parenting Perceptions of Mothers in Recovery from Substance Abuse by Chabay, Lori Adams, PhD from Stanford University, 1996, 103 pages http://wwwlib.umi.com/dissertations/fullcit/9630266

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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 Prediction of Retention in a Substance Abuse Program Based upon the Assessment of Congruence between Personological and Environmental Dimensions (Treatment Retention) by Yenchko, Anne, PhD from The Pennsylvania State University, 1990, 266 pages http://wwwlib.umi.com/dissertations/fullcit/9032400

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The Problem of Order: Empirical Tests of a Holographic Minimum Unit Model Linking Culture, Cognition-emotion, and Social Action in Substance Abuse Decisions by O'Brien, John David, PhD from Kent State University, 1991, 309 pages http://wwwlib.umi.com/dissertations/fullcit/9200536

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The Process of Long-term Recovery from Substance Abuse among African American Men: Implications for Counselor Training and Practice by Lamberty, Paul John; PhD from University of New Orleans, 2000, 255 pages http://wwwlib.umi.com/dissertations/fullcit/9997632

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The Professional Ex- (recovering Counselors, Substance Abuse Treatment) by Brown, James David, PhD from University of Denver, 1991, 333 pages http://wwwlib.umi.com/dissertations/fullcit/9130860

Dissertations 157

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The Relationship between Adolescent Substance Abuse and Family Functioning by Sharp, Jeffrey Gile, PhD from University of California, Berkeley, 1989, 129 pages http://wwwlib.umi.com/dissertations/fullcit/9006509

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The Relationship between Conceptual Level and Moral Development of Substance Abuse Prevention Professionals Working in Higher Education and Their Comprehensiveness of Programming by Crozier, Mary Katherine; EDD from The College of William and Mary, 2001, 177 pages http://wwwlib.umi.com/dissertations/fullcit/3030207

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The Relationship between Cultural Values of Alaskan Natives and Substance Abuse by Jerrel, Viola Mae, PhD from United States International University, 1988, 152 pages http://wwwlib.umi.com/dissertations/fullcit/8909924

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The Relationship between Depression and Substance Abuse among Multiplediagnosed Homeless Population in Services-enhanced Transitional Housing by Chu, Dave M. Wei-Cherng; PhD from Alliant International University, San Francisco Bay, 2002, 190 pages http://wwwlib.umi.com/dissertations/fullcit/3052969

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The Relationship between Live Supervision, Counselor Development and Selfefficacy for Substance Abuse Counselors in the United States Navy by Durham, Thomas G.; PhD from Northcentral University, 2003, 91 pages http://wwwlib.umi.com/dissertations/fullcit/3094924

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The Relationship between Psychiatric Disorder, Retention in Treatment, and Client Progress, among Admissions to a Residential, Drug Free Modality (substance Abuse) by Jainchill, Nancy, PhD from New York University, 1989, 243 pages http://wwwlib.umi.com/dissertations/fullcit/9004290

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The Relationship of Job Satisfaction, Attitude toward Education and Self Actualization with Academic Achievement among Paraprofessional Workers in the Substance Abuse Field by Isaacson, Eileen Barbara, EDD from Rutgers the State University of New Jersey - New Brunswick, 1982, 130 pages http://wwwlib.umi.com/dissertations/fullcit/8301582

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The Relationship of Pain Perception in Newly Sober, Chemically Dependent Persons: As Moderated by Depression and Locus of Control (alcoholism, Substance Abuse) by Sims, Linda Wooding, PhD from The University of Akron, 1986, 129 pages http://wwwlib.umi.com/dissertations/fullcit/8613647

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The Relationship of Self-esteem, Family Attachment, Locus-of-control, and Time-inrecovery with Career Adaptability among Persons Recovering from Substance Abuse: a Predictor Model by Drury, Carol Scott; PhD from The George Washington University, 2003, 278 pages http://wwwlib.umi.com/dissertations/fullcit/3085540

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The Relationship of Time Management and Lifestyle Organization to Problem Drinking in College Students (alcoholism, Substance Abuse) by McKee, Kevin Francis, EDD from The University of Tennessee, 1994, 117 pages http://wwwlib.umi.com/dissertations/fullcit/9518123

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The Relationships among Competition, Niche Width, Imaging Strategies, and Performance in Private Substance Abuse Treatment Centers by Ritchie, Misty K., PhD from University of Georgia, 1999, 104 pages http://wwwlib.umi.com/dissertations/fullcit/9928988

158 Substance Abuse

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The Religiosity and Parent/child Socialization Connection with Adolescent Substance Abuse by Kent, Ricky Ray, PhD from Brigham Young University, 1987, 153 pages http://wwwlib.umi.com/dissertations/fullcit/8712623

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The Response of New Jersey High Schools to Students' Substance Abuse by Grandey, Dorothy Durci, EDD from Rutgers the State University of New Jersey - New Brunswick, 1988, 194 pages http://wwwlib.umi.com/dissertations/fullcit/8827347

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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 Denial and Group Process in Substance Abuse Psycho-education Groups by Belman, Samara Lynn; PhD from George Mason University, 2003, 148 pages http://wwwlib.umi.com/dissertations/fullcit/3079350

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The Role of Negative Affect Intensity in Substance Abuse and Recovery by Sturiano, Christopher Victor; PhD from Long Island University, the Brooklyn Center, 2003, 82 pages http://wwwlib.umi.com/dissertations/fullcit/3086810

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The Role of Rejection Messages in Substance Abuse and Recovery: a Qualitative Investigation of Christians in Recovery by Miller, Christine Ann; PhD from Regent University, 2003, 675 pages http://wwwlib.umi.com/dissertations/fullcit/3081105

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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 Role of Socialization, Gender, and Ethnicity in Substance Abuse among Anglo and Mexican American Adolescents by James, Robert, PhD from University of Denver, 1995, 244 pages http://wwwlib.umi.com/dissertations/fullcit/9525707

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The Role of the Comprehensive Student Assistance Program in Affecting Adolescents' Attitudes toward Substance Abuse by Jones, Jeanne Gaskin; EDD from Northern Arizona University, 2000, 165 pages http://wwwlib.umi.com/dissertations/fullcit/9982894

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The Short Term Effects of a Developmentally Based Substance Abuse Program with Incarcerated Youth by McLaren, Everett Gerard, Jr., EDD from The College of William and Mary, 1983, 174 pages http://wwwlib.umi.com/dissertations/fullcit/8403869

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The Social Construction of the Codependency Construct: College Students' Evaluation of 'codependent' Characteristics in Themselves and Others (substance Abuse, Alcoholism) by Hollabaugh, Lisa Carole, PhD from Southern Illinois University at Carbondale, 1995, 210 pages http://wwwlib.umi.com/dissertations/fullcit/9536547

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The Status of Substance Abuse Control in Public Secondary Schools by Giger, Jerry Allen, EDD from University of Missouri - Columbia, 1988, 257 pages http://wwwlib.umi.com/dissertations/fullcit/8915285

Dissertations 159

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The Struggling Adolescent: a Social-phenomenological Study of Adolescent Substance Abuse by Wolf, Barry Marc, PhD from The University of Michigan, 1979, 324 pages http://wwwlib.umi.com/dissertations/fullcit/8007862

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The Training in Empowerment for Professionals and Paraprofessionals for Enhancement of Substance Abuse Treatment, Integration and Systems by Sarmanian, Jack, EDD from University of Massachusetts, 1992, 198 pages http://wwwlib.umi.com/dissertations/fullcit/9233159

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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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The Utilization of Student Research and Gestalt Organizational Theory in the Development of Alcoholism and Substance Abuse Curriculum (alcoholism Curriculum) by Goldstein, Mel L., DSW from City University of New York, 1991, 417 pages http://wwwlib.umi.com/dissertations/fullcit/9119631

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The Willow Tree Teen Institute: an Evaluative Study of a Resiliency-based Substance Abuse Prevention Program for Middle School Students by Hunter-Mazzella, Susan M.; EDD from Seton Hall University, College of Education and Human Services, 2003, 161 pages http://wwwlib.umi.com/dissertations/fullcit/3093187

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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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Therapeutic Intervention in the Treatment of Substance Abuser's Unresolved Grief Reactions in an Inpatient Hospital Setting: a Study of Two Group Approaches by Forrest, Alan Wayne, EDD from The College of William and Mary, 1990, 180 pages http://wwwlib.umi.com/dissertations/fullcit/9024573

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Toward an Integrative Approach to Substance Abuse: an Inquiry into the Recognition, Diagnosis and Treatment of Substance Abuse by Social Workers by Churchill, Diane M.; PhD from New York University, 2002, 309 pages http://wwwlib.umi.com/dissertations/fullcit/3061160

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Training for Administrators of Substance Abuse Programs: an Evaluation. by Renfrew, Keith Wheeler, EDD from The University of Arizona, 1977, 75 pages http://wwwlib.umi.com/dissertations/fullcit/7729508

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Transforming Lives: Evidence of Mezirow's Perspective Transformation in Substance Abusers Undergoing Family-of-Origin Therapy (Jack Mezirow) by Rich, Gerald Mathis; PhD from The University of Southern Mississippi, 2001, 113 pages http://wwwlib.umi.com/dissertations/fullcit/3021036

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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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Traumatic Brain Injury and Substance Abuse: a Comparative Analysis of Family Functioning by DePompei, Roberta Ann, PhD from The University of Akron, 1991, 214 pages http://wwwlib.umi.com/dissertations/fullcit/9207613

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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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Treatment Outcome in Chemical Substance Abuse As Perceived by the Client, Therapist, and a Significant Other. by Petersen, Gerald Paul, PhD from University of Pittsburgh, 1977, 159 pages http://wwwlib.umi.com/dissertations/fullcit/7721259

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Trends in Employee Assistance Program (EAP) Referrals: One Corporation's Experience with Primary Prevention and Outreach (McDonnell Douglas Corporation, Substance Abuse) by Beckman, Mardee A., PhD from Saint Louis University, 1991, 93 pages http://wwwlib.umi.com/dissertations/fullcit/9115488

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Validating the Alcohol and Drug Use Survey and Determining the Relationships of Familial and Age-Related Variables with Substance Abuse of Adolescents in a Correctional Facility by Altieri, Kathy Marie; PhD from Kent State University, 2001, 146 pages http://wwwlib.umi.com/dissertations/fullcit/3042389

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Victimization, Substance Abuse, and High-risk Behavior As Predictors of Health among Women at Admission to Prison by Mullings, Janet Lynne, PhD from Sam Houston State University, 1997, 200 pages http://wwwlib.umi.com/dissertations/fullcit/9807584

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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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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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What Is a Mother's Lived Experience of Participation in Residential Treatment for Substance Abuse with Her Children? by Kunkel, Wendy Cheryl; Ma from Trinity Western University (Canada), 2002, 131 pages http://wwwlib.umi.com/dissertations/fullcit/MQ77424

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Women's Alcohol Consumption: Personal, Familial, and Geopolitical Dimensions (Substance Abuse) by Goetz, Kathryn W., PhD from Oregon State University, 1994, 133 pages http://wwwlib.umi.com/dissertations/fullcit/9525266

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Women's Attitudes towards Selected Health Issues: Implications for Nursing Education (Abortion, Euthanasia, Sexuality, Contraception, Substance Abuse) by Thompson, Jacqueline K., PhD from State University of New York at Buffalo, 1986, 374 pages http://wwwlib.umi.com/dissertations/fullcit/8629119

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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 SUBSTANCE ABUSE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning substance abuse.

Recent Trials on Substance Abuse The following is a list of recent trials dedicated to substance abuse.8 Further information on a trial is available at the Web site indicated. •

Behavioral Economics of Human Drug Self-Administration Condition(s): Drug Dependence Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Research Resources (NCRR) Purpose - Excerpt: The objective of this protocol is to examine the utility of behavioral economics for understanding reinforcer interactions as they pertain to drug selfadministration. In a series of 6 experiments, the researchers will attempt to quantify the effects of qualitatively different reinforcers (money, cigarettes, alcohol, nicotine gum) and their interactions. This work represents a continuation of research by this investigator in the area of addiction and pharmacology. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005765

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Brain Function in Response to Motivational Stimuli Condition(s): Drug Dependence Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA)

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These are listed at www.ClinicalTrials.gov.

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Purpose - Excerpt: This study seeks more information about the biology of substance dependency by exploring the brain areas involved in feeling positive and negative emotions. Specifically, it will determine whether a brain chemical called dopamine affects activity in certain brain regions during performance of a game that involves winning and losing money. Brain activity will be examined using magnetic resonance imaging (MRI), a test that uses a magnetic field and radio waves to produce images of brain structure and function. Young to middle-aged healthy adults may participate in this study. Candidates will be screened with a medical history, physical examination, electrocardiogram (EKG), psychiatric interview, and blood and urine tests. Participants will be assigned to one of the two study procedures, as follows: Tyrosine/Phenylalanine This study requires two overnight stays at the NIH Clinical Center. For each stay, subjects are admitted to the hospital the afternoon before the MRI scan. From the time of admission until after the scan, their diets are restricted to food relatively low in amino acids, prepared by NIH dietitians. The next day, participants undergo MRI scanning. For this procedure, the subject lies on a table that is moved into the scanner, a metal cylindrical machine. Earplugs are worn to muffle loud noises that occur with electrical switching of the radio frequency circuits. Imaging of brain structure takes about 10 to 15 minutes. Additional scans are then taken to measure brain activity while the subject plays simple computer games for money. These scans take about another 20 to 45 minutes. Five hours before the MRI, the subject drinks one of two beverages containing amino acids. A different beverage is given for each of the two visits: one drink lacks the essential amino acids tyrosine and phenylalanine, from which the body makes dopamine; the other contains balanced amounts of these two amino acids. Finally, subjects fill out mood-rating questionnaires before and after drinking each of the beverages. Dextroamphetamine This study requires two outpatient visits to the NIH Clinical Center. For one visit, participants are given an injection of 0.2 mg/kg body weight of the drug dextroamphetamine; for the other, they are given an injection of saline (salt water). After each injection, they undergo MRI scanning while playing computer games for money, as described above. They will fill out mood-rating questionnaires before and after each brain scan. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00047866 •

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) 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

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Improving Substance Abuse Treatment Aftercare Adherence and Outcome Condition(s): Substance Abuse; Alcoholism

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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 •

Incentive Programs for Female Substance Abusers who Smoke - 3 Condition(s): Tobacco Use Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: Incentive Programs for Female Substance Abusers who Smoke Phase(s): Phase II; Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00064922

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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

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Study Status: This study is currently recruiting patients. 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

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medical condition requiring ongoing care in three or more organ systems. Major 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 •

Phase 2, Double-Blind, Placebo Controlled Trial of Cabergoline for the Treatment of Cocaine Dependence - 1 Condition(s): Cocaine-Related Disorders; Substance-Related Disorders Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA); University of California, Los Angeles Purpose - Excerpt: A Phase 2, Double-Blind, Placebo-Controlled Trial of Cabergoline for 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/NCT00033111

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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. 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

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.

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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 “substance 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 SUBSTANCE 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 “substance abuse” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on substance abuse, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Substance Abuse By performing a patent search focusing on substance 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. 9Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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The following is an example of the type of information that you can expect to obtain from a patent search on substance abuse: •

2-hydroxymethylolanzapine compositions and methods Inventor(s): Yelle; William E. (Littleton, MA) Assignee(s): Sepracor Inc. (Marlborough, MA) Patent Number: 6,174,882 Date filed: November 22, 1999 Abstract: Methods and compositions are disclosed utilizing 2-hydroxymethylolanzapine for the treatment of psychosis in humans. 2-Hydroxymethylolanzapine exhibits a lessened liability toward drug-drug interactions than olanzapine and a more predictable dosing regimen than olanzapine. 2-Hydroxymethylolanzapine is also useful for the treatment of acute mania, mild anxiety states, anxiety disorders, schizophrenia, bipolar disorder, attention deficit hyperactivity disorder, autistic disorder, excessive aggression, substance abuse, depressive signs and symptoms, tic disorder, functional bowel disorder and fungal dermatitis. Excerpt(s): The invention relates to methods of treating psychosis, acute mania, mild anxiety states, schizophrenia, bipolar disorder, autistic disorder, excessive aggression, substance abuse, depressive signs and symptoms, tic disorder, functional bowel disorder and fungal dermatitis. It is commercially available as Zyprexa.RTM. from Eli Lilly Co. The antipsychotic effect of olanzapine is ascribed by the literature to blocking of the dopamine D.sub.2 receptor and to 5-HT antagonism. Formation of 2hydroxymethylolanzapine occurs in the liver through the enzymes of the P450 system. 2-Hydroxymethylolanzapine is formed by cytochrome P450 2D6 (CYP2D6). CYP2D6 is polymorphically expressed in the human population. The mutant allele constitutes the recessive trait. Homozygous carriers of the mutation completely lack CYP2D6 and are referred to as poor metabolizers; persons homozygous and heterozygous for the "normal" allele are extensive metabolizers. In addition to problems arising from variability in dosage regimens, the clinical use of CYP2D6-metabolized drugs and of CYP2D6 inhibitors, which includes a variety of antiarrhythmic agents, betaadrenoceptor blockers and tricyclic antidepressants, in conjunction with olanzapine, may inhibit olanzapine metabolism. Web site: http://www.delphion.com/details?pn=US06174882__

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Interactive behavior modification system Inventor(s): Hall; Jeffrey R. (10912 Orleans Way, Kensington, MD 20895), Sloane; Sharon R. (4636 Cherry Valley Dr., Rockville, MD 20853) Assignee(s): none reported Patent Number: 5,813,863 Date filed: May 1, 1996 Abstract: A multimedia behavior modification system for promoting awareness and changing high-risk behaviors in areas of significant concern, for example, HIV/AIDS, diabetes, eating disorders, Alzheimer's disease, heart disease, smoking cessation, substance abuse, campus violence, etc. The system includes the computer courseware and two exemplary architectures for presenting the courseware. The computer

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architectures may be a generic computer with specific multimedia capabilities, and a kiosk-type device with touch-screen capabilities. The courseware can also be delivered over a local area network (LAN), wide area network, or the internet. The courseware includes a selectable progression of modules including dynamic introductory modules leading to a combination of educational modules. The introductory modules are an installation step, a title page, an attention-getting teaser step, and a main menu. The main menu module provides user-selectable links to multiple primary learning modules. In addition, while a user is navigating the foregoing modules, a tracking module tracks the users decisions and other characteristics and alters the program content accordingly. The unique combination of primary learning modules includes an interactive/contextual adventure, local information, topical encyclopedia, and subject matter quizzes. The interactive/contextual adventure module gives each user a first hand virtual experience of the cause and effect results of his/her own habits and behaviors which increase the risk of such diseases. The disclosed system embodiment is described in the context of AIDS awareness and education. However, it may be readily adapted for other subjects. The "courseware" remains constant and allows easy change to the audio-visual subject matter presented to a user. The virtual experience provided by the system can be easily and unique developed to appeal to any particular social, cultural, or economic class, or any other segment of the population. Excerpt(s): The present invention relates to educational systems, and, more particularly, to a device and method of computer-implemented multi-media instruction that promotes behavior modification by role play and cause-and-effect decision-making in order to eliminate habits that compromise, for instance, the public health. There are over 40,000 new human immunodeficiency virus (HIV) infections in the United States each year. In February of 1996, the number of diagnosed cases of AIDs in the U.S. reached 500,000. It has become the number one cause of death of people aged 25-44 years (ahead of accidental injury). All of this is evidence that HIV education and prevention efforts have heretofore failed to stop the epidemic. Also, the prospects for a near-term cure are remote and this underscores the importance of HIV prevention and education. Over a decade of experience with HIV has demonstrated that lasting changes in individual behaviors are needed to avoid infection. However, social, cultural, and attitudinal barriers limit the effectiveness of existing HIV education programs. A successful educational program must be capable of reaching those groups most at risk of transmitting and contracting HIV. However, such groups span a diverse cross-section of the population, and traditional methods have failed to impact many of them. The traditional methods entail conventional classroom teaching of AIDS awareness/prevention including written materials and/or lectures. Effectiveness can be gauged by homework assignments and/or tests which measure retention of the material. There are also mass media campaigns which attempt to educate and/or modify behavior. However, such campaigns generally prove ineffective as a stand-alone tool. They are expensive and in need of constant reinforcement to have any long term effect. None of the traditional methods have succeeded at reaching high-risk populations including adolescents and young adults, nor do they measure with any credibility the attitudes and behaviors of the groups that can be reached. Even if they could, their format and tone has proven incapable of achieving any lasting behavior change within the groups. Educators have long recognized that the effectiveness of these conventional methods varies not only across cultural and economic groups, but also varies with age and aptitude. Provision must be taken of differing rates of learning, the need for individual attention, and cultural, ethnic, and environmental differences. Meanwhile, the number of individuals in need of HIV/AIDs education grows as HIV infection increases exponentially, even outside of the traditional "high-risk groups". This

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increase in need and scarce fiscal resources puts a great burden on the educators to standardize their approach, which in turn yields an even lower effectiveness. There are alternate teaching methods such as self-study programs and videotaped programs which more efficiently use time and resources. However, these methods are generally ineffective within some target groups where users lack the ability, motivation, or discipline to teach themselves. It is recognized that the effectiveness of teaching programs can be increased by interspersing the educational material with audio-visual stimuli designed to attract the attention of the recipient. Such stimuli may include familiar scenarios that put the information in context, or popular songs, humor, pictures, etc. Such material tends to break down any existing cultural barriers and catches the interest of the students. It is also known that a "learning-by-doing" or experiential approach is the most effective. When AIDS-related information is presented in the context of the first hand experiences leading to an increased risk for HIV, learning is greatly facilitated. Unfortunately, first hand experience is an unforgiving teacher in the AIDS arena. Fortunately, computer and digital technology provides the ability to create "virtual experiences", which can be used as powerful teaching tools. It would be greatly advantageous to provide a computerized system and method for promoting HIV/AIDS awareness by synthesizing HIV/AIDS facts and statistics with advance prevention methodologies in a multimedia educational program which gives a first-hand virtual experience to the user of the decisions that lead to an increased risk of HIV and/or any other public health concerns. Virtual reality would take a front seat over theory, and this would help to capture the attention of those groups most at risk. The system and method would have the potential to be effective at achieving lasting behavior change and true behavior modification. Web site: http://www.delphion.com/details?pn=US05813863__ •

Method for modification of anti-social behavior Inventor(s): O'Donnell, Jr.; Francis E. (709 The Hamptons La., Town & Country, MO 63017) Assignee(s): none reported Patent Number: 5,921,245 Date filed: May 30, 1997 Abstract: Precise, three-dimensional localization of neuroanatomic substrates responsible for an established pattern of anti-social behavior such as violence, substance abuse, pedophilia and the like is used to guide temporally and spatially coordinated pulsed multi-origin ablative modalities, wherein the pulse duration is shorter than thermal relaxation time of the target tissue. By selectively destroying aberrant neural networks, the anti-social behavior is eliminated while minimizing unwanted neurologic side-effects. Excerpt(s): It is well-established that rehabilitation programs for most anti-social behavior is inadequate. The very high rate of recidivism for violent criminals, drug abusers, and pedophiles, for example, is well-established. Simply building more prisons to warehouse these individuals has placed a severe burden upon the economic resources of society. Moreover, the personal tragedy of a life wasted by fatal behavior flaws defies economic analysis. Our understanding of the origins of aberrant behavior has increased dramatically in the last decades. The ability to successfully control the extremes of aberrant behavior such as schizophrenia by neuro-pharmacologic manipulation suggested that a neurotransmitter-related abnormality could be the source of less

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extreme abnormal behavior. The more recent success of psychoactive drugs such as Prozac on personality traits such as shyness confirmed this concept. In addition, neuropharmacologic research has identified specific neuroanatomic sites involved in specific anti-social behavior. For example, Snyder's discovery of endorphins and their localization has pinpointed a critical site involved in narcotics abuse. Web site: http://www.delphion.com/details?pn=US05921245__ •

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 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__

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Method for treating substance abuse withdrawal Inventor(s): Bumol; Thomas F. (Carmel, IN), Kallman; Mary J. (Greenfield, IN), Rasmussen; Kurt (Fishers, IN), Steinberg; Mitchell I. (Indianapolis, IN), Watanabe; August M. (Indianapolis, IN) Assignee(s): Eli Lilly and Company (Indianapolis, IN) Patent Number: 5,732,717 Date filed: August 12, 1996 Abstract: This invention provides a method for treating a condition resulting from the cessation or withdrawal of tobacco or nicotine, opioids, ethanol or combinations thereof comprising administering an effective amount of 4-chloro-5-(imidazoline-2-y(amino)-6methoxy-2-methylpyrimidine. Excerpt(s): This application claims priority to U.S. provisional application number 60/002,341, filed Aug. 15, 1995 now abandoned. The present invention is in the fields of pharmacology and pharmaceutical chemistry and provides a method for using 4-chloro5-(imidazoline-2-ylamino)-6-methoxy-2-methylpyrimidine, for the treatment of smoking cessation, nicotine withdrawal, opioid withdrawal, ethanol withdrawal, and combinations thereof, and alleviation of the craving for a tobacco product, nicotine, opioids, ethanol and combinations thereof. It is well known that the chronic administration of nicotine, opioids, ethanol or combinations thereof results in tolerance and, eventually, dependence. The use of tobacco, opioids, and ethanol are extremely widespread in many countries, despite the well known adverse effects of their use. Web site: http://www.delphion.com/details?pn=US05732717__

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Method of overcoming substance abuse Inventor(s): Laka; Eugene J. (245 E. 63rd St., Apt. 810, New York, NY 10021) Assignee(s): none reported Patent Number: 5,759,042 Date filed: March 1, 1996 Abstract: A method involving the application of two labels containing respective positive and negative messages to a container having an addictive substance therewithin to empower and inspire fear of the addictive substance and to encourage the substance abuser from further substance abuse. The labels may be applied by the substance abuser or by individuals associated with the substance abuser to containers of the addictive substance in the abuser's possession. Upon each use of the addictive substance, positive and negative messages are conveyed to the user to assist the user in gradually eliminating their dependence on the addictive substance. Excerpt(s): The invention relates generally to a method of helping substance abusers overcome their addictions and, more particularly, to the use and application of various forms of labels to containers of addictive substances to both encourage and inspire fear in a substance abuser to eradicate their substance abuse. In the past, various attempts at eliminating abuse of addictive substances, such as cigarettes, have been made. However, such attempts have only achieved, at best, limited success. Some attempts have focused on providing sporadic visual anti-smoking messages to the user. One such attempt is described in U.S. Pat. No. 4,926,573 to Hetrick. In this patent, a cover having an anti-

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smoking message for a smoking accessory, such as a socket for a vehicle cigarette lighter or an ashtray, is shown. Web site: http://www.delphion.com/details?pn=US05759042__ •

N-aminoalkyl-2-anthraquinonecarboxamides: specific ligands

new

dopamine

receptor

subtype

Inventor(s): Chen; Xi (New Haven, CT), Wasley; Jan William Francis (Guilford, CT) Assignee(s): Neurogen Corporation (Branford, CT) Patent Number: 5,922,879 Date filed: December 22, 1997 Abstract: Disclosed are compounds of the formula: or the pharmaceutically acceptable acid addition salts thereof wherein:R.sub.1, R.sub.2, R.sub.3, R.sub.4, R.sub.5, R.sub.6, and R.sub.7 are the same or different and represent hydrogen, halogen, alkyl, alkoxy, hydroxy, cyano, nitro, trifluoromethyl, trifluoromethoxy; --O.sub.2 CR', --NHCOR', -COR', --SO.sub.m R', where R' is C.sub.1 -C.sub.6 alkyl and wherein m is 0, 1 or 2; orR.sub.1 R.sub.2, R.sub.3, R.sub.4, R.sub.5, R.sub.6, and R.sub.7 independently represent --CONR'R", or --NR'R" where R' and R" independently represent hydrogen or C.sub.1 -C.sub.6 alkyl;R.sub.8 is hydrogen or lower alkyl;X represents an optionally substituted alkylene group; andY represents a mono-, di- or trisubsituted cyclic amino group,which compounds are useful in the treatment of affective disorders such as schizophrenia, depression, Alzheimer's disease, movement disorders such as Parkinsonism and dystonia, and other disorders which respond to dopaminergic blockade such as substance abuse and obsessive compulsive disorders. Further, compounds of this invention may be useful in treating the extrapyramidal side effects associated with the use of conventional neuroleptic agents. Excerpt(s): This invention relates to anthraquinonecarboxamide derivatives which selectively bind to brain dopamine receptor subtypes. More specifically, it relates to NAminoalkylanthraquinonecarboxamides and to pharmaceutical compositions comprising such compounds. It further relates to the use of such compounds in the treatment or prevention of various neuropsychological disorders such as schizophrenia and other central nervous system diseases. The therapeutic effect of conventional antipsychotics, known as neuroleptics, is generally believed to be exerted through blockade of dopamine receptors. However, neuroleptics are frequently responsible for undesirable extrapyramidal side effects (EPS) and tardive dyskinesias, which are attributed to blockade of D.sub.2 receptors in the striatal region of the brain. The dopamine D.sub.3 receptor subtype has recently been identified (Sokoloff et al., Nature, 347, 146 (1990)). Its unique localization in limbic brain areas and its differential recognition of various antipsychotics indicates that the D.sub.3 receptor plays a significant role in the etiology of schizophrenia Selective D.sub.3 antagonists are thought to be effective antipsychotics free from the neurological side effects displayed by conventional neuroleptics. U.S. Pat. No. 5,395,835 discloses N-aminoalkyl-2napthalamides said to have affinity at dopamine D.sub.3 receptors. Web site: http://www.delphion.com/details?pn=US05922879__

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Pharmaceutical composition containing desoxypeganine for the treatment of drug dependence Inventor(s): Asmussen; Bodo (Bendorf, DE), Hille; Thomas (Neuwied, DE), Hoffmann; Hans-Rainer (Neuwied, DE), Opitz; Klaus (Munster, DE) Assignee(s): HF Aezneimittelforschung GmbH (Werne, DE), LTS Lohmann TherapieSysteme AG (Andernach, DE) Patent Number: 6,599,511 Date filed: October 17, 2001 Abstract: Desoxypeganine and its pharmaceutically acceptable acid addition salts can be used in the treatment of drug addiction or drug dependence. Said substances are administered preferably in a continuos and controlled manner. The pharmaceutical administration form enables controlled release, e.g. for oral transdermal or another route of parenteral administration. Excerpt(s): Desoxypeganine and/or its pharmaceutically acceptable acid addition salts can be used for the treatment of drug dependence. These substances are administered in a controlled manner, preferably in a continuous manner. The pharmaceutical administration form makes controlled release possible for, for example, oral, transdermal or alternatively parenteral administration. The invention relates to the use of desoxypeganine and its pharmaceutically suitable acid addition salts for the treatment of drug dependence and/or drug addiction. These compounds are released, for example, continuously or otherwise in a controlled manner from appropriate pharmaceutical formulations, which are administered, for example, orally, transdermally or otherwise parenterally. Such administration forms can also make subcutaneous, sublingual or intramuscular administration possible. Finally, administration as an implant is also possible. The term parenteral, however, also comprises other administration forms apart from the oral form, i.e., for example, also rectal, intravenous, intramuscular, intraoperitoneal and nasal administration. Desoxypeganine or a pharmaceutically acceptable acid addition salt or a mixture of base and salt is used for the substitution therapy of drug addicts such as, for example, opiate addicts, for example heroin addicts or cocaine addicts. Web site: http://www.delphion.com/details?pn=US06599511__

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Substituted aryl compounds useful as modulators of acetylcholine receptors Inventor(s): McDonald; Ian A. (San Diego, CA), Vernier; Jean-Michel (San Diego, CA) Assignee(s): Merck & Co., Inc. (Rahway, NJ) Patent Number: 6,316,490 Date filed: July 8, 1997 Abstract: In accordance with the present invention, a novel class of substituted aryl compounds (containing ether, ester, amide, ketone or thioether substitution) that promote the release of ligands involved in neurotransmission have been discovered. In a particular aspect, compounds of the present invention are capable of modulating acetylcholine receptors. The compounds of the present invention are capable of displacing one or more acetylcholine receptor ligands, e.g.,.sup.3 H-nicotine, from mammalian neuronal membrane binding sites. Invention compounds may act as agonists, partial agonists, antagonists or allosteric modulators of acetylcholine receptors.

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Therapeutic indications for compounds with activity as acetylcholine receptors include diseases of the central nervous system such as Alzheimer's disease and other diseases involving memory loss and/or dementia (including AIDS dementia); cognitive dysfunction (including disorders of attention, focus and concentration), disorders of extrapyramidal motor function such as Parkinson's disease, progressive supramuscular palsy, Huntington's disease, Gilles de la Tourette syndrome and tardive dyskinesia; mood and emotional disorders such as depression, anxiety and psychosis; substance abuse including withdrawal symptoms and substitution therapy; neurocrine disorders and dysregulation of food intake, including bulimia and anorexia; disorders of nociception and control of pain; autonomic disorders including dysfimction of gastrointestinal motility and function such as inflammatory bowel disease, irritable bowel syndrome, diarrhea, constipation, gastric acid secretion and ulcers; pheochromocytoma, cardiovascular dysfunction including hypertension and cardiac arrhythmias, as well as co-medication uses in surgical applications. Excerpt(s): The present invention relates to compounds which potentiate neurotransmission by promoting the release of neurotransmitters such as acetylcholine, dopamine and norepinephrine. More particularly, the present invention relates to compounds that are capable of modulating acetylcholine receptors. Invention compounds are useful, for example, for treatment of dysfunction of the central and autonomic nervous systems (e.g. dementia, cognitive disorders, neurodegenerative disorders, extrapyramidal disorders, convulsive disorders, cardiovascular disorders, endocrine disorders, eating disorders, affective disorders, drug abuse, and the like). In addition, the present invention relates to pharmaceutical compositions containing these compounds, as well as various uses therefor. By modulating neurotransmitter release (including dopamine, norepinephrine, acetylcholine and serotonin) from different brain regions, acetylcholine receptors are involved in the modulation of neuroendocrine function, respiration, mood, motor control and function, focus and attention, concentration, memory and cognition, and the mechanisms of substance abuse. Ligands for acetylcholine receptors have been demonstrated to have effects on attention, cognition, appetite, substance abuse, memory, extrapyramidal function, cardiovascular function, pain and gastrointestinal motility and function. The distribution of acetylcholine receptors that bind nicotine, i.e., nicotinic acetylcholine receptors, is widespread in the brain, including the basal ganglia, limbic system, cerebral cortex and mid- and hind-brain nuclei. In the periphery, the distribution includes muscle, autonomic ganglia, the gastrointestinal tract and the cardiovascular system. Acetylcholine receptors have been shown to be decreased, inter alia, in the brains of patients suffering from Alzheimer's disease or Parkinson's disease, diseases associated with dementia, motor dysfunction and cognitive impairment. Such correlations between acetylcholine receptors and nervous system disorders suggest that compounds that modulate acetylcholine receptors will have beneficial therapeutic effects for many human nervous system disorders. Thus, there is a continuing need for compounds which have the ability to modulate the activity of acetylcholine receptors. In response to such need, the present invention provides a new family of compounds which modulate acetylcholine receptors. Web site: http://www.delphion.com/details?pn=US06316490__

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Substituted pyridines as modulators of the mammalian neuronal nicotinic acetylcholine receptor Inventor(s): Casida; John E. (Berkeley, CA), Latli; Bachir (Danbury, CT) Assignee(s): The Regents of the University of California (Oakland, CA) Patent Number: 6,303,638 Date filed: August 20, 1999 Abstract: Novel compounds are provided that modulate the neuronal nicotinic acetylcholine receptor (nAChR), particularly the mammalian nAChR (m-nAChR). The compounds are substituted pyridine derivatives such as analogs of 1-[(6-chloro-3pyridinyl)methyl]-2-imidazolidine and 1-[(6-chloro-3-pyridinyl)methyl]-2iminothiazole. Methods of using the novel m-nAChR modulators are also provided, including methods of using the compounds as m-nAChR probes and as therapeutic agents to treat mammalian individuals suffering from conditions, disorders or diseases that are responsive to administration of an m-nAChR modulator. The compounds are useful in treating (1) CNS disorders such as Alzheimer's disease, AIDS-associated dementia, Tourette's Syndrome, attention deficit disorder, and attention deficit disorder, (2) inflammation and inflammatory diseases, (3) conditions caused by or associated with smooth muscle contractions, and (4) withdrawal symptoms associated with cessation of chemical substance abuse. The compounds are also useful as non-opiate analgesics, to treat mild, moderate or severe pain. Pharmaceutical formulations containing an mnAChR modulator of the invention are provided as well. Excerpt(s): The present invention relates generally to modulation of the neuronal nicotinic acetylcholine receptor (nAChR). More particularly, the invention relates to novel heterocyclic compounds, specifically substituted pyridine compounds, as modulators of the mammalian nAChR (m-nAChR). The invention additionally relates to methods for synthesizing the novel compounds, to methods for using the novel compounds to modulate the m-nAChR, and to pharmaceutical formulations containing an m-nAChR modulator of the invention as a therapeutic agent. There are a myriad of neurotransmitters and neurotransmitter receptors, each influencing a specific activity within an organism. One type of neurotransmitter receptor is the nAChR, which in humans is found throughout the nervous system in healthy individuals. The nAChR is an acetylcholine receptor that can bind to nicotine and its analogs (i.e., nicotinic agonists). The receptor is known to perform critical functions in humans and is involved in several central nervous system (CNS) disorders, including Alzheimer's disease, AIDSassociated dementia, Tourette's syndrome, cognitive dysfunction (e.g., disorders of attention, focus and concentration, such as "Attention Deficit Disorder" (ADD) and "Attention Deficit Hyperactivity Disorder" (ADHD)) and possibly Parkinson's disease; see, e.g., Halladay et al. (1997) J. Med. Chem. 40:4169-4194, U.S. Pat. No. 5,736,560 to Cosford et al., and U.S. Pat. No. 5,922,723 to Bencherif et al. When nicotine itself is administered into the human blood stream, both central and peripheral effects of nicotine are seen such as fever, increased heart rate, trembling, nausea, increased blood pressure and convulsions, even when the drug is administered in relatively small amounts; nicotine can in fact be fatal when taken orally at doses of 250-350 mg. However, it has been suggested that certain nicotine analogs may, by contrast, be beneficial in the treatment of many diseases (Lin et al. (1994) J. Med Chem. 37:3542). That is, it has been proposed that certain nicotinic agents could modulate the nAChR as desired, but without significantly affecting those receptors that have the potential to induce undesirable side effects.

Patents 179

Web site: http://www.delphion.com/details?pn=US06303638__ •

Treating depression with alcohol extracts of tobacco Inventor(s): Burton; Harold R. (Lexington, KY), Delorenzo; Robert J. (Richmond, VA), Williams; Jonnie R. (Manakin-Sabot, VA) Assignee(s): Regent Court Technologies (Town and Country, MI) Patent Number: 6,350,479 Date filed: June 4, 1999 Abstract: The present invention provides a group of tobacco alkaloids, tobacco extract, Yerbamate extract, and an extract of chewing gum and lozenges which are modulators of monoamine oxidase (MAO) activity (i.e., compounds and substances which inhibit MAO enzyme and prevent its biological activity). The MAO inhibitors of the present invention can cause an increase in the level of norepinephrine, dopamine, and serotonin in the brain and other tissues, and thus can cause a wide variety of pharmacological effects mediated by their effects on these compounds. The MAO inhibitors of the present invention are useful for a variety of therapeutic applications, such as the treatment of depression, disorders of attention and focus, mood and emotional disorders, Parkinson's disease, extrapyramidal disorders, hypertension, substance abuse, smoking substitution, antidepression therapy, eating disorders, withdrawal syndromes, and the cessation of smoking. Excerpt(s): The present invention relates to the novel use of compounds and substances which are capable of modulating monoamine oxidase (MAO) activity by inhibiting the MAO enzyme. The present invention also relates to MAO inhibitors and their therapeutic use as a drug or dietary supplement in the treatment of various conditions or disorders, including psychiatric and neurological illnesses. More particularly, the present invention relates to the therapeutic use of tobacco alkaloids, Yerbamate (Ilex paraguariensis) extract, or tobacco extracts to inhibit MAO activity to provide a treatment for various disorders or conditions. By inhibiting MAO activity, MAO inhibitors can regulate the level of mono amines and their neurotransmitter release in different brain regions and in the body (including dopamine, norepinephrine, and serotonin). Thus, MAO inhibitors can affect the modulation of neuroendocrine function, respiration, mood, motor control and function, focus and attention, concentration, memory and cognition, and the mechanisms of substance abuse. Inhibitors of MAO have been demonstrated to have effects on attention, cognition, appetite, substance abuse, memory, cardiovascular function, extrapyramidal function, pain and gastrointestinal motility and function. The distribution of MAO in the brain is widespread and includes the basal ganglia, cerebral cortex, limbic system, and mid and hind-brain nuclei. In the peripheral tissue, the distribution includes muscle, the gastrointestinal tract, the cardiovascular system, autonomic ganglia, the liver, and the endocrinic system. It has been suggested that cigarette smoke may have irreversible inhibitory effect towards monoamine oxidase (MAO). A. A. Boulton, P. H. Yu and K. F. Tipton, "Biogenic Amine Adducts, Monoamine Oxidase Inhibitors, and Smoking," Lancet, 1(8577): 114-155 (Jan. 16, 1988), reported that the MAO-inhibiting properties of cigarette smoke may help to explain the protective action of smoking against Parkinson's disease and also observed that patients with mental disorders who smoke heavily do not experience unusual rates of smoking-induced disorders. It was suggested that smoking, as an MAO inhibitor, may protect against dopaminergic neurotoxicity

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that leads to Parkinson's disease and that the MAO-inhibiting properties of smoking may result in an antidepressive effect in mental patients. Web site: http://www.delphion.com/details?pn=US06350479__ •

Treatments for obesity and methods for identifying compounds useful for treating obesity Inventor(s): Hadcock; John R. (East Lyme, CT), Swick; Andrew G. (East Lyme, CT) Assignee(s): Pfizer Inc. (New York, NY) Patent Number: 6,451,783 Date filed: January 16, 2001 Abstract: The present invention provides a method of treating obesity, sexual dysfunction (including erectile dysfunction), diabetes, insulin resistance, hyperinsulinemia, Syndrome X, adrenal dysfunction, hypertension, hypercholesterolemia, atherosclerosis, hyperlipoproteinemia, hypertriglyceridemia, or substance abuse, the method comprising the step of administering to a patent having or at risk of having one of the above-mentioned diseases a therapeutically effective amount of a compound that attenuates the binding of agouti-related protein to melanocortin receptors, but does not attenuate the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors. The present invention also provides a method of identifying a compound that is useful for the treatment or prevention of obesity, sexual dysfunction (including erectile dysfunction), diabetes, insulin resistance, hyperinsulinemia, Syndrome X, adrenal dysfunction, hypertension, hypercholesterolemia, atherosclerosis, hyperlipoproteinemia, hypertriglyceridemia, or substance abuse, the method comprising the steps of: 1) determining if a compound affects the binding of agoutirelated protein to melanocortin receptors; 2) determining if a compound affects the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors; and 3) selecting a compound that attenuates the binding of agouti-related protein to melanocortin receptors, but does not affect the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors. Excerpt(s): The present invention provides methods of treating obesity, sexual dysfunction (including erectile dysfunction), diabetes, insulin resistance, hyperinsulinemia, Syndrome X, adrenal dysfunction, hypertension, hypercholesterolemia, atherosclerosis, hyperlipoproteinemia, hypertriglyceridemia, or substance abuse, the methods comprising the step of administering to a patient having or at risk of having one of the above-mentioned diseases or conditions a therapeutically effective amount of a compound that attenuates the binding of agouti-related protein to melanocortin receptors, but does not attenuate the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors. The present invention also provides methods of identifying a compound that is useful for the treatment of obesity, sexual dysfunction (including erectile dysfunction), diabetes, insulin resistance, hyperinsulinemia, Syndrome X, adrenal dysfunction, hypertension, hypercholesterolemia, atherosclerosis, hyperlipoproteinemia, hypertriglyceridemia, or substance abuse, the methods comprising the steps of: 1) determining if a compound affects the binding of agouti-related protein to melanocortin receptors; 2) determining if a compound affects the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors; and 3) selecting a compound that attenuates the binding of agouti-related protein to melanocortin receptors, but does not attenuate the binding of cc-melanocyte stimulating hormone to melanocortin receptors. Obesity is a devastating

Patents 181

disease. In addition to harming physical health, obesity can wreak havoc on mental health because obesity affects self-esteem, which ultimately can affect a person's ability to interact socially with others. Unfortunately, obesity is not well understood, and societal stereotypes and presumptions regarding obesity only tend to exacerbate the psychological effects of the disease. Because of the impact of obesity on individuals and society, much effort has been expended to find ways to treat obesity, but little success has been achieved in the long-term treatment and/or prevention of obesity. Web site: http://www.delphion.com/details?pn=US06451783__ •

Use of amino hydrogenated quinazoline compounds and derivatives thereof for abstaining from drug dependence Inventor(s): Pan; Xinfu (Beijing, CN), Qiu; Fanglong (Hunan, CN) Assignee(s): Nanning Maple Leaf Pharmaceutical Co., Ltd. (Guangxi Province, CN) Patent Number: 5,846,975 Date filed: May 21, 1996 Abstract: This invention relates to the use of amino hydrogenated quinazoline compounds and derivatives thereof, such as tetrodotoxin, for abstaining from drug dependence in human. Such compounds are administered by subcutaneous, intramuscular or intravenous injection for abstaining from drug dependence, the said drug is alkaloids and nitrogen-containing non-amino acid compound, for example opium, morphine, heroin and the like. Such compounds without drug dependence and low toxicity and side effect can abstain rapidly from drug dependence. Excerpt(s): This invention is concerned with amino hydrogenated quinazoline compounds and derivatives thereof, particularly their new application for causing humans to abstain from drug dependence on alkaloids and synthetic non-amino acid nitrogen. The research of amino-hydro quinazoline and its derivatives originated from the knowledge for crystal tetrodotoxin(TTX). (1). TTX produces pronounced analgesic effect on various pains caused by burning, trauma, injuries from falls, fractures, contusions and strains, especially for neuragia, myalgia and arthralgia. Unless the diseases are inveterate, TTX is a powerful analgesic. Web site: http://www.delphion.com/details?pn=US05846975__

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Use of cotinine in treating psychiatric disorders Inventor(s): Rolf; David (Eden Prairie, MN) Assignee(s): LecTec Corporation (Minnetonka, MN) Patent Number: 5,889,029 Date filed: November 13, 1997 Abstract: Methods are provided for treating schizophrenia, Tourette's Syndrome, obsessive-compulsive disorder, substance abuse or substance addiction including drug or alcohol addiction, manic-depression syndrome, anexoria or bulimia comprising administering an amount of cotinine or a pharmaceutically acceptable salt thereof, which amount is effective to reduce or alleviate at least one of the symptoms of schizophrenia, Tourette's Syndrome, obsessive-compulsive disorder, substance abuse or

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substance addiction including drug or alcohol addiction, manic-depression syndrome, anexoria or bulimia in a human or other mammal. Excerpt(s): This invention relates to treatment of certain psychiatric disorders through the administration of cotinine or salts of cotinine. U.S. Pat. No. 3,870,794 describes the use of cotinine in reducing anger, hostility, irritability and frustration, fear and anxiety without general sedation effects. U.S. Pat. No. 5,187,169 describes the effectiveness of cotinine in treating Alzheimer's Disease and Parkinson's disease through its ability to bind to and hence cause activation of nicotinic cholinergic receptors of the brain of the patient while acting as a nicotinic agonist. Australian Patent 273715 describes the use of cotinine as an effective tranquilizer through its action as a muscle relaxant or antispasmodic and in lowering blood pressure. Cotinine has also been shown to assist in tobacco withdrawal (pending U.S. application Ser. Nos. 124,004 and 885,314) as well as in human body weight management (pending U.S. application Ser. No. 964,277) and as a therapeutic agent in treating inflammatory bowel disorder such as Crohn's disease or ulcerative colitis in humans (pending U.S. application Ser. No. 08/405,607). It has not, however, been previously recognized that cotinine is also able to provide a therapeutic effect in psychiatric disorders such as obsessive-compulsive behavior, Tourette's Syndrome and schizophrenia which are characterized by irrational behavior or repetitive thoughts. In obsessive-compulsive behavior, the patient is under a compulsion to repeat irrational or inappropriate behavior patterns and/or thoughts, while in Tourette's Syndrome the patient has an uncontrollable compulsion to utter inappropriate sounds or words. Similarly, in schizophrenia, the patient has uncontrolled inappropriate or irrational thoughts, delusions or behavior patterns. Schizophrenia, of course, has other characteristics, primarily disorganized or impoverished speech or behavior, flattened affect and avolition, social withdrawal and diminished interest in school or work. While a number of pharmacological treatments have been used for these psychiatric disorders in recent years with a degree of success, no studies have reported the successful treatment of all subjects or the absence of unwanted side effects, e.g., depression, drowsiness, sedation, tardive dyskinesia, agranulocytosis, and other problems. Consequently, a continuing need exists for pharmacological treatments that will alleviate or reduce obsessive-compulsive disorder, Tourette's Syndrome and schizophrenia. Web site: http://www.delphion.com/details?pn=US05889029__

Patent Applications on Substance 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 substance abuse:

10

This has been a common practice outside the United States prior to December 2000.

Patents 183

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1,3,8-Triazaspiro[4.5]decan-4-one derivatives useful for the treatment of ORL-1 receptor mediated disorders Inventor(s): Jordan, Alfonzo; (North Wales, PA), Pan, Kevin; (Shanghai, CN), Reitz, Allen B.; (Lansdale, PA) Correspondence: Philip S. Johnson, ESQ.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20030109539 Date filed: April 5, 2002 Abstract: The present invention is directed to novel 1,3,8-triazaspiro[4.5]decan-4-o- ne derivatives of the general formula 1wherein all variables are as defined herein, useful in the treatment of disorders and conditions mediated by the ORL-1 G-protein coupled receptor. More particularly, the compounds of the present invention are useful in the treatment of disorders and conditions such as anxiety, depression, substance abuse, neuropathic pain, acute pain, migraine, asthma, cough and for improved cognition. Excerpt(s): This application claims priority form U.S. provisional application Serial No. 60/282,722, filed Apr. 10, 2001, the contents of which are hereby incorporated by reference. The present invention is directed to novel 1,3,8-triazaspiro[4.5]de- can-4-one derivatives useful in the treatment of disorders and conditions mediated by the ORL-1 G-protein coupled receptor. More particularly, the compounds of the present invention are useful in the treatment of disorders and conditions such as anxiety, depression, substance abuse, neuropathic pain, acute pain, migraine, asthma, cough and for improved cognition. Nociceptin binding to ORL-1 receptors causes inhibition of cAMP synthesis, inhibition of voltage-gated calcium channels, and activation of potassium conductance. In vivo, nociceptin produces a variety of pharmacological effects that at times oppose those of the opioids, including hyperalgesia and inhibition of morphineinduced analgesia. Mutant mice lacking nociceptin receptors show better performance in learning and memory tasks. These mutant mice also have normal responses to painful stimuli. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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6-(4-arylalkylpiperazin-1-yl) benzodioxane and 6-(4-arylalkylpiperazin-1-ychromane derivatives: dopamine receptor subtype specific ligands

l)

Inventor(s): Thurkauf, Andrew; (Danbury, CT), Tran, Jennifer N.; (Branford, CT) Correspondence: Steven J. Sarussi; Mcdonnell Boehnen Hulbert & Berghoff; 32nd Floor; 300 S. Wacker Drive; Chicago; IL; 60606; US Patent Application Number: 20010005753 Date filed: January 16, 2001 Abstract: Disclosed are compounds of the formula: 1or the pharmaceutically acceptable acid addition salts thereof wherein:R.sub.1, R.sub.2, R.sub.3, R.sub.4 and R.sub.5 are the same or different and represent hydrogen, halogen, C.sub.1-C.sub.6 alkyl, C.sub.1C.sub.6 alkoxy, C.sub.1-C.sub.4 alkylthio, hydroxy, amino, mono- or di(C.sub.1C.sub.6)alkylamino, cyano, nitro, trifluoromethyl or trifluoromethoxy; andX is oxygen, a bond, C.sub.1-C.sub.2 alkylene, or methyleneoxy, which compounds are useful for the treatment and/or prevention of neuropsychological disorders including, but not limited to, schizophrenia, mania, dementia, depression, anxiety, compulsive behavior,

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substance abuse, Parkinson-like motor disorders and motion disorders related to the use of neuroleptic agents. Excerpt(s): This invention relates to 6-(4-arylalkylpiperazin-1-yl)benzodioxane- s and 6(4-arylalkylpiperazin-1-yl)chromanes and pharmaceutical compositions containing such compounds. It also relates to the use of such compounds in the treatment or prevention of psychotic disorders such as schizophrenia and other central nervous system diseases. The therapeutic effect of conventional antipsychotics, known as neuroleptics, is generally believed to be exerted through blockade of dopamine receptors. However, neuroleptics are frequently responsible for undesirable extrapyramidal side effects (EPS) and tardive dyskinesias, which are attributed to blockade of D.sub.2 receptors in the striatal region of the brain. The dopamine D.sub.4 receptor subtype has recently been identified (Nature, 350: 610 (Van Tol et al., 1991); Nature, 347: 146 (Sokoloff et al., 1990)). Its unique localization in limbic brain areas and its differential recognition of various antipsychotics indicates that the D.sub.4 receptor plays a major role in the etiology of schizophrenia. Selective D.sub.4 antagonists are considered effective antipsychotics free from the neurological side effects displayed by conventional neuroleptics. X is oxygen, a bond, C.sub.1-C.sub.2 alkylene, or methyleneoxy. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Acylamino cyclopropane derivatives Inventor(s): Fliri, Anton F.J; (Stonington, CT), Reinhold, Anthony R.; (Mystic, CT) Correspondence: Paul H. Ginsburg; Pfizer Inc; 20th Floor; 235 East 42nd Street; New York; NY; 10017-5755; US Patent Application Number: 20020103198 Date filed: October 9, 2001 Abstract: This invention relates to novel acylamino cyclopropane derivatives, processes for their preparation, pharmaceutical compositions containing them and their use as modulators of dopamine D3 receptors and for the treatment of anxiety, psychosis, substance abuse, Parkinson's disease, sexual dysfunction, and other central nervous system disorders. Excerpt(s): The present invention relates to novel acylamino cyclopropane derivatives, processes for their preparation, pharmaceutical compositions containing them and their use as modulators of dopamine D3 receptors and for the treatment of anxiety, psychosis, substance abuse, Parkinsons disease, sexual dysfunction, and other central nervous system disorders. The dopamine D3 receptor (the "D3 receptor") subtype has been identified (Sokoloff, P. et al., Nature, 1990, 347, 146). The D3 receptor is preferentially expressed in limbic brain regions such as the septal area and amygdala (Landwehrmeyer et al., Mol. Brain Res. (1993), 18 (1-2), 187-92). These regions are thought to be important brain areas for the regulation of cognition, motivation and emotion (Graeff et al., Braz. J. Med. Biol. Res. (1994), 27(10), 2453-6). The unique localization of D3 receptors and their differential recognition of various antipsychotics suggest that such receptors may play a major role in the etiology of schizophrenia. Moreover, in patients suffering from Parkinson's disease (PD), repeated administration of levodopa, a dopamine precursor, results in progressive resumption of motor performances as well as in development of abnormal involuntary movements, suggesting sensitization to the drug. In a rat model of PD, it was shown that the unexpected appearance of the dopamine D3 receptor in the denervated caudate

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putamen, an area from which it is normally absent, accounts for the sensitization process: sensitization occurs and declines with the same time course and sensitization is blocked by a preferential D3 receptor antagonist, suggesting that dopamine D3 receptor antagonists may be useful in therapy of PD. Biomed. Health Res. (2000), 26, "Molecular Biology Approach to Parkinson's Disease", edited by Jenner, P., 49-60. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Adenosine receptor ligands and their use in the treatment of disease Inventor(s): Borroni, Edilio Maurizio; (Basle, CH), Huber-Trottmann, Gerda; (Grindel, CH), Kilpatrick, Gavin John; (England, GB), Norcross, Roger David; (Rheinfelden, CH) Correspondence: Hoffmann-la Roche INC.; Patent Law Department; 340 Kingsland Street; Nutley; NJ; 07110 Patent Application Number: 20010027196 Date filed: February 20, 2001 Abstract: The invention relates to cyclic heteroaromatic compounds, containing at least one nitrogen atom, and to their use in the manufacture of medicaments for the treatment of diseases, related to adenosine receptor modulators, such as Alzheimer's disease, Parkinson's disease, neuroprotection, schizophrenia, anxiety, pain, respiration deficits, depression, asthma, allergic responses, hypoxia, ischaemia, seizure, substance abuse, sedation and they may be active as muscle relaxants, antipsychotics, anti epileptics, anticonvulsants and cardiaprotective agents. Excerpt(s): The present invention is generally related to compounds useful as adenosine receptor ligand and more particularly to compounds showing activity as modulators of the andenosine receptor system. Several compounds related to general formula I have been reported. and to their pharmaceutically acceptable salts. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Benzylpiperazinyl-indolinylethanones Inventor(s): Thurkauf, Andrew; (Danbury, CT), Zhao, He; (Branford, CT) Correspondence: Steven J. Sarussi; Mcdonnell Boehnen Hulbert & Berghoff; 32nd Floor; 300 S. Wacker Drive; Chicago; IL; 60606; US Patent Application Number: 20020128274 Date filed: March 12, 2002 Abstract: Disclosed are benzylpiperazinyl-indolinylethanone compounds which are useful for the treatment and/or prevention of neuropsychological disorders including, but not limited to, schizophrenia, mania, dementia, depression, anxiety, compulsive behavior, substance abuse, Parkinson-like motor disorders and motion disorders related to the use of neuroleptic agents. Pharmaceutical compositions, including packaged pharmaceutical compositions, are further provided. Compounds of the invention are also useful as probes for the localization of GABA.sub.A receptors in tissue samples. Excerpt(s): This application claims priority to provisional application No. 60/138,974 filed Jun. 14, 1999, which is hereby incorporated by reference in its entirety. This

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invention relates to benzylpiperazinyl-indolinylethanones, and to compounds that bind to dopamine receptors. This invention also relates to pharmaceutical compositions comprising such compounds and to the treatment of central nervous system (CNS) diseases, particularly the treatment or prevention of psychotic disorders such as schizophrenia. Additionally this invention relates to the use of compounds as probes for the localization of dopamine receptors in tissue sections. The therapeutic effect of conventional antipsychotics, known as neuroleptics, is generally believed to be exerted through blockade of dopamine receptors. However, neuroleptics are frequently responsible for undesirable extrapyramidal side effects (EPS) and tardive dyskinesias, which are attributed to blockade of D.sub.2 receptors in the striatal region of the brain. The dopamine D.sub.4 receptor subtype has been identified and cloned. Its unique localization in limbic brain areas and its differential recognition of various antipsychotics suggest that the D.sub.4 receptor may play a major role in the etiology of schizophrenia. The dopamine D.sub.4 receptor shares sequence homology with dopamine D.sub.2 and D.sub.3 receptors, however the D.sub.4 receptor possesses a unique pharmacological profile. Selective D.sub.4 antagonists, including the marketed antipsychotic chlozapine, are considered effective antipsychotics free from the neurological side effects displayed by conventional neuroleptics. Compounds that possess a 10-fold or more higher affinity for dopamine D.sub.4 receptors than D.sub.2 receptors are considered particularly desirable as antipsychotics. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

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 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

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DRUG ABUSE PREVENTION COMPUTER GAME Inventor(s): Rapoza, Darion; (Durham, NC), Urquhart, William Eldridge; (Wetumpka, AL) 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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Ecstasy-class analogs and use of same in detection of ecstasy-class compounds Inventor(s): Coty, William A.; (Fremont, CA), Davoudzadeh, David; (Pleasanton, CA), Rouhani, Riaz; (Concord, CA), Sanchez, Anthony de Jesus; (Concord, CA), Vistica, Cynthia A.; (Dublin, CA) Correspondence: David E. Pritchard; Wood, Herron & Evans, L.L.P.; 2700 Carew Tower; 441 Vine Street; Cincinnati; OH; 45202-2917; US Patent Application Number: 20030207469 Date filed: June 9, 2003

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Abstract: The present invention provides a system for the improved detection of ecstasyclass compounds in biological samples. New ecstasy-class analogs are provided for detection of such ecstasy-class drugs. These analogs are compounds, or salts thereof, of a 2-amino-methylenedioxyphenyl (MDP) derivative attached to Z, where Z is a moiety capable of bonding, either directly or indirectly, with an immunogenic carrier, a detectable label, or a solid capture vehicle. Such analogs may be used to construct immunogens, enzyme or enzyme-donor conjugates, and other conjugates. The immunogens reproducibly generate antibodies with an exquisite ability to distinguish various ecstasy-class drugs in biological samples from potentially interfering substances. The specific antibodies and the conjugates may be used to distinguish and measure various ecstasy-class compounds in biological samples, such as those obtained from an individual suspected of substance abuse. In another aspect, the invention includes certain reagents, reagent combinations, and kits for performing assay methods for ecstasy-class compounds in a biological sample. Excerpt(s): This application is a Divisional application of U.S. patent application Ser. No. 09/521,070 filed Mar. 8, 2000, now pending. This invention relates generally to the field of determining drugs of abuse in biological samples. More specifically, it provides a system of derivatives, conjugates and specific antibodies which may be used in assay systems for detection or quantitation of 3,4-methylenedioxymethamph- etamine (MDMA), also known as ecstasy, and other related compounds. Designer drugs are specific derivatives of commonly encountered drugs of abuse which are popular within some geographic regions and populations. Use of designer drugs carries all of the risks involved in use of more common drugs, as well as additional risks, in that detection and subsequent treatment is complicated by designer drugs' relative uniqueness. For example, some emergency facilities may not be able to detect designer drugs because such facilities lack the sophisticated and expensive instrumentation, such as gas chromatography/mass spectroscopy (GC/MS) equipment, used in confirming a positive result. Rapid screening methods such as immunoassays are more widely available, easy to use, and economical, but commonly detect only a single one of, or at most, a limited number of, the most commonly encountered drugs. Thus, they are not specific for a larger class of designer drugs. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Hapten-carrier conjugates for use in drug-abuse therapy and methods for preparation of same Inventor(s): Exley, Mark A.; (Chestnut Hill, MA), Fox, Barbara S.; (Wayland, MA), Gefter, Malcolm L.; (Lincoln, MA), Greenstein, Julia L.; (West Newton, MA), Powers, Stephen P.; (Waltham, MA), Schad, Victoria C.; (Cambridge, MA), Swain, Philip A.; (Boston, MA) Correspondence: William D. Noonan, M.D.; Klarquist Sparkman Campbell; Leigh & Whinston, Llp; 121 SW Salmon ST., Suite 1600; Portland; OR; 97204-2988; US Patent Application Number: 20020032316 Date filed: June 14, 2001 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

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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 •

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 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

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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 •

Method of using and compositions comprising (-) sibutramine optionally in combination with other pharmacologically active compounds Inventor(s): Jerussi, Thomas P.; (Framingham, MA), Young, James W.; (Palo Alto, CA) Correspondence: Pennie & Edmonds Llp; 1667 K Street NW; Suite 1000; Washington; DC; 20006 Patent Application Number: 20020006963 Date filed: January 29, 2001 Abstract: This invention encompasses methods for the treatment and prevention of disorders that include, but are not limited to, eating disorders; weight gain; obesity; irritable bowel syndrome; obsessive-compulsive disorders; platelet adhesion; apnea; affective disorders such as attention deficit disorders, depression, and anxiety; male and female sexual function disorders; restless leg syndrome; osteoarthritis; substance abuse including nicotine and cocaine addiction; narcolepsy; pain such as neuropathic pain, diabetic neuropathy, and chronic pain; migraines; cerebral function disorders; chronic disorders such as premenstrual syndrome; and incontinence.The invention further encompasses pharmaceutical compositions and dosage forms which comprise optically pure (-) sibutramine, optionally in combination with a phosphodiesterase inhibitor or a lipase inhibitor. Excerpt(s): This is a continuation-in-part of U.S. patent application 09/721,669, filed Nov. 27, 2000, which is a continuation of U.S. patent application 08/461,608, both of which are incorporated herein by reference in their entireties. This invention is directed to methods and compositions for the treatment or prevention of conditions using optically pure (-) sibutramine, optionally in combination with other pharmacologically active compounds. Sibutranmine, chemically named [N-1-[1-(4chlorophenyl)cyclobutyl]-- 3-methylbutyl]-N,N-dimethylamine, is a neuronal monoamine reuptake inhibitor which was originally disclosed in U.S. Pat. Nos. 4,746,680 and 4,806,570. Sibutramine inhibits the reuptake of norepinephrine and, to a lesser extent, serotonin and dopamine. See, e.g., Buckett et al., Prog. Neuro-psychopharm. & Biol. Psychiat., 12:575-584, 1988; King et al., J. Clin. Pharm., 26:607-611 (1989). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods for the treatment of substance abuse Inventor(s): Shulman, Albert; (Victoria, AU) Correspondence: Knobbe Martens Olson & Bear Llp; 2040 Main Street; Fourteenth Floor; Irvine; CA; 92614; US Patent Application Number: 20030144271 Date filed: November 6, 2002 Abstract: The present invention relates to methods of therapy for substance addiction comprising the administration to a subject in need thereof a combination of: (i) a.mu.opioid receptor antagonist; (ii) a calcium channel blocker which is long-acting or in sustained-release form or which is nimodipine in rapid release form; and (iii) an NMDA glutamate receptor modulator; as well as combinations, kits and composition useful therefor. Excerpt(s): The present invention relates generally to methods of therapy and the combinations and compositions suitable therefor. In particular, the invention relates to methods for the treatment of substance abuse, including alcohol and opiate addiction. Substance addiction involves an overwhelming and uncontrollable physical or psychological craving for a particular substance such as alcohol, heroin, morphine, methadone, nicotine, amphetamines, solvent inhalants, cocaine or marijuana and can impose significant social and financial costs to both the addict and the community. In many cases, withdrawal from the substance without adjunctive treatment, either pharmacological or psychotherapeutic, can cause acute physical and mental illness. Attempts to treat substance addiction by methods such as psychotherapy, behaviour modification or certain other drugs has had only limited success, with many addicts relapsing to chronic use. It is well known that the powerful and long-acting competitive and specific CNS.mu.,.delta.,.kappa.-opioid receptor antagonist naltrexone is used for rapid opiate detoxification, but the method is not without hazard. Since the chronic addicting action of ethanol also appears to be mediated substantially, either directly at CNS opioid receptors or indirectly by liberation of endogenous opiates, long-term daily naltrexone treatment has also been used successfully to prevent craving and relapse in both detoxified opiate and ethanol addicts. More recently, the ethanol anti-craving drug acamprosate has enjoyed similar success in the long-term management of detoxified chronic ethanol addicts. However when given alone, neither naltrexone nor acamprosate provide an effective long-term cure for these conditions, relapse to chronic opiate or ethanol craving and dependence frequently recurring within 3-12 months. It has now been found that a combined treatment using a.mu.-opioid receptor antagonist (.mu.ORA), an N-methyl-D-aspartic acid (NMDA) glutamate receptor modulator and a calcium channel blocker (CCB), which is either long-acting or formulated in a sustainedrelease form, may be effective in the treatment of substance abuse and may provide a longer-term remission or cure of, or reduction in, craving for, or relapse to chronic dependence on substances such as opiates, ethanol (alcohol) and other addicting drugs. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods of using and compositions comprising sibutramine metabolites optionally in combination with other pharmacologically active compounds Inventor(s): Fang, Qun K.; (Wellesley, MA), Jerussi, Thomas P.; (Framingham, MA), Senanayake, Chrisantha H.; (Shrewsbury, MA) Correspondence: Pennie & Edmonds Llp; 1667 K Street NW; Suite 1000; Washington; DC; 20006 Patent Application Number: 20020010198 Date filed: January 29, 2001 Abstract: Methods are disclosed for the treatment and prevention of disorders and conditions such as, but are not limited to: eating disorders; weight gain; obesity; irritable bowel syndrome; obsessive-compulsive disorders; platelet adhesion; apnea; affective disorders such as attention deficit disorders, depression, and anxiety; male and female sexual function disorders; restless leg syndrome; osteoarthritis; substance abuse including nicotine and cocaine addiction; narcolepsy; pain such as neuropathic pain, diabetic neuropathy, and chronic pain; migraines; cerebral function disorders; chronic disorders such as premenstrual syndrome; and incontinence.Pharmaceutical compositions and dosage forms are also disclosed which comprise a racemic or optically pure sibutramine metabolite and an optional additional pharmacologically active compound. Excerpt(s): This application is a continuation-in-part of U.S. application Ser. No. 09/662,135, filed Sep. 14, 2000, which is a continuation-in-part of U.S. application Ser. No. 09/372,158, filed Aug. 11, 1999, both of which are incorporated herein by reference in their entireties. The invention relates to methods of using and compositions comprising dopamine reuptake inhibitors such as racemic and optically pure metabolites of sibutramine, optionally in combination with other pharmacologically active compounds. Sibutramine, chemically named [N-1-[1-(4-chlorophenyl)cyclobutyl]3- -methylbutyl]-N,N-dimethylamine, is a neuronal monoamine reuptake inhibitor which was originally disclosed in U.S. Pat. Nos. 4,746,680 and 4,806,570. Sibutramine inhibits the reuptake of norepinephrine and, to a lesser extent, serotonin and dopamine. See, e.g., Buckett et al., Prog. Neuro-psychopharm. & Biol. Psychiat., 12:575-584, 1988; King et al., J. Clin. Pharm., 26:607-611 (1989). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Monoamine oxidase (MAO) inhibitors and uses thereof Inventor(s): Burton, Harold R.; (Lexington, KY), DeLorenzo, Robert J.; (Richmond, VA), Williams, Jonnie R.; (Manakin-Sabot, VA) Correspondence: Banner & Witcoff; 1001 G Street N W; Suite 1100; Washington; DC; 20001; US Patent Application Number: 20020054926 Date filed: January 11, 2002 Abstract: The present invention provides a group of tobacco alkaloids, tobacco extract, Yerbamat extract, and an extract of chewing gum and lozenges which are modulators of monoamine oxidase (MAO) activity (i.e., compounds and substances which inhibit MAO enzyme and prevent its biological activity). The MAO inhibitors of the present invention can cause an increase in the level of norepinephrine, dopamine, and serotonin

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in the brain and other tissues, and thus can cause a wide variety of pharmacological effects mediated by their effects on these compounds. The MAO inhibitors of the present invention are useful for a variety of therapeutic applications, such as the treatment of depression, disorders of attention and focus, mood and emotional disorders, Parkinson's disease, extrapyramidal disorders, hypertension, substance abuse, smoking substitution, anti-depression therapy, eating disorders, withdrawal syndromes, and the cessation of smoking. Excerpt(s): This application is a division of application Ser. No. 09/325,852, filed Jun. 4, 1999, which claims priority under 35 U.S.C.sctn.119(e) to Provisional Application No. 60/088,117, filed Jun. 5, 1998. The present invention relates to the novel use of compounds and substances which are capable of modulating monoamine oxidase (MAO) activity by inhibiting the MAO enzyme. The present invention also relates to MAO inhibitors and their therapeutic use as a drug or dietary supplement in the treatment of various conditions or disorders, including psychiatric and neurological illnesses. More particularly, the present invention relates to the therapeutic use of tobacco alkaloids, Yerbamat (Ilex paraguariensis) extract, or tobacco extracts to inhibit MAO activity to provide a treatment for various disorders or conditions. By inhibiting MAO activity, MAO inhibitors can regulate the level of monoamines and their neurotransmitter release in different brain regions and in the body (including dopamine, norepinephrine, and serotonin). Thus, MAO inhibitors can affect the modulation of neuroendocrine function, respiration, mood, motor control and function, focus and attention, concentration, memory and cognition, and the mechanisms of substance abuse. Inhibitors of MAO have been demonstrated to have effects on attention, cognition, appetite, substance abuse, memory, cardiovascular function, extrapyramidal function, pain and gastrointestinal motility and function. The distribution of MAO in the brain is widespread and includes the basal ganglia, cerebral cortex, limbic system, and mid and hind-brain nuclei. In the peripheral tissue, the distribution includes muscle, the gastrointestinal tract, the cardiovascular system, autonomic ganglia, the liver, and the endocrinic system. The present invention overcomes the problems and limitations of the prior art by providing methods and systems. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Novel compounds for use as antidepressants, aphrodisiacs and adjunctive therapies in humans Inventor(s): Berger, Patricia J.; (Cora, WY), Negus, Norman C.; (Cora, WY), Rosenfeld, Mark J.; (Salt Lake City, UT) Correspondence: Mallinckrodt & Mallinckrodt; 10 Exchange Place, Suite 510; Salt Lake City; UT; 84111; US Patent Application Number: 20010053789 Date filed: April 13, 2001 Abstract: Phenolic compounds with a phenolic molecule to which are covalently linked an oxygen-containing group, a nitrogen- or another oxygen containing group, and a C.sub.1-C.sub.4 alkoxy group, obtainable from monocotyledonous plants, animals that eat such plants, or chemical synthesis, have been found to act as an antidepressant or otherwise a treatment for bettering mood, a therapy for improving sexual desire or performance, an adjunctive therapy for achieving weight loss, and an adjunctive therapy for substance abuse and addiction. These compounds, at concentrations suitable for human therapeutic use, may be obtained from plants such as corn in their

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early growth stages and from parts of animals such as the velvet antler tips of deer and elk. Excerpt(s): The invention is in the field of treating depression, sexual dysfunction, substance abuse or addiction, and in inducing weight loss, compounds used in such treatments, and the making of such compounds. An estimated 35-40 million living Americans will suffer major depressive episodes, and many more will experience lesser bouts. Of the approximately 17.5 million Americans with ongoing depressions, about 9.2 million are at a clinically debilitating level. Clinical depression is characterized by a list of symptoms that last over a long time span. It is a serious problem that is usually or initially caused by outside stressors. As stresses escalate or persist, a chemical imbalance can result. Clinical depression can be very debilitating both physically and mentally and even lead to death by means of suicide. However, lost productivity and relationship problems are also consequences of lesser depressions. At present, antidepressant medications are the cornerstones of treating depression, especially those that are at least moderately severe. Although depressed people tend to improve when treated with antidepressants, many do not respond to the first one. Such individuals may eventually benefit from a different antidepressant or a combination of antidepressants. Sexual dysfunction is a pervasive disorder. In the overall population, 43 percent of women and 31 percent of men between the ages of 18 and 59 repeatedly experience it. Sexual dysfunction includes lacking interest in sex, problems with arousal, not enjoying sex, and anxiety about sexual performance. Indeed, feeling good in general has significant impact on sexual function, with those people unhappy or depressed more likely to experience difficulties. Arousal problems affect over 20 million American males, about two in 10 adult men, with such difficulties often associated with or accompanied by some sort of depression. Meanwhile, prescription antidepressants actually exacerbate the situation, since a frequent side effect of their use is sexual dysfunction. In fact, sexual response diminishes in up to 75% of prescription antidepressant users. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Olanzapine-N-oxide compositions and methods Inventor(s): Yelle, William E.; (Littleton, MA) Correspondence: Mary Louise Gioeni; Heslin Rothenberg Farley & Mesiti P.C.; 5 Columbia Circle; Albany; NY; 12203; US Patent Application Number: 20020065272 Date filed: October 30, 2001 Abstract: Methods and compositions are disclosed utilizing olanzapine-N-oxide for the treatment of psychosis in humans. Olanzapine-N-oxide exhibits a lessened liability toward drug-drug interactions than olanzapine and a more predictable dosing regimen than olanzapine. Olanzapine-N-oxide is also useful for the treatment of acute mania, mild anxiety states, anxiety disorders, schizophrenia, bipolar disorder, attention deficit hyperactivity disorder, autistic disorder, excessive aggression, substance abuse, depressive signs and symptoms, tic disorder, functional bowel disorder and fungal dermatitis. Excerpt(s): The invention relates to methods of treating psychosis, acute mania, mild anxiety states, schizophrenia, bipolar disorder, autistic disorder, excessive aggression, substance abuse, depressive signs and symptoms, tic disorder, functional bowel disorder and fungal dermatitis. It is commercially available as Zyprexa.RTM. from Eli

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Lilly Co. The antipsychotic effect of olanzapine is ascribed by the literature to blocking of the dopamine D.sub.2 receptor and to 5-HT antagonism. Because olanzapine is oxidized to olanzapine-N-oxide in the liver by P450 enzymes, drug-drug interactions arise from the concomitant administration of other drugs that stimulate or inhibit P450 or rely on P450 enzymes for their disposition. The human liver flavin-containing monooxygenase (FMO3) is involved in the metabolism of olanzapine-N-oxide. Exemplary drugs metabolized by the FMO3 enzyme include cimetidine and tamoxifen. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Pharmaceutical composition for the prevention and treatment of nicotine addiction in a mammal Inventor(s): Coe, Jotham W.; (Niantic, CT), Harrigan, Edmund P.; (Old Lyme, CT), O'Neill, Brian T.; (Old Saybrook, CT), Sands, Steven B.; (Stonington, CT), Watsky, Eric Jacob; (Stonington, CT) Correspondence: Pfizer Inc; 150 East 42nd Street; 5th Floor - Stop 49; New York; NY; 10017-5612; US Patent Application Number: 20030109544 Date filed: January 21, 2003 Abstract: Pharmaceutical compositions are disclosed for the treatment of nicotine dependence or addiction, tobacco dependence or addiction, reduction of nicotine withdrawal symptoms or aiding in the cessation or lessening of tobacco use or substance abuse. The pharmaceutical compositions are comprised of a therapeutically effective combination of a nicotine receptor partial agonist and an anti-depressant or anxiolytic agent and a pharmaceutically acceptable carrier. The method of using these compounds is also disclosed. Excerpt(s): The present invention relates to pharmaceutical compositions for the treatment of nicotine dependence or addiction in a mammal (e.g. human) comprising a nicotine receptor partial agonist (NRPA) and an anti-depressant or anxiolytic agent. The term NRPA refers to all chemical compounds which bind at neuronal nicotinic acetylcholine specific receptor sites in mammalian tissue and elicit a partial agonist response. A partial agonist response is defined here to mean a partial, or incomplete functional effect in a given functional assay. Additionally, a partial agonist will also exhibit some degree of antagonist activity by its ability to block the action of a full agonist (Feldman, R. S., Meyer, J. S. & Quenzer, L. F. Principles of Neuropsychopharmacology, 1997; Sinauer Assoc. Inc.). The present invention may be used to treat mammals (e.g. humans) for tobacco dependence or addiction and nicotine dependence or addiction; to palliate the effects of nicotine withdrawal and to enhance the outcomes of other smoking cessation therapies. The invention also relates to aryl fused azapolycylic compounds that bind to neuronal nicotinic acetylcholine specific receptor sites and are useful in modulating cholinergic function and are referred to in WO 9818798-A1, WO 9935131-A1 and WO 9955680-A1. The foregoing applications are owned in common with the present application and are incorporated herein by reference in their entireties. The NRPA compounds that bind to neuronal nicotinic receptor sites can be used in combination with an anti-depressant such as for example, a tricyclic anti-depressant (e.g. amitryptyline, imipramine), a serotonin reuptake inhibitor anti-depressant (SRI) (e.g. sertraline, paroxetine, or fluoxetine), an atypical antidepressant (bupropion, nefazodone), or a monoamine oxidase inhibitor (e.g., phenelzine, tranylcypromine) in order to treat the depression associated with addiction

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such as to nicotine or tobacco, alcohol dependence, cocaine addiction or tobacco or nicotine dependence independently of other psychiatric illness. The compounds that bind to neuronal nicotinic receptor sites can be used in combination with anxiolytic agents, such as for example, a benzodiazepine (e.g. diazepam, alprazolam, chlordiazepoxide) or non-benzodiazepine anxiolytics (e.g. buspirone, hydroxyzine, doxepin) in order to treat the anxiety associated with addiction such as to nicotine or tobacco, alcohol dependence, cocaine addiction or tobacco or nicotine dependence independently of other psychiatric illness. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Pharmaceutical composition which reduces or eliminates drug abuse potential Inventor(s): Joshi, Yatindra; (Princeton, NJ), Somma, Russell; (Sparta, 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. 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

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Psychonutracological method for craving reduction in humans Inventor(s): Scott, Nick; (Santa Barbara, CA) Correspondence: Nick Scott; 201 Bath #2; Santa Barbara; CA; 93101; US Patent Application Number: 20020150632 Date filed: March 12, 2002 Abstract: A method for reducing or eliminating cravings associated with habitual substance abuse by administering to a human a synergistic composition containing an effective amount of each of Glutamine, gamma aminobutyric acid, tyrosine, taurine, theanine, 5-hydroxtryptamine, phenylethylamine, phosphatidyl serine, phosphatidyl choline, inositol, thiamin, riboflavin, niacin, pyridoxin, folic acid, biotin, pantothenic acid, cyanocobalamin, chromium polynicotinate magnesium, and decosahexaenoic acid. The pharmaceutical composition can be administered after complete cessation of a given habit forming substance, or to nullify cravings and to reduce abuse of a given habit forming substance, without total and complete remittance prior to administration of the composition. Worthy of note, all constituents found in this composition may be derived by synthetic means, or from natural sources. Excerpt(s): The present invention relates to a composition that is useful for drug craving reduction in humans and as a treatment for addiction or habitual use to a variety of substances. More specifically the invention is directed toward a composition containing 4 subgroups of nutrients, each grouping implicating it's distinctive role in craving reduction and overall recovery from physical addiction. Furthermore the invention is a composition containing a B-vitamin complex, neurologically active amino acids, and specific lipids that synergistically elicit reduced withdrawal symptoms, and normalize the neurochemical imbalance caused by chronic, habitual use of a physically detrimental substance. Substance abuse and addiction is an age-old dilemma that has plagued many societies. Many, many methods have been contrived to help people stop the cycle of abuse. These methods include everything from psychotherapy, to group congregations, to replacement drug treatment, and other varying nutritional practices. These methods have varying degrees of efficacy and no one method is right for every individual. Frequently, more than one method should be simultaneously administered. There is continuing research for the biological, environmental, and evolutional roots of substance abuse, and they cannot be separated into different entities, because of their high correlation factor. Substance abuse is a broad and widely encompassing term, and within this patent document the term may be used to describe the habitual use of a variety of chemical compounds, some very common and fairly benign, and others highly dangerous, and relatively uncommon. The composition may be used to nullify cravings for such chemical substances consumed by humans such as refined sugar, caffeine, alcohol, nicotine, ephedrine, meth-amphetamines, opiates, and cocaine. It has been suggested that genetics play a role in substance abuse, and that certain individuals have a propensity towards chronic, frequent use where others are only prone to experimental or sporadic use. Propensity towards addiction can be considered a weak link in genetics, but it can also be attributed to environmental stimuli, such as societal images, peer pressure, behavioral stereotypes of different age groups, and ethnic cultural background. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Recombinant plasmids and method for treating substance abuse Inventor(s): Alestrom, Peter; (Oslo, NO), Berg, Kare; (Oslo, NO), Fagerlund, Tore H.; (Osteras, NO) Correspondence: Christian D. Abel; Postboks 333 Sentrum; Bergen; N-5804; NO Patent Application Number: 20020064833 Date filed: September 24, 2001 Abstract: The present invention relates to a polynucleotide for use in therapy directed at the peripheral and central nervous system in humans for the purpose of treating psychological dependence on, and abuse of, substances which have a stimulating and euphoric effect. In particular, the invention relates to a recombinant plasmid comprising a plurality of sequences that encode for beta-endorphin, said sequences being separated by a proteolytic cleavage site. Excerpt(s): This is a continuation of application Ser. No. 09/426,877, filed Oct. 26, 1999. Dependence on, and abuse of, addictive substances is currently treated with medications administered orally or parenterally. The medications used in this connection consist of foreign matter with special pharmacological characteristics and effects for each individual who takes them. Some of the characteristics and effects of these medications are desirable, while others are less desirable (side effects). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Substituted imidazoles as cannabinoid receptor modulators Inventor(s): Finke, Paul E.; (Milltown, NJ), Mills, Sander G.; (Scotch Plains, NJ), Plummer, Christopher W.; (Keasbey, NJ), Shah, Shrenik K.; (Metuchen, NJ), Truong, Quang T.; (Edison, NJ) Correspondence: Merck And CO Inc; P O Box 2000; Rahway; NJ; 070650907 Patent Application Number: 20030114495 Date filed: July 17, 2002 Abstract: The use of compounds of the present invention as antagonists and/or inverse agonists of the Cannabinoid-1 (CB1) receptor particularly in the treatment, prevention and suppression of diseases mediated by the Cannabinoid-1 (CB1) receptor. The invention is concerned with the use of these novel compounds to selectively antagonize the Cannabinoid-1 (CB1) receptor. As such, compounds of the present invention are useful as psychotropic drugs in the treatment of psychosis, memory deficits, cognitive disorders, migraine, neuropathy, neuro-inflammatory disorders including multiple sclerosis and Guillain-Barre syndrome and the inflammatory sequelae of viral encephalitis, cerebral vascular accidents, and head trauma, anxiety disorders, stress, epilepsy, Parkinson's disease, and schizophrenia. The compounds are also useful for the treatment of substance abuse disorders, particularly to opiates, alcohol, and nicotine. The compounds are also useful for the treatment of obesity or eating disorders associated with excessive food intake and complications associated therewith. Novel compounds of structural formula (I) are also claimed. Excerpt(s): The present application claims priority of U.S. provisional application Serial No. 60/307,224, filed Jul. 20, 2001. and pharmaceutically acceptable salts thereof which are antagonists and/or inverse agonists of the Cannabinoid-1 (CB1) receptor and are useful in the treatment, prevention and suppression of diseases mediated by the

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Cannabinoid-1 (CB1) receptor. The invention is concerned with the use of these novel compounds to selectively antagonize the Cannabinoid-1 (CB1) receptor. As such, compounds of the present invention are useful as psychotropic drugs in the treatment of psychosis, memory deficits, cognitive disorders, migraine, neuropathy, neuroinflammatory disorders including multiple sclerosis and Guillain-Barre syndrome and the inflammatory sequelae of viral encephalitis, cerebral vascular accidents, and head trauma, anxiety disorders, stress, epilepsy, Parkinson's disease, and schizophrenia. The compounds are also useful for the treatment of substance abuse disorders, particularly to opiates, alcohol, and nicotine. The compounds are also useful for the treatment of obesity or eating disorders associated with excessive food intake and complications associated therewith. The present invention is also concerned with treatment of these conditions, and the use of compounds of the present invention for manufacture of a medicament useful in treating these conditions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Therapeutic agents for drug dependence Inventor(s): Matsuno, Kiyoshi; (Toyonaka, JP), Mita, Shiro; (Nishinomiya, JP), Suzuki, Tsutomu; (Yokohama, JP) Correspondence: Frishauf, Holtz, Goodman, Langer & Chick, P.C.; Attorneys AT Law; 767 Third Avenue; New York; NY; 10017-2023; US Patent Application Number: 20020019399 Date filed: May 7, 2001 Abstract: A method for preventing or treating drug dependence comprising administering to a human in need thereof a pharmaceutically effective amount of a 1,4(diphenylalkyl)piperazine compound represented by the following formula [I] or a pharmaceutically acceptable salt thereof, wherein R.sup.1 is lower alkoxy; R.sup.2 is lower alkoxy; A is lower alkylene and B is lower alkylene; 1 Excerpt(s): This application is a continuation-in-part application of International Application No. PCT/JP99/06148 (not published in English), filed Nov. 4, 1999, the entire contents of which are incorporated by reference herein. The present invention relates to drugs which contain 1,4-(diphenylalkyl)piperazine derivatives as active ingredients and are useful for the prevention or treatment of drug dependence due to drug abuse. Drug dependence is a functional adaptive condition of the central nervous system changed by interactions between living bodies and drugs. Drug dependence is classified as a psychological dependence wherein one depends on the psychological effects of drugs and has a physical dependence to avoid unpleasant bioreactions due to withdrawal (withdrawal symptoms). Symptoms always observed in drug dependence are psychological dependence on drugs which have been ingested and a strong impulse to demand the drugs (Pharmacia, 34, 900-904 (1998)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Thiophenopyrimidines Inventor(s): Chen, Chen; (San Diego, CA), McCarthy, James R.; (Solana Beach, CA), Moran, Terence J.; (San Diego, CA), Webb, Thomas R.; (Olivenhain, CA) Correspondence: Scully, Scott, Murphy & Presser; 400 Garden City Plaza; Garden City; NY; 11530; US Patent Application Number: 20020052362 Date filed: June 29, 2001 Abstract: This invention concerns compounds of formula 1including the stereoisomers and the pharmaceutically acceptable acid addition salt forms thereof, wherein X is S, SO or SO.sub.2; R.sup.1 is NR.sup.4R.sup.5 or OR.sup.5; R.sup.2 is C.sub.1-6alkyl, C.sub.16alkyloxy or C.sub.1-6alkylthio; R.sup.3 is hydrogen, C.sub.1-6alkyl, C.sub.16alkylsulfonyl, C.sub.1-6alkylsulfoxy or C.sub.1-6alkylthio; R.sup.4 is hydrogen, C.sub.1-6alkyl, mono- or di(C.sub.3-6cycloalkyl)meth- yl, C.sub.3-6cycloalkyl, C.sub.36alkenyl, hydroxyC.sub.1-6alkyl, C.sub.1-6alkylcarbonyloxyC.sub.1-6alkyl or C.sub.16alkyloxyC.sub.1-6alky- l; R.sup.5 is C.sub.1-8alkyl, mono- or di(C.sub.36cycloalkyl)methyl, Ar.sup.1CH.sub.2, C.sub.1-6alkyloxy-C.sub.1-6alkyl, hydroxyC.sub.1-6alkyl, C.sub.3-6alkenyl, thienylmethyl, furanylmethyl, C.sub.16alkylthioC.sub.1-6alkyl, morpholinyl, mono- or di(C.sub.1-6alkyl)aminoC.sub.1-6alkyl, di(C.sub.1-6alkyl)amino, C.sub.1-6alkylcarbonylC.sub.1-6alkyl, C.sub.1-6alkyl substituted with imidazolyl; or a radical of formula --Alk--O--CO--Ar.sup.1; or R.sup.4 and R.sup.5 taken together with the nitrogen atom to which they are attached may form an optionally substituted pyrrolidinyl, piperidinyl, homopiperidinyl or morpholinyl group; Ar is phenyl, substituted phenyl, pyridinyl or substituted pyridinyl; having CRF receptor antagonistic properties; pharmaceutical compositions containing such compounds as active ingredients; methods of treating disorders related to hypersecretion of CRF such as depression, anxiety, substance abuse, by administering an effective amount of a compound of formula (I). Excerpt(s): This invention relates to thiophenopyrimidines which possess CRF receptor antagonistic properties, to pharmaceutical compositions containing these compounds as active ingredient, and the use thereof in the treatment of endocrine, psychiatric and neurologic conditions or illnesses, including stress-related disorders in general. The first corticotropin-releasing factor (CRF) was isolated from ovine hypothalmi and identified as a 41-amino acid peptide (Vale et al., Science 213:1394-1397, 1981). Subsequently, sequences of human and rat CRF were isolated and determined to be identical, but different from ovine CRF in 7 of the 41 amino acid residues (Rivier et al., Proc. Natl. Acad. Sci. USA 80:4851, 1983; Shibahara et al., EMBO J. 2:775, 1983). CRF has been found to produce profound alterations in endocrine, nervous and immune system functions. CRF is believed to be the major physiological regulator of the basal and stress-release of adrenocorticotropic hormone ("ACTH"),.beta.-endorphin, and other proopiomelanocortin ("POMC")-derived peptides from the anterior pituitary (Vale et al., Science 213:1394-1397, 1981). Briefly, CRF is believed to initiate its biological effects by binding to a plasma membrane receptor which has been found to be distributed throughout the brain (DeSouza et al., Science 221:1449-1451, 1984), pituitary (DeSouza et al., Methods Enzyinol. 124:560, 1986; Wynn et al., Biochem. Biophys. Res. Comm. 110:602-608, 1983), adrenals (Udelsman et al., Nature 319:147-150, 1986) and spleen (Webster, E. L., and E. B. DeSouza, Endocrinology 122:609-617, 1988). The CRF receptor is coupled to a GTP-binding protein (Perrin et al., Endocrinology 118: 1171- 1179, 1986) which mediates CRF-stimulated increase in intracellular production of cAMP (Bilezikjian, L. M., and W. W. Vale, Endocrinology 113:657-662, 1983). In addition to its

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role in stimulating the production of ACTH and POMC, CRF is also believed to coordinate many of the endocrine autonomic, and behavioral responses to stress, and may be involved in the pathophysiology of affective disorders. Moreover, CRF is believed to be a key intermediary in communication between the immune, central nervous, endocrine and cardiovascular systems (Crofford et al., J. Clin. Invest. 90:25552564, 1992; Sapolsky et al., Science 238:522-524, 1987; Tilders et al., Regul. Peptides 5:7784, 1982). Overall, CRF appears to be one of the pivotal central nervous system neurotransmitters and plays a crucial role in integrating the body's overall response to stress. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Treatments for obesity and methods for identifiying compounds useful for treating obesity Inventor(s): Hadcock, John R.; (East Lyme, CT), Swick, Andrew G.; (East Lyme, CT) Correspondence: Gregg C. Benson; Pfizer INC.; Patent Department, MS 4159; Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20020065277 Date filed: January 16, 2001 Abstract: The present invention provides a method of treating obesity, sexual dysfunction (including erectile dysfunction), diabetes, insulin resistance, hyperinsulinemia, Syndrome X, adrenal dysfunction, hypertension, hypercholesterolemia, atherosclerosis, hyperlipoproteinemia, hypertriglyceridemia, or substance abuse, the method comprising the step of administering to a patent having or at risk of having one of the above-mentioned diseases a therapeutically effective amount of a compound that attenuates the binding of agouti-related protein to melanocortin receptors, but does not attenuate the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors. The present invention also provides a method of identifying a compound that is useful for the treatment or prevention of obesity, sexual dysfunction (including erectile dysfunction), diabetes, insulin resistance, hyperinsulinemia, Syndrome X, adrenal dysfunction, hypertension, hypercholesterolemia, atherosclerosis, hyperlipoproteinemia, hypertriglyceridemia, or substance abuse, the method comprising the steps of: 1) determining if a compound affects the binding of agoutirelated protein to melanocortin receptors; 2) determining if a compound affects the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors; and 3) selecting a compound that attenuates the binding of agouti-related protein to melanocortin receptors, but does not affect the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors. Excerpt(s): This application claims priority of U.S. Provisional Application No. 60/176,508 and 60/206,126, filed Jan. 18, 2000 and May 22, 2000, respectively. The present invention provides methods of treating obesity, sexual dysfunction (including erectile dysfunction), diabetes, insulin resistance, hyperinsulinemia, Syndrome X, adrenal dysfunction, hypertension, hypercholesterolemia, atherosclerosis, hyperlipoproteinemia, hypertriglyceridemia, or substance abuse, the methods comprising the step of administering to a patient having or at risk of having one of the above-mentioned diseases or conditions a therapeutically effective amount of a compound that attenuates the binding of agouti-related protein to melanocortin receptors, but does not attenuate the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors. The present invention also provides methods of identifying a

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compound that is useful for the treatment of obesity, sexual dysfunction (including erectile dysfunction), diabetes, insulin resistance, hyperinsulinemia, Syndrome X, adrenal dysfunction, hypertension, hypercholesterolemia, atherosclerosis, hyperlipoproteinemia, hypertriglyceridemia, or substance abuse, the methods comprising the steps of: 1) determining if a compound affects the binding of agoutirelated protein to melanocortin receptors; 2) determining if a compound affects the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors; and 3) selecting a compound that attenuates the binding of agouti-related protein to melanocortin receptors, but does not attenuate the binding of.alpha.-melanocyte stimulating hormone to melanocortin receptors. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with substance 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 “substance 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 substance abuse. You can also use this procedure to view pending patent applications concerning substance 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 SUBSTANCE ABUSE Overview This chapter provides bibliographic book references relating to substance abuse. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on substance 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 “substance 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 substance abuse: •

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 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,

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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. •

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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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 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.

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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.

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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. •

Psychotherapy and Counseling in the Treatment of Drug Abuse 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 assembles a collection of papers delineating the methodological problems in doing psychotherapy and counseling research in the area of drug abuse treatment, and describing strategies researchers can use in dealing with those problems. The first two papers are reviews of research findings. One discusses psychotherapy and counseling in opiate abuse, and the other examines retention of cocaine abusers in individual supportive- expressive therapy and structural-strategic family therapy. The second group of papers focuses exclusively on methodological and design issues in carrying out psychotherapy and counseling research, with emphases on problems in doing this kind of research with drug abusers. The final paper explores research priorities and future directions.

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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

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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. •

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 cultural context of epidemiologic research; the role of ethics in evaluation, psychometrics, and culture, the history and philosophy of science, and acculturation.

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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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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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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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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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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

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juvenile offenders; dialectical behavior therapy; substance abuse research; and clinical trials. •

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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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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Substance Abuse and HIV/AIDS Curriculum Contact: University of Washington, Northwest AIDS Education and Training Center, 901 Boren Ave Ste 1100, Seattle, WA, 98104-3596, (800) 677-4799, http://depts.washington.edu/nwaetc/. Summary: This teaching guide presents a curriculum for a training program on Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome (AIDS) for substance-abuse counselors. The overall goal of this counselor-education program is to develop AIDS-relevant counseling skills. The course describes the clinical course of HIV infection, including the effects of HIV on the immune system, the stages of HIV-disease progression, and available treatment programs. Participants in the program learn to identify major epidemiological trends, including U.S. prevalence of HIV and AIDS, distribution of cases, and the impact of AIDS on specific populations. The primary determinants of HIV transmission and risk factors that are identified in the course enable participants to recognize universal-transmission criteria, the odds of exposure to HIV, and the odds of HIV infection. Methods for increasing occupational safety and personal protection that are examined include abstinence and avoidance, barrier methods, viricides, and specific HIV-prevention measures. The course focuses on skills to manage personal attitudinal barriers, including fear and resistance. The curriculum identifies four types of relationships between substance abuse and HIV risk, including intravenous drug abuse, sexual risks, infection cofactors, and treatment and case management complications. Participants learn to develop a strategic approach to risk

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reduction using a client-centered intervention model, to develop specialized AIDS risk intervention skills and procedures, to identify special counseling issues related to HIVantibody testing, to identify special counseling issues for HIV-positive persons, and to develop strategies for making legal and ethical decisions. •

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.

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 “substance abuse” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “substance abuse” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “substance abuse” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Adolescent Substance Abuse Treatment in the United States: Exemplary Models from a National Evaluation Study by Sally J., PhD Stevens (Editor), Andrew R., PhD Morral (Editor) (2003); ISBN: 0789016079; http://www.amazon.com/exec/obidos/ASIN/0789016079/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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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: 1572306599; http://www.amazon.com/exec/obidos/ASIN/1572306599/icongroupinterna

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Criminal Conduct and Substance Abuse Treatment : Strategies for Self-Improvement and Change - The Participant's Workbook by Kenneth W. Wanberg (Author), Harvey B. Milkman (Author) (1998); ISBN: 0761909443; http://www.amazon.com/exec/obidos/ASIN/0761909443/icongroupinterna

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Drug Abuse by Roman Espejo (Editor), Greenhaven Press (2002); ISBN: 0737708530; http://www.amazon.com/exec/obidos/ASIN/0737708530/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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Free at Last: Daily Meditations by and for Inmates: The Dramatic Promise of Recovery from Substance Abuse (A Parkside Meditation Book) by Annette Mambuca (Editor) (1993); ISBN: 1568380704; http://www.amazon.com/exec/obidos/ASIN/1568380704/icongroupinterna

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Fundamentals of Substance Abuse Practice by Jerry Johnson (2003); ISBN: 053462667X; http://www.amazon.com/exec/obidos/ASIN/053462667X/icongroupinterna

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Global Criteria: The 12 Core Functions of the Substance Abuse Counselor by John W. Herdman; ISBN: 1556912048; http://www.amazon.com/exec/obidos/ASIN/1556912048/icongroupinterna

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Group Treatment for Substance Abuse: A Stages-of-Change Therapy Manual by Mary Velasquez, et al; ISBN: 1572306254; http://www.amazon.com/exec/obidos/ASIN/1572306254/icongroupinterna

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Improving Treatment Compliance: Counseling and Systems Strategies for Substance Abuse and Dual Disorders by Dennis C. Daley, Allan Zuckoff (1999); ISBN: 1568382812; http://www.amazon.com/exec/obidos/ASIN/1568382812/icongroupinterna

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Network Therapy for Alcohol and Drug Abuse: A New Approach in Practice by Marc, M.D. Galanter; ISBN: 0465000991; http://www.amazon.com/exec/obidos/ASIN/0465000991/icongroupinterna

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Of Course You're Angry: A Guide to Dealing With the Emotions of Substance Abuse by Gayle Rosellini, et al (1997); ISBN: 1568381417; http://www.amazon.com/exec/obidos/ASIN/1568381417/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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Psychotherapy and Substance Abuse: A Practitioner's Handbook by Arnold M. Washton (Editor); ISBN: 157230202X; http://www.amazon.com/exec/obidos/ASIN/157230202X/icongroupinterna

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Seeking Safety: A Treatment Manual for PTSD and Substance Abuse by Lisa M. Najavits; ISBN: 1572306394; http://www.amazon.com/exec/obidos/ASIN/1572306394/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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Sourcebook on Substance Abuse: Etiology, Epidemiology, Assessment, and Treatment by Peggy J. Ott (Author), et al; ISBN: 0205198023; http://www.amazon.com/exec/obidos/ASIN/0205198023/icongroupinterna

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Substance Abuse and Dependence in Adolescence: Epidemiology, Risk Factors and Treatment by Cecilia A. Essau (Editor) (2003); ISBN: 1583912630; http://www.amazon.com/exec/obidos/ASIN/1583912630/icongroupinterna

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Substance Abuse Assessment and Diagnosis: A Comprehensive Guide for Counselors and Helping Professionals by Gerald A. Juhnke (2002); ISBN: 158391367X; http://www.amazon.com/exec/obidos/ASIN/158391367X/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 Counseling: Theory and Practice (2nd Edition) by Patricia Stevens (Author), Robert L. Smith (Author); ISBN: 0130212857; http://www.amazon.com/exec/obidos/ASIN/0130212857/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 (Just for the Health of It!, Unit 6) by Patricia Rizzo Toner (1993); ISBN: 0876288794; http://www.amazon.com/exec/obidos/ASIN/0876288794/icongroupinterna

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Substance Abuse Treatment and the Stages of Change: Selecting and Planning Interventions by Gerard Joseph Connors (Author), 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 by David W. Springer, et al (2003); ISBN: 1557989907; http://www.amazon.com/exec/obidos/ASIN/1557989907/icongroupinterna

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Substance Abuse: A Comprehensive Textbook by Joyce H. Lowinson, et al; ISBN: 068305211X; http://www.amazon.com/exec/obidos/ASIN/068305211X/icongroupinterna

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Substance Abuse: From Principles to Practice by David M. McDowell, Henry I. Spitz; ISBN: 0876308892; http://www.amazon.com/exec/obidos/ASIN/0876308892/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 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 First Session with Substance Abusers by Nicholas A. Cummings (Author), Janet L. Cummings (Author) (2000); ISBN: 0787949337; http://www.amazon.com/exec/obidos/ASIN/0787949337/icongroupinterna

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The Practical Art of Suicide Assessment : A Guide for Mental Health Professionals and Substance Abuse Counselors by Shawn Christopher Shea (Author) (2002); ISBN: 0471237612; http://www.amazon.com/exec/obidos/ASIN/0471237612/icongroupinterna

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The Social Norms Approach to Preventing School and College Age Substance Abuse : A Handbook for Educators, Counselors, and Clinicians by H. Wesley Perkins (Editor) (2003); ISBN: 078796459X; http://www.amazon.com/exec/obidos/ASIN/078796459X/icongroupinterna

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Therapist's Guide to Substance Abuse Intervention (Practical Resources for the Mental Health Professional) by Sharon Johnson (Author), Sharon L. Johnson (2003); ISBN: 0123875811; http://www.amazon.com/exec/obidos/ASIN/0123875811/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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Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders by Paige Ouimette (Editor), Pamela J. Brown (Editor) (2003); ISBN: 1557989389; http://www.amazon.com/exec/obidos/ASIN/1557989389/icongroupinterna

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Treating Substance Abuse, Second Edition: Theory and Technique by Frederick Rotgers (Editor), et al; ISBN: 1572308974; http://www.amazon.com/exec/obidos/ASIN/1572308974/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 “substance 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 •

AIDS, agencies and drug abuse: the Edinburgh experience Author: McRae, Jackie.; Year: 1989; Norwich: Social Work Monographs, 1989; ISBN: 0946751595 http://www.amazon.com/exec/obidos/ASIN/0946751595/icongroupinterna

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Complete handbook for combating substance abuse in the workplace: medical facts, legal issues, and practical solutions Author: Banta, William F.; Year: 1989; Lexington, Mass.: Lexington Books, c1989; ISBN: 0669178799 http://www.amazon.com/exec/obidos/ASIN/0669178799/icongroupinterna

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Current issues of drug abuse testing: first international symposium Author: Segura, Jordi.; Year: 1992; Boca Raton: CRC Press, c1992; ISBN: 084934283X http://www.amazon.com/exec/obidos/ASIN/084934283X/icongroupinterna

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Drug abuse treatment Author: Watson, Ronald R. (Ronald Ross); Year: 1992; Totowa, N.J.: Humana Press, c1992; ISBN: 0896032337

11

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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http://www.amazon.com/exec/obidos/ASIN/0896032337/icongroupinterna •

Infections in intravenous drug abusers Author: Levine, Donald P.; Year: 1991; New York: Oxford University Press, 1991; ISBN: 019506223X http://www.amazon.com/exec/obidos/ASIN/019506223X/icongroupinterna

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Strategic planning for workplace drug abuse programs Author: Backer, Thomas E.; Year: 1987; Rockville, Md.: U.S. Dept. of Health and Human Services, Public Health Service, Alcohol, Drug

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The law of substance abuse for healthcare providers Author: American Hospital Association. Ad Hoc Labor Relations Advisory Committee. Substance Abuse Task Force.; Year: 1987; [Chicago, Ill.: American Hospital Association], Office of General Counsel, [1987]

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Workplace drug abuse policy: considerations and experience in the business community Author: Walsh, J. Michael (Joseph Michael),; Year: 1989; [Rockville, Md.]: Dept. of Health and Human Services, Public Health Service, Alcohol, Drug

Chapters on Substance Abuse In order to find chapters that specifically relate to substance abuse, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and substance 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 “substance abuse” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on substance abuse: •

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 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.

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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 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

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combination; estimates of incidence and prevalence of substance abuse, including substance abuse among deaf people; research regarding any predisposing factors 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.

Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to substance 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 •

Rural health, mental health, and substance abuse resources directory Source: Rockville, MD: Office of Rural Health Policy, U.S. Department of Health and Human Services. 1996. 96 pp. Contact: Available from U.S. Office of Rural Health Policy, Parklawn Building, Room 905, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-0835 or (800) 633-7701 or (301) 656-3100 / fax: (301) 443- 2803 / Web site: http://www.nal.usda.gov. Single copies available at no charge. Also available for $10.00 for postage and handling from National Rural Health Association, One West Armour Boulevard, Suite 301, Kansas City, MO, 64111. Telephone: (816) 756-3140. Prepayment required by check, MasterCard, Visa, or American Express; make checks payable to NRHA. Summary: This directory lists agencies and organizations concerned with providing rural populations health services or mental health services and substance abuse programs. Within those two categories, the directory lists federal agencies, national organizations, federally funded regional organizations, state agencies and organizations, area health education centers (AHECs) and Health Education Training Centers (HETCs), federally funded research centers, foundations, and other resources. The directory combines entries which appeared in the 1994 'Rural Health Resources Directory' and the 1993 'Rural Mental Health and Substance Abuse Resources Directory.'.

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Substance abuse prevention and treatment programs: A family approach Source: Washington, DC: Graduate Public Policy Program, Georgetown University; Arlington, VA: National Center for Education in Maternal and Child Health. 1995. 2 v. Contact: Available from Librarian, National Center for Education in Maternal and Child Health, 2000 15th Street, North, Suite 701, Arlington, VA 22201-2617. Telephone: (703) 524-7802 / fax: (703) 524- 9335 / e-mail: [email protected] / Web site: http://www.ncemch.org. Photocopy available at no charge. Summary: This report provides a brief introduction to issues addressed by a DC Family Policy Seminar in February 1995 which focused on the role of the family in the

12 You will need to limit your search to “Directory” and “substance 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 “substance 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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prevention and treatment of substance abuse. Volume 1 (written by Kerry Whitacre, Mark Rom, and Amy Scott) provides a background and introduction to the role of the family in substance abuse and briefly describes the key issues involved in community and family-oriented prevention and treatment strategies for substance abuse. An annotated list of prevention and treatment programs and organizations is included in this volume. Volume 2 provides highlights of the seminar's discussions. [Funded by the Maternal and Child Health Bureau].

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CHAPTER 8. MULTIMEDIA ON SUBSTANCE ABUSE Overview In this chapter, we show you how to keep current on multimedia sources of information on substance 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 substance abuse is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “substance 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 “substance abuse” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on substance abuse: •

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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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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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 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.

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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

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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). •

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.

•

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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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.

•

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.

•

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 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

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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. •

Silent Suffering: Substance Abuse in the Deaf Community Source: Salem, OR: Sign Enhancers, Inc. 1994. (videocassette). Contact: Available from Sign Enhancers, Inc. 10568 Southeast Washington Street, Portland, OR 97216-2809. TTY/Voice (800) 767-4461. Fax (503) 257-3013. PRICE: $49.95 plus shipping and handling; $224.00 for Mental Health and Recovery Video Package. Number MH-5. Summary: This videotape program provides an in-depth exploration of substance abuse in the Deaf community. Narrated by Alan Barnwiolek (ALB), the program explores cultural issues with Barbara Kannapell; treatment issues with Cynthia Weitzel; and recovery issues with Betty G. Miller. The program is in American Sign Language, with voice over and closed-captioning. (AA-M).

•

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 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.

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 “substance abuse” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on substance abuse: •

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

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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. •

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 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.

•

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.

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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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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).

Bibliography: Multimedia on Substance 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 substance 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 substance abuse: •

Drug abuse [slide] Source: [presented by the Ohio Medical Education]; Year: 1989; Format: Slide; [Columbus, Ohio: Ohio Medical Education Network, 1989]

•

Drug abuse and HIV [videorecording]: reaching those at risk Source: National Institute on Drug Abuse; produced by Issembert Productions; Year: 1995; Format: Videorecording; Rockville, MD: National Clearinghouse for Alcohol and Drug Information, 1995

•

Nursing care of clients with substance abuse in chemical dependency treatment centers [videorecording] Source: Mosby; Samuel Merritt College, Studio Three Productions; Year: 1995; Format: Videorecording; [St. Louis, Mo.]: Mosby-Year Book, c1995

•

The Door to recovery [videorecording]: community drug abuse treatment Source: a presentation of the National Institute on Drug Abuse; a production of State of the Art, Inc. and Technical Assistance & Training Corporation; Year: 1990; Format: Videorecording; [Bethesda, Md.]: NIDA, [1990]

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CHAPTER 9. PERIODICALS AND NEWS ON SUBSTANCE ABUSE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover substance abuse.

News Services and Press Releases One of the simplest ways of tracking press releases on substance abuse is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “substance abuse” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to substance abuse. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “substance abuse” (or synonyms). The following was recently listed in this archive for substance abuse: •

Most substance abuse programs ignore the elderly Source: Reuters Health eLine Date: October 17, 2003

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•

U.S. survey reveals millions of new drug abusers Source: Reuters Health eLine Date: September 05, 2003

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Survey finds millions of previously unrecognized drug abusers in U.S. Source: Reuters Medical News Date: September 05, 2003

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Severe attention disorder linked with drug abuse Source: Reuters Health eLine Date: August 18, 2003

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US launches prescription drug abuse campaign Source: Reuters Health eLine Date: January 16, 2003

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History of abortion linked to increased substance abuse in later pregnancies Source: Reuters Medical News Date: January 09, 2003

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Stimulant treatment for ADHD not linked to drug abuse in adulthood Source: Reuters Industry Breifing Date: January 06, 2003

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Federal initiatives allow office-based treatment of opioid dependence Source: Reuters Industry Breifing Date: October 18, 2002

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Drug abuse holds steady among anesthesiologists Source: Reuters Health eLine Date: September 27, 2002

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CORRECTION: Officials alarmed by rising US drug abuse numbers Source: Reuters Health eLine Date: September 06, 2002

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Sharp rise in drug abuse seen in US Source: Reuters Medical News Date: September 05, 2002

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Officials alarmed by rising US drug abuse numbers Source: Reuters Health eLine Date: September 05, 2002

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Depression and substance abuse increase mortality in HIV-infected women Source: Reuters Medical News Date: August 06, 2002

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Substance abuse increased in New York City after events of 9/11 Source: Reuters Medical News Date: May 31, 2002

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Substance abuse up in NYC after Sept. 11 attacks Source: Reuters Health eLine Date: May 28, 2002

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Study: Mom is best weapon against teen drug abuse Source: Reuters Health eLine Date: May 10, 2002

Periodicals and News

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Drug abuse treatment demand rises post-Sept. 11th Source: Reuters Health eLine Date: April 05, 2002

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More US teens in substance abuse treatment: report Source: Reuters Health eLine Date: December 27, 2001

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Some drug abusers wait 10 years to seek treatment Source: Reuters Health eLine Date: December 24, 2001

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “substance abuse” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “substance abuse” (or synonyms). If you know the name of a company that is relevant to substance abuse, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “substance abuse” (or synonyms).

Newsletters on Substance Abuse Find newsletters on substance abuse using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “substance abuse.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “substance abuse” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •

Healthy beginnings, Healthy growing, and Healthy choices: Newsletters from Michigan's Comprehensive School Health Education program Source: Lansing, MI: School Health Section, Michigan Department of Public Health. 1994-. quarterly. Contact: Available from Michigan Department of Public Health, School Health Section, 3423 North Logan/M.L. King Jr. Boulevard, P.O. Box 30195, Lansing, MI 48909. Summary: This set of three newsletters is designed to help parents teach their children how to make health decisions. It was developed as part of Michigan's Comprehensive School Health Education program, a health education curriculum for kindergarten through 8th grade students. Topics covered include physical fitness, substance abuse, nutrition, sexuality, sexual abuse, and injury prevention. Each newsletter is geared for parents of children in particular age groups. Healthy Beginnings is targeted to parents of children in kindergarten through 3rd grades. Healthy Growing is for parents of 4th and 5th graders, and Healthy Choices is for parents of 6th through 8th grade students.

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “substance abuse” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on substance abuse: •

Impotence: Don't Let Embarrassment Stop You From Getting Help Source: Mayo Clinic Health Letter. 15(8): 4-5. August 1997. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037.

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Summary: This newsletter article encourages readers with concerns about erectile dysfunction (impotence) to consult their health care providers for information and treatment. The author stresses that, although impotence was once a taboo subject, attitudes are changing. More and more men are seeking help, and physicians now have a better understanding of the causes of impotence. A growing number of treatments are available, many them less invasive and less intimidating than previous options. The article outlines the causes of erectile dysfunction, including physical diseases and disorders, surgery or trauma, medications, substance abuse, and stress, anxiety, or depression. The author then details the treatment options currently in use, including treating the underlying disease or disorder, needle injection therapy, self-intraurethral therapy (MUSE, or medicated urethral system for erection), vacuum devices, vascular surgery, and penile implants. One sidebar briefly describes sildenafil, an experimental drug that can be taken orally to produce an erection. 1 figure. (AA-M).

Academic Periodicals covering Substance Abuse Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to substance abuse. In addition to these sources, you can search for articles covering substance abuse that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for substance abuse. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with substance abuse. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to substance abuse: Benzodiazepines •

Systemic - U.S. Brands: Alprazolam Intensol; Ativan; Dalmane; Diastat; Diazepam Intensol; Dizac; Doral; Halcion; Klonopin; Librium; Lorazepam Intensol; Paxipam; ProSom; Restoril; Serax; Tranxene T-Tab; Tranxene-SD; Tranxene-SD Half Strength; Valium; Xanax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html

Carbamazepine •

Systemic - U.S. Brands: Atretol; Carbatrol; Epitol; Tegretol; Tegretol-XR http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202111.html

Cocaine •

Systemic http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202111.html

Nefazodone •

Systemic - U.S. Brands: Serzone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203491.html

Niacin (Vitamin B 3 ) •

Systemic - U.S. Brands: Endur-Acin; Nia-Bid; Niac; Niacels; Niacor; Nico-400; Nicobid Tempules; Nicolar; Nicotinex Elixir; Slo-Niacin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202405.html

Nicotine •

Systemic http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203491.html

•

Systemic - U.S. Brands: Habitrol; Nicorette; Nicotrol; Prostep http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202407.html

Trazodone •

Systemic - U.S. Brands: Desyrel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202573.html

Valproic Acid •

Systemic - U.S. Brands: Depacon; Depakene; Depakote; Depakote Sprinkle http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202588.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

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Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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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

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

13

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

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

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

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

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

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

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

•

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/

•

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

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

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/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

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

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

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

14 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

•

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 “substance 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 “substance abuse” (or synonyms) into the “For these words:” box. The following is a sample result: •

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.

•

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

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screening and treatment process. The remaining chapters provide protocols for specific infectious diseases. •

Sexuality, AIDS, Substance Abuse and Pregnancy, and Family Life Education Materials: Annotated Bibliography of Curricula and Resources Contact: Catholic Family Service, 2537 S University, Fargo, ND, 58103, (701) 235-4457. Summary: This annotated bibliography reviews sexuality education curricula, AIDS education resources, and substance abuse and pregnancy resources. Each listing contains the title, address of producer, brief description, and commentary on the material's strengths and limitations. The bibliography recommends guidelines for review and selection of a sexuality education program, including: 1) teaching positive communication skills to strengthen family bonds; 2) encouragement of self-control and self-discipline in adolescent sexual relationships; 3) promotion of adoption as a positive option; and 4) involvement of parents in the educational process. Not all of the material reviewed meets the stated guidelines, but they form the basis for the critiques and endorsements. Also included are a catalog of brochures, ordering instructions for the material, and a list of rental fees for the curricula.

•

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. 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.

•

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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•

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.

•

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.

•

Funding Resource Guide for Substance Abuse Programs 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 manual assists administrators of substance abuse programs in preparing development plans that support their program mission and describes tasks that give direction to fundraising efforts. Section one makes recommendations for the organizational structure of substance abuse programs. Section two focuses on how to assess fundraising capabilities and develop a fundraising action plan. The third section articulates methods of fundraising. The guide addresses third party payments from Medicare, Medicaid, and private insurance; and provides information on local, state, and Federal funding sources.

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Substance Abuse Intervention: Training and Resource Manual for Primary Care Providers Contact: University of Washington, Northwest AIDS Education and Training Center, 901 Boren Ave Ste 1100, Seattle, WA, 98104-3596, (800) 677-4799, http://depts.washington.edu/nwaetc/. Summary: This manual outlines a training program on substance-abuse intervention for primary health care providers; substance-abuse intervention can also be a major method of preventing the spread of Human immunodeficiency virus (HIV), the etiologic agent of Acquired immunodeficiency syndrome (AIDS). Each section consists of a cover sheet, session overview, training guidelines, appendixes, and visual aids. The first lesson in the manual focuses on substance-abuse definitions and terms, as participants develop a common vocabulary for discussing substance abuse and related issues. In the second lesson, participants learn to identify the essential features of commonly used drugs, including the effects and uses of heroin, cocaine and other stimulants, alcohol and other sedatives, marijuana, PCP and other hallucinogens, and psychoactive inhalants. In this section, each drug is also examined in terms of its relationship to intravenous drug use, sexual risk, infection and conversion, and HIV treatment. The third section of the manual helps participants develop skills for selecting or developing substance-abuse assessments, including general screening procedures, identification of substance-abuse problems, and identification of recovery needs. The fourth section introduces substance abuse intervention concepts, including fundamental principles of behavior change, major barriers to change, and strategic approaches to overcome those barriers. Finally, participants learn substance abuse intervention skills including facilitation tasks, communication skills, specific intervention models, and practical applications.

•

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.

•

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

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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. •

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.

•

Medical Care, Substance Abuse Treatment, and Community Follow - Up of HIV Positive Incarcerated Women Contact: Brown University, Miriam Hospital, Fain Building Ste E, 164 Summit Ave 2Fl, Providence, RI, 02906, (401) 793-2500, http://www.brown.edu/departments/brunap/mirindx.htm. Summary: This paper describes a program that provides medical care, substance abuse treatment, and psychosocial support to HIV positive women who have been released. At 3-6 months prior to each woman's release, she meets with a program coordinator to discuss post-release plans. The goal is to establish the initial linkage with community resources, including substance abuse treatment and primary medical care. HIV-positive women who participated in the program in the first year had a recidivism rate of 12 percent within 6 months and 17 percent within 12 months. Women who did not participate in the program had a recidivism rate of 27 percent within 6 months and 39 percent within 12 months.

•

An International Perspective on Substance Abuse and AIDS: Correlates Between Latinos and African - Americans Contact: University of Ibadan, College of Medicine, Department of Preventive and Social Medicine, African Regional Health Education Centre, AIDS Information Exchange Resource Centre. Summary: This paper looks at possible links between the ways that both Acquired immunodeficiency syndrome (AIDS) and drug abuse affect Hispanic and African American cultures. It says that understanding AIDS status and its correlates in behavior patterns may help diminish the global spread of Human immunodeficiency virus (HIV) infection. The paper says that the tradition, culture, historical background, and social issues of the Hispanic and African American cultures are very similiar. Therefore, it

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would seem logical to design a strategic approach to prevent drug abuse and its contributions to the AIDS epidemic by examining the relationship between the two cultures. The paper goes on to examine the link between substance abuse and AIDS; it points out that substance abuse in Hispanic and African American communities is linked to many socioeconomic conditions and problems. It then presents an indepth analysis of the AIDS epidemic in Africa. Theories on the origin of HIV are presented. •

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 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.

•

AIDS Risk Reduction Interventions for IV Drug Abusers: A Health Education Program Contact: Spectrum Help System, CiviGenics, PO Box 1208, Westboro, MA, 01581, (508) 898-1570, http://www.civigenics.com. Summary: This program describes risk-reduction programs for the Human immunodeficiency virus (HIV) specifically geared for Intravenous-drug users (IVDU's) participating in the Spectrum House Primary Care program. It presents a study of specific issues affecting timing and strategies for behavior modification for IVDU's. It examines three options for education: Cognitive option during detoxification, cognitive option after detoxification, and the enhanced option, comprised of a behavioral approach. It summarizes Acquired immunodeficiency syndrome (AIDS) education and counseling activities at Spectrum Primary Care and presents detailed program plans. The appendix contains additional resource materials used for program development and implementation, including AIDS-related activities; risk assessment encounter forms; daily schedules for the enhanced group; behavioral analysis of risk reduction in IVDU's; and additional situations for role playing and videorecordings.

•

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. •

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.

•

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.

•

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

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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. •

Quick Guide for Clinicians: Based on TIP 37: Substance Abuse Treatment for Persons with HIV/AIDS Summary: This report presents information about the provision of substance abuse treatment for persons with the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). It discusses HIV transmission and prevention among HIV-positive substance abusers, HIV testing among substance abusers, why substance abuse treatment is important for persons with HIV/AIDS, how to structure a culturally and socially sensitive treatment program, and legal issues related to substance abuse treatment for persons with HIV/AIDS.

•

Strategic Planning for Workplace Drug Abuse Programs 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 provides a written guide to help employers plan and organize anti-drug abuse programs. In order for these programs to succeed, managers must commit themselves to the program and provide the needed personnel and financial resources to develop and implement an appropriate plan. Following an introductory section, the report examines successes and shortcomings of current programs, ways to adapt the model and plan a successful program, and ways to implement the program. Special issues, such as the needs of special populations, are considered. The report presents model programs from seven large companies.

•

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

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presents specific mechanisms and models of coordination and offers case examples to illustrate them. Chapter 6 presents recommendations for the future. •

Summary of Contract Activities Supported by the Center for Substance Abuse Prevention (CSAP) Contact: US Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, State Prevention Systems Program, 5600 Fishers Ln, Rockwall II 9th Fl, Rockville, MD, 20857, (301) 443-7942. Summary: This report summarizes the activities supported by the Center for Substance Abuse Prevention (CSAP). It provides information on all contracts administered by CSAP and is designed to assist readers in identifying CSAP activities of particular interest to them. The booklet is divided into three sections: 1) a list of CSAP contracts by office/division; 2) charts explaining the range of provided services, broken down by office/division; and 3) charts illustrating how the six service categories are addressed across offices/divisions.

•

What's the Big Deal? Storyline on Substance Abuse, Sexually Transmitted Diseases and HIV Prevention Contact: Corner Health Center, Young Adults Health Center Incorporated, 47 N Huron, Ypsilanti, MI, 48197, (734) 484-3600, http://comnet.org/local/orgs/corner/index.html. Summary: This script dramatizes dangers of unprotected sexual relationships, including sexually transmitted diseases like gonorrhea and AIDS. The cast of characters and an outline of the plot is included. Using drugs and alcohol is portrayed as a risk factor for unprotected sex.

•

Leading From the Ground Up: The Third National Survey of the Community Movement Against Substance Abuse Contact: Join Together, 441 Stuart St 7th Fl, Boston, MA, 02116-5019, (617) 437-1500, http://www.jointogether.org. Summary: This survey discusses the community movement against substance abuse and the need for expansion of services. The survey indicates that community coalitions have a direct impact on substance abuse in their communities. In some communities, these groups prevent youth from experimenting with alcohol and drugs; however, the survey also found that substance abuse is getting worse in many communities. Additional topics include: 1) coalitions - a growing and important force in communities; 2) coalition impact; 3) how coalitions rate the performance of major community institutions; 4) public policy views of coalition leaders; and 5) recommendations. A copy of the questionnaire used to collect information from coalitions is included as an appendix.

•

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

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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. •

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 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.

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. Type “substance 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.

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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Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 139492 6956 1331 4860 665 153304

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 “substance 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.

19

The HSTAT URL is http://hstat.nlm.nih.gov/.

20

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/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

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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 substance 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 substance 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 substance 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 “substance 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 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 substance 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

•

Treatment Drug Abuse and Treatment Source: National Women's Health Information Center http://www.4woman.gov/faq/substanc.htm Principles of Drug Addiction Treatment: A Research-Based Guide Source: National Institute on Drug Abuse http://www.nida.nih.gov/PODAT/PODATindex.html 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 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

•

Latest News Puffing in Pregnancy Ups Risk Child Will Smoke Source: 12/03/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14951 .html Smoking During Pregnancy Linked with ADHD Source: 11/20/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14767 .html

•

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/

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•

Prevention/Screening Government Warning Label Source: National Council on Alcoholism and Drug Dependence http://www.ncadd.org/facts/govwarn.html

•

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

•

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 substance 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: •

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.

•

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.

•

If You Are a Substance Abuser AIDS Is Deadly. ADAPT Contact: Association for Drug Abuse Prevention and Treatment, 815 Broadway, Brooklyn, NY, 11206-5318, (718) 782-2080.

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Summary: This brochure shows a death certificate and an IV-drug needle and warns that Acquired immunodeficiency syndrome (AIDS) is deadly. It cautions drug users and addicts not to share IV needles or leave them where they might be used by others. It also warns that sometimes used needles are sold as new. •

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 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.

•

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.

•

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.

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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 syndrome (AIDS) information. Specialized information for minorities, sex workers, and pregnant women is also included. •

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).

•

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).

•

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

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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. •

Prenatal Substance Abuse Source: in DeFeo, A.B., ed. Parent Articles 2. San Antonio, TX: Communication Skill Builders. 1995. p. 143-144. Contact: Available from Communication Skill Builders. Customer Service, 555 Academic Court, San Antonio, TX 78204-2498. (800) 211-8378; Fax (800) 232-1223. PRICE: $55.00 plus shipping and handling. Order Number 076-163-0732. Summary: This fact sheet, from a communication skills book for parents, provides information on prenatal substance abuse and their subsequent effect on a child. Topics covered include general information about substance abuse, the incidence of problems in babies whose mothers used drugs during pregnancy, diagnostic issues, health problems of children with substance abuse-related disorders, general guidelines for families coping with a child affected by substance abuse. The latter section provides guidelines in each of three age categories: infancy, preschool, and elementary school age. The author provides detailed suggestions for parent-child interaction, including recommended activities. The author encourages parents to incorporate these suggestions into everyday routines and to act as their child's advocate. 1 reference.

•

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.

•

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

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is using ATOD, and how to help teens use other resources to find out more about ATOD. •

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). 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.

•

Substance Abuse and HIV/AIDS Contact: US Department of Health and Human Services, Public Health Service, Health Resources and Services Administration, HIV/AIDS Bureau, Division of Training and Technical Assistance, 5600 Fishers Ln Rm 7-13, Rockville, MD, 20857, (301) 443-4092, http://www.hrsa.dhhs.gov/hab. Summary: This information sheet discusses the connection between substance abuse and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). The information sheet reports surveillance data, statistics, and critical issues on HIV/AIDS and IDU for the year 2000 and how the Ryan White CARE Act functions to provide substance abusers HIV services through all CARE Act programs.

•

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.

•

Foundations for decision making: Arming children with knowledge to fight drug abuse Source: Cedar Grove, NJ: American Liver Foundation. n.d. 26 items.

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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. •

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. 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.

•

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.

•

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.

•

Benefits for substance abusers repealed: Impact in California Source: Los Angeles, CA: UCLA Center for Health Policy Research, University of California at Los Angeles. 1997. 4 pp. Contact: Available from UCLA Center for Health Policy Research, 650 Charles E. Young Drive, South Room 21-293 CHS, Los Angeles, CA 90095-1772. Telephone: (310) 825-5491

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/ fax: (310) 825-5960 / e-mail: [email protected] / Web site: http://www.healthpolicy.ucla.edu. Available at no charge. Summary: This paper examines the impact of federal legislation which reduces the provision of financial support to individuals receiving substance abuse treatment; the law takes effect on January 1, 1997. The paper discusses the rationale of the legislation, evaluates its impact on the citizenry in California, and projects a reduction in individuals participating in treatment programs and a corresponding rise in the costs of other social services as a result. The paper suggests techniques state and local officials can take to shift the focus and funding of programs to prevent a potential increase in untreated substance abuse. •

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'. 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 “substance 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=substance+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=substance+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=substance+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=substance+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=substance+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=substance+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=substance+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:

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A Family Guide To Keeping Youth Mentally Healthy and Drug Free Summary: A Family Guide To Keeping Youth Mentally Healthy and Drug Free is a public education Web site developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) to communicate to 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=7537

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Addiction Technology Transfer Centers Internet Links and Resources Summary: Browse this index of internet links and resources related to substance abuse addiction treatment and technology. Source: Addiction Technology Transfer Center Network http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3930

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American Indian and Alaska Native Women's Health Summary: This page features links to information on cancer, diabetes, cardiovascular disease, substance abuse, and other topics. Source: Indian Health Service http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6861

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American Indian and Alaska Native Women's Health: Substance Abuse/Mental Health Summary: This page features links to information on drugs, tobacco, alcohol, and mental health. Source: Indian Health Service http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6868

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Asian/Pacific Islander Americans and Substance Abuse Summary: There are some metabolic factors in Asians which lead to a greater sensitivity to alcohol. 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=7439

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Asians and Pacific Islanders in Substance Abuse Treatment Summary: Although Asians and Pacific Islanders made up almost 4 percent of the U.S. Source: SAMHSA's National Mental Health Information Center, Center for Mental Health Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7260

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Calendar and Events - National Clearinghouse for Alcohol and Drug Information (NCADI) Summary: NCADI's calendar offers an up-to-date listing of upcoming substance abuserelated conferences and events. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1777

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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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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 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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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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Families In Recovery Summary: This article discusses the involvement of and impact on other family members--especially children--of another member's substance abuse recovery. Source: National Association for Children of Alcoholics http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2821

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Federal Health Care for the Homeless (HCH) Program Summary: The goal of this program is to improve access to primary health care and substance abuse treatment for homeless individuals. Source: Bureau of Primary Health Care, Health Resources and Services Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2478

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If Someone Close Has A Problem With Alcohol Or Other Drugs Summary: This article explains how substance abuse affects more people than the user, and supports friends and family in dealing with their loved one's problems. Provides tips on helping the user. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=952

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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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Is Someone You Care About in Trouble? Summary: This online fact sheet provides suggestions and guidelines for identifying and helping a coworker with 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=4662

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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 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 Asian/Pacific Islander Americans Summary: This document outlines actions needed to make prevention work for Asian Americans and Pacific Islander Americans dealing with substance abuse and access to health care services. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7489

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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 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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National Treatment Improvement Evaluation Study (NTIES) Highlights Summary: Links to summary findings of the various studies conducted to determine how Federally funded substance abuse treatment programs and therapies needed improvement. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2127

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News Page - Substance Abuse and Mental Health Services Administration (SAMHSA) Summary: This page provides visitors with current news, events and announcements related to the services of this U.S. Department of Health and Human Services agency. 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=1765

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News Room - National Mental Health Services Knowledge Exchange Network Summary: Current national news items with an emphasis on mental health and a link to press releases and announcements related to Substance Abuse and Mental Health Services Administration's (SAMHSA) programs Source: SAMHSA's National Mental Health Information Center, Center for Mental Health Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1528

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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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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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PREVLINE: Prevention Online at the National Clearinghouse for Alcohol and Drug Information (NCADI) Summary: The National Clearinghouse for Alcohol and Drug Information (NCADI) is the information service of the Center for Substance Abuse Prevention, and PREVLINE is the name of its multi-faceted online Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=337

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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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SAMHSA Model Programs Summary: This Web site is a comprehensive resource for anyone interested in preventing substance abuse and creating sustained positive change in our nation's communities. 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=6967

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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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Science and Technology Page - Office of National Drug Control Policy Summary: Browse this page for research reports and releases on current addiction research news from experts in the substance abuse field. Source: Office of National Drug Control Policy, The White House http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2151

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Search The Prevention Materials Database (PMD) Summary: Users are guided through data fields to search for substance abuse prevention materials -- alcohol and other drugs; drug education; and substance abuse prevention. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=955

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State Planning - Center for Mental Health Services (CMHS) Programs Summary: Visit this site for details related to grants and funding programs available to states and community health departments involved in substance abuse and mental health services and programs. Source: SAMHSA's National Mental Health Information Center, Center for Mental Health Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2084

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Straight Facts About Drugs and Alcohol Summary: This publication is designed to help adolescents recognize and deal with their or a peer's 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=2459

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Substance Abuse Facility Locator Summary: The Substance Abuse and Mental Health Services Administration (SAMHSA) has provided this online service to help you locate a drug and alcohol abuse treatment program near you. 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=6225

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Substance Abuse Information Database Summary: This interactive database provides a one-stop source of information with summaries and full text of materials relating to workplace substance abuse issues. Source: Office of the Assistant Secretary for Policy, U.S. Department of Labor http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6595

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Substance Abuse Information for American Indian/Alaska Native Women Summary: This brief fact sheet describes the effects of substance abuse on minority women. Source: National Women's Health Information Center, U.S. Public Health Service's Office on Women's Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6950

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Surgeon General's Call to Action to Prevent Suicide Summary: The Surgeon General’s Call to Action introduces a blueprint for reducing suicide and the associated toll that mental and substance abuse disorders take in the United States. Source: Office of the Surgeon General, U.S. Department of Health and Human Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4654

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The Small Business Drug and Alcohol Workplace Kit Summary: The effects of substance abuse hurt more than just users, especially in the workplace. Source: Office of the Assistant Secretary for Policy, U.S. Department of Labor http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=965

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Treatment Improvement Exchange (TIE) Summary: This site links health professionals to information on substance abuse treatment policies, funding sources, grant programs, statistical data and treatment services resources for individuals who abuse 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=1174

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Websites of Substance Abuse and/or Mental Health Agencies serving Asian Americans & Pacific Islanders Summary: This list includes state agencies serving Asian Americans and Pacific Islanders who may have substance abuse or mental health problems. Source: National Asian Pacific American Families Against Substance Abuse, Inc. http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7281

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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

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Working Partners Small Business Workplace Kit: Hospitality Summary: Small industries, including the hospitality industry, suffer consequences of substance abuse among their workers. Source: Office of the Assistant Secretary for Policy, U.S. Department of Labor http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=962

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Working Partners Small Business Workplace Kit: Manufacturing Summary: The effects of substance abuse on the manufacturing industry are summarized, and why this industry is particularly vulnerable is explained. Source: Office of the Assistant Secretary for Policy, U.S. Department of Labor http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=960

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Working Partners Small Business Workplace Kit: Retail Summary: Small industries, particularly retail, suffer consequences of substance abuse among their employees. Source: Office of the Assistant Secretary for Policy, U.S. Department of Labor http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=963

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Working Partners Small Business Workplace Kit: Wholesale Summary: The wholesale industry, especially, is impacted by substance abuse among employees. Source: Office of the Assistant Secretary for Policy, U.S. Department of Labor http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=964 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 substance 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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WebMDHealth: http://my.webmd.com/health_topics

Associations and Substance Abuse The following is a list of associations that provide information on and resources relating to substance 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.

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to substance abuse. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with substance 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 substance 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. 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.

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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 “substance 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 “substance 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 “substance 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 “substance 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.24

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

24

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)25: •

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/

•

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/

•

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

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

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

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

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/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

281

•

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/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

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

•

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/

•

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

•

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/

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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

283

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

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

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

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

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 substance abuse: •

Basic Guidelines for Substance 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 Substance 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

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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 285

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 •

Diagnostics and Tests for Substance Abuse ALT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003473.htm

Online Glossaries 287

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 CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Cocaine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm CT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003330.htm EKG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003868.htm Head CT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003786.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 Lumbar puncture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003428.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 RPR Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003533.htm T4 Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003517.htm THC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm TSH Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003684.htm

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•

Nutrition for Substance Abuse Caffeine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002445.htm

•

Background Topics for Substance 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 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

Online Glossaries 289

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 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

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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

291

SUBSTANCE 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: A localized, circumscribed collection of pus. [NIH] Acculturation: Process of cultural change in which one group or members of a group assimilates various cultural patterns from another. [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] 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] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and 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

292 Substance Abuse

referred to as adolescence lie between 13 and 18 years of age. [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] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [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] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Agranulocytosis: A decrease in the number of granulocytes (basophils, eosinophils, and neutrophils). [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] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [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] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alternative medicine: Practices not generally recognized by the medical community as

Dictionary 293

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] 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] 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] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [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, 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] 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] Androgenic: Producing masculine characteristics. [EU]

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Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [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] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] 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] 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 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] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [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] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

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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] 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 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] Antispasmodic: An agent that relieves spasm. [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] Apathy: Lack of feeling or emotion; indifference. [EU] Apnea: A transient absence of spontaneous respiration. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Aptitude: The ability to acquire general or special types of knowledge or skill. [NIH] Aqueous: Having to do with water. [NIH] Area Health Education Centers: Education centers authorized by the Comprehensive Health Manpower Training Act, 1971, for the training of health personnel in areas where health needs are the greatest. May be used for centers other than those established by the United States act. [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]

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Arteries: The vessels carrying blood away from the heart. [NIH] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arthralgia: Pain in the joint. [NIH] Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [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] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] 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, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU]

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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] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form 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] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [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-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]

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Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [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] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotin: Hexahydro-2-oxo-1H-thieno(3,4-d)imidazole-4-pentanoic acid. Growth factor present in minute amounts in every living cell. It occurs mainly bound to proteins or polypeptides and is abundant in liver, kidney, pancreas, yeast, and milk.The biotin content of cancerous tissue is higher than that of normal tissue. [NIH] 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] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [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-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] 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

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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] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [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] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] 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] Bupropion: A unicyclic, aminoketone antidepressant. The mechanism of its therapeutic actions is not well understood, but it does appear to block dopamine uptake. The hydrochloride is available as an aid to smoking cessation treatment. [NIH] Buspirone: An anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam. [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] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing

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pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Channels: Voltage-dependent cell membrane glycoproteins selectively permeable to calcium ions. They are categorized as L-, T-, N-, P-, Q-, and R-types based on the activation and inactivation kinetics, ion specificity, and sensitivity to drugs and toxins. The L- and T-types are present throughout the cardiovascular and central nervous systems and the N-, P-, Q-, & R-types are located in neuronal tissue. [NIH] Cannabis: The hemp plant Cannabis sativa. Products prepared from the dried flowering tops of the plant include marijuana, hashish, bhang, and ganja. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] 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] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [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] 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 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 Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH]

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Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Diseases: Diseases of any component of the brain (including the cerebral hemispheres, diencephalon, brain stem, and cerebellum) or the spinal cord. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the 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] Cetirizine: A potent second-generation histamine H1 antagonist that is effective in the treatment of allergic rhinitis, chronic urticaria, and pollen-induced asthma. Unlike many traditional antihistamines, it does not cause drowsiness or anticholinergic side effects. [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] Check-up: A general physical examination. [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] Chest Pain: Pressure, burning, or numbness in the chest. [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 Custody: The formally authorized guardianship or care of a child. [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] Chlordiazepoxide: An anxiolytic benzodiazepine derivative with anticonvulsant, sedative, and amnesic properties. It has also been used in the symptomatic treatment of alcohol withdrawl. [NIH]

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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 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] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [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] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P450. [NIH] Citalopram: A selective neuronal serotonin reuptake inhibitor and a clinically effective antidepressant with tolerable side effects. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia (TD) in preference to tricyclic antidepressants, which aggravate this condition. [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] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [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,

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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] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] 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 behavior therapy: A system of psychotherapy based on the premise that distorted or dysfunctional thinking, which influences a person's mood or behavior, is common to all psychosocial problems. The focus of therapy is to identify the distorted thinking and to replace it with more rational, adaptive thoughts and beliefs. [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] 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] Colitis: Inflammation of the colon. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] 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 Mental Health Centers: Facilities which administer the delivery of psychologic and psychiatric services to people living in a neighborhood or community. [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

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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] 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] Compulsive Behavior: The behavior of performing an act persistently and repetitively without it leading to reward or pleasure. The act is usually a small, circumscribed behavior, almost ritualistic, yet not pathologically disturbing. Examples of compulsive behavior include twirling of hair, checking something constantly, not wanting pennies in change, straightening tilted pictures, etc. [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

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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] 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] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] 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] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] 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] Contusions: Injuries resulting in hemorrhage, usually manifested in the skin. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral

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discharge (e.g., in response to hypotension). [NIH] Convulsive: Relating or referring to spasm; affected with spasm; characterized by a spasm or spasms. [NIH] 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 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] Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer. [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] Cotinine: 1-Methyl-5-(3-pyridyl)-2-pyrrolidinone antidepressant. Synonym: Scotine. [NIH]

fumarate.

Stimulant

proposed

as

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

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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] 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] 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] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] 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] 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] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Daptomycin: A lipopeptide antibiotic that inhibits gram-positive bacteria. [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] Deamination: The removal of an amino group (NH2) from a chemical compound. [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]

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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. 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] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [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] 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] Dentists: Individuals licensed to practice dentistry. [NIH] Dermatitis: Any inflammation of the skin. [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] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] 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

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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] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diastolic blood pressure: The minimum pressure that remains within the artery when the heart is at rest. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [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] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Diploid: Having two sets of chromosomes. [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, or identity. [EU] 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

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consciousness and, thus separated, function as a unitary whole. [EU] Dissociative Disorders: Sudden temporary alterations in the normally integrative functions of consciousness. [NIH] Diuresis: Increased excretion of urine. [EU] 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] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Doxepin: A dibenzoxepin tricyclic compound. It displays a range of pharmacological actions including maintaining adrenergic innervation. Its mechanism of action is not fully understood, but it appears to block reuptake of monoaminergic neurotransmitters into presynaptic terminals. It also possesses anticholinergic activity and modulates antagonism of histamine H(1)- and H(2)-receptors. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [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] Duct: A tube through which body fluids pass. [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] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dystonia: Disordered tonicity of muscle. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH]

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Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [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] Electrocardiogram: Measurement of electrical activity during heartbeats. [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 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] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]

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 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] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent

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naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [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] Enkephalin: A natural opiate painkiller, in the hypothalamus. [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] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Ephedrine: An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. [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] 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] Epithalamus: The dorsal posterior subdivision of the diencephalon. The epithalamus is generally considered to include the habenular nuclei (habenula) and associated fiber bundles, the pineal body, and the epithelial roof of the third ventricle. The anterior and posterior paraventricular nuclei of the thalamus are included with the thalamic nuclei although they develop from the same pronuclear mass as the epithalamic nuclei and are sometimes considered part of the epithalamus. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] 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]

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Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [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] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [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] Evacuation: An emptying, as of the bowels. [EU] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiration: The act of breathing out, or expelling air from the lungs. [EU] 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] Extrapyramidal: Outside of the pyramidal tracts. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Facial: Of or pertaining to the face. [EU] Family Health: The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members. [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] Family Therapy: A form of group psychotherapy. It involves treatment of more than one member of the family simultaneously in the same session. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue

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development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [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] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] 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] 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] 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] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [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] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized

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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] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [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] 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]

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] Ginkgo biloba: Exclusive species of the genus Ginkgo, family Ginkgoacea. It produces extracts of medicinal interest. Ginkgo may refer to the genus or species. [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] Globus Pallidus: The representation of the phylogenetically oldest part of the corpus striatum called the paleostriatum. It forms the smaller, more medial part of the lentiform nucleus. [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] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [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] Gonadal: Pertaining to a gonad. [EU] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital

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tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] 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] Government Agencies: Administrative units of government responsible for policy making and management of governmental activities in the U.S. and abroad. [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] 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] Gram-Positive Bacteria: Bacteria which retain the crystal violet stain when treated by Gram's method. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Gravidity: Pregnancy; the condition of being pregnant, without regard to the outcome. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Gyrus Cinguli: One of the convolutions on the medial surface of the cerebral hemisphere. It surrounds the rostral part of the brain and interhemispheric commissure and forms part of the limbic system. [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] 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] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [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]

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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] 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] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [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] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the

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formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] 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] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [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] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [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] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydroxyzine: A histamine H1 receptor antagonist that is effective in the treatment of chronic urticaria, dermatitis, and histamine-mediated pruritus. Unlike its major metabolite cetirizine, it does cause drowsiness. It is also effective as an antiemetic, for relief of anxiety and tension, and as a sedative. [NIH] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperlipoproteinemia: Metabolic disease characterized by elevated plasma cholesterol

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and/or triglyceride levels. The inherited form is attributed to a single gene mechanism. [NIH] Hypersecretion: Excessive secretion. [EU] 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 are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertensive Encephalopathy: Brain dysfunction or damage resulting from malignant hypertension, usually associated with a diastolic blood pressure in excess of 125 mmHg. Clinical manifestations include headache, nausea, emesis, seizures, altered mental status (in some cases progressing to coma), papilledema, and retinal hemorrhage. Focal neurologic signs may develop. Pathologically, this condition may be associated with the formation of ischemic lesions in the brain (brain ischemia). [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypotension: Abnormally low blood pressure. [NIH] 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] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] 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] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [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] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH]

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Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunogenic: Producing immunity; evoking an immune response. [EU] 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] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impotence: The inability to perform sexual intercourse. [NIH] Impulsive Behavior: An act performed without delay, reflection, voluntary direction, or obvious control in response to a stimulus. [NIH] 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] Incest: Sexual intercourse between persons so closely related that they are forbidden by law to marry. [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [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] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] 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]

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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] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [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] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [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] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [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] Insurance Benefits: Payments or services provided under stated circumstances under the terms of an insurance policy. In prepayment programs, benefits are the services the programs will provide at defined locations and to the extent needed. [NIH] 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 cause-

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effect relation by modifying the supposed causal factor(s) in the study population. [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] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] 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] Ions: An atom or group of atoms that have a positive or negative electric charge due to a 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] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Irritable Mood: Abnormal or excessive excitability with easily triggered anger, annoyance, or impatience. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [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] 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] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU]

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Lactate Dehydrogenase: A tetrameric enzyme that, along with the coenzyme NAD+, catalyzes the interconversion of lactate and pyruvate. In vertebrates, genes for three different subunits (LDH-A, LDH-B and LDH-C) exist. [NIH] 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]

Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. 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] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligands: A RNA simulation method developed by the MIT. [NIH] Ligase: An enzyme that repairs single stranded discontinuities in double-stranded DNA molecules in the cell. Purified DNA ligase is used in gene cloning to join DNA molecules together. [NIH] Ligase Chain Reaction: A DNA amplification technique based upon the ligation of oligonucleotide probes. The probes are designed to exactly match two adjacent sequences of a specific target DNA. The chain reaction is repeated in three steps in the presence of excess probe: (1) heat denaturation of double-stranded DNA, (2) annealing of probes to target DNA, and (3) joining of the probes by thermostable DNA ligase. After the reaction is repeated for 20-30 cycles the production of ligated probe is measured. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [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] Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and

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water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [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]

Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [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] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [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] 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] 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] 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

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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] 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] 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]

Mammary: Pertaining to the mamma, or breast. [EU] 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] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] 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] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Marijuana Abuse: The excessive use of marijuana with associated psychological symptoms and impairment in social or occupational functioning. [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] 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]

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Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [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] 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] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] 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] 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] 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] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH]

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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] 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] Microwaves: That portion of the electromagnetic spectrum lying between UHF (ultrahigh frequency) radio waves and heat (infrared) waves. Microwaves are used to generate heat, especially in some types of diathermy. They may cause heat damage to tissues. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [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] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] 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 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] 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]

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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] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [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] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [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] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Myalgia: Pain in a muscle or muscles. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] 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] 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] 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] 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,

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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] 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] Neostriatum: The phylogenetically newer part of the corpus striatum consisting of the caudate nucleus and putamen. It is often called simply the striatum. [NIH] 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] 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] 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] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU]

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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 system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous 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] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [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] Nicotinic Agonists: Drugs that bind to and activate nicotinic cholinergic receptors (receptors, nicotinic). Nicotinic agonists act at postganglionic nicotinic receptors, at neuroeffector junctions in the peripheral nervous system, and at nicotinic receptors in the central nervous system. Agents that function as neuromuscular depolarizing blocking agents are included here because they activate nicotinic receptors, although they are used clinically to block nicotinic transmission. [NIH] Nimodipine: A calcium channel blockader with preferential cerebrovascular activity. It has marked cerebrovascular dilating effects and lowers blood pressure. [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] 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] Normal Distribution: Continuous frequency distribution of infinite range. Its properties are as follows: 1) continuous, symmetrical distribution with both tails extending to infinity; 2) arithmetic mean, mode, and median identical; and 3) shape completely determined by the mean and standard deviation. [NIH]

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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] 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] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [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] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oligonucleotide Probes: Synthetic or natural oligonucleotides used in hybridization studies in order to identify and study specific nucleic acid fragments, e.g., DNA segments near or within a specific gene locus or gene. The probe hybridizes with a specific mRNA, if present. Conventional techniques used for testing for the hybridization product include dot blot assays, Southern blot assays, and DNA:RNA hybrid-specific antibody tests. Conventional labels for the probe include the radioisotope labels 32P and 125I and the chemical label biotin. [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] Orthostatic: Pertaining to or caused by standing erect. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment

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in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [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] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] 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] 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] Papaverine: An alkaloid found in opium but not closely related to the other opium alkaloids in its structure or pharmacological actions. It is a direct-acting smooth muscle relaxant used in the treatment of impotence and as a vasodilator, especially for cerebral vasodilation. The mechanism of its pharmacological actions is not clear, but it apparently can inhibit phosphodiesterases and it may have direct actions on calcium channels. [NIH] Papilledema: Swelling around the optic disk. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Paresthesia: Subjective cutaneous sensations (e.g., cold, warmth, tingling, pressure, etc.) that are experienced spontaneously in the absence of stimulation. [NIH] Parity: The number of offspring a female has borne. It is contrasted with gravidity, which refers to the number of pregnancies, regardless of outcome. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU]

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Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of depression. [NIH]

Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] 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] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pedophilia: A sexual disorder occuring in a person 16 years or older and that is recurrent with intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child (generally age 13 or younger). (from APA, DSM-IV, 1994). [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] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [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] 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] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Permissiveness: The attitude that grants freedom of expression and activity to another

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individual, but not necessarily with sanction or approval. [NIH] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] Personnel Management: Planning, organizing, and administering all activities related to personnel. [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] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [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] 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] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [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] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [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]

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Piracetam: A compound suggested to be both a nootropic and a neuroprotective agent. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [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] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. [NIH] 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] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [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] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [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]

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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] Predictive factor: A situation or condition that may increase a person's risk of developing a certain disease or disorder. [NIH] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prefrontal Cortex: The rostral part of the frontal lobe, bounded by the inferior precentral fissure in humans, which receives projection fibers from the mediodorsal nucleus of the thalamus. The prefrontal cortex receives afferent fibers from numerous structures of the diencephalon, mesencephalon, and limbic system as well as cortical afferents of visual, auditory, and somatic origin. [NIH] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [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] 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 Health Services: Services designed for promotion of health and prevention of 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] 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] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [NIH] Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).

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[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] 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 and unexposed groups. [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 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] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [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] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU]

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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] 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] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [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] 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 Housing: Housing subsidized by tax funds, usually intended for low income persons or families. [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] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH]

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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]

Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Putamen: The largest and most lateral of the basal ganglia lying between the lateral medullary lamina of the globus pallidus and the external capsule. It is part of the neostriatum and forms part of the lentiform nucleus along with the globus pallidus. [NIH] Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the 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] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radiologist: A doctor who specializes in creating and interpreting pictures of areas inside the body. The pictures are produced with x-rays, sound waves, or other types of energy. [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] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU]

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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] 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, Nicotinic: One of the two major classes of cholinergic receptors. Nicotinic receptors were originally distinguished by their preference for nicotine over muscarine. They are generally divided into muscle-type and neuronal-type (previously ganglionic) based on pharmacology, molecular biology, and biophysical properties of the channels. [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] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] 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] 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] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH]

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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 with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Hemorrhage: Bleeding from the vessels of the retina. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rhabdomyolysis: Necrosis or disintegration of skeletal muscle often followed by myoglobinuria. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [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] Ristocetin: An antibiotic mixture of two components, A and B, obtained from Nocardia lurida (or the same substance produced by any other means). It is no longer used clinically because of its toxicity. It causes platelet agglutination and blood coagulation and is used to assay those functions in vitro. [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]

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Saline: A solution of salt and water. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] 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] 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 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] 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] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Self Administration: Administration of a drug or chemical by the individual under the

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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] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [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] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septal Nuclei: Neural nuclei situated in the septal region. They have afferent and cholinergic efferent connections with a variety of forebrain and brainstem areas including the hippocampus, the lateral hypothalamus, the tegmentum, and the amygdala. Included are the dorsal, lateral, medial, and triangular septal nuclei, septofimbrial nucleus, nucleus of diagonal band, nucleus of anterior commissure, and the nucleus of stria terminalis. [NIH] Sequence Homology: The degree of similarity between sequences. Studies of amino acid and nucleotide sequences provide useful information about the genetic relatedness of certain species. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [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] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [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] 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]

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Shyness: Discomfort and partial inhibition of the usual forms of behavior when in the presence of others. [NIH] Sibutramine: A drug used for the management of obesity that helps reduce food intake and is indicated for weight loss and maintenance of weight loss when used in conjunction with a reduced-calorie diet. It works to suppress the appetite primarily by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin. Side effects include dry mouth, headache, constipation, insomnia, and a slight increase in average blood pressure. In some patients it causes a higher blood pressure increase. [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] 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] 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 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] 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

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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 Welfare: Organized institutions which provide services to ameliorate conditions of need or social pathology in the community. [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] 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] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [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] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Soybean Oil: Oil from soybean or soybean plant. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [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

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types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [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] 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] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] 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] 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] Stool: The waste matter discharged in a bowel movement; feces. [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]

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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] Sublingual: Located beneath the tongue. [EU] 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 Abuse Treatment Centers: Health facilities providing therapy and/or rehabilitation for substance-dependent individuals. Methadone distribution centers are included. [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]

Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function. [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] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU]

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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 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] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [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 Membranes: Cell membranes associated with synapses. Both presynaptic and postsynaptic membranes are included along with their integral or tightly associated specializations for the release or reception of transmitters. [NIH] 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] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]

Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Taboo: Any negative tradition or behavior that is generally regarded as harmful to social welfare and forbidden within a cultural or social group. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Taurine: 2-Aminoethanesulfonic acid. A conditionally essential nutrient, important during mammalian development. It is present in milk but is isolated mostly from ox bile and strongly conjugates bile acids. [NIH] 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

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science arising from government research are made available to private enterprise. [NIH] Teichoic Acids: Bacterial polysaccharides that are rich in phosphodiester linkages. They are the major components of the cell walls and membranes of many bacteria. [NIH] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [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] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Tetrodotoxin: Octahydro-12-(hydroxymethyl)-2-imino-5,9:7,10a-dimethano10aH(1,3)dioxocino(6,5-a)pyrimidine-4,7,10,11,12-pentol. An aminoperhydroquinazoline poison found mainly in the liver and ovaries of fishes in the order Tetradontiformes (pufferfish, globefish, toadfish), which are eaten. The toxin causes paresthesia and paralysis through interference with neuromuscular conduction. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]

Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [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] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] 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] Tic: An involuntary compulsive, repetitive, stereotyped movement, resembling a purposeful movement because it is coordinated and involves muscles in their normal synergistic relationships; tics usually involve the face and shoulders. [EU] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH]

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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] Tonicity: The normal state of muscular tension. [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] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] 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] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [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] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [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 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]

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Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] 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] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [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] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [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]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [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] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [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] Vancomycin: Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU]

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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] 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] 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] Ventricular: Pertaining to a ventricle. [EU] 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] Viral: Pertaining to, caused by, or of the nature of virus. [EU] 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] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Voltage-gated: It is opened by the altered charge distribution across the cell membrane. [NIH]

Weight Gain: Increase in body weight over existing weight. [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] 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] Zidovudine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by an azido group. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The

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compound is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA during reverse transcription. It improves immunologic function, partially reverses the HIVinduced neurological dysfunction, and improves certain other clinical abnormalities associated with AIDS. Its principal toxic effect is dose-dependent suppression of bone marrow, resulting in anemia and leukopenia. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

355

INDEX A Abdomen, 291, 298, 299, 322, 324, 346 Abdominal, 283, 291, 322, 332, 336, 351 Abdominal Pain, 291, 322, 351 Aberrant, 172, 291, 303 Abscess, 291, 343 Acculturation, 32, 72, 124, 206, 291 Acetylcholine, 176, 177, 178, 195, 291, 302 Acquired Immunodeficiency Syndrome, 196, 219, 247, 261, 291 Acute renal, 214, 291 Adaptation, 51, 63, 135, 291, 321 Adenine, 291, 339 Adenosine, 185, 186, 291, 299, 334 Adjunctive Therapy, 193, 291 Adjustment, 31, 156, 291 Adolescence, 29, 35, 39, 52, 58, 63, 78, 85, 104, 210, 241, 260, 291 Adrenal Glands, 292, 293 Adrenal Medulla, 292, 300, 312, 330 Adrenergic, 292, 294, 295, 310, 312, 347, 351 Adverse Effect, 174, 292, 336, 344 Afferent, 292, 336, 343 Affinity, 175, 186, 292, 296, 345 Age Groups, 46, 68, 197, 228, 292 Aged, 80 and Over, 292 Agonist, 182, 195, 292, 299, 310, 312, 325, 328, 330, 348 Agoraphobia, 292, 319, 332 Agranulocytosis, 182, 292 Akathisia, 292, 295 Alertness, 292, 299 Algorithms, 292, 298 Alimentary, 292, 332 Alkaline, 292, 293, 299 Alkaloid, 292, 299, 302, 303, 327, 330, 332 Allergen, 292, 343 Alternative medicine, 227, 292 Amino Acid Sequence, 293, 294, 297, 337 Amino Acids, 164, 197, 293, 296, 297, 333, 335, 337, 341, 343, 350, 351 Ammonia, 293, 347, 351 Amphetamine, 83, 196, 254, 293, 308 Amplification, 293, 323 Amygdala, 184, 293, 323, 343 Amyloid, 4, 293, 340 Amyloidosis, 4, 214, 293

Anabolic, 106, 293 Anal, 42, 69, 84, 214, 293, 314, 324 Analgesic, 181, 288, 293, 299, 303, 312, 326, 327, 331, 332 Anaphylatoxins, 293, 304 Anatomical, 293, 296, 320, 342 Androgenic, 106, 293 Anemia, 294, 314, 353 Animal model, 70, 75, 294 Annealing, 294, 323 Anorexia, 177, 294 Antagonism, 170, 195, 294, 299, 310, 325 Anti-Anxiety Agents, 294, 338, 350 Antiarrhythmic, 170, 294 Antibacterial, 294, 346, 351 Antibiotic, 294, 307, 333, 341, 346 Antibodies, 188, 189, 294, 316, 319, 324, 335 Antibody, 189, 204, 205, 209, 246, 258, 292, 294, 295, 303, 316, 318, 320, 325, 331, 343, 345 Anticholinergic, 294, 301, 310 Anticoagulant, 294, 337 Anticonvulsant, 294, 301 Antidepressant, 193, 194, 294, 299, 302, 306, 314, 319 Antidepressive Agents, 294, 338 Antiemetic, 294, 295, 318 Antigen, 292, 294, 295, 304, 318, 319, 320, 325, 343 Antigen-Antibody Complex, 295, 304 Antipsychotic, 62, 170, 186, 195, 295, 329, 341, 350 Antispasmodic, 295, 331 Antitussive, 295, 331 Anus, 293, 295, 299, 340 Anxiety, 7, 11, 12, 60, 70, 77, 78, 89, 132, 155, 170, 177, 182, 183, 184, 185, 190, 192, 194, 196, 198, 199, 200, 229, 284, 292, 294, 295, 318, 332 Anxiety Disorders, 12, 89, 170, 194, 198, 199, 295, 332 Anxiolytic, 195, 295, 299, 301 Apathy, 295, 329 Apnea, 190, 192, 295 Applicability, 39, 57, 295 Aptitude, 171, 295 Aqueous, 196, 295, 297

356 Substance Abuse

Area Health Education Centers, 215, 295 Aromatic, 295, 334 Arrhythmia, 294, 295 Arterial, 295, 296, 299, 306, 319, 337, 348 Arteries, 295, 296, 298, 306, 327, 338 Arteriosclerosis, 296, 319 Arthralgia, 181, 296 Articular, 296, 331 Articulation, 24, 296 Artificial Organs, 296, 341 Aspartate, 7, 296 Aspartic, 191, 296 Aspartic Acid, 191, 296 Assay, 188, 195, 296, 341 Astrocytes, 296, 327 Asymptomatic, 240, 296 Atrial, 296, 306, 351 Atrioventricular, 296, 306 Atrium, 296, 306, 351, 352 Atrophy, 87, 296 Atypical, 195, 296, 341 Auditory, 296, 336 Autoimmune disease, 296, 328 Autonomic, 12, 177, 179, 193, 201, 291, 295, 296, 297, 307, 330, 333, 345, 347 Autonomic Nervous System, 12, 177, 297, 307, 333, 345, 347 B Bacteremia, 73, 297 Bacteria, 294, 295, 297, 314, 316, 327, 335, 346, 349, 351 Bacterial Physiology, 291, 297 Bactericidal, 73, 297, 313 Bacterium, 297, 303 Basal Ganglia, 23, 177, 179, 193, 295, 297, 302, 323, 339 Base, 69, 176, 291, 297, 307, 308, 322, 349 Basophils, 292, 297, 316 Behavior Therapy, 208, 297 Benign, 197, 297, 316, 329 Benzene, 297 Benzodiazepines, 213, 232, 297, 299 Beta-Endorphin, 198, 297 Beta-pleated, 293, 297 Bile, 297, 298, 314, 324, 346, 348 Bile Acids, 297, 298, 346, 348 Binding Sites, 176, 298 Biochemical, 298, 331, 343 Biological Transport, 298, 309 Biopsy, 4, 298 Biosynthesis, 298, 343 Biotechnology, 72, 73, 212, 227, 239, 298

Biotin, 197, 298, 331 Biotransformation, 298 Bipolar Disorder, 67, 97, 170, 194, 298 Bladder, 298, 320, 328, 351 Bloating, 298, 322 Blood Coagulation, 298, 299, 341, 349 Blood Platelets, 298, 343 Blood pressure, 178, 182, 285, 287, 298, 300, 301, 319, 327, 330, 338, 344, 345 Blood vessel, 298, 299, 300, 301, 306, 312, 313, 322, 324, 333, 344, 346, 349, 351, 352 Blood-Brain Barrier, 18, 298, 323 Bone Marrow, 297, 298, 319, 324, 353 Bone scan, 299, 342 Bowel, 170, 182, 194, 293, 299, 309, 321, 322, 346, 351 Bowel Movement, 299, 309, 346 Brain Ischemia, 299, 319 Brain Stem, 196, 299, 301 Branch, 220, 281, 299, 311, 315, 324, 333, 338, 345, 347, 349 Breakdown, 3, 299, 309, 315 Bulimia, 127, 177, 181, 299 Buprenorphine, 11, 19, 167, 299 Bupropion, 195, 299 Buspirone, 18, 196, 299 C Caffeine, 79, 123, 197, 288, 299, 339 Calcium, 183, 191, 299, 300, 303, 330, 332, 344 Calcium channel blocker, 191, 299 Calcium Channels, 183, 300, 332 Cannabis, 79, 123, 288, 300 Capsules, 300, 310 Carbon Dioxide, 300, 314, 340 Carcinogenic, 297, 300, 321, 346 Carcinogens, 300, 302 Cardiac, 21, 177, 294, 299, 300, 306, 311, 312, 313, 328, 346 Cardiovascular, 79, 123, 177, 179, 193, 201, 265, 293, 300, 307, 343, 345 Cardiovascular disease, 265, 300 Cardiovascular System, 177, 179, 193, 201, 300, 307 Catecholamine, 294, 300, 310, 334 Catheterization, 22, 300, 322 Causal, 15, 40, 56, 300, 322 Cause of Death, 171, 300 Cell Division, 297, 300, 326, 335, 337 Cell membrane, 298, 300, 334, 348, 352 Cell Respiration, 300, 340 Cellulose, 300, 335

Index 357

Central Nervous System, 52, 175, 177, 178, 184, 186, 196, 198, 199, 201, 214, 291, 293, 297, 299, 300, 301, 303, 307, 308, 312, 315, 316, 323, 325, 326, 327, 328, 330, 335, 343 Central Nervous System Diseases, 175, 184, 301 Cerebellum, 301, 335 Cerebral hemispheres, 297, 299, 301, 349 Cerebrovascular, 300, 301, 330 Cerebrum, 301, 349 Cetirizine, 301, 318 Chancroid, 240, 301 Character, 10, 187, 301, 308 Check-up, 14, 30, 301 Chemoreceptor, 295, 301 Chemotactic Factors, 301, 304 Chest Pain, 21, 301 Child Behavior, 28, 301 Child Custody, 88, 301 Child Welfare, 17, 88, 99, 137, 140, 301 Chlamydia, 240, 301 Chlordiazepoxide, 196, 301 Cholesterol, 17, 297, 302, 306, 318, 346, 348 Choline, 197, 302 Cholinergic, 182, 195, 295, 302, 330, 340, 343 Chorea, 295, 302 Chromium, 197, 302 Chromosomal, 293, 302, 335 Chromosome, 302, 316, 323 Chronic renal, 214, 302 Cimetidine, 195, 302 Citalopram, 64, 302 Clinical Medicine, 302, 336 Clinical study, 302, 305 Clinical trial, 8, 9, 14, 19, 20, 30, 36, 39, 56, 163, 165, 168, 208, 239, 302, 305, 337, 339 Cloning, 298, 302, 323 Coca, 302 Codeine, 303, 331, 332 Coenzyme, 303, 323 Cofactor, 303, 337, 349 Cognition, 46, 156, 177, 179, 183, 184, 193, 303, 329 Cognitive behavior therapy, 65, 303 Cognitive Therapy, 207, 209, 303 Colchicine, 4, 303 Colitis, 303, 322 Collapse, 299, 303 Communication Barriers, 259, 303 Community Mental Health Centers, 9, 303

Comorbidity, 16, 18, 24, 41, 42, 58, 61, 63, 66, 68, 95, 115, 149, 153, 303 Competency, 57, 303 Complement, 23, 293, 303, 304, 343 Complementary and alternative medicine, 121, 128, 304 Complementary medicine, 121, 304 Complete remission, 304, 340 Compulsion, 182, 304, 352 Compulsive Behavior, 182, 183, 185, 304 Computational Biology, 239, 304 Computed tomography, 106, 304, 305, 342 Computer Simulation, 45, 304 Computerized axial tomography, 304, 305, 342 Computerized tomography, 304, 305 Conception, 305, 314 Concomitant, 4, 84, 195, 305 Condoms, 220, 305 Conduction, 305, 349 Confounding, 12, 305 Confusion, 305, 309, 329 Congestion, 295, 305 Conjugated, 305, 307, 328 Connective Tissue, 299, 305, 314, 315 Consciousness, 285, 293, 294, 305, 308, 310 Constipation, 177, 295, 305, 322, 344 Constriction, 305, 320, 322 Consultation, 9, 17, 50, 56, 57, 93, 305 Consumption, 34, 46, 60, 114, 160, 208, 254, 305, 308, 331, 332 Contamination, 305, 317, 331 Continuum, 30, 305 Contraception, 109, 160, 241, 305 Contraindications, ii, 305 Control group, 28, 35, 38, 305, 339 Controlled clinical trial, 36, 44, 61, 305 Contusions, 181, 305 Convulsions, 178, 284, 294, 305 Convulsive, 177, 306 Coordination, 24, 141, 247, 275, 285, 301, 306, 328 Cor, 200, 306, 337 Coronary, 300, 306, 327 Coronary heart disease, 300, 306 Coronary Thrombosis, 306, 327 Cortex, 177, 179, 193, 306, 314, 318, 336, 339 Cortical, 12, 306, 336, 342 Cost Savings, 65, 306 Cost-benefit, 13, 75, 306 Cost-Benefit Analysis, 75, 306

358 Substance Abuse

Cotinine, 181, 182, 306 Crack Cocaine, 35, 306 Creatine, 186, 307 Creatinine, 4, 307 Creatinine clearance, 4, 307 Cues, 22, 307 Curare, 307, 328 Curative, 307, 330, 349 Cyclic, 175, 185, 299, 307, 334, 342 Cytidine, 186, 307 Cytochrome, 170, 302, 307 Cytosine, 186, 307 D Daptomycin, 73, 307 Data Collection, 28, 30, 51, 58, 246, 307, 314 Databases, Bibliographic, 239, 307 Deamination, 307, 327, 351 Decision Making, 207, 261, 307 Degenerative, 308, 317, 328, 331 Deletion, 22, 308 Delirium, 295, 308 Delivery of Health Care, 308, 317 Delusions, 182, 308, 338 Dementia, 177, 178, 183, 185, 291, 295, 308 Denaturation, 308, 323 Dendrites, 308, 330 Dendritic, 308, 346 Dental Care, 213, 308 Dentists, 5, 213, 308 Dermatitis, 170, 194, 308, 318 Designer Drugs, 188, 308 Detoxification, 34, 38, 191, 245, 308 Deuterium, 308, 318 Developing Countries, 308, 348 Dextroamphetamine, 164, 293, 308, 326, 327 Diabetes Mellitus, 6, 309, 315 Diagnostic procedure, 169, 227, 309 Diarrhea, 177, 284, 309, 322 Diastolic, 309, 319 Diastolic blood pressure, 309, 319 Diencephalon, 301, 309, 312, 319, 336, 349 Dietary Fats, 309, 324 Diffusion, 59, 298, 309 Digestion, 292, 297, 299, 309, 322, 324, 346 Digestive system, 168, 309 Dimethyl, 190, 192, 309 Diploid, 309, 335 Direct, iii, 30, 39, 59, 62, 72, 214, 231, 248, 302, 303, 309, 310, 324, 332, 340, 348 Discrimination, 69, 72, 259, 309

Disease Progression, 208, 309 Disinfectant, 309, 313 Disorientation, 214, 305, 308, 309 Disposition, 118, 195, 309 Dissociation, 84, 147, 292, 309 Dissociative Disorders, 12, 309, 310 Diuresis, 299, 310 Domestic Violence, 113, 132, 310 Dopa, 310, 323 Dosage Forms, 190, 192, 310 Dose-dependent, 310, 353 Doxepin, 196, 310 Drug Interactions, 5, 170, 194, 195, 219, 233, 310 Drug Tolerance, 310, 350 Duct, 300, 310, 342, 347 Dyes, 293, 297, 310, 330 Dyskinesia, 177, 182, 295, 302, 310 Dystonia, 175, 295, 310 E Eating Disorders, 170, 177, 179, 190, 192, 193, 198, 199, 310 Edema, 311, 322, 329 Effector, 291, 303, 311, 329, 330, 334 Effector cell, 311, 329, 330 Electrocardiogram, 164, 311 Electrolyte, 308, 311, 335, 345 Electrons, 297, 311, 322, 332, 339 Electrophysiological, 52, 311 Emaciation, 291, 311 Emesis, 311, 319 Empirical, 12, 23, 29, 41, 45, 60, 129, 155, 156, 311 Encephalitis, 198, 199, 311 Encephalitis, Viral, 311 Endemic, 311, 346 Endocarditis, 32, 73, 214, 311 Endocardium, 311 Endocrine System, 311, 329 Endorphin, 200, 297, 311 Endothelial cell, 298, 311, 312, 349 Endotoxins, 304, 312 End-stage renal, 4, 302, 312 Enkephalin, 297, 312, 337 Environmental Health, 238, 240, 312 Enzymatic, 299, 304, 312, 318, 341 Enzyme, 179, 188, 192, 193, 195, 303, 311, 312, 323, 327, 333, 334, 337, 344, 349, 353 Eosinophils, 292, 312, 316 Ephedrine, 197, 312 Epidemic, 171, 189, 205, 242, 243, 245, 246, 312, 346

Index 359

Epidemiological, 53, 68, 204, 207, 208, 267, 312 Epinephrine, 292, 310, 312, 330, 351 Epithalamus, 309, 312, 323 Erectile, 180, 201, 229, 312, 333 Erection, 229, 312 Ergot, 312, 325 Erythrocytes, 294, 299, 313, 343 Esophagus, 309, 313, 346 Estrogen, 313, 342, 348 Ethanol, 64, 130, 174, 191, 302, 313 Ether, 176, 313 Ethnic Groups, 68, 204, 242, 313 Evacuation, 305, 313 Excitability, 313, 322 Exhaustion, 294, 313 Exogenous, 298, 313 Expiration, 313, 340 Expiratory, 312, 313 Expiratory Reserve Volume, 312, 313 Extracellular, 22, 293, 296, 305, 313, 327, 345 Extracellular Space, 313, 327 Extrapyramidal, 175, 177, 179, 184, 186, 193, 292, 295, 310, 313 Exudate, 313, 331 F Facial, 313, 344, 345 Family Health, 43, 313 Family Planning, 144, 239, 313 Family Relations, 32, 313 Family Therapy, 49, 79, 205, 313 Fat, 299, 306, 313, 324, 328, 335, 351 Fatty acids, 18, 313 Feces, 305, 314, 346 Ferritin, 7, 314 Fetus, 314, 336 Fibrosis, 48, 314, 342 Fissure, 314, 336 Fixation, 314, 343 Flatus, 314, 315 Fluoxetine, 65, 195, 314 Focus Groups, 38, 314 Folate, 314 Fold, 186, 314 Folic Acid, 197, 314 Forearm, 298, 314 Frontal Lobe, 314, 336 G Gait, 286, 314 Gallbladder, 291, 309, 314

Ganglia, 177, 179, 193, 291, 314, 329, 333, 347 Gas, 188, 293, 300, 309, 312, 314, 315, 318, 322, 330, 352 Gastric, 177, 302, 310, 315, 318, 333 Gastric Acid, 177, 302, 315 Gastrin, 302, 315, 318 Gastrointestinal, 177, 179, 193, 307, 312, 313, 315, 343, 345, 347 Gastrointestinal tract, 177, 179, 193, 313, 315, 343 Gene, 22, 141, 212, 298, 315, 319, 323, 331 General practitioner, 214, 315 Genetics, 92, 197, 315 Gestation, 315, 333 Gestures, 315, 344 Ginkgo biloba, 121, 315 Gland, 292, 315, 332, 335, 342, 346, 347, 349 Globus Pallidus, 315, 339 Glucose, 6, 300, 302, 309, 315, 321, 342 Glucose Intolerance, 309, 315 Glutamate, 191, 315 Glutamic Acid, 314, 315 Glycine, 315, 343 Glycogen, 301, 315 Glycoprotein, 214, 315, 340, 349 Gonadal, 315, 346 Gonorrhea, 240, 248, 315 Gout, 303, 316 Governing Board, 94, 316, 335 Government Agencies, 53, 316, 335 Grade, 28, 132, 145, 150, 151, 155, 228, 316 Gram-negative, 301, 316 Gram-positive, 73, 307, 316 Gram-Positive Bacteria, 307, 316 Granulocytes, 292, 316, 344, 352 Grasses, 314, 316 Gravidity, 316, 332 Growth, 15, 16, 31, 46, 54, 69, 194, 275, 291, 294, 298, 308, 316, 325, 329, 335, 342, 349, 351 Gyrus Cinguli, 316, 323 H Habitual, 197, 301, 316 Habituation, 214, 316 Hallucinogen, 316, 325 Haploid, 316, 335 Haptens, 292, 316 Headache, 299, 316, 319, 336, 344 Health Behavior, 23, 114, 317 Health Care Costs, 166, 317

360 Substance Abuse

Health Education, 99, 111, 215, 218, 219, 228, 244, 245, 317 Health Expenditures, 317 Health Promotion, 16, 38, 51, 208, 218, 256, 317 Health Status, 25, 166, 313, 317 Heart attack, 300, 317 Heart failure, 312, 317 Heme, 307, 317, 328 Hemorrhage, 55, 305, 316, 317, 346 Hemostasis, 317, 343 Hepatitis, 32, 214, 218, 240, 262, 263, 317 Hepatitis A, 218, 317 Hepatocytes, 317 Hepatovirus, 317 Hereditary, 316, 317, 328 Heredity, 315, 317 Herpes, 240, 317, 318 Herpes Zoster, 318 Heterogeneity, 54, 292, 318 Hippocampus, 318, 323, 343 Histamine, 293, 295, 301, 302, 310, 318 Homeless Persons, 25, 71, 82, 91, 105, 124, 318 Homeless Youth, 53, 85, 318 Homeostasis, 95, 318, 345 Homicide, 65, 318 Homogeneous, 13, 305, 318, 334 Homologous, 318, 343, 348 Hormonal, 95, 296, 318 Hormone, 180, 200, 201, 297, 312, 315, 318, 321, 336, 342, 344, 349 Host, 318, 319, 352 Hybrid, 79, 318, 331 Hydrogen, 175, 183, 200, 297, 308, 318, 327, 332, 334, 337 Hydrolysis, 296, 298, 318, 335, 337 Hydroxyzine, 196, 318 Hyperalgesia, 183, 318 Hypercholesterolemia, 180, 201, 318 Hyperlipoproteinemia, 180, 201, 318, 319 Hypersecretion, 200, 319 Hypersensitivity, 292, 319, 343 Hypertension, 127, 177, 179, 180, 193, 201, 300, 316, 319 Hypertensive Encephalopathy, 55, 319 Hypertriglyceridemia, 180, 201, 319 Hypertrophy, 306, 319, 351 Hypotension, 295, 306, 319 Hypothalamus, 297, 309, 312, 319, 323, 335, 337, 343 Hypoxia, 185, 299, 308, 319

I Id, 119, 126, 263, 264, 274, 280, 282, 319 Illusions, 319, 342 Imidazole, 298, 318, 319 Imipramine, 195, 319 Immune response, 295, 296, 316, 319, 320, 343, 347, 352 Immune Sera, 319 Immune system, 200, 208, 222, 258, 311, 319, 320, 324, 328, 351, 352 Immunity, 291, 319, 320, 350 Immunization, 189, 262, 319, 343 Immunogenic, 188, 320 Immunologic, 301, 319, 320, 353 Immunology, 292, 320 Impairment, 55, 141, 177, 214, 308, 310, 320, 325, 326, 338 Impotence, 228, 229, 312, 320, 332 Impulsive Behavior, 64, 320 In vitro, 320, 341 In vivo, 22, 183, 188, 320, 327 Incarceration, 27, 138, 320 Incest, 107, 136, 320 Incision, 320, 322 Incontinence, 190, 192, 312, 320 Indicative, 52, 209, 320, 333, 351 Induction, 295, 320 Infancy, 14, 46, 260, 320 Infant Behavior, 301, 320 Infant, Newborn, 292, 320 Infarction, 299, 306, 320, 327 Infection Control, 208, 320 Inflammation, 178, 303, 308, 311, 313, 314, 317, 318, 321, 341, 351, 352 Inflammatory bowel disease, 177, 321 Informed Consent, 34, 321 Ingestion, 33, 321, 335 Inhalation, 45, 321, 335 Initiation, 18, 47, 88, 91, 98, 321 Inner ear, 321, 351 Innervation, 310, 321 Inositol, 197, 321, 342 Inotropic, 310, 321 Inpatients, 20, 34, 130, 321 Insight, 52, 248, 321, 341 Insomnia, 78, 127, 285, 321, 336, 344 Institutionalization, 173, 321 Insulator, 321, 328 Insulin, 5, 180, 201, 321, 341 Insulin-dependent diabetes mellitus, 321 Insurance Benefits, 85, 321 Intermittent, 321, 324

Index 361

Internal Medicine, 78, 86, 106, 166, 321, 329 Intervention Studies, 63, 321 Intestine, 299, 322, 323 Intoxication, 248, 308, 322, 352 Intracellular, 200, 214, 299, 320, 322, 335, 340, 342, 344 Intramuscular, 176, 181, 322, 332 Intravenous, 73, 167, 176, 181, 208, 213, 214, 219, 220, 222, 243, 245, 258, 289, 322, 332 Intrinsic, 292, 322 Intubation, 300, 322 Invasive, 205, 229, 319, 322, 325 Involuntary, 106, 184, 302, 322, 328, 345, 349 Ion Channels, 296, 322, 330, 348 Ions, 297, 300, 309, 311, 318, 322, 327 Irritable Bowel Syndrome, 177, 190, 192, 322 Irritable Mood, 56, 322 Ischemia, 296, 299, 322 J Joint, 262, 296, 322, 331 K Kb, 238, 322 Kidney Disease, 168, 214, 238, 322 Kidney Failure, 312, 322 Kinetic, 322 L Labile, 303, 322 Lactate Dehydrogenase, 7, 323 Large Intestine, 309, 322, 323, 340, 344 Latent, 26, 45, 46, 53, 54, 69, 137, 323, 336 Length of Stay, 26, 323 Lesion, 23, 323, 324, 348 Lethal, 297, 323 Leucine, 297, 323, 333 Leukopenia, 323, 353 Levodopa, 184, 310, 323 Library Services, 280, 323 Ligands, 175, 176, 177, 183, 185, 323 Ligase, 38, 323 Ligase Chain Reaction, 38, 323 Ligation, 323 Limbic, 175, 177, 179, 184, 186, 193, 293, 316, 323, 336 Limbic System, 177, 179, 193, 293, 316, 323, 336 Linkage, 8, 30, 33, 43, 61, 244, 323 Lipase, 190, 323 Lipid, 296, 302, 321, 324, 328, 351

Lithium, 295, 324 Liver scan, 324, 342 Lobe, 324, 337 Local Government, 42, 324 Localization, 172, 173, 175, 184, 185, 186, 324 Localized, 291, 293, 299, 301, 314, 320, 324, 327, 335, 351 Locomotion, 324, 335 Longitudinal Studies, 27, 204, 246, 324 Longitudinal study, 20, 46, 324 Long-Term Care, 19, 23, 324 Lymphatic, 320, 324, 346, 349 Lymphatic system, 324, 346, 349 Lymphocyte, 291, 295, 324, 325 Lymphocyte Count, 291, 324 Lymphoid, 294, 324 Lysergic acid, 213, 324 Lysergic Acid Diethylamide, 213, 325 M Magnetic Resonance Imaging, 164, 325, 342 Malignant, 291, 319, 325, 329 Malnutrition, 296, 325 Mammary, 325, 348 Mandatory Testing, 66, 325 Mandible, 6, 325 Mania, 170, 183, 185, 194, 325 Manic, 67, 181, 295, 298, 324, 325, 338 Manic-depressive psychosis, 325, 338 Manifest, 52, 325 Marijuana Abuse, 9, 254, 325 Marital Status, 247, 325 Mass Media, 171, 325 Mediate, 38, 39, 310, 325 Mediator, 14, 28, 112, 310, 325, 343 Medical Records, 165, 325 Medicament, 199, 325 MEDLINE, 239, 325 Medullary, 326, 339 Megaloblastic, 314, 326 Meiosis, 326, 348 Melanin, 326, 334, 351 Membrane, 176, 200, 296, 300, 304, 313, 316, 322, 326, 327, 334, 340, 341, 344, 346, 348 Memory, 23, 130, 177, 179, 183, 193, 198, 199, 285, 294, 308, 326 Meninges, 301, 326 Menstrual Cycle, 326, 336 Menstruation, 326, 336

362 Substance Abuse

Mental Disorders, 11, 16, 24, 164, 168, 179, 326, 338 Mental Processes, 309, 326, 338 Mental Retardation, 59, 130, 209, 261, 326 Mentors, 23, 39, 41, 59, 326 Meperidine, 308, 326 Mesolimbic, 71, 295, 326 Meta-Analysis, 52, 326 Metabolite, 192, 289, 298, 309, 318, 326 Methamphetamine, 23, 113, 196, 326 Methionine, 297, 309, 326, 337 Methylphenidate, 102, 196, 327 MI, 21, 33, 34, 49, 179, 218, 228, 248, 290, 327 Microbe, 327, 350 Microbiology, 291, 296, 327 Microdialysis, 22, 327 Microwaves, 327, 339 Mobility, 261, 327 Modeling, 16, 29, 40, 42, 43, 45, 65, 69, 137, 149, 218, 327 Modification, 64, 87, 170, 171, 172, 191, 219, 222, 245, 308, 327, 339, 352 Modulator, 178, 191, 327 Molecular, 56, 112, 185, 189, 239, 250, 298, 304, 327, 340, 351 Molecular Structure, 327, 351 Molecule, 193, 295, 297, 298, 303, 304, 309, 311, 318, 327, 332, 335, 340, 344 Monitor, 67, 96, 218, 307, 327, 331 Monoamine, 179, 190, 192, 193, 195, 293, 294, 309, 327, 351 Monoamine Oxidase, 179, 192, 193, 195, 293, 294, 309, 327, 351 Morphine, 181, 183, 191, 299, 303, 326, 327, 328, 331 Motility, 177, 179, 193, 327, 343 Motion Sickness, 328 Motivations, 10, 32, 113, 328 Motor Activity, 305, 328 Motor nerve, 328 Movement Disorders, 175, 295, 328 Mucus, 328, 351 Multiple sclerosis, 198, 199, 328 Muscle relaxant, 182, 185, 294, 328 Muscle tension, 328 Myalgia, 181, 214, 328 Myelin, 328 Myocardium, 327, 328 Myoglobin, 214, 328 N Naloxone, 19, 297, 328

Naltrexone, 18, 191, 328 Narcolepsy, 190, 192, 308, 312, 327, 328 Narcotic, 326, 327, 328, 332 Nausea, 178, 214, 285, 294, 295, 310, 319, 328, 332, 336 NCI, 1, 168, 237, 328 Necrosis, 320, 327, 329, 341 Need, 3, 9, 14, 15, 21, 30, 31, 35, 36, 47, 49, 55, 59, 61, 73, 76, 130, 171, 173, 177, 182, 189, 191, 199, 203, 204, 213, 215, 217, 219, 222, 228, 240, 242, 248, 257, 262, 276, 302, 315, 329, 345, 350, 351 Needle Sharing, 217, 219, 221, 329 Neoplasms, 291, 300, 329 Neostriatum, 329, 339 Nephrology, 4, 214, 329 Nephropathy, 214, 322, 329 Nephrosis, 329 Nephrotic, 4, 214, 329 Nephrotic Syndrome, 4, 214, 329 Nerve, 292, 308, 321, 325, 327, 328, 329, 335, 340, 342, 346, 350 Networks, 42, 57, 150, 172, 329 Neural, 23, 85, 172, 292, 293, 327, 329, 343 Neuroanatomy, 23, 323, 329 Neuroeffector Junction, 329, 330 Neuroendocrine, 46, 64, 177, 179, 193, 329 Neuroleptic, 91, 175, 184, 185, 292, 295, 329 Neurologic, 104, 114, 172, 200, 294, 319, 329 Neuromuscular, 291, 329, 330, 349 Neuromuscular Junction, 291, 329 Neuronal, 18, 176, 178, 190, 192, 195, 300, 302, 329, 340 Neurons, 70, 303, 308, 314, 323, 328, 329, 330, 347, 348 Neuropathy, 190, 192, 198, 199, 330 Neurophysiology, 64, 70, 330 Neurotoxicity, 179, 330 Neurotransmitters, 73, 177, 178, 201, 310, 330, 336, 344, 345 Neutrophils, 292, 316, 330 Niacin, 197, 232, 330, 351 Nicotinic Agonists, 178, 330 Nimodipine, 191, 330 Nitrogen, 181, 185, 193, 200, 292, 314, 330, 351 Nonverbal Communication, 330, 338 Norepinephrine, 177, 179, 190, 192, 193, 292, 310, 312, 330, 344 Normal Distribution, 52, 330

Index 363

Nuclear, 297, 311, 313, 323, 329, 331, 349 Nuclear Family, 313, 331 Nuclei, 177, 179, 193, 293, 311, 312, 325, 331, 337, 343 Nucleic acid, 307, 330, 331, 339, 352 Nucleus, 297, 307, 308, 312, 315, 326, 329, 330, 331, 336, 337, 339, 343, 345 Nutritional Status, 6, 331 O Observational study, 20, 21, 331 Obsession, 304, 331 Ointments, 310, 331 Oligonucleotide Probes, 323, 331 Opium, 181, 327, 331, 332 Opportunistic Infections, 291, 331 Orthostatic, 295, 331 Osteoarthritis, 190, 192, 331 Ovaries, 332, 343, 349 Oxidation, 298, 307, 332 Oxycodone, 124, 332 Oxygen Consumption, 332, 340 P Palliative, 332, 349 Palsy, 177, 332, 345 Pancreas, 291, 298, 309, 321, 324, 332 Panic, 319, 332 Panic Disorder, 319, 332 Papaverine, 331, 332 Papilledema, 319, 332 Paralysis, 307, 332, 345, 349 Parenteral, 176, 332 Paresthesia, 332, 349 Parity, 37, 77, 85, 116, 332 Parkinsonism, 175, 295, 323, 332 Paroxetine, 195, 333 Partial remission, 333, 340 Patch, 333, 350 Pathogenesis, 214, 262, 333 Pathologic, 298, 306, 319, 333 Pathophysiology, 52, 201, 333 Patient Education, 256, 278, 280, 290, 333 Pedophilia, 172, 333 Penicillin, 294, 333 Penis, 305, 333 Pepsin, 302, 333 Pepsin A, 302, 333 Peptide, 200, 297, 333, 335, 337 Perceived risk, 35, 333 Perception, 134, 155, 157, 208, 333, 342 Perfusion, 319, 333 Perinatal, 14, 100, 110, 141, 204, 333

Peripheral Nervous System, 330, 332, 333, 336, 347 Permissiveness, 36, 333 Personality Disorders, 12, 152, 222, 334 Personnel Management, 205, 334 PH, 106, 263, 334 Pharmaceutical Solutions, 310, 334 Pharmacokinetic, 334 Pharmacologic, 15, 37, 172, 334, 350 Pharmacotherapy, 18, 19, 37, 334 Phenyl, 200, 326, 334 Phenylalanine, 164, 333, 334, 351 Phosphodiesterase, 190, 334 Phospholipids, 313, 321, 334 Phosphorus, 299, 334 Physical Examination, 164, 301, 334 Physical Fitness, 139, 228, 334 Physiologic, 46, 292, 298, 310, 326, 334, 340 Physiology, 218, 311, 329, 330, 334 Pigment, 328, 334 Pilot Projects, 17, 45, 334 Pilot study, 84, 334 Piracetam, 121, 335 Pituitary Gland, 335, 337 Plants, 193, 292, 296, 300, 302, 315, 330, 335, 342, 350 Plasma, 200, 294, 300, 315, 317, 318, 322, 335 Plasma cells, 294, 335 Plasmid, 198, 335 Poisoning, 308, 312, 322, 328, 335 Policy Making, 316, 335 Polypeptide, 293, 328, 333, 335, 353 Polyunsaturated fat, 17, 335 Pons, 299, 335 Posterior, 293, 301, 312, 332, 335 Postnatal, 46, 335 Postsynaptic, 329, 335, 344, 348 Post-traumatic, 60, 70, 328, 335 Potassium, 183, 335 Potentiate, 177, 335, 336 Potentiation, 12, 335, 344 Practicability, 335, 350 Practice Guidelines, 166, 250, 263, 335 Preclinical, 18, 56, 64, 336 Precursor, 131, 184, 302, 310, 311, 312, 323, 330, 334, 336, 337, 351 Predictive factor, 39, 336 Predisposition, 189, 336 Prefrontal Cortex, 23, 336 Premenstrual, 190, 192, 336 Premenstrual Syndrome, 190, 192, 336

364 Substance Abuse

Prenatal, 46, 80, 130, 140, 145, 148, 256, 260, 336 Prescription drug abuse, 226, 336 Presynaptic, 310, 329, 336, 348 Presynaptic Terminals, 310, 336 Prevalence, 5, 6, 10, 24, 31, 36, 38, 46, 51, 52, 55, 61, 62, 63, 66, 80, 105, 122, 148, 189, 208, 215, 241, 269, 336 Preventive Health Services, 48, 336 Probe, 323, 327, 331, 336 Problem Solving, 218, 336 Progesterone, 336, 346 Prognostic factor, 336, 347 Program Development, 43, 245, 336 Program Evaluation, 206, 246, 337 Progression, 68, 133, 171, 294, 337 Progressive, 177, 184, 302, 308, 310, 316, 329, 331, 337 Projection, 330, 336, 337 Prone, 72, 197, 337 Pro-Opiomelanocortin, 200, 337 Prophase, 337, 348 Prospective study, 27, 63, 106, 324, 337 Protein C, 183, 293, 314, 337, 351 Protein S, 212, 298, 337, 341 Proteins, 22, 293, 295, 296, 298, 300, 303, 327, 330, 333, 335, 337, 340, 343, 349, 350 Proteinuria, 4, 329, 337 Proteolytic, 198, 304, 337 Protocol, 30, 49, 163, 243, 249, 262, 337 Protons, 318, 337, 339 Proximal, 336, 337, 343 Proxy, 67, 337 Pruritus, 318, 337 Psychic, 338, 342 Psychology, Social, 204, 338 Psychometrics, 206, 338 Psychomotor, 308, 329, 338 Psychopathology, 12, 16, 40, 46, 60, 63, 65, 70, 72, 99, 148, 338 Psychosis, 125, 170, 177, 184, 194, 198, 199, 295, 338 Psychosomatic, 5, 338 Psychotherapy, 15, 93, 112, 191, 197, 205, 210, 303, 313, 338 Psychotomimetic, 293, 309, 338 Psychotropic, 107, 196, 198, 199, 338 Psychotropic Drugs, 198, 199, 338 Public Housing, 26, 71, 338 Public Policy, 23, 27, 47, 61, 131, 146, 189, 215, 220, 239, 248, 338 Publishing, 6, 7, 10, 24, 73, 76, 204, 338

Pulmonary, 298, 305, 306, 322, 338, 352 Pulmonary Artery, 298, 338, 352 Pulmonary hypertension, 306, 338 Pulse, 55, 172, 287, 327, 339 Purines, 339, 343 Putamen, 185, 329, 339 Pyramidal Tracts, 313, 339 Q Quality of Life, 24, 55, 166, 339, 347 R Race, 12, 29, 43, 72, 192, 247, 310, 339 Radiation, 306, 339, 342, 352 Radio Waves, 164, 327, 339 Radioactive, 299, 318, 324, 331, 339, 342 Radiologist, 111, 339 Random Allocation, 339 Randomization, 34, 54, 108, 167, 339 Randomized, 13, 15, 20, 25, 27, 30, 49, 56, 65, 71, 72, 165, 166, 311, 339 Randomized clinical trial, 13, 15, 20, 56, 72, 165, 166, 339 Reagent, 188, 339 Reality Testing, 338, 340 Receptors, Nicotinic, 330, 340 Receptors, Serotonin, 340, 343 Recombinant, 198, 340 Rectal, 176, 340 Rectum, 295, 299, 309, 314, 315, 320, 321, 323, 340 Recurrence, 298, 325, 340 Refer, 1, 5, 303, 314, 315, 318, 324, 329, 338, 340 Refraction, 340, 346 Regimen, 13, 170, 194, 219, 311, 334, 340 Relapse, 17, 18, 22, 29, 30, 59, 62, 103, 125, 173, 191, 258, 340 Relaxant, 332, 340 Reliability, 33, 50, 53, 66, 108, 118, 340 Remission, 125, 191, 298, 325, 340 Renal amyloidosis, 4, 340 Research Design, 40, 47, 61, 267, 340 Respiration, 177, 179, 185, 193, 295, 300, 301, 307, 327, 340 Retina, 340, 341 Retinal, 319, 341 Retinal Hemorrhage, 319, 341 Retrospective, 106, 149, 341 Rhabdomyolysis, 214, 341 Rhinitis, 301, 312, 341 Riboflavin, 197, 341 Ribose, 291, 307, 341 Ribosome, 341, 350

Index 365

Rigidity, 285, 332, 335, 341 Risk factor, 24, 33, 35, 54, 67, 85, 104, 114, 208, 241, 248, 337, 341 Risk-Taking, 77, 248, 341 Risperidone, 84, 341 Ristocetin, 341, 351 Robotics, 71, 341 Role Playing, 134, 245, 246, 341 Role-play, 38, 187, 341 Rural Population, 215, 341 S Safe Sex, 219, 341 Saline, 164, 342 Salivary, 309, 342 Salivary glands, 309, 342 Saponins, 342, 346 Scans, 164, 342 Schizoid, 342, 352 Schizotypal Personality Disorder, 342, 352 Sclerosis, 296, 328, 342 Screening, 12, 34, 56, 57, 75, 105, 114, 188, 240, 243, 249, 262, 302, 325, 342 Second Messenger Systems, 330, 342 Secretion, 177, 302, 318, 319, 321, 328, 342 Sedative, 301, 303, 318, 319, 342 Seizures, 214, 286, 308, 319, 342 Selective estrogen receptor modulator, 342, 348 Self Administration, 22, 71, 342 Self Care, 244, 343 Self-Help Groups, 97, 343 Sensibility, 318, 343 Sensitization, 184, 343 Septal, 184, 323, 343 Septal Nuclei, 323, 343 Sequence Homology, 186, 343 Serine, 197, 343 Sertraline, 18, 195, 343 Serum, 4, 7, 293, 303, 319, 343 Sex Characteristics, 291, 343 Sexual Partners, 7, 10, 343 Sexually Transmitted Diseases, 38, 75, 78, 114, 248, 257, 262, 341, 343 Shock, 289, 343, 350 Shyness, 173, 344 Sibutramine, 190, 192, 344 Sign Language, 4, 218, 221, 344 Signal Transduction, 321, 344 Signs and Symptoms, 6, 170, 194, 340, 344 Skeletal, 214, 307, 341, 344, 345 Skeleton, 322, 344 Small intestine, 318, 322, 344

Smiling, 219, 344 Smooth muscle, 178, 293, 299, 318, 327, 332, 344, 345, 347 Social Behavior, 103, 155, 172, 344 Social Conditions, 203, 344 Social Environment, 339, 344, 345 Social Problems, 26, 72, 344 Social Sciences, 51, 345 Social Support, 27, 44, 63, 72, 126, 136, 144, 150, 159, 345 Social Welfare, 17, 345, 348 Sodium, 316, 345, 347 Solitary Nucleus, 297, 345 Solvent, 191, 297, 313, 334, 345 Somatic, 291, 323, 326, 333, 336, 345 Sound wave, 305, 339, 345 Soybean Oil, 335, 345 Spasm, 295, 306, 345 Spasmodic, 182, 345 Spastic, 322, 345 Specialist, 220, 275, 345 Species, 22, 301, 303, 307, 312, 315, 318, 326, 339, 343, 344, 345, 347, 350, 351, 352 Specificity, 292, 300, 345 Spectrum, 5, 6, 56, 240, 243, 245, 327, 339, 346 Spike, 71, 346 Spinal cord, 261, 296, 299, 301, 302, 326, 329, 330, 333, 339, 346, 347 Spirochete, 346, 348 Spleen, 200, 293, 324, 346 Sporadic, 174, 197, 346 Stabilizer, 56, 346 Staging, 342, 346 Standardize, 172, 346 Sterilization, 221, 346 Steroid, 106, 342, 346 Stimulant, 23, 84, 196, 205, 226, 293, 299, 306, 308, 318, 326, 327, 346 Stimulus, 311, 320, 321, 322, 346, 349 Stomach, 291, 309, 313, 315, 318, 328, 333, 344, 346 Stool, 320, 322, 323, 346 Striatum, 22, 315, 329, 346 Stroke, 127, 168, 238, 300, 346 Stupor, 214, 328, 346 Subacute, 320, 346 Subclinical, 139, 320, 342, 347 Subcutaneous, 4, 176, 181, 311, 332, 347 Sublingual, 176, 347 Subspecies, 345, 347

366 Substance Abuse

Substance Abuse Treatment Centers, 109, 157, 347 Substance P, 16, 61, 326, 341, 342, 347 Support group, 258, 288, 289, 347 Supportive care, 42, 347 Suppression, 198, 347, 353 Survival Analysis, 16, 347 Sweat, 284, 347 Sweat Glands, 347 Sympathetic Nervous System, 297, 347 Sympathomimetic, 293, 308, 310, 312, 326, 330, 347, 351 Symptomatic, 289, 294, 301, 347 Symptomatic treatment, 294, 301, 347 Symptomatology, 23, 49, 55, 62, 63, 147, 347 Synapses, 329, 330, 346, 348 Synapsis, 348 Synaptic, 18, 330, 344, 348 Synaptic Membranes, 18, 348 Synaptic Transmission, 330, 348 Synergistic, 197, 348, 349 Syphilis, 240, 348 Systemic, 232, 293, 298, 299, 308, 312, 320, 348, 350, 351 Systolic, 319, 348 T Taboo, 229, 348 Tachycardia, 286, 297, 348 Tachypnea, 286, 297, 348 Tamoxifen, 195, 342, 348 Tardive, 175, 177, 182, 184, 186, 295, 302, 348 Taurine, 197, 348 Technology Transfer, 37, 265, 348 Teichoic Acids, 316, 349 Telencephalon, 297, 349 Temporal, 293, 318, 349 Temporal Lobe, 293, 349 Terminator, 349, 353 Tetrodotoxin, 181, 349 Thalamus, 309, 312, 323, 336, 349 Therapeutics, 39, 77, 190, 213, 233, 327, 349 Thermal, 172, 309, 349 Threonine, 343, 349 Threshold, 313, 319, 349 Thrombin, 337, 349 Thrombomodulin, 337, 349 Thrombosis, 337, 346, 349 Thymus, 319, 324, 349 Thyroid, 349, 351

Thyroxine, 334, 349 Tic, 170, 194, 349 Tolerance, 111, 130, 173, 174, 299, 315, 350 Tomography, 106, 350 Tonicity, 310, 350 Tooth Preparation, 291, 350 Topical, 171, 257, 313, 350 Toxic, iv, 297, 307, 316, 319, 330, 350, 351, 353 Toxicity, 181, 310, 341, 350 Toxicokinetics, 350 Toxicology, 55, 118, 125, 167, 240, 350 Toxins, 295, 300, 311, 312, 320, 350 Trace element, 302, 350 Tranquilizing Agents, 338, 350 Transdermal, 176, 350 Transfection, 298, 350 Transfer Factor, 319, 350 Translation, 24, 350 Transmitter, 291, 296, 310, 322, 325, 330, 348, 350, 351 Transplantation, 4, 110, 302, 319, 350 Trauma, 27, 32, 55, 60, 93, 146, 147, 159, 181, 198, 199, 212, 229, 308, 316, 329, 350 Triage, 43, 351 Tricuspid Atresia, 306, 351 Tricyclic, 170, 195, 294, 302, 310, 319, 351 Trigger zone, 295, 351 Triglyceride, 319, 351 Tryptophan, 343, 351 Tuberculosis, 240, 242, 262, 305, 351 Tyramine, 327, 351 Tyrosine, 164, 197, 310, 351 U Ulcerative colitis, 182, 321, 351 Unconscious, 112, 134, 289, 319, 351 Urea, 347, 351 Urethra, 333, 351 Urinary, 312, 320, 351 Urine, 6, 18, 32, 33, 38, 118, 164, 165, 167, 214, 298, 307, 310, 320, 337, 341, 351 Urogenital, 315, 351 Urticaria, 301, 318, 351 V Vaccine, 219, 337, 351 Vancomycin, 73, 351 Vascular, 198, 199, 229, 320, 351 Vasculitis, 114, 214, 352 Vasodilator, 310, 318, 332, 352 VE, 78, 89, 165, 219, 220, 352 Vein, 322, 331, 352 Venereal, 348, 352

Index 367

Venous, 337, 351, 352 Ventricle, 293, 296, 306, 312, 318, 319, 338, 339, 348, 349, 351, 352 Ventricular, 306, 351, 352 Vertebrae, 346, 352 Veterinary Medicine, 239, 352 Viral, 198, 199, 218, 311, 352, 353 Virulence, 350, 352 Visceral, 297, 323, 352 Visceral Afferents, 297, 352 Vitamin A, 321, 352 Vivo, 352 Volition, 132, 322, 352

Voltage-gated, 183, 352 W Weight Gain, 190, 192, 352 White blood cell, 294, 323, 324, 328, 335, 352 Withdrawal, 118, 173, 174, 177, 178, 179, 182, 191, 193, 195, 197, 199, 308, 326, 352 X Xenograft, 294, 352 X-ray, 304, 305, 331, 339, 342, 346, 352 Z Zidovudine, 118, 352 Zymogen, 337, 353

368 Substance Abuse