Treating drug problems

Article Abstract:

A summary is provided of a report released in September 1990 by the Institute of Medicine of the National Academy of Sciences regarding the effectiveness of drug-treatment programs. The report was prepared by a committee of people from various walks of life, selected by the Institute. Initial drug use is voluntary, and only a small proportion of drug users eventually become drug abusers. An estimated 5.5 million people are dependent on drugs or are abusing them, with almost half in the criminal-justice system. Recovery from using illicit drugs was defined as the ability to function in society, not as complete abstinence. There are four main approaches to drug treatment: methadone maintenance, an ambulatory program for opiate-dependent individuals; therapeutic communities; outpatient nonmethadone programs; and chemical-dependency programs (mainly for treating alcoholism). Methadone maintenance, with the most positive results and the most controversial approach, is subjected to charges of substituting one addiction for another. Therapeutic communities, formerly composed mainly of heroin-dependent people, now house cocaine users in large numbers. They have a high attrition rate, but can lead to considerable behavioral improvement in those who finish the program. Outpatient nonmethadone programs have results similar to those of therapeutic communities. These three approaches are considered to be cost effective. Detoxification, by itself, rarely leads to recovery. Prison treatment programs, in general, can not combat recidivism. Treatment programs are funded by the public (mostly outpatient nonmethadone facilities) or the private sector (mostly hospitals for treating patients in chemical-dependency programs). The committee offered different recommendations for each type of support. A system for gathering and organizing data on treatment effectiveness, dismantled since the early 1980s, must be established to fight the problem. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug treatment centers

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Management of cocaine abuse and dependence

Article Abstract:

Treating cocaine addiction should go beyond drug therapy to include caring and psychological attention. Cocaine users typically present a number of behavioral, legal, financial, social, and learning difficulties. Moreover, people taking cocaine may either sniff, inhale, or inject it in addition to other drugs. It is hard to evaluate the benefits of drug therapy in such complex user groups. For example, abusers with mood swings may benefit from antidepressants but results have been mixed. There has been limited success using dopamimetic drugs, opioid antagonists, and the anticonvulsant carbamazepine, as well as innovative psychotherapeutic techniques. Further research on the properties of dopamine receptors in the brain may produce more effective cocaine blocking agents. A gradual decrease of cocaine use may be preferable to the usual recommendation of total abstinence.

Cocaine abuse

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Effects of alcohol ingestion on estrogens in postmenopausal women

Article Abstract:

Alcohol intake appears to increase blood levels of estrogen in women who take estrogen replacement therapy. This was demonstrated in a study of 24 postmenopausal women, 12 of whom were taking estrogen. Compared to a placebo, alcohol raised blood estradiol levels 3-fold in women who were taking estrogen. However, estradiol levels remained unchanged after alcohol consumption in women not taking estrogen. Both groups drank the same amount of alcohol and their blood alcohol levels were similar.

Health aspects, Measurement, Physiological aspects, Alcohol, Ethanol, Postmenopausal women, Estrogen, Estrogens, Estradiol

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