164 research outputs found
Compensatory and mimetic conditioned responses to effects of heroin in addicted persons
Study 1: The aim of this study was to analyze in persons detoxified of heroin, compensatory conditioned responses (CCRs) that are opposite to the unconditioned physiological, and subjective effects that are induced by this substance. The procedure consisted in presenting slides with images of neutral stimuli (NSs) and conditioned stimuli (CSs) of heroin to both non-addicted and detoxified addicted persons. The evaluated responses were heart rate (HR) and desire for heroin (DH). Study 2: The aim was to facilitate the emission of mimetic conditioned responses (MCRs) to the unconditioned physiological, and subjective effects of heroin in detoxified heroin addicts. Three different stimulus series were manipulated: SA, during which the participant remained alone; SB, administration of a needle prick given by the researcher; SC, performance of the 'pump' ritual without drug by the participants. The responses measured were HR and DH. The results of both studies are considered, respectively, to be indicators of compensatory and mimetic conditioned responses
Anticipatory conditioned responses to subjective and physiological effects of heroin in addicted persons
Study 1: The aim of this experiment was to analyze in persons detoxified
of heroin, conditioned responses (CRs) that are opposite to the unconditioned physiological
and subjective effects that are induced by this substance. The basic procedure consisted
in presenting slides with images of neutral stimuli (NSs) and conditioned stimuli (CSs)
of heroin to both non-addicted and detoxified addicted persons. The evaluated responses
were conductance (C) and self-perception of abstinence symptoms (SAS). The results
are considered to be indicators of compensatory conditioned responses (CCRs) (conditioned
abstinence). Study 2: The aim of this experiment was to facilitate the emission of
mimetic conditioned responses (MCRs) to the unconditioned subjective effects of heroin
in detoxified heroin addicts. Three different stimulus series were manipulated: SA,
during which the participant remained alone; SB, administration of a needle prick given
by the researcher; SC, performance of the «pump» ritual without drug by the participants.
The response measured was SAS. The results are considered to be indicators of MCRs.
The results of both studies are discussed in the context of the environmental specificity
model of anticipatory responses to the effects of drugs.Estudio 1: El objetivo de este experimento fue analizar en personas
desintoxicadas a la heroína respuestas condicionadas (RCs) opuestas a ciertos efectos
fisiológicos y subjetivos de esta droga. El procedimiento consistió en presentar diapositivas
con imágenes de estímulos neutros (ENs) y estímulos condicionados (ECs) de la heroína
a personas no adictas y a personas adictas desintoxicadas. Las respuestas evaluadas
fueron conductancia (C) y autopercepción de síntomas de abstinencia (ASA). Los resultados
se consideraron como indicadores de respuestas condicionadas compensatorias
de los efectos de la heroína (abstinencia condicionada). Estudio 2: El objetivo de este
experimento fue facilitar en personas adictas desintoxicadas a la heroína la emisión de
respuestas condicionadas miméticas (RCMs) de los efectos subjetivos incondicionados
de la heroína. Para ello se utilizaron tres series estimulares: SA, serie control; SB, el
investigador administra un leve pinchazo; SC, el participante realiza el ritual de “bombeo”
sin droga. La respuesta medida fue ASA. Los datos obtenidos se consideraron
como indicadores de RCMs. Los resultados de ambos estudios se discutieron desde el
modelo de la especificidad ambiental de las respuestas anticipatorias de los efectos de
las drogas.Estudo 1: O objectivo desta experiência foi analisar em pessoas desintoxicadas
de heroína, respostas condicionadas que são opostas a certos efeitos incondicionados
fisiológicos e subjectivos desta droga. O procedimento consistiu em apresentar diapositivos
com imagens de estímulos neutros (ENs) e estímulos condicionados (ECs) da heroína
a pessoas não aditas e a pessoas aditas desintoxicadas. As respostas avaliadas foram
condutância (C) e autopercepção de sintomas de abstinência (ASA). Os resultados
consideraram-se como indicadores de respostas condicionadas compensatórias dos efeitos
da heroína (abstinência condicionada). Estudo 2: O objectivo desta experiência foi
facilitar em pessoas aditas desintoxicadas da heroína a emissão de respostas condicionadas
miméticas (RCMs) dos efeitos subjectivos incondicionados da heroína. Para isso
utilizaram-se três séries de estímulos: SA, série controlo; SB, o investigador administra
uma leve picada; SC, o participante realiza o ritual de “bombear” sem droga. A resposta
medida foi ASA. Os dados obtidos consideraram-se como indicadores de RCMs. Os
resultados de ambos os estudos são discutidos a partir do modelo da especificidade
ambiental das respostas antecipatórias dos efeitos das drogas
A critical analysis of user satisfaction surveys in addiction services: Opioid maintenance treatment as a representative case study
Background: Satisfaction with services represents a key component of the user's perspective, and user satisfaction surveys are the most commonly used approach to evaluate the aforementioned perspective. The aim of this discursive paper is to provide a critical overview of user satisfaction surveys in addiction treatment and harm reduction services, with a particular focus on opioid maintenance treatment as a representative case. Methods: We carried out a selective critical review and analysis of the literature on user satisfaction surveys in addiction treatment and harm reduction services. Results: Most studies that have reported results of satisfaction surveys have found that the great majority of users (virtually all, in many cases) are highly satisfied with the services received. However, when these results are compared to the findings of studies that use different methodologies to explore the patient's perspective, the results are not as consistent as might be expected. It is not uncommon to find that "highly satisfied" patients report significant problems when mixed-methods studies are conducted. To understand this apparent contradiction, we explored two distinct (though not mutually exclusive) lines of reasoning, one of which concerns conceptual aspects and the other, methodological questions. Conclusion: User satisfaction surveys, as currently designed and carried out in addiction treatment and harm reduction services, do not significantly help to improve service quality. Therefore, most of the enthusiasm and naiveté with which satisfaction surveys are currently performed and interpreted - and rarely acted on in the case of nonoptimal results - should be avoided. A truly participatory approach to program evaluation is urgently needed to reshape and transform patient satisfaction surveys. Keywords: patient satisfaction, substance abuse treatment services, harm reduction services, patient-centered evaluation, service user perspective, user involvemen
Captación de participantes en el programa experimental de prescripción de estupefacientes en Andalucía (PEPSA)
ResumenEsta nota tiene como finalidad describir los pasos seguidos en el proceso de captación de los participantes en el ensayo andaluz de prescripción de heroína intravenosa. El programa experimental de prescripción de estupefacientes en Andalucía (PEPSA) compara el tratamiento de heroína respecto a la metadona oral, en la mejoría de la salud física y mental y la integración social. Dada las características de la población diana (usuarios de heroína por vía intravenosa en situación de exclusión social para quienes no han sido efectivos los tratamientos disponibles), se planificó un abordaje específico para acercar dichas personas al estudio. Tras una investigación previa sobre la distribución de la población diana en la ciudad de Granada, se dividió ésta en 3 zonas. Se acudía a los principales centros de reunión (plazas, comedores sociales, dispensarios de metadona) y se concretaba una cita con un médico del PEPSA. El trabajo apoyado en iguales ha sido una herramienta fundamental en este proceso de captación, y ha facilitado el acercamiento a la población diana. Asimismo, este trabajo ha permitido entablar contacto con usuarios de drogas que no acceden a los servicios sociosanitarios, por lo que la labor del equipo de captación también ha sido educar en la reducción de daños y ofrecer alternativas sociales y sanitarias más allá del ensayo.AbstractIn this field note we describe the steps followed in the process of recruiting participants for the experimental drug prescription program in Andalusia (PEPSA). This trial is a comparative, randomized, open study of the difference between intravenous heroin treatment and oral methadone for socially excluded, opiate-dependent patients, in whom other available treatments have been unsuccessful. Because this is a hidden and hard-to-reach population, a specific approach was planned to put as many patients as possible in touch with the program. A previous study of the target population’s distribution in the City of Granada was performed and the city was divided into three areas. Potential participants were interviewed in squares, soup kitchens and methadone dispensaries by outreach workers and peers, who suggested they make an appointment with a PEPSA physician. Peer-driven intervention was a crucial instrument in this recruitment procedure, allowing greater access to the target population. Furthermore, this approach allowed contact with drug users who do not attend health and social services. The work of the outreach team involved educating these users in harm reduction and offering them health and social alternatives beyond the clinical trial
Differential long-term outcomes for voluntary and involuntary transition from injection to oral opioid maintenance treatment
A chance to stop and breathe: participants’ experiences in the North American Opiate Medication Initiative clinical trial
The political and scientific challenges in evaluating compulsory drug treatment centers in Southeast Asia
Opioid substitution and antagonist therapy trials exclude the common addiction patient: a systematic review and analysis of eligibility criteria
The SALOME study: recruitment experiences in a clinical trial offering injectable diacetylmorphine and hydromorphone for opioid dependency
Differential long-term outcomes for voluntary and involuntary transition from injection to oral opioid maintenance treatment
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