Readiness to Change as a Mediator of the Effect of a Brief Motivational Intervention on Posttreatment Alcohol-Related Consequences of Injured Emergency Department Hazardous Drinkers

Evaluated impact of motivational enhancement (ME) of substance abuse treatment compared to relaxation training (RT) on sex without condoms (overall and involving substance use) 3 months following release among incarcerated adolescents. This randomized clinical trial involved 114 incarcerated adolescents from the Northeast. Regression analyses determined if treatment condition, baseline levels of depressive symptoms, and their interaction predicted condom non-use 3 months post-release, controlling for baseline condom non-use. Among those who reported fewer baseline depressive symptoms, those in ME condition reported significantly less condom non-use, in general and involving marijuana use compared with those in RT condition. Periods of incarceration represent opportunities to help juvenile detainees reduce behaviors that impact their health and the health of those with whom they interact in the community

Effective and Inexpensive Procedures for Decreasing Client Attrition in an Outpatient Alcohol Treatment Program

Dropout rates in alcohol treatment programs are typically quite high. Three studies with outpatient alcohol abusers investigated several different follow-through procedures designed to increase the return rate of clients who prematurely drop out of treatment. Subjects were also asked why they had abruptly left treatment. Inexpensive letter and telephone follow-through procedures were found to be effective at reducing early client attrition and at providing valuable information about the fate of dropouts

Behavioral Assessment and Treatment Planning With Alcohol and Drug Abusers: a Review with an Emphasis on Clinical Application

Assessment and treatment of substance abuse is a complex and difficult task that involves more than the mere measurement of substance use. A detailed evaluation of the functions of a substance abuser\u27s alcohol and drug use is necessary to the development of meaningful and effective treatment goals and strategies. This paper reviews several new and established assessment methods and instruments which can be used in clinical practice to evaluate the severity of alcohol and drug problems and to provide direction for treatment planning. The advantages and limitations of the various techniques are discussed with the recognition that the utility of each technique depends upon the needs and problems of each client. The importance and application of recent research findings to assessment and treatment planning are also noted throughout this review

Do Quantity-Frequency Data Underestimate Drinking-Related Health Risks?

Identifying health impairment related to ethanol consumption is one of the major objectives of public health research. The most frequently used method for assessing drinking behavior in public health surveys and related research has been estimation formulae, like the Quantity-Frequency (QF) method which derives an estimate of typical/average levels of daily consumption. In recent years, questions have arisen as to whether the QF method can accurately reflect actual drinking patterns. This study compares a QF method of assessing daily drinking behavior with a newer, more quantitative method (Time-Line, TL) of assessing daily drinking. The QF and TL methods yielded similar mean daily ethanol consumption levels; however, in contrast to the TL method, the QF method seriously masked subjects\u27 actual drinking patterns by failing to identify certain types of ethanol consumption days, especially those thought to be associated with health risks. These findings, while provocative, were obtained with a small number of subjects (N = 40). Extrapolation to populations other than problem drinkers, while likely, awaits further empirical validation

Can Disulfiram Precipitate Urges To Drink Alcohol?

Although pharmacological data suggest that patients taking disulfiram should have a reduced desire to drink alcohol, voluntary compliance with disulfiram treatment is quite poor. As a possible explanation for why so many patients discontinue taking disulfiram and return to excessive drinking, it was hypothesized that daily disulfiram administration might serve as a cognitive stimulus precipitating urges to drink alcohol and/or inadvertently exposing patients to additional drinking-related cues. If this is the case, then patients taking disulfiram should report more thoughts about or urges to drink alcohol. In an exploratory, uncontrolled clinical study, alcohol abusers who were taking disulfiram tended to self-record more cravings for alcohol over a two week period than did abstinent patients who were not taking disulfiram. Controlled research is needed to investigate whether disulfiram use may serve as a cue antecedent to relapse to drinking