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At the Drug Detoxification Program of the Haight Ashbury Free Clinics, we conducted a randomized clinical trial of imipramine in the treatment of methamphetamine dependence. The purposes of the trial were to test the efficacy of imipramine as a treatment for methamphetamine dependence and to establish the feasibility of conducting a controlled clinical trial at the Clinic. Thirty-two subjects were randomly assigned to receive either 10 or 150 mg/day of imiprine for 180 days. Imipramine 10 mg/day was the control. Subjects received intensive counseling. Retention in treatment was significantly longer for subjects who were treated with 150 mg of imipramine compared to control (median days: 33.0 vs. 10.5). There were no consistent differences in percent of urine samples positive for methamphetamine, Beck Depression Inventory scores, or craving. Determination of the full extent of imipramine's utility in the treatment of methamphetamine dependence awaits a larger trial.
J Subst Abuse Treat
PMID:A controlled trial of imipramine for the treatment of methamphetamine dependence. 921 47

The purpose of the present study was to (a) describe the trend in depressive symptoms in a sample of postpartum women who used cocaine and who completed drug treatment; and (b) to examine possible correlates of those trends including treatment type and selected pretreatment characteristics. Self-reported levels of depressive symptoms improved from treatment entry to discharge and remained relatively stable through three postdischarge follow-up points. Baseline level of depression was the only pretreatment factor that was correlated with the trend in depressive symptoms. And length of time in treatment, previous drug treatment, and baseline severity of drug use were not.
J Subst Abuse Treat
PMID:The course of depressive symptoms over time for women who completed drug treatment. 925 56

Measures of psychopathology among mentally ill chemical abusers (MICAs) were examined as predictors of levels of functioning in two types of community based, residential programs: therapeutic community (TC) and community residence (CR). Non-significant associations were generally observed between scales of psychiatric symptoms (e.g., depression, psychotic ideation, cognitive disorientation, and hostility) and counselors' ratings of the residents' capacity to meet the social and interpersonal expectations of the programs (e.g., personal care, involvement in interpersonal relationships, and development of work skills). The study suggests that individuals with moderately severe psychopathology can be successfully engaged in residential treatment, even in programs with relatively high expectations for interpersonal involvement and functioning, such as the therapeutic community.
J Subst Abuse Treat
PMID:Mentally ill chemical abusers in residential treatment programs: effects of psychopathology on levels of functioning. 930 2

Females incarcerated for drug-related offenses represent one of the fastest growing populations within jails and prisons. The few studies of female offenders with substance abuse disorders depict a population with multiple psychosocial problems and treatment needs, and one that is characterized by frequent exposure to sexual abuse and other violence. The current study examined intake assessment results from a sample of 1,655 substance-involved jail inmates referred to a jail treatment program in Tampa, Florida, including 26% female and 74% male inmates. The study was designed to identify gender differences in psychosocial characteristics and substance abuse treatment needs among jail inmates. Results indicate that female inmates more frequently experienced employment problems, had lower incomes, more frequently reported cocaine as the primary drug of choice, and were more likely to report depression, anxiety, suicidal behavior, and a history of physical and sexual abuse. Implications for developing specialized treatment approaches for female offenders are discussed, including use of integrated treatment strategies.
J Subst Abuse Treat
PMID:Treatment of substance-abusing jail inmates. Examination of gender differences. 936 10

Histories of sexual and physical abuse are frequently reported by individuals participating in substance abuse treatment, these experiences may be associated with psychopathology and poor drug treatment outcomes. This paper presents the findings from a longitudinal study of 330 subjects participating in 26 outpatient treatment programs. Sexual abuse among women was associated with higher levels of depression, anxiety, suicidal ideation, suicide attempts, and PTSD, while physical abuse was associated with fewer psychological disturbances. For men, sexual abuse was associated only with anxiety. Physical abuse was associated with depression, anxiety, suicidal ideation, and PTSD. However, no significant association was found between sexual and physical abuse, and lower levels of treatment participation or drug use at follow-up. These findings indicate that there is a complex connection between abuse, psychopathology, treatment participation, and relapse. Clinical and research implications of these findings are discussed.
J Subst Abuse Treat
PMID:Sexual and physical abuse: do they compromise drug treatment outcomes? 936 11

Abuse of and dependence on drugs, alcohol and other substances in schizophrenia are being increasingly recognized and well documented in the literature. It has been suggested that up to 60% of patients with schizophrenia use illicit drugs. A total of 41 subjects who fulfilled DSM-III-R criteria for schizophrenia and substance abuse or dependence were asked to describe their reasons for using such substances, the reasons why they might stop and the subjective effects of the substances. Drugs were reportedly used to increase pleasure, to 'get high' and to reduce depression. However, subjective effects of increased depression and positive symptoms were also reported. These results are considered in the context of potential treatment strategies.
 ...
PMID:Reasons for substance use in schizophrenia. 939 49

This study examines the relationship of substance use to birth outcome, infant, and maternal health in a large, nationally representative sample. Multiple regression analyses, accommodating the nature of the survey data using the SUDAAN software package, indicated that drinking and smoking independently and/or interactively with depression account for poor health and serious medical conditions among pregnant women as well as negative birth outcomes or adverse health consequences in those infants who are live births. In addition, African American women and their infants are more likely than those of other racial groups to suffer these adverse outcomes. Given the risk profiles of individual illnesses, this study suggests the need for developing and targeting health education and preventive efforts specific to those groups that are clearly at greater risk.
J Subst Abuse 1997
PMID:The effects of substance use during gestation on birth outcome, infant and maternal health. 949 43

Two studies examined the relationships between anxiety sensitivity (AS), drug use, and reasons for drug use. In Study 1, 229 university students (57% F) completed the Anxiety Sensitivity Index (ASI) and a drug use survey, assessing use of a variety of drugs within the last month, and coping reasons for drug use. Consistent with a modified tension-reduction hypothesis, ASI scores were positively correlated with the number of both anxiety- and depression-related reasons for drug use endorsed. In Study 2, 219 university students (74% F) completed the ASI and a drug use survey, assessing use of several drugs (e.g., alcohol, cigarettes, caffeine, and marijuana/hashish) within the last year, and primary reasons (coping, affiliative, or enhancement) for the use of each drug. Marijuana/hashish users reported lower ASI scores than non-users supporting a negative relation between AS and the use of cannabis. ASI scores were positively correlated with the use of alcohol primarily to cope, and negatively correlated with the use of alcohol primarily to affiliate, among both gender groups, and ASI scores were positively correlated with the use of nicotine primarily to cope among the females. Implications of these findings for understanding risk for abuse of stress-response-dampening drugs by high AS individuals are discussed.
J Subst Abuse 1997
PMID:Anxiety sensitivity and self-reported reasons for drug use. 949 51

Correlates of substance abuse disorders in teenagers may suggest new treatment modalities. The present article examines correlates of self-reported substance abuse and dependence among a sample of 1936 youth at high risk for drug abuse, from 21 southern California continuation high schools. Among 32 demographic, drug use, drug use intention, coping, or health attitude-related variables, gender, cigarette smoking, anger coping, depression, and addiction concern were most consistently associated with self-reported substance abuse or substance dependence. These results suggest that affect management may help facilitate the prevention or control of adolescent drug abuse.
J Subst Abuse 1997
PMID:The correlates of substance abuse and dependence among adolescents at high risk for drug abuse. 949 52

The objectives of this study were to examine the prevalence and presentation of depression among patients with substance use disorders, and to explore the relationship between depression and the outcome of addictions treatment. Seventy-five patients were consecutively recruited upon entering addictions treatment, and were assessed by clinical and semi-structured interviews, Hamilton Rating Scale for Depression, Global Assessment Scale, and Beck Depression Inventory. At intake, 22.4% of patients had primary depressive disorders, 8.4% had substance-induced depressions, and 5.6% had mixed features of primary and substance-induced depressions. Female and alcoholic patients were more likely to suffer from both primary and substance-induced depressions. At 3 months, 93.3% of patients were reinterviewed. Depressed patients had longer duration of abstinence and greater decreases in symptomatology. Patients with substance-induced depression achieved almost complete discontinuation of primary substance use. Depression had a significant impact on addictions treatment outcome, but many important predictors of outcome have not yet been identified.
J Subst Abuse Treat
PMID:The impact of depression on the outcome of addictions treatment. 956 51


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