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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to determine whether untreated pregnant and recently post-partum cocaine-abusing women could be differentiated from women who enrolled in drug treatment programs. The experimental sample was selected from women referred to the Georgia Addiction, Pregnancy, and Parenting Project, an intervention program for pregnant and postpartum addicted women, between January 1987 and January 1988 (n = 45). The comparison group was randomly selected from women who were admitted to two (2) day treatment programs during the same time period (n = 50). Groups were compared using the Addiction Severity Index (ASI) and the Psychiatric Symptom Checklist-90 (SCL-90). Results indicated that untreated women were less impaired socially and exhibited fewer symptoms of psychiatric distress. These findings confirm the commonly held belief that the severity of psychosocial distress may be an important motivating factor in the decision to enter drug treatment. Alternatively, the lack of gender-sensitive program components, such as childcare, and the social stigma attached to drug use in pregnancy may also account for the reluctance of pregnant and post-partum mothers to seek drug treatment. Implications for the development of intervention and treatment programs for women are discussed.
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PMID:A comparison study of treated and untreated pregnant and postpartum cocaine-abusing women. 133 70

We report the cases of three adults with a history of intravenous drug abuse who developed endocarditis caused by Corynebacterium xerosis, Neisseria subflava, and Neisseria flavescens, respectively. No cases of endocarditis caused by C. xerosis or N. flavescens and only one case caused by N. subflava have previously been reported in association with narcotic addiction. The prominent clinical features in all patients included poor response to antibiotic therapy, persistent fever, and major embolic events. Stigmata of infection with human immunodeficiency virus, as manifested by oral candidiasis, cervical lymphadenopathy, and serologic evidence, were present in two of the three patients. At our institution, where Staphylococcus aureus remains the most frequent etiologic agent of narcotic-associated endocarditis, the occurrence of these three cases in a 9-month period is striking. We speculate that infection with human immunodeficiency virus may play a role in the pathogenesis of endocarditis caused by these unusual organisms.
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PMID:Unusual pathogens in narcotic-associated endocarditis. 235 5

A well organized, structured programme with facilities for follow-up and after-care helps the addict and his family to recover from addiction. Recovery from addiction is a continuous process from the time of initial treatment. Recovery is a multiphased problem. Hence various treatment modalities have to be included in the treatment regime of addicts. The disease model helps the addicts to accept their dependency and reduce their shame and guilt. It helps the community to accept the problems and also helps the community to take responsibility in preventive programmes. It reduces the stigma attached to addiction. It also helps the family and the addict seek professional help. When the treatment agency recognizes 'abstinence' as the goal of the therapy, the agency should provide enough scope for dealing with sobriety-based problems for the addicts. With varied follow-ups, after-care and relapse prevention programmes, relapses could be minimized.
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PMID:Towards freedom: treatment approaches to drug dependence at TTK Hospital. 261 23

One of every eight American children is the child of a parent who has a past or present drinking problem. Children of alcoholic parents are at great risk. They are significantly more likely to develop addiction problems and a variety of mental health disorders. They live in homes with high levels of stress. Poor communication, permissiveness, undersocialization, neglect, and violence are common and can be truly devastating. Because of the stigma and denial associated with chemical dependency, these children often suffer in silence, unidentified and unassisted.
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PMID:Children of alcoholics. 372 99

The knowledge and attitudes of 36 psychiatric out-patients regarding medication were investigated by personal interview. Over 80 per cent of the variance of self-report medication compliance was predictable from an array of socio-economic variables and cognitive variables. Compliers and non-compliers differed in their expectancy and prior experience of beneficial effects of the medication, and in their fear of undesirable side-effects and the problem of addiction. Using causal modeling procedures, self-report compliant behaviour was causally linked to favourable attitudes and fear, which in turn were linked to knowledge of name, dose, purpose, and side-effects of the medication and the perceived stigma of the illness. Implications for patient education aimed at improving patient compliance are discussed.
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PMID:Medication compliance in a Chinese psychiatric out-patient setting. 670 40

Dual diagnosis refers to the co-occurrence of substance abuse and mental illness, which may take many forms. Women who abuse alcohol or drugs are more likely than men to be diagnosed with a psychiatric disorder, particularly depression or personality disorder. The interaction of pregnancy, addiction, and mental illness creates complex needs that often go unrecognized by treatment providers. Clinical issues concern adequate prenatal care, use of medications while pregnant and/or nursing, maternal bonding, and coordinated treatment planning among medical, addiction, and mental health treatment providers. Barriers to service delivery to perinatal substance-abusing women with a mental illness include the difficulty in diagnosing a dual disorder, child care and custody concerns, lack of health insurance or funds to pay for treatment, and the stigma associated with mental illness and addiction. Services currently available for the dually diagnosed are typically fragmented and uncoordinated and provision of those services is often hampered by philosophical differences, categorical funding, competition for scarce resources, inadequate staff training, and lack of a central administrative authority or mandate. Several models have been suggested that coordinate services for the dually diagnosed. Awareness of the service needs of dually-diagnosed perinatal women must be included within these models and integrated at all levels of the treatment system.
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PMID:Services for perinatal women with substance abuse and mental health disorders: the unmet need. 911 Feb 67

Methadone maintenance treatment (MMT) for opioid addiction is safe and effective but underutilized because of inaccessibility, under-financing and the stigma generally attached to maintenance therapies. In addition, cumbersome regulation of methadone prescription and treatment impedes the delivery of care and retards expansion of methadone maintenance into office practice settings. Exaggeration of the problem of methadone diversion further hinders development of MMT. Despite obstacles, methadone maintenance has been successfully expanded and extended into primary care settings abroad. Initial trials in the U.S. have shown that methadone maintenance in physician office-based settings yields positive results with some advantages over care in large methadone clinics. Alternatives to methadone, such as buprenorphine, are also being explored in primary care settings. With implementation of the NIH Consensus Statement on Effective Medical Treatment of Heroin Addiction, including training of primary care physicians, methadone maintenance treatment could reach many more patients, achieve higher success rates, and substantially reduce the deleterious effects of opioid addiction in the U.S.
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PMID:Access to narcotic addiction treatment and medical care: prospects for the expansion of methadone maintenance treatment. 1033 71

With increasing pressure on general physicians by managed care organizations and the public to treat and advocate for drug and alcohol addicted patients, it is more necessary than ever that physicians have the knowledge and skills to appropriately address this segment of the population. Specifically, physicians need a better understanding of the prevalence of alcohol and drug dependence in a variety of populations, along with increased awareness of the economic impact of addictive illnesses on our society. Routine screening questions should be incorporated into patient encounters, and physicians should be able to identify environments that may pose a risk for the development of addiction. Physicians need training and practice in referring patients to treatment teams, monitoring patients in recovery, and providing interventions that will eliminate or reduce substance abuse before it becomes addiction. The treatment outcomes in abstinence-based programs, particularly those combined with referral to AA, have been encouraging, demonstrating that addiction is a treatable illness and not a character defect. In addition, several studies provide evidence that addiction treatment is cost-beneficial, resulting in reduced medical costs, lowered absenteeism, and increased productivity. Despite these encouraging results, there is still room for improvement. Treatment is not always effective, and it is not sufficiently available to everyone who needs it. Addicted individuals are both stigmatized and marginalized, and many are too ill to advocate for themselves. Widespread recognition in the medical community of addiction as a treatable illness will contribute to a greater understanding of addictive disorders and reduce the stigma attached to the diagnosis and treatment of addiction. For this to occur, better training for physicians in the recognition and management of addictive disorders, starting at the medical school level, is necessary. The approval of addiction medicine as a clinical specialty by the American Medical Association also has helped to advance the legitimacy of addiction as a treatable illness, and provides a focal point for the synthesis and integration of clinical, teaching, and research activities central to addiction medicine. The combination of knowledge, skills, and attitudes outlined in the article will go a long way toward increasing physicians' abilities to assist their patients with recovery from addiction.
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PMID:The role of the physician in addiction prevention and treatment. 1038 46

Research into resocialization of criminals or into recovery from substance dependence has stressed the need to give up the deviant identity and lifestyle. However, addiction careers, crime, and other types of deviant behavior require a wide range of skills. Such competence may facilitate the alternative or simultaneous pursuit of "respectable" careers in treatment, prevention, research, or policy matters. Former alcoholics fill important positions in the service structures of Alcoholics Anonymous, current or former users are appreciated as partners in AIDS prevention programs, and drug addicts can become privileged-access interviewers and be recruited by research institutes. The paper discusses "market conditions" that favor or impede career shifts. How society and professionals perceive individuals with a history of stigma varies from complete rejection to admiration or recognition of usefulness. This assessment depends on such factors as degree of political and scientific interest in controlling, changing, and detecting hidden deviant populations, as well as public fascination with "authentic" deviants, combined with increasing scepticism about conventional expert knowledge.
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PMID:Addiction careers and careers in addiction. 1046 5

Due to a pervasive bias toward Asian Americans, such as tendency to view Asian Americans as model minorities, drug use behaviors among them are often ignored by health professionals, researchers, and community members, including Asian community members. This study identified patterns of drug use behaviors in relation to cultural factors among Asian drug users in San Francisco, CA. A sample of 92 Asian drug users (35 Chinese, 31 Filipino, 26 Vietnamese) who were not currently enrolled in drug treatment programs were recruited through targeted sampling methods and interviewed using a questionnaire with open-ended questions. The study evaluated responses of the participants and used content analyses. This study clearly revealed that the patterns of drug use among Asian drug users are unique to their ethnicity, gender, immigrant status, and age groups. Also, Asian drug users share cultural constructs related to drug use such as fear of addiction and injecting drugs, and stigma attached to drug users in the community. Therefore, drug abuse prevention programs should address both common factors among Asian drug users, as well as unique factors in specific target groups (e.g., ethnic groups, Asian immigrants, Asian women, refugees, and adolescents).
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PMID:Drug use behaviors among Asian drug users in San Francisco. 1062 16


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