Number Of Previous Detoxifications Research Articles

An in vivo Study of the Relationship between Craving and Reaction Time during Alcohol Detoxification Using the Ecological Momentary Assessment

To study cognitive interference associated with craving for alcohol, the Ecological Momentary Assessment (EMA) method was used to measure the relationship between craving and reaction time. A secondary aim was the study of the predictive factors for craving during alcohol detoxification. The EMA enables both repeated measures of craving in a natural setting and the recording of reaction time without the patient being aware of this. Craving for alcohol, reaction time, sadness and anxiety were recorded 8 to 12 times a day, over three weeks of detoxification in 14 alcoholics (n=1767 measures), on an electronic diary issuing random prompts. Mixed models were used for statistical analysis (alpha=5%, 1-beta=88%). Reaction time was significantly increased in univariate analysis when a craving episode occurred but this difference did not persist after multivariate analysis. Craving episodes were more frequent and intense than previously reported. Predictive factors of craving during detoxification were: age, gender, sadness, anxiety and the number of previous detoxifications. Antidepressants, anti-craving medications but not benzodiazepines were negatively associated to craving.

Contribution of frontal cerebral blood flow measured by (99m)Tc-Bicisate spect and executive function deficits to predicting treatment outcome in alcohol-dependent patients.

To determine whether inhibition and working memory deficits, and reduced regional cerebral blood flow (rCBF) (previously shown to be related), measured at the end of a detoxification programme, predict alcoholic relapse 2 months later. Twenty uncomplicated alcoholic inpatients were investigated at the end of detoxification, at least 7 days since the last dose of diazepam, and a mean of 18.8 days since the last drink. Their performance was assessed on the inhibition (Hayling) test, working memory (Alpha-span task), episodic memory (California Verbal Learning Test) and abstract reasoning (Progressive Matrices). Frontal CBF was assessed at the same time with a semiquantitative (99m)Tc-Bicisate SPECT procedure. Patients were contacted 2 months later. Patients who abstained (n = 9) did not differ from those who relapsed (n = 11) on age, gender, smoking, duration of alcohol misuse, number of previous detoxifications, amount of ethanol consumed the month prior to admission to the detoxification programme, state anxiety, trait anxiety, or depression. Relapsed subjects had shown a lower uptake of (99m)Tc-Bicisate in the bilateral medial frontal gyrus (n = 9; mean ratio +/- SD = 0.69 +/- 0.006) than abstainers (n = 11; 0.85 +/- 0.19), and poorer performance on the Alpha-span task and the Hayling test. The other tests were not different. Inhibition and working memory deficits, associated with low levels of CBF in the medial frontal gyrus, are related to the difficulty of maintaining short-term abstinence from alcohol.

Drug-related behaviour in a high HIV prevalence rate population at Myktyina drug treatment centre, Kachin State, northern Myanmar (Burma)

Drug-related behaviour in a high HIV prevalence rate population at Myktyina drug treatment centre, Kachin State, northern Myanmar (Burma)

Use of a Sense of Coherence Test and Hopkins Symptom Checklist to Predict Completion of Stay in a Postdetoxification Counseling Unit

The author observed 61 multi-substance abusers with a mean length of abuse of 16 years who were tested with two psychometric tests to predict completion of a 3-week post-detoxification, residential counseling period. Age at entry, length of abusing career, and number of previous detoxifications at the facility did not discriminate between completers and noncompleters of the counseling period. In women, 54% and in men, 79% completed the residential period. Hopkins Symptom Checklist (HSCL-24) scores indicated psychological stress in both groups but not significantly more in noncompleters. However, Antonovsky's Sense of Coherence Scale differentiated significantly between groups. Noncompleters had a mean score of 2.72 vs. completers' 31. This difference indicates less manageability, comprehensibility, and meaning in the lives of noncompleters. Although the HSCL did not differ between groups, the level of distress was high in both groups. Thus, using both tests may give clinicians a tool to predict early drop-out. (American Journal on Addictions 1996; 5:327–333)