Substance-dependent Men Research Articles

A comparative analysis of burden of care and coping styles between wives of monosubstance- and polysubstance-dependent men.

Polysubstance dependence has emerged as a clinically distinct entity from monosubstance dependence, yet its impact on patients' wives is understudied. Wives of substance-dependent men face a tremendous burden in their social lives, leading to faulty coping and burden of care. Comparative studies between monosubstances and polysubstances are lacking. This study compared the burden of care and coping styles between wives of monosubstance- and polysubstance-dependent men. A comparative analysis was performed between wives of 70 monosubstance-dependent and 70 polysubstance-dependent patients. The burden of care was assessed by the Burden Assessment Schedule (BAS), whereas coping styles were assessed using the Brief Coping Orientation to Problems Experienced (Brief COPE) Inventory. Both groups faced a moderate burden of care, which was significantly higher in wives of polysubstance abusers as compared to monosubstance abusers (U = 366.50, P < 0.01). The difference was mainly seen in their impact on well-being and relationships with others. Avoidant coping was significantly higher in wives of polysubstance abusers (U = 341.00, P < 0.01), whereas emotion-focused and problem-solving coping styles were equally represented. Avoidant and problem-solving coping styles positively correlated with the burden of care (P < 0.01). The burden of care and avoidant coping strategies are higher in wives of polysubstance-dependent men. An increased burden of care is associated with increased use of both avoidant coping and problem-solving coping.

Comparing Defensive Mechanisms and Suicidal Thoughts in Addicted Men and Women

e present study aimed to compare the defensive mechanisms and suicidal thoughts among substance-dependent men and women. The research design was a retrospective (causal-comparative) study. The sample included 112 substance users (56 women and 56 men) from addiction rehabilitation centers in Gilan province, selected through convenience sampling based on entry criteria for this study. Two questionnaires were used in this study: the Defense Style Questionnaire (DSQ-40) and the Beck Scale for Suicide Ideation (BSSI). The collected data were analyzed using multivariate analysis of variance with SPSS software version 26. Data analysis showed no significant difference in the defensive mechanisms between men and women dependent on substances; however, there was a significant difference in suicidal thoughts between men and women dependent on substances. Considering the results of this study, therapists and counselors working with substance-dependent individuals are advised to pay attention to the defensive mechanisms and suicidal thoughts of these individuals, as awareness of these variables can assist in providing better and more appropriate services to these patients.

A mixed-methods study of self-change among severely substance-dependent Israelis: does gender make a difference?

A mixed-methods design was used to examine gender differences in self-change (SC), and integrate the quantitative findings with information extracted from qualitative narratives. The sample included 133 self-changers (52 women and 81 men), with a subsample of 25 respondents. The quantitative analysis showed no significant gender differences in personal characteristics, except in history of child abuse. Women reported a higher rate of emotional and sexual abuse than men. In comparison, the qualitative findings showed gender differences in constructing the SC process, which was based on gender stereotypes. Respondents simultaneously expressed two types of attitudes: egalitarian attitudes toward gender equality, and traditional attitudes toward gender roles and traits. In conclusion, the findings suggest that SC can occur among severely substance-dependent women and men. Both genders attributed their successful SC to the ability to regulate their emotions, and their explanations were rooted in gender stereotypes.

Mental health disorders among homeless, substance-dependent men who have sex with men.

Homelessness is associated with increased prevalence of mental health disorders, substance use disorders and mental health/substance use disorder comorbidity in the United States of America. Gay, bisexual and other men who have sex with men (MSM) living in the United States are at increased risk for homelessness, and have also evidenced elevated mental health and substance use disorder prevalence relative to their non-MSM male counterparts. Secondary analysis of data from a randomised controlled trial estimating the diagnostic prevalence of substance use/mental health disorder comorbidity among a sample of homeless, substance-dependent MSM (DSM-IV verified; n = 131). The most prevalent substance use/mental health disorder comorbidities were stimulant dependence comorbid with at least one depressive disorder (28%), alcohol dependence comorbid with at least one depressive disorder (26%) and stimulant dependence comorbid with antisocial personality disorder (25%). Diagnostic depression and antisocial personality disorder both demonstrated high rates of prevalence among homeless, substance-dependent (particularly stimulant and alcohol dependent) MSM. [Fletcher JB, Reback CJ. Mental health disorders among homeless, substance-dependent men who have sex with men. Drug Alcohol Rev 2016;36:555-559].

Sex and HIV serostatus differences in decision making under risk among substance-dependent individuals

ABSTRACTHIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV– substance-dependent men and women. HIV+ participants made significantly poorer decisions than HIV– participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ substance-dependent individuals (SDIs). Potential factors for the HIV+ women’s relatively greater impairment are discussed.

Relapse precipitants, life events &amp; coping behaviors among substance users

Relapse is common and stressful aspect among substance abusers. In the present study there has been an attempt to study relapse precipitants, life events and coping behaviors among opioids, alcohol and multiple substance dependent men. A descriptive survey was conducted after enrolling 45 substance dependent men. Clients were interviewed by using socio-demographic profile and clinical sheet, relapse precipitate inventory (RPI), presumptive stressful life scale (PSLES), and coping behaviour inventory (CBI). Study results reveals that onset of substance abuse was earlier in alcohol dependents in contrast to long duration of substance abuse and hospitalization in opioids dependents. The relapse phenomena was significantly associated with age, marital status, occupation, number of previous relapse, frequency of detoxification, duration of follow up, substance abuse and hospitalization. Factors influencing relapse appeared to be largely similar with more use of coping strategies in multiple substance dependents, especially behavioral one. Future researchers are encouraged to replicate this study and explore more dynamic nature of relapse phenomena.

Contingency management voucher redemption as an indicator of delayed gratification

This prospective analysis tested whether frequency of voucher redemptions during a contingency management (CM) substance use intervention was significantly associated with participants' ongoing substance use. Homeless, substance-dependent men who have sex with men (N=131) were randomized into either a “full” or “lite” voucher-based CM intervention. All participants earned vouchers for attendance and participation; participants in the CM-full condition also received vouchers for substance abstinence and enactment of prosocial and/or health-promoting behaviors. Multivariate longitudinal negative binomial regression analyses (n=118) assessed the association between substance use during the intervention and frequency of voucher redemptions. Participants who used methamphetamine (IRR=0.66; 95% CI=0.44–0.99) and/or opiates (IRR=0.60; 95% CI=0.40–0.99) during the intervention exhibited less time between voucher redemptions than individuals who achieved abstinence from these substances. Voucher redemption logs can be cost-effective and unobtrusive tools for measuring study participants' tendency to delay gratification.

Contingency Management Reduces Symptoms of Psychological and Emotional Distress among Homeless, Substance-dependent Men Who Have Sex with Men.

This prospective analysis evaluated the efficacy of a contingency management (CM) intervention to improve the psychological health of non-treatment seeking, homeless, substance-dependent, men who have sex with men in Los Angeles. It was hypothesized that administration of CM would be associated with reductions in participants' symptoms of psychological and emotional distress. One hundred and thirty-one participants were randomized into either a voucher-based contingency management (CM; n = 64) condition reinforcing substance abstinence and prosocial/health-promoting behaviors, or to a control condition (n = 67). Participants' symptoms of psychological and emotional distress were assessed at intake and at 12-months post-randomization. Participants randomized into the CM intervention exhibited significantly lower levels of psychological distress in all measured symptom domains up to one year post randomization, reductions not evidenced in the control arm. Omnibus tests resultant from seemingly unrelated regression analysis confirmed that CM was significantly associated with reductions in symptoms of psychological and emotional distress, even when controlling for biomarker-confirmed substance use outcomes (χ2(9) = 17.26; p < 0.05). Findings demonstrate that a CM intervention reduced symptoms of psychological and emotional distress among a sample of non-treatment seeking, homeless, substance-dependent men who have sex with men.

Comparison between personality traits and copying strategies in Substance dependent men and non dependent group

Comparison between personality traits and copying strategies in Substance dependent men and non dependent group

Comparison between personality traits and copying strategies in Substance dependent men and non dependent group

زمینه و هدف: در درمان سوء مصرف مواد، توجه به مشکلات شخصیتی و شیوه های مقابله ای بیماران حائز اهمیت است. این پژوهش با هدف بررسی مقایسه ای بین مولفه های شخصیتی و راهبردهای مقابله ای در معتادین به مواد مخدر و افراد غیر معتاد صورت گرفت. مواد و روش کار : جامعه آماری را کلیه مردان معتاد به مواد مخدر شهر بجنورد تشکیل داده اند که با استفاده از روش نمونه گیری در دسترس از بین کلینیک های ترک اعتیاد 100 مرد معتاد و 100 مرد بدون سابقه اعتیاد از سطح شهر انتخاب شدند. در این مطالعه از پرسشنامه ویژگیهای شخصیت NEO-PT-R و پرسشنامه راهبردهای مقابله ای لازاروس و فولکمن (1985) استفاده گردید. یافته ها : بیماران مبتلا به اعتیاد بطور معناداری دارای مولفه های شخصیتی روان نژندی بالاتر و برونگرایی، دلپذیر بودن و وجدان گرایی پایین تر از افراد سالم بودند ( 001/ 0 P < ) و در مولفه شخصیتی (انعطاف پذیری) تفاوت معنادار وجود نداشت. (همچنین افراد معتاد نسبت به افراد سالم بطور معناداری از راهبردهای مقابله ای مساله مدار کمتر و از راهبردهای مقابله ای هیجان مدار بیشتر استفاده کردند. (265/0 P = ) نتیجه گیری: هرچند بیماران مبتلا به اعتیاد دارای خصوصیات شخصیتی متفاوت هستند و این خصوصیات تاثیر بارزی بر راهکارهای مقابله با مشکلات انها گذاشته است ولی راهکار های مقابله ای با آموزش قابل تغییر و اصلاح است و لازم است در برنامه های درمانی بیماران مراجعه کننده برای ترک به ان توجه ویژه شود. واژه های کلیدی: شخصیت، راهبردهای مقابله، اعتیاد، مردان

Interpersonal violence against wives by substance dependent men

BackgroundIndian research on intimate partner violence (IPV) with substance use covers only alcohol, and very few studies have reported on IPV with other substances. The study aims to assess IPV against wives by substance dependent men. MethodsThe study sample was recruited by convenient sampling from men (and their wives) seeking treatment at a de-addiction centre in North India between October, 2011 and February, 2012. The consenting wives self-administered the violence questionnaire. Results267 wives were recruited into the study. The prevalence rates for IPV were: 55% for the whole sample, 63.19% for alcohol dependence and 42.33% for opioid dependence. IPV was associated with higher age of husband, lower education or unemployment of either spouse, lower income of family and nuclear family structure. ConclusionsPresent research confirms that IPV against wives is highly prevalent among substance dependent men, more with alcohol dependence as compared to opioid dependence. Addressing IPV should be an integral part of substance abuse management.

Codependence in spouses of alcohol and opioid dependent men

Codependence in family members of substance users seems to be a culturally influenced construct. This phenomenon is an understudied area in the developing world. The present study aimed to assess codependence in spouses of substance dependent men in a developing country and to evaluate its relationship with other clinical factors. A total of 100 spouses of alcohol or opioid dependent men seeking treatment at a de-addiction centre in India were recruited. Socio-demographic and clinical data were obtained and codependence was evaluated using Codependence Assessment Questionnaire. Codependence was present in 56 and 64% of the spouses in the alcohol and opioid dependence groups, respectively. Binary logistic regression revealed codependence to be associated with the younger age of the spouse. The study suggests that codependence should be looked for in the spouses and taken into consideration while managing patients with substance use disorders.

Antisocial personality disorder predicts methamphetamine treatment outcomes in homeless, substance-dependent men who have sex with men

One-hundred-thirty-one homeless, substance-dependent MSM were enrolled in a randomized controlled trial to assess the efficacy of a contingency management (CM) intervention for reducing substance use and increasing healthy behavior. Participants were randomized into conditions that either provided additional rewards for substance abstinence and/or health-promoting/prosocial behaviors (“CM-full”; n=64) or for study compliance and attendance only (“CM-lite”; n=67). The purpose of this secondary analysis was to determine the affect of ASPD status on two primary study outcomes: methamphetamine abstinence, and engagement in prosocial/health-promoting behavior. Analyses revealed that individuals with ASPD provided more methamphetamine-negative urine samples (37.5%) than participants without ASPD (30.6%). When controlling for participant sociodemographics and condition assignment, the magnitude of this predicted difference increases to 10% and reached statistical significance (p<.05). On average, participants with ASPD earned fewer vouchers for health-promoting/prosocial behaviors than participants without ASPD ($10.21 [SD=$7.02] versus $18.38 [SD=$13.60]; p<.01). Participants with ASPD displayed superior methamphetamine abstinence outcomes regardless of CM schedule; even with potentially unlimited positive reinforcement, individuals with ASPD displayed suboptimal outcomes in achieving health-promoting/prosocial behaviors.

Metabolic syndrome among substance dependent men: A study from north India

Background:Substance abuse, alcohol in particular, is associated with increased risk of diabetes and metabolic syndrome (MS). The relationship between the substance abuse and MS is complex and the literature is sparse.Objectives:The present research was aimed to study the prevalence and predictors of MS among outpatients with substance dependence.Materials and Methods:Patients with substance dependence were recruited from a deaddiction center in North India, who attended outpatient clinic from 1st January, 2010-31st December, 2010. MS was assessed using International Diabetes Federation (IDF) criteria.Results:Out of 250 subjects, 34 (13.6%) of the subjects met the IDF criteria for MS and highest being in alcohol group (21.6%). The commonest abnormality was increased triglycerides (TG; 54%) and increased waist circumference (36.8%). Age, body weight, body mass index, and obesity were significant predictor of MS.Conclusion:MS was highest in subjects with alcohol dependence with the commonest abnormality of TG and blood pressure. Hence, routine screening is advisable in this population to address emerging MS.

Disparities in safe sex counseling &amp; behavior among individuals with substance dependence: a cross-sectional study

BackgroundDespite the vast literature examining disparities in medical care, little is known about racial/ethnic and mental health disparities in sexual health care. The objective of this study was to assess disparities in safe sex counseling and resultant behavior among a patient population at risk of negative sexual health outcomes.MethodsWe conducted a cross-sectional analysis among a sample of substance dependent men and women in a metropolitan area in the United States. Multiple logistic regression models were used to explore the relationship between race/ethnicity (non-Hispanic black; Hispanic; non-Hispanic white) and three indicators of mental illness (moderately severe to severe depression; any manic episodes; ≥3 psychotic symptoms) with two self-reported outcomes: receipt of safe sex counseling from a primary care physician and having practiced safer sex because of counseling.ResultsAmong 275 substance-dependent adults, approximately 71% (195/275) reported ever being counseled by their regular doctor about safe sex. Among these 195 subjects, 76% (149/195) reported practicing safer sex because of this advice. Blacks (adjusted odds ratio (AOR): 2.71; 95% confidence interval (CI): 1.36,5.42) and those reporting manic episodes (AOR: 2.41; 95% CI: 1.26,4.60) had higher odds of safe sex counseling. Neither race/ethnicity nor any indicator of mental illness was significantly associated with practicing safer sex because of counseling.ConclusionsThose with past manic episodes reported more safe sex counseling, which is appropriate given that hypersexuality is a known symptom of mania. Black patients reported more safe sex counseling than white patients, despite controlling for sexual risk. One potential explanation is that counseling was conducted based on assumptions about sexual risk behaviors and patient race. There were no significant disparities in self-reported safer sex practices because of counseling, suggesting that increased counseling did not differentially affect safe sex behavior for black patients and those with manic episodes. Exploring the basis of how patient characteristics can influence counseling and resultant behavior merits further exploration to help reduce disparities in safe sex counseling and outcomes.Trial registrationNCT00278447

Insula and Orbitofrontal Cortical Morphology in Substance Dependence Is Modulated by Sex

Frontolimbic circuits are involved in learning and decision-making processes thought to be affected in substance-dependent individuals. We investigated frontolimbic cortical morphometry in substance-dependent men and women and determined whether morphometric measurements correlated with decision-making performance. Twenty-eight abstinent SDI (17 men/11 women) were compared with 28 controls (13 men/15 women). Cortical thicknesses and volumes were computed by using FreeSurfer. After controlling for age and intracranial volume, group and sex effects were analyzed in 3 a priori regions of interest: the insula, orbitofrontal cortex, and anterior cingulate cortex by using analysis of covariance. A secondary whole-brain analysis was conducted to verify region-of-interest results and to explore potential differences in other brain regions. Region-of-interest analyses revealed a main effect of group on the left insula cortex, which was thinner in SDI compared with controls (P = .02). There was a group by sex interaction on bilateral insula volume (left, P = .02; right, P = .001) and right insula cortical thickness (P = .007). Compared with same-sex controls, female SDI had smaller insulae, whereas male SDI had larger insulae. Neither ACC nor OFC significantly differed across group. Performance on a decision-making task was better in controls than SDI and correlated with OFC measurements in the controls. SDI and controls differed in insula morphology, and those differences were modulated by sex. No group differences in OFC were observed, but OFC measurements correlated with negative-reinforcement learning in controls. These preliminary results are consistent with a hypothesis that frontolimbic pathways may be involved in behaviors related to substance dependence.

The Efficacy of Escalating and Fixed Contingency Management Reinforcement on Illicit Drug Use in Opioid-dependent Pregnant Women

OBJECTIVES: Contingency management (CM), long known to be efficacious in the treatment of substance-dependent men and women, has also been found to be efficacious for substance-dependent pregnant women. However, the specific CM reinforcement parameters in the special population of opioid-dependent pregnant women have been less fully and systematically studied. The Drug Abuse Incentive Systems (DAISY) study, a randomized controlled trial (RCT) of opioid-dependent pregnant patients, found that escalating reinforcement was not superior to a fixed reinforcement CM schedule after a 13-week intervention. To further examine CM's reinforcement parameters in this population, this study aims to test the hypothesis that there is an early treatment response showing an escalating reinforcement schedule to be significantly more efficacious than a fixed schedule after 5 weeks of intervention in opioid-dependent pregnant patients. METHODS: Nine measures of opioid and cocaine abstinence among fixed and escalating CM schedule participants in the DAISY RCT (N=90) were compared over the initial 5 weeks of the intervention. RESULTS: No statistically significant difference in the opioid and cocaine abstinence measures was found between escalating and fixed conditions after 5 weeks (14 opportunities for each participant to leave a urine sample). The mean (SD) number of drug negative urine samples was 8.1 (4.5) and 7.4 (4.3), for escalating and fixed groups, respectively (p=0.46). CONCLUSIONS: These results further the scientific knowledge regarding CM treatment in opioid-dependent pregnant women by supporting the finding that the escalating and fixed CM schedules produce similar amounts of drug negatives urine samples early in treatment.

Co‐occurring mental health problems among substance dependent offenders of intimate partner violence

PurposeThis study aims to evaluate differences between substance dependent men who were arrested for intimate partner violence (IPV) with and without concurrent psychiatric problems.Design/methodology/approachIn total, 63 participants were randomly assigned to manual‐guided group behavioral therapies (cognitive behavioral therapy for substance dependent domestic violence offenders (SADV) or drug counseling (DC)) and assessed across 12 weeks of treatment.FindingsDespite excluding psychotic disorders and bipolar disorders at baseline, 23 percent of clients reported prior mental health treatment. SADV participants with co‐occurring mental health were different than SADV participants without co‐occurring mental health symptoms on both baseline and post‐treatment time periods. SADV participants with co‐occurring mental health symptoms had more pre‐treatment impairments, more drug use during treatment, a trend for more problems with aggressive behaviors throughout treatment and significantly more impairments in anger control subscales at post treatment compared to SADV participants without co‐occurring mental health symptoms.Practical implicationsThe findings suggest the need to target and treat co‐occurring psychiatric symptoms and distress among SADV offenders. Perhaps offering clients targeted behavioral or pharmacotherapy adjunctive treatments can help improve treatment outcomes among substance dependent offenders of IPV when mental health problems are present.Originality/valueThis study is one of the first to evaluate differences between substance dependent men arrested for IPV with and without concurrent psychiatric problems. It shows that men who are violent toward their partners tend to have a co‐occurring problem with addiction, yet little is known about differences between substance dependent male offenders who have dual mental health problems.

Lifetime Substance Use and HIV Sexual Risk Behaviors Predict Treatment Response to Contingency Management Among Homeless, Substance-Dependent MSM

Homeless, substance-dependent men who have sex with men (MSM) continue to suffer health disparities, including high rates of HIV. One-hundred and thirty one homeless, substance- dependent MSM were randomized into a contingency management (CM) intervention to increase substance abstinence and health-promoting behaviors. Participants were recruited from a community-based, health education/risk reduction HIV prevention program and the research activities were also conducted at the community site. Secondary analyses were conducted to identify and characterize treatment responders (defined as participants in a contingency management intervention who scored at or above the median on three primary outcomes). Treatment responders were more likely to be Caucasian/White (p < .05), report fewer years of lifetime methamphetamine, cocaine, and polysubstance use (p ≤ .05), and report more recent sexual partners and high-risk sexual behaviors than nonresponders (p < .05). The application of evidence-based interventions continues to be a public health priority, especially in the effort to implement effective interventions for use in community settings. The identification of both treatment responders and nonresponders is important for intervention development tailored to specific populations, both in service programs and research studies, to optimize outcomes among highly impacted populations.

Relationship of alexithymia and dissociation with severity of borderline personality features in male substance-dependent inpatients

The aim of this study was to evaluate possible interactions between severity of borderline personality features (BPFs), dissociative experiences, and alexithymia among substance-dependent men while controlling for their current age, depression, and anxiety. Participants were 200 substance-dependent men consecutively admitted to a dependency treatment unit. The Borderline Personality Inventory, the Toronto Alexithymia Scale, the Dissociative Experiences Scale, the Beck Depression Inventory, and the Spielberger State-Trait Anxiety Inventory were administered to all participants. Severity of negative affect, alexithymia, dissociative experiences, and BPF were correlated with each other. Being younger, severity of dissociative experiences, difficulty in identifying feelings, depression, and trait anxiety predicted the severity of BPF in linear regression analysis. These findings suggest that alexithymia and dissociative experiences may be a way of coping with depression and chronic anxiety, but they also seem to be related to the severity of BPF independent of the negative affect and from each other.