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NIDA Science & Practice Perspectives

Volume 1, Number 1 - July 2002

From the Director

Two Perspectives, One Goal
[PDF - 164K]

Glen R. Hanson, Ph.D., D.D.S.

From the Editor

Dialogue and Collaboration: A Path for Progress
[PDF - 136K]
David Anderson

Research Reviews

HIV/Hepatitis Prevention in Drug Abuse Treatment Programs: Guidance From Research
[PDF - 316K]
James L. Sorensen, Ph.D., Carmen L. Masson, Ph.D., and David C. Perlman, M.D.
A large body of research examines the relationship between HIV and drug dependence, but considerably less information is available on viral hepatitis and drug dependence. This article summarizes research indicating what drug abuse treatment programs can do to prevent their patients from acquiring HIV or hepatitis infection and to limit the consequences for patients who are already infected. Drug treatment programs can play a pivotal role in preventing, detecting, and treating HIV and hepatitis. Some activities can be accomplished by providers’ simply becoming aware of the issues; others will require significant infusion of leadership, education, and fiscal support.

The Neurobiology of Opioid Dependence: Implications for Treatment
[PDF - 400K]
Thomas R. Kosten, M.D., and Tony P. George, M.D.
Opioid tolerance, dependence, and addiction are all manifestations of brain changes resulting from chronic opioid abuse. The opioid abuser’s struggle for recovery is in great part a struggle to overcome the effects of these changes. Medications such as methadone, LAAM, buprenorphine, and naltrexone act on the same brain structures and processes as addictive opioids, but with protective or normalizing effects. Despite the effectiveness of medications, they must be used in conjunction with appropriate psychosocial treatments.

Clinical Perspectives

Treatment Practice and Research Issues in Improving Opioid Treatment Outcomes
[PDF - 344K]
T. Ron Jackson, M.S.W.
Providers of treatment for opioid addiction have entered a new era of accountability, as Federal and State regulators increasingly demand objective evidence of treatment effectiveness. Since the length of treatment is associated with success of treatment, opioid treatment programs that demonstrate an ability to retain patients can make a strong case that they are effective. The challenge to opioid treatment providers is to examine their practices and begin organizational change to incorporate scientifically proven practices to improve patient retention. The challenge to the research community is to partner more effectively with community-based providers to help them through the transition.

Treating Women Drug Abusers: Action Therapy and Trauma Assessment
[PDF - 324K]
Ann S. Uhler, M.A., and Olga V. Parker, Ph.D.
The authors suggest that action therapy, a group of techniques including psychodrama, drama therapy, and role training, warrants research attention to determine whether it is well suited to the special characteristics and needs of women clients. In addition, the authors call on researchers to develop a new standardized tool for counselors to use during initial interviews to determine whether women presenting for drug abuse treatment also have significant issues related to trauma. The authors believe the use of existing trauma assessment tools or unassisted clinical judgment in first interviews may drive patients away by probing for painful information that clients are not yet ready to confront or divulge.

Science and Practice in Action

Using Behavioral Reinforcement To Improve Methadone Treatment Participation
[PDF - 324K]
Robert K. Brooner, Ph.D., and Michael Kidorf, Ph.D.
A new service delivery system for the treatment of opioid dependence, called "motivational stepped care," matches the intensity of counseling services to each patient’s clinical progress. Adherence to a counseling schedule is reinforced through the linking of counseling attendance with the patient’s methadone dosage schedule and, ultimately, his or her ability to continue receiving treatment services. The article describes the scientific evidence supporting the major elements of the model, the model in action, and evaluations that have been conducted to date.

Connecticut Partnership Targets Substance-Abusing Parents
[PDF - 260K]
Kathleen Carroll, Ph.D., Bryce Libby, M.S.W., Joseph Sheehan, M.A., M.S., L.A.D.C., Debbie Beckwith, B.S., Nancy Hyland, C.C.S., and Sue Caulkins, B.S. C.A.D.C.
In 1999 a coalition of practitioners, researchers, and State and community treatment program administrators in Connecticut jointly developed, implemented, and conducted a successful research study of the use of motivational enhancement treatment (MET) techniques in a community treatment program. From its initial stages through its conclusion, the pilot study exemplified how researchers, treatment providers, and administrators can work together as equal partners to meet their own and each other’s needs and goals—and benefit the families of substance-abusing caregivers.

Authors and Respondents

This Issue's Authors
[PDF - 156K]

Graphic Evidence

The Consequences of Long-Term Heroin Addiction and the Effects of Treatment
[PDF - 140K]

Continuing Education Quiz for Counselors

You can earn two nationally certified continuing education (CE) hours by reading the indicated articles and completing this multiple-choice quiz. This is an open-book exam. Complete the quiz by circling one or more ofthe multiple-choice answers. Be sure to answer all questions; unanswered questions will be scored as incorrect. You must score at least 70 percent to earn CE hours.
[PDF - 120K]

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