Clients in the national Drug Abuse Treatment Outcome Study reported significant overall improvements in drug use and related measures during a 12-month follow-up period. A quasi-experimental design was used to examine the relationship of treatment duration with outcomes in each of the 3 major modalities represented. Client subsamples with longer retention in long-term residential programs and in outpatient methadone treatment had significantly better outcomes than those with shorter lengths of stay (results were inconclusive for outpatient drug-free programs because of sample limitations). This study used several methodological enhancements and showed general continuity of findings on retention effects from previous national evaluations of treatment effectiveness. It supports the need for more careful study of treatment process in relation to outcomes.

In AIDS research, relatively little attention has been paid to reliability of self-report of drug users. The authors examined the test-retest reliability of the Risk Behavior Assessment (NIDA, 1991) questionnaire. This structured-interview questionnaire was administered twice to 196 drug users in 5 cities over a 48-hr period. Findings indicated that respondents consistently self-report drug use, injection practices, and sexual behaviors; discrepancies do not appear to reflect systematic decreases or increases in self-report; unreliability is associated with poorly worded questions and respondent characteristics; and discrepant reports warrant attention in analysis and interpretation of data. Measurement error has implications for estimating risks, understanding relationships between behavior and HIV transmission, and interpreting change after interventions. Items with low reliability have been revised, and further reliability studies are examining whether revisions have led to improved reliability.During the first decade of the AIDS epidemic, many researchers have relied on interviewer-

Substance abuse treatment for adolescents is effective in achieving many important behavioral and psychological improvements. Strategies specific to adolescents to improve their treatment retention and completion are needed to maximize the therapeutic benefits of drug treatment.

The purpose of this study was to identify the relationships between various fitness parameters and firefighting performance on an "Ability Test" (AT) that included a set of 6 simulated firefighting tasks. The relationships between each fitness parameter and each task of the AT were determined. Ninety firefighters participated in this study (age 33 ± 7 years). The AT completion time was associated with abdominal strength (r = -0.53, p < 0.01), relative power (r = -0.44, p < 0.01), upper-body muscular endurance (push-ups, r = -0.27, p < 0.05) (sit-ups, r = -0.41, p < 0.01), and upper-body strength (1 repetition maximum bench press, r = -0.41, p < 0.01). In addition, poor performance on the AT was associated with high resting heart rate (r = 0.36, p < 0.01), high body mass index (r = 0.34, p < 0.01), high body fat (BF)% (r = 0.57, p < 0.01), increasing age (r = 0.42, p < 0.01), and large waist size (r = 0.67, p < 0.01). Multiple regression analyses indicated that a significant (F[5, 53] = 14.02, p < 0.01) proportion (60%) of the variation observed in the AT was explained by the variation of the fitness parameters used in the model. This study demonstrated that fitness variables, such as abdominal strength, power (step test), push-ups, resting Hr, and BF%, contributed significantly to the predictive power of firefighters' AT performance. The findings of this study may be useful to fire department instructors and trainers in the design and implementation of training programs that are more specifically tailored to improving both individual firefighting skills and general fire suppression performance.

1 Linopirdine (DuP 996) has been shown to enhance depolarization-induced release of several neurotransmitters in the CNS through a mechanism which may involve K+ channel blockade. The electrophysiological effects of linopirdine were therefore investigated directly, by use of conventional voltage recording and single electrode voltage-clamp.2 Linopirdine (10 gM) reduced spike frequency adaptation (SFA) in rat hippocampal CAl pyramidal neurones in vitro. The reduction of SFA comprised an increase in number of spikes and a reduction in inter-spike intervals after the first, but with no effect on time to first spike. Linopirdine also caused a voltage-dependent depolarization of resting membrane potential (RMP). 3 M-current (IM), a current known to underlie SFA and to set RMP, was blocked by linopirdine in a reversible, concentration-dependent manner (IC50 = 8.5 gM). This block was not reversed by atropine (10 gM).4 Linopirdine did not affect IQ, the slow after-hyperpolarization following a spike train, or spike duration. 5 Linopirdine may represent a novel class of K+ blocker with relative selectivity for the M-current. This block of IM is consistent with the suggestion from a previous study that linopirdine may affect a tetraethylammonium-sensitive channel, and it could be speculated that IM blockade may be involved with the enhancement of neurotransmitter release by linopirdine.

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This paper explores the epidemiology of co-occurring disorders with an emphasis on the implications of study findings for the functioning and potential of substance abuse treatment. Severity of disorder is discussed as an issue that may have particular significance for the selection of specialized as opposed to traditional substance abuse treatment forms. Exploration is made, as well, of the resources currently available to substance abuse treatment, especially the human resources available, and the implications of resource availability for undertaking initiatives specific to co-occurring disorder. Findings from standard and enhanced treatment for comorbid individuals are examined in an effort to clarify areas of need for specialized and typical treatment personnel. Issues are raised for consideration by the clinical research and treatment provider communities in terms of assessment and diagnosis, manpower and training, and response to the challenge of relapse in this population.

Background-Despite the proven effectiveness of methadone treatment, the majority of heroindependent individuals are out-of-treatment.