Using data gathered on 368 current methadone clients and 142 narcotics users not in treatment in structured interviews and through ethnographic fieldwork, the study examines the image of methadone maintenance treatment in the drug-using community and discusses the effect of that image on recruitment of addicts into methadone treatment. The results indicate that the image of the methadone client as a "loser," fear of the long-term effects of methadone, and the perception of treatment as an intrusion in the user's daily life make addicts often difficult to recruit and, once in treatment, ambivalent about their participation. The image of methadone is based on both misinformation about treatment and the user's contrasting of a treatment status with the stereotypic ideal of the "righteous dope fiend." Policy implications and suggestions derived from the data are discussed.
This paper examines the nature and extent of methadone diversion, drawing on interviews and ethnographic data collection with methadone maintenance clients and current narcotics users not in treatment. We explore the social as well as the economic role of diversion in the drug world and find that it is a more complex phenomenon than the simple monetary transaction it is often portrayed to be. Our data indicate that selling or sharing of methadone by methadone clients, though still uncommon, is the primary source of street methadone. We find that removal of take-home dosages from the client population would have deleterious effects on retaining in treatment many otherwise compliant clients and would have minimal effect on diversion. A flexible and differentiated approach might help to reduce diversion while a singular, punitive administrative approach is unlikely to do more than simply contain the situation on the surface and drive it underground.
This paper reviews research conducted on the link between pathological gambling and substance misuse. We first examine the phenomenon of "pathological gambling," including similarities between pathological gambling and substance misuse, instruments used to measure pathological gambling, and the prevalence of pathological gambling in the United States and internationally. We then examine research on substance misuse among pathological gamblers, pathological gambling among substance misusers, and the treatment of the pathological gambler-substance misuser. We conclude with a discussion of future research needs.
Because the innocence and vulnerability of children typically arouse feelings of nurturance and protectiveness, how do we understand homicides involving women who have killed children? As part of a NIDA-funded study that examined the role of drugs in homicides committed by women, life history interviews with 42 women convicted of killing children were conducted. Repeated experiences of damage to the self, including physical and sexual victimization, suicide attempts, and substance abuse, were evident throughout the lives of these women. The extent that these self-damage indicators interfered with the women's ability to parent children is discussed. Links between these self-damage experiences and the homicide are explored.
Trauma typically occurs when one experiences a situation where life has been threatened or lost. If the trauma is not resolved, negative residual effects may result in alcohol and drug use, involvement in violent activities as well as the development of mental health problems such as posttraumatic stress disorder (PTSD). Findings from a National Institute on Drug Abuse-funded study examining the link between trauma, drug use and violence among youth are presented. Results from interviews with 414 juveniles remanded to the Office of Children and Family Services (formerly New York State Division For Youth) for assault, sexual assault, robbery or homicide, document the trauma experienced by these youth, as well as how it correlated with their drug usage and participation in violent, illegal activities. Discussion of these findings, their implications for understanding and intervening, and recommendations for future research are highlighted.
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