Given the far-reaching effects of the terrorist attacks on September 11, 2001, a study was conducted under the supervision of the New York State Office of Alcoholism and Substance Abuse Services to assess the impact on New York City's substance abuse treatment programs. A stratified, random sample of 15 treatment programs was selected to represent the system's major modalities. Administrators representing these programs were interviewed face-to- face using a structured interview schedule. The questions mainly probed the problems experienced on 9/11 and afterwards, patient issues and the lessons learned. The findings show major concerns for the mental health of both staff members and patients, the failure of the telephone communication system, the particular sensitivity of drug-free outpatient clinics, the challenges experienced by methadone programs, and the need to update disaster planning. A host of problems came to the fore now requiring another level of thinking.
The attacks on 9/11 may have contributed to relapse among drug users and exacerbated existing mental health problems among patients with a history of concurrent drug use and mental illness.
Cocaine, mainly in the form of crack, continues to dominate New York City's illicit drug scene. Trends in cocaine-involved deaths, hospital emergencies, arrest and treatment admissions are reviewed from the late 1980s to the early 1990s. Also, street studies conducted at drug coping areas throughout New York City during this period yield ethnographic insights. At the same time that cocaine trends were showing increases in the 1990s, heroin trends and marijuana trends were also showing decisive increases. An upsurge in heroin activity may be directly related to cocaine activity. Heroin's ameliorative effects for the cocaine user are the most direct association. The sequence-first cocaine, then heroin-has been documented by historians in the field. The association between cocaine trends and marijuana trends is less direct, and may represent the substitution of or a retreat to marijuana, a drug that is perceived as much safer.
Although many studies suggest that substance use and other delinquent or problem behaviors are related to youthful violence, few have assessed the unique contribution of each of these behaviors, and many have restricted their samples to high school students, neglecting middle school students. Findings obtained from multiple regression analysis of a statewide survey of both middle and high school students indicate that after other relevant variables (e.g., gender) were controlled, substance use, other nonviolent delinquent behaviors, and gang involvement were all about equally useful in explaining violent behavior among middle school students. However, among high school students, gang involvement was more useful than either substance use or other nonviolent delinquent behaviors. The findings would argue that although violence prevention efforts targeted at middle school students should stress an approach that addresses multiple problem behaviors, the deterrence of gang involvement should be emphasized in those efforts designed for high school students.
Detection of current (past 30 days) drug use by analysis of hair was examined along with self-reports of current use in a 1994 treatment needs assessment survey; the sample was 179 homeless/transient adults in New York state. Results of radioimmunoassay of hair (RIAH) were used to evaluate the veracity of self-reports of current cocaine use. Only 26% of those persons whose hair tested positive for cocaine (n=115) admitted to having used cocaine in the past 30 days. Subjects eligible for treatment, as indicated by a DSM-III-R diagnosis of cocaine dependency, were nearly four times as likely to admit current cocaine use than those who were not dependent. These results are consistent with other studies of populations at high risk for substance use.
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