This article presents an addiction treatment model based on craving identification and management (CIM). Craving is broadly defined as the desire to use alcohol or other drugs; it increases the likelihood of use of these substances. In the CIM Model treatment interventions are referenced to craving, i.e., helping clients to identify their craving level and equipping them with strategies to avoid use. Four causes of craving are identified: (1) environmental cues (triggers): exposure to people, places, and things associated with prior drug-using experiences may cause immediate and overwhelming craving; (2) stress: addicted persons experience stress as craving; (3) mental illness; and (4) drug withdrawal: symptoms of both mental illness and withdrawal lead to craving if clients associate use with relief of these symptoms. The CIM Model incorporates four service delivery elements: Relapse Prevention Workshop, individual counseling, medical/psychiatric services, and screening for ongoing drug use. At its core, the CIM Model asks clients to be aware of craving, analyze its causes, and, based on those causes, implement specific strategies to prevent and manage craving. The CIM Model combines several treatment components, including control of exposure to environmental cues, establishment of a daily schedule, the use of behaviors that dissipate craving (tools), and treatment (with medications when appropriate) of mental health and withdrawal symptoms. The CIM Model is a client-derived approach to achieving and maintaining sobriety based on a process of analyzing craving and managing it with an individualized program of recovery activities.
The Methamphetamine Treatment Project is a multisite trial that compares the effectiveness of eight models of outpatient treatment for methamphetamine dependence to that of the Matrix model. These eight "treatment-as-usual" models represent diverse approaches developed in a variety of settings to serve markedly different populations. The theoretical foundations of these treatments are described as well as the settings in which they are delivered. To facilitate comparisons, details are presented with respect to frequency of group and individual sessions, duration of treatment, therapist qualifications, and access to ancillary services. The populations served by these programs vary with respect to race and ethnicity. Most programs serve primarily non-Hispanic Caucasians, but some programs serve significant proportions of Hispanics, Asians, Pacific Islanders, and Native Americans. Usual route of administration of methamphetamine also varies by site, with snorting, smoking, and injecting each reported as the most common route of administration at one or more sites. The Minnesota model and cognitive-behavioral approaches are most commonly used in these programs, although contingency management and psychodynamic approaches are also represented. The intensive phase of treatment ranges between four and 24 weeks; the number of hours per week of client contact varies between one and 13. This trial will provide the opportunity to test the effectiveness of a wide range of treatments currently in use in community settings.
Hospital, Cept pediatrics, Johannesburg, South Af'rica.-W e examined t h e relationship between AS and biochemical asph using 2 observers (obs ). Obs 1 was aware of antepartun history, obs 2 exposed t o t h e i n f a n t a t t h e time of delivery. Obs changed r o l e s a f t e r every 10th delivery. Independent AS'S were assigned a t 1 and 5 mins. W i n g t h e i r 5 minute period of observation, obs predicted outcome a s : normal; grade Ia asph (2 of pH q , 2 0 , bicarb <16mol/l, base d e f i c i t >10 ); grade I b ( I a + >5 mins t o spontaneous r e s p i r a t i o n ) ; grade I1 ( I b + c l i n i c a l s i g n s ;seizures, lethargy, e t c ). Cord blood gas (CBG) was taken a t delivery and l a t e r compared with AS and predicted outcome. Thirty f i v e term d e l i v e r i e s were studied. Using t h e above c r i t e r i a , 10 were Ia asph on subsequent CBG analysis; 3 were Ib; 22 were normal. The correlation c o e f f i c i e n t f o r interobserver AS was 1-2.97 a t 1 and 5 mins, and obs agreed on predicted outcome i n 97% of cases. However, obs correctly predicted only 25% of asph and 62% of normals. The obs A S correlated with delivery room s t a f f assessment of need f o r positive pressure resuscitation (PPR). All obs AS'S of 6 a t 1 min had PPR vs only 2 of 26 with AS a, however CBG r e s u l t s suggest t h a t PPR was f o r primary apnea i n 55%. W e conclude : 1 ) the previously demonstrated poor correlation between AS and biochemical asph is not improved by an awareness of antenatal events; 2 ) neither AS nor apparent need f o r PPR a r e r e l i a b l e indicators of asph; 3 ) strict defini t i o n is required i n s t u d i e s reporting long term outcome of In most published studies an etiology has been defined i n less than half of cases of vulvovaginitis i n prepubertal g i r l s . NSV,a synergistic infection involving Gardnerella vaginalis and anaerobic bacteria, i s a common cause of vaginitis in adults, but has not been described i n children. W e studied 17 g i r l s , age 2-11 y n . wash specimen was a r e a e d . diagnosed if t k wash contained "clue c e l l s " and gave off a fishy odor when 10% KOH was added.W e were able t o makea microbial diagnosis in 11/17 (65%) pts: Hence, we studied differences between pediatricians' perceptions and parents' r e p o r t s of hane -g-t of childhood a s h . 46 pediatricians f r m ttm wban teaching h o s p i t a l s were asked to estimate the proportion of parents who employed s p e c i f i c m g -t techniques. Appropriateness of mnagement was tested in a rand m sample of families seeking care f o r a c h i l d with acute asthma (n=148) in an urban emergency room. Pediatricians tended t o overestimate the s p e c i f i c medical knowledge possessed by families: pediatricians estimated that 30% of parents could count respiratory rate, wllereas only 11% of families possessed t h i s knowledge (pC.001); m t r i c i a n s estimated t h a t 48% of p a t i e n t s attended an a l l e r g y c l i n i c b u t only 19% a c t u a l l y d i d (p(-05).Hayeve...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.