The purposes of this study were to examine predictors of benzodiazepine use among methadone maintenance treatment patients, to determine whether baseline benzodiazepine use influenced ongoing use during methadone maintenance treatment, and to assess the effect of ongoing benzodiazepine use on treatment outcomes (i.e., opioid and cocaine use and treatment retention). A retrospective chart review of 172 methadone maintenance treatment patients (mean age = 34.6 years; standard deviation = 8.5 years; 64% male) from January 1997 to December 1999 was conducted. At baseline, 29% were "non-users" (past year) of benzodiazepine, 36% were "occasional users," and 35% were "regular/problem users." Regular/problem users were more likely to have started opioid use with prescription opioids, experienced more overdoses, and reported psychiatric comorbidity. Being female, more years of opioid use, and a history of psychiatric treatment were significant predictors of baseline benzodiazepine use. Ongoing benzodiazepine users were more likely to have opioid-positive and cocaine-positive urine screens during methadone maintenance treatment. Only ongoing cocaine use was negatively related to retention. Benzodiazepine use by methadone maintenance treatment patients is associated with a more complex clinical picture and may negatively influence treatment outcomes.

No abstract

There is conflicting evidence regarding the relation between heaviness of smoking and the likelihood of quitting smoking. We investigated this issue using the data set of the 1986 Adult Use of Tobacco Survey, a telephone survey of the smoking behavior of noninstitutionalized, civilian, US adults aged greater than 16 years. Analyses were based on a subsample of 4,383 individuals who had made a serious attempt to stop smoking 1-10 years before the survey. Among younger smokers, the lighter smokers (less than 25 cigarettes/day) were the most likely to stop, whereas among older smokers, the heavier smokers (greater than or equal to 25 cigarettes/day) were the most likely to stop. These results indicate that age is an important factor in the relation between heaviness of smoking and success in quitting smoking.

The present study evaluated a motivationally based, 4-session outpatient intervention for young substance abusers presenting for addiction treatment. Follow-up interviews were conducted 6 months after assessment on (a) clients who sought additional help (n = 22) and (b) clients who did not seek additional help (n = 28). Results indicated that (a) participating in an assessment and brief intervention was associated with reduced use and consequences and increased confidence in high-risk situations up to 6 months after entry into the program, and (b) clients who participated in additional treatment showed less of a decrease in substance-related consequences. These findings suggest that brief interventions can serve as either a stand-alone intervention for individuals who need short-term assistance or a first-step intervention for those with more specialized or long-term needs.

Summary The Marital Systems Study (MSS) compared the effectiveness of a short‐term systems‐based outpatient treatment consisting of eight sessions of Conjoint Therapy with a single session of Advice Counselling which also involved the spouse. Eligible couples were randomly assigned to either Conjoint Therapy or Advice Counselling. In all, 218 couples were recruited for the Study. From this initial sample, 102 couples dropped out of treatment or follow‐up leaving the remaining 116 couples as the Study sample. Couples in both Advice Counselling and Conjoint Therapy showed significant improvement on all marital adjustment and drinking‐related outcome measures. Although significant treatment‐by‐time interactions were found on three of the nine variables, there were no significant differences in the change pattern between the groups on the principal drinking outcome measure, the percentage of heavy drinking days. There were also no significant between‐group differences on any of the outcome measures. In essence, a single session of Advice Counselling was as effective as eight sessions of Conjoint Therapy. Couples completing the Study represented a socially stable group, with a moderate degree of alcohol‐related difficulties and relatively non‐distressed marital relationships. Thus, the findings pertaining to the relative effectiveness of the two treatments may be limited to this specific client population.