Drug and alcohol dependence
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Drug Alcohol Depend · Sep 2008
Randomized Controlled Trial Multicenter StudyA Phase 3 placebo-controlled, double-blind, multi-site trial of the alpha-2-adrenergic agonist, lofexidine, for opioid withdrawal.
Lofexidine is an alpha-2-adrenergic receptor agonist that is approved in the United Kingdom for the treatment of opioid withdrawal symptoms. Lofexidine has been reported to have more significant effects on decreasing opioid withdrawal symptoms with less hypotension than clonidine. ⋯ Lofexidine is well tolerated and more efficacious than placebo for reducing opioid withdrawal symptoms in inpatients undergoing medically supervised opioid detoxification.
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Drug Alcohol Depend · Sep 2008
The video assessment of simulated encounters-revised (VASE-R): reliability and validity of a revised measure of motivational interviewing skills.
The video assessment of simulated encounters-revised (VASE-R) is a video-based method, administered in individual or group settings, for assessing motivational interviewing (MI) skills. The 18-item instrument includes three video-based vignettes, in which actors portray substance abusers, with each vignette followed by questions that prompt examinees to write responses that are then scored against MI standards. The VASE-R was administered to two independent samples: (1) substance abuse practitioners participating in a study of MI training methods, and (2) MI training facilitators with a high level of MI skill and expertise. ⋯ The findings indicate excellent inter-rater reliability using intra-class correlations for the full-scale score (.85) and acceptable levels for subscales (.44 to .73). The instrument displayed strong concurrent validity with the Helpful Responses Questionnaire (HRQ) and a behavioral sample of clinician behavior with a standardized patient scored using the MI Treatment Integrity (MITI) system, as well as good sensitivity to improvement in MI skill as a result of training. The findings provide an empirical basis for suggesting VASE-R benchmarks for beginning proficiency and expert MI practice.
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The areca nut is consumed by approximately 10% of the world's population, and its consumption is associated with long-term health risks, with or without tobacco additives. However, it is not known whether its use is associated with a dependence syndrome, as is seen with other psychoactive substances. ⋯ Areca nut use by itself and more so with tobacco additives, is associated with the development of a dependence syndrome in a substantial numbers of users.