Journal of substance abuse treatment
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J Subst Abuse Treat · May 1993
The ambulatory treatment of noncompulsive users of psychoactive substances.
This paper presents the experience of "La Casa" Programme, a center of the University of Los Andes (Bogotá, Colombia) aimed at prevention, treatment, and research in the fields of drug addiction and AIDS. The multimodal strategy at "La Casa", ambulatory and almost free of charge, has constituted a unique approach in Colombia. The country has a heavy and specific drug consumption problem: in the last ten years the number of regular consumers of a mixture of alcohol, coca paste ("basuco")/cocaine and marihuana has increased to almost 500,000 people; state facilities and human resources are scarce, thus the importance of an appropriate use of them and search for alternatives.
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J Subst Abuse Treat · Jan 1992
One-year follow-up after multimodal inpatient treatment for cocaine and methamphetamine dependencies.
Of a randomly selected sample of 214 patients treated with aversion therapy for cocaine dependence in four chemical dependency units operated by Schick Shadel Hospitals, 156 were followed up 12 to 20 months posttreatment (average 15.2 months). Significant other validation was obtained in 33%. Total abstinence from cocaine for the group overall was 53% at one year post treatment, and current abstinence of at least 6 months at follow-up was 68.6%. ⋯ Family/Work stress was associated with relapse in 33% of cases and unpleasant feelings in 24% of cases. The use of both reinforcement treatments and the use of support following treatment were associated with improved abstinence rates from cocaine. Those patients who reported losing all urges for cocaine after treatment had a total abstinence from cocaine of 90%, those who reported losing all the uncontrollable urges had a total abstinence of 64%, and those who reported still having the urge reported only 33% total abstinence from cocaine.
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The basic thesis of this article is that addictive substances, because of their need-grafifying and self-medication value, become so central to the life of the addicted person that their absence is associated with a grief reaction. Painful feelings of loss and helplessness accompany drug surrender. ⋯ Also presented are case vignettes that demonstrate the grief aspects of drug surrender. Finally, the role of brief psychotherapy as a vehicle for helping clients cope with their grief reactions is discussed.