Amiram Sheffet

An evaluation of detoxification as an initial step in the treatment of heroin addiction.

Of 802 voluntary patients admitted to the detoxification unit of a comprehensive treatment system, 69% completed detoxification but only 9.6% of thest patients sought long-term treatment. The demographic profile of detoxification patients differed somewhat from that of patients in long-term treatment. The authors suggest that new approaches, including legal pressure, are needed to induce detoxification patients to accept prolonged therapy.

Assessment of Treatment Outcomes in a Drug Abuse Rehabilitation Network: Newark, New Jersey

A comparative evaluation outcome model designed to aid in referral of clients to appropriate drug abuse treatment centers was developed for a multimodality drug abuse rehabilitation network in Newark, New Jersey. The model analyzes retention rates and treatment dropout outcome to assess impact, and graduate outcome to assess the effectiveness of the various drug abuse treatment centers. Study of 3,943 addicts found a number of demographic and psychosocial variables that correlated with retention in specific programs; retention of some subgroups in specific treatments was substantially longer than overall retention rates. One year retention rates of 65% in methadone maintenance; 22, 16, and 8.5% in the three therapeutic communities; and less than 5% in two outpatient drug-free programs suggested a study of treatment dropouts outcome. Significant reduction in criminality and drug use were found for all treatment dropouts including a “no-treatment” comparison group; however, significantly larger improvements...

Influence of magnesium on the intestinal absorption of lead

Lead balance studies were compared between a group of dogs ingesting a synthetic cation-free diet (controls) and a group ingesting the same diet but with added magnesium. The lead absorption was proportionate to ingested lead in the control group. The absorption for the magnesium-fed group was 8.6 ± 1.4% of the ingested lead and 26.5 ± 1.7% for the control group (P < 0.01). There was also more evidence of lead toxicity in the group not ingesting magnesium. We conclude that in this experimental situation dietary magnesium decreases intestinal absorption of lead.

Recent trends in nonmedical use of drugs reported by students in two suburban New Jersey communities.

Abstract Recent findings in follow-up studies of student nonmedical drug use have indicated that adolescent drug use in the United States is likely to be leveling off. This paper reports trends in student drug use measured by means of repeat surveys conducted in two suburban communities in New Jersey, and compares these trends with those observed in other diverse school populations. Patterns of utilization of specific drugs and categories of drugs are examined, for each sex and school class, using three measurement criteria—experimentation, involvement, and multiple drug use. The New Jersey survey findings are in general agreement with repeat surveys conducted elsewhere. Although teenage experimentation with one or more of a wide variety of illegal substances continues to increase, it appears that, with the possible exception of marijuana, young people are not becoming more committed to the regular use of these substances. However, the New Jersey studies revealed marked age—sex differences in the patterns of usage not only between nearby communities but also within the same community, suggesting that local conditions within a community may have an important effect upon male—female drug use patterns. Some implications of the survey findings for community drug abuse prevention programs are discussed.

Baseline Behavioral Assessment for the New Jersey Health Wellness Promotion Act

Purpose. To determine baseline use rates for health-promoting behaviors of the recently adopted New Jersey Health Wellness Promotion Act and to examine the effects of demographic and socioeconomic factors on the use of preventive services included in the Act. Design. A random telephone survey of 3094 households was conducted using questions from the Behavioral Risk Factor Surveillance System supplemented by questions related to provisions of the Act. Setting. All New Jersey households. Subjects. State representative adult sample of 1246 subjects. Measures. Rates for getting timely screening tests, for obtaining influenza immunizations, and engaging in selected health-promoting behaviors. Results. Rates for receiving recommended screening tests ranged from 0.88 for blood pressure testing to 0.29 for osteoporosis screening. According to bivariate analysis, having insurance was the most consistent determinant associated with receiving preventive services but was associated only with sigmoidoscopy, mammography, and Pap smear testing in the multivariate modeling. Reminders were significantly associated with respective screening tests. Age was positively associated with receiving the majority of tests. Gender, ethnicity, education, and income affected receipt sporadically. Half the respondents were overweight and a quarter were current smokers. Conclusions. Receipt of appropriate screening tests and adoption of health-promoting behaviors fell short of desired goals. Having health insurance increased receipt rates, but was not enough to achieve usage goals. Procedure-specific reminders may improve usage rates.

Wealth from Health: an incentive program for disease and population management: a 12-year project.

The future of healthcare is linked with its ability to face the challenges of consumerism. Disease and population management will represent the dominant style of healthcare delivery in the future. This article describes the Wealth from Health programs which utilize current and future technologies to help the healthcare system become a leader in healthcare delivery and to assist many communities at an affordable cost.

Treatment benefit functions for a drug abuse rehabilitation treatment system

While generally justifying the large amount of money invested in the treatment effort, evaluation studies of treatment centers for drug addiction do not offer a rational method of allocating scarce resources among the various available treatment programs. The problem is further confounded by different costs associated with the different programs and also because clients rarely complete the prescribed treatment. We developed functional relationships between treatment outcomes and time in treatment that allow the inclusion of probable length of stay of patients and cost per week for a particular treatment program in the evaluation considerations. The model evolved from a drug addiction treatment system operating in Newark, New Jersey consisting of six different treatment centres. Treatment outcome measures are derived from a psychosocial questionnaire which was administered to patients at appropriate time intervals. The questionnaire probed into the important facets of human behavior as related to the use or non-use of drugs for non-medical reasons. Gompertz curves reflecting treatment benefit are computed for each treatment center by least square fit of the collected data to appropriate differential equations and used together with cost of treatment and treatment retention rates to compute expected net benefit for each treatment center. These enable the researcher to find the treatment centers with the best treatment outcome or alternately with the best expected cost benefit ratio for any patient type.