Andrea Mitchell

Collective amnesia: reversing the global epidemic of addiction library closures

Special libraries in the addiction field have been downsized or closed at an alarming rate during the past decade. This editorial describes what is happening, why,and what can be done to prevent further erosion of contemporary and historical records so vital to an interdisciplinary field.

SBIRT—Screening, Brief Intervention, Referral, and Treatment

SBIRT is the acronym for the SAMHSA funded program, Screening, Brief Intervention, Referral, and Treatment. The program is an objective of the second edition of Healthy People 2010, section 26 Substance Abuse. Starting in 2006 SAMHSA began awarding money for implementing SBIRT to states, universities and colleges, and one tribal council. Fo rav ery succinct overview of SBIRT as a government initiative for reducing AOD related problems, see: The Office of National Drug Control Policy Treatment site, http://www. whitehousedrugpolicy.gov/treat/screen brief intv.html The following websites were selected because they offer the most informative information about SBIRT, including helpful resources such as toolkits, screening tool samples, and training. Not listed here are many other websites of the individual state programs; WA-SBIRT (Washington SBIRT), CA-SBIRT (California SBIRT), and WIHPL (Wisconsin Initiative to Promote Healthy Living) are a just a few. Keyword searching for these on Google will retrieve PDFs of state announcements, newsletters, and websites that discuss the individual state initiatives to implement SBIRT. Simply putting in the acronym for the state program, e.g., WASBIRT or Washington SBIRT will retrieve relevant results. SAMHSA—CSAT Screening Brief Intervention, Referral and Treatment http://sbirt.samhsa.gov SAMHSA’s website is the best place to gain an understanding of SBIRT, including the aims and goals of the program, and which states are grant recipients. The site presents a brief overview and then describes the various features. In the side menu are links to more information about the individual components, news, tools, and resources.

Stages of Change

The Transtheoretical Model of Change or Stages of Change as it has become known in the substance abuse field, was developed by James O. Prochaska and Carlo C. DiClemente to describe the stages employed by an individual in making a behavior change. The stages in the model are: Precontemplation: this is the stage in which the person is generally unaware of the problem and has no intention of changing Contemplation: the person is aware of the problem and thinking about change but has not made a serious commitment to change. Preparation: the person may have made small inroads into the behavior change but has not reached a level of effective action. Action: the person modifies the behavior or experience or environment to overcome the behavior. Maintenance: the person focuses on relapse prevention and consolidation of the accomplishments of the action phase. To read more in the literature about this model, online databases ETOH, http://etoh.niaaa.nih.gov, PUBMED and PsychInfo provide a number of very useful citations. There are also a number of websites concerned with this model and topic, but many of them are redundant in that they mainly go over the five stages of change as listed above. The ones provided below do more than that, and offer a variety of different modes to learning about this model, from bibliography to articles, to a live web cast and more.

Medical Consequences of Cocaine

Cocaine is known to affect many organs and bodily systems. To get a quick overall picture of this, the National Institute on Drug Abuse (NIDA) has provided a web page entitled Medical Consequences of Drug Abuse (http://www. drugabuse.gov/consequences/). Here a list of various organs/bodily systems and the effect of the drug are provided. Some of the items in the list include: Cardiovascular effects, Respitory effects, Gastrointestinal, Musculoskeletal, Neurological, Mental Helath, Kidney and Liver. In the Director’s Report (NIDA Notes Vol. 18 No. 6 Feb. 2004), NIDA Director, Nora Volkov states, “NIDA-supported research has shown that cocaine restricts blood flow to the brain, increases heart rate, and elevates levels of blood components that promote clotting—effects that can lead to stroke or heart attack even in those not otherwise at risk for these dangerous cardiovascular events. Now, NIDA research suggests that cocaine also limits the body’s ability to fight infection, putting cocaine abusers at greater risk for illnesses ranging from the common cold to hepatitis, sexually transmitted diseases, and HIV/AIDS” (see also http://www.drugabuse. gov/NIDA notes/NNvol18N6/Cocaine “Cocaine May Compromise Immune System, Increase Risk of Infection”). A collection of articles that address research on cocaine can be found at http://www.drugabuse.gov/NIDA Notes/NN0066. html. These NIDA Notes articles include: “Cocaine-Related Environmental Cues Elicit Physiological Stress Responses,” “Cocaine Abusers’ Cognitive Deficits Compromise Treatment Outcomes,” “Cocaine May Compromise Immune System, Increase Risk of Infection,” “Cocaine’s Effect on Blood Components May Be Linked to Heart Attack and Stroke,” and “Study Finds Significant Mental Deficits in Toddlers Exposed and to Cocaine Before Birth.” The site http://www.narconon.org/druginfo/cocaine coke.html is offered by Narconon International, a “non-profit drug rehab program dedicated to eliminating drug abuse and drug addiction through drug prevention, education, and rehabilitation.” In a section titled “Information on alcohol and other drugs,” links to materials on the history, signs, symptoms, and effects of various drugs are presented. Written in a very readable style, the information on cocaine includes short-term effects, long-term effects, and medical complications. At http://www.narconon.ca/Cocaine.htm there is more on health hazards and the effects of maternal cocaine use on the baby. Although this latter area still needs more research “many scientific studies have documented that babies born to mothers who abuse cocaine during pregnancy are often prematurely delivered, have low birth weights and smaller head circumferences, and are often shorter in length.” More medical consequences can be found at h2g2, a BBC (UK) site (http://www.bbc.co.uk/dna/h2g2/A10832384). This page is titled “Cocaine—The History and the Risks” and given its date (created June 7, 2006), is the most recent entry in this column. There are many interesting facts presented here about cocaine including: What is cocaine? Why do people take cocaine? Cocaine and popular culture, How cocaine is used, How cocaine was used historically, The Brompton cocktail, and Progression.

Harm Reduction Resources

&NA; A first time non‐violent drug offender seen in a drug court is given an option for drug treatment instead of prison. Not only does this mitigate the consequences to the user, it also saves taxpayer dollars. Providing clean needles to drug users decreases the chances of spreading AIDS, and not just between drug users. Methadone maintenance helps people dependent on heroin to readjust to their lives, to enable them to work and live in more satisfying ways.