D. Adrian Wilkinson

Validation of self-reported cannabis use by urine analysis

Abstract A study of 113 young multiple drug users, interviewed at one year follow-up, was designed to assess the validity of self-reported cannabis use. Subjects provided information about the recency, frequency and typical dose of their use of cannabis in the preceding 30 days. Urine samples were collected and analyzed for δ 9 THC metabolites. Recency of use was the best predictor of urine test results, but a measure of frequency of use significantly increased the proportion of variance accounted for. The results strongly supported the validity of self-reported cannabis use and indicate that valid self-reports of drug consumption can be obtained from multiple drug users in treatment.A study of 113 young multiple drug users, interviewed at one year follow-up, was designed to assess the validity of self-reported cannabis use. Subjects provided information about the recency, frequency and typical dose of their use of cannabis in the preceding 30 days. Urine samples were collected and analyzed for delta 9 THC metabolites. Recency of use was the best predictor of urine test result, but a measure of frequency of use significantly increased the proportion of variance accounted for. The results strongly supported the validity of self-reported cannabis use and indicate that valid self-reports of drug consumption can be obtained from multiple drug users in treatment.

Additivity of components of prismatic adaptation

Ss pointed with each hand at a light or at the unseen toe and looked in the direction of the unseen toe before, during, and after training one arm to point to a visual target which was progressively displaced to one side by a prism. Results show that a proprioceptive change in the trained arm is a universal component of the adaptation. When a change in the eye-head system occurs, it and the proprioceptive change in the arm sum to the total adaptation and it is accompanied by a predictable degree of intermanual transfer of the adaptation, as a felt-position theory of adaptation would predict. However, when there is no change in the eye-head system, the proprioceptive shift is not always sufficient to account for the total adaptive shift.

The drug avoidance self-efficacy scale

Several scales have been developed to measure self-efficacy for addictive behaviors but there is no such scale applicable to multiple drug users. The Drug Avoidance Self-Efficacy Scale (DASES) was developed to fill this gap. The properties of the scale were evaluated using a sample of 373 young multiple-drug users 16 to 30 years old presenting for treatment at the Addiction Research Foundation. The 16-item scale appeared to be unidimensional. Cronbachs alpha was .9140. Construct validity, evaluated on a subset of the sample, was evident in significant correlations with concurrent measures of drug use severity and differential rates of changes in self-efficacy associated with two types of treatment. The DASES appears to be a reliable and valid scale for the measurement of self-efficacy in multiple-drug users.

Relevance of brain dysfunction to treatment objectives: Should alcohol-related cognitive deficits influence the way we think about treatment?

Abstract Chronic heavy consumption of alcohol is associated with cognitive deficits, such as impaired ability to abstract, to solve problems and to learn new information. Since much treatment for alcoholism involves the learning of coping strategies of various levels of complexity, an assessment of the cognitive abilities of the clients would appear to be required both for differential assignment to treatment and for the prediction of duration of treatment. This argument is based upon the assumption that learning-in-treatment is an important determinant of outcome, and that alcohol-related cognitive deficits account for a significant proportion of the variance in learning ability. There is very little literature, of even a descriptive nature, on the relationship of neuropsychological status to treatment outcome, although research interest has accelerated in the last two years. Formidable methodological problems are inherent in such research. Problems in designing a study of the possible relationship of cognitive deficit to treatment outcome are discussed. An alternative procedure would be to continue descriptive studies, and to assess the impact of objective feedback about physiological and functional consequences of chronic drinking on subsequent decisions to drink. This approach is proposed. In a treatment study of problem drinkers recovery of function resulted from abstinence or very low levels of consumption, but moderate levels of consumption prevented this process. These data should inform the setting of target levels for consumption in the initial stages in programs teaching non-problematic drinking.

The Chronic Effects of Alcohol on Memory

Recent studies have indicated that impairment of memory is a common cognitive deficit related to long-term alcohol consumption. Such deficits range from subtle disturbance through a “subclinical” amnesic disorder to full-blown Korsakoff syndrome. This finding is congenial with the hypothesized continuum of alcohol-related impairment of memory. Among alcoholics, this memory impairment appears to be etiologically distinct from the commonly observed deficits in abstracting and problem-solving abilities.

Methodological issues in the evaluation of treatment of drug dependence

Abstract Studies of treatment outcome for drug dependence are methodologically inferior to those for alcohol dependence, probably because scientific interest in drug use is more recent. Also, the behavior of drug dependence is very complex, since multiple drug use is normative for psychoactive drugs. Compared to clients in alcohol and tobacco studies, those in studies of drug dependence are more heterogeneous in their drug use. It is recommended that research priority be given to the identification of homogeneous subsets of the drug user population, including users of alcohol and tobacco. Several methods of measuring drug use have been advocated, but all have limitations, and little is known about their impact on the interpretation of treatment outcome. Recently the quality of designs in this area of research has improved, but avoidance of randomized trials continues to retard the acquisition of knowledge about the relative effectiveness of treatment procedures. Variability in the duration of follow-ups also impedes interpretation of findings; a minimum of six months post treatment is recommended. It is concluded that measures of drug use should be the principal outcome in evaluations of treatment effectiveness, that the role of therapist variables deserves research attention, and that criteria be developed for the interpretation of nonabstinent outcomes, which are the norm of clients treated for drug dependence.