Jeannette L. Johnson

Reason for Medical Hospitalization Among Adult Alcohol and Drug Abusers

This study attempts to identify the associations between types of substance use and particular medical problems as causes of acute hospital admission on an inpatient substance abuse consultation service. Records of all consultations performed from 1994 to 1998 were analyzed. A total of 4,526 complete records were available. Cocaine (p < .01), heroin (p < .001), and injection drug (p < .001) users were more likely to be admitted to the hospital for infection. Both alcohol (p < .001) and marijuana (p < .001) users were more likely to be hospitalized for trauma related injuries. Individuals that used alcohol were also more likely to be admitted for the treatment of gastrointestinal disorders (p < .001). Clinicians who treat patients with these diagnoses should have a high index of suspicion of co-morbid substance use disorders. Effective treatment of substance use disorders can lead to a decrease in medical morbidity, improved outcomes for individual patients, and decreased costs for the health care system.

Outpatient Benzodiazepine Detoxification Procedure for Methadone Patients

Benzodiazepines are used by a substantial minority of opioid addicts on methadone maintenance. Alprazolam, now the most widely prescribed benzodiazepine in the United States, appears to have supplanted diazepam as the benzodiazepine drug of choice in this population. Its greater addiction liability, shorter half-life, and more intense withdrawal symptoms make addiction to alprazolam more likely and its management in methadone patients more complicated. This article describes a slow outpatient tapered reduction procedure that was utilized to detoxify benzodiazepine dependent methadone patients seen over a two-year period. The reduction procedure was offered to 22 opioid addicts on methadone maintenance who were regularly ingesting low to moderate amounts of benzodiazepines, primarily alprazolam. Of the 22 patients, 4 patients refused outpatient detoxification, and 18 were started on a reduction procedure. Twelve patients completed the detoxification procedure which averaged 7.8 weeks. Comparisons are made between completers and non-completers and essential design features of the procedure are discussed.

The Relationship Between Parental History and Substance Use Severity in Drug Treatment Patients

The authors explored the relationship between the history of parental problematic alcohol and drug use and their adult childrens alcohol and drug use disorders. Subjects were 347 admissions to an outpatient substance abuse program. There was a positive relationship between the number of parents affected by alcohol and/or drug problems and the percentage of probands with co-existing alcohol and drug use disorders for probands with alcohol use disorders but not for those with only drug abuse. Probands with two affected parents had significantly higher alcohol abuse scores and drug, family, and psychiatric composite test scores than those with a negative family history. This preliminary study indicates that the severity of a probands substance use disorder may be influenced by parental substance use history.

Attributional Style in Children of Substance Abusers

This study examined attributional style in children of substance abusers. We hypothesized that children of substance abusers are more likely to develop a depressogenic attributional style. Forty children between the ages of 8 and 14 participated in the study. Twenty children were from families with a history of substance abuse and 20 were from families without such a history. Each child completed self-report measures of depression and attributional style. After controlling for depression and other factors, the results revealed that children of substance abusers had a more depressogenic attributional style than did children without such a family history. Implications of the results for children of substance abusers and for hopelessness theory are discussed.