John Imhof

Countertransferential and Attitudinal Considerations in the Treatment of Drug Abuse and Addiction

This article explores countertransferential and attitudinal considerations in relation to their impact on the evaluation, diagnosis, and therapeutic management of drug-dependent individuals. Following a literature survey of the manner in which countertransference has been applied to the treatment of drug dependency, the authors discuss the status of the drug-dependent individual as a psychiatric patient and the resultant treatment implications when such a patient is viewed from within, rather than exclusive of, the mental health treatment delivery system. A number of examples are provided of patient-induced countertransferential reactions, in addition to specific attitudinal factors often present in the treatment of addiction.

Is auricular acupuncture beneficial in the inpatient treatment of substance-abusing patients? A pilot study

Patients with comorbid substance abuse problems who were admitted to a psychiatric unit of a general hospital over an 11-month period were offered treatment with auricular acupuncture. Subsequently and retrospectively, the medical records of these patients were examined to assess compliance, side effects, impact on course, and acceptance of discharge recommendations. Patients continuation of treatment in destination programs was also followed. Seventy-seven patients were offered acupuncture: 30 patients refused or had four or fewer treatments (control group), and 47 had acupuncture five or more times (treatment group). The treatment group did significantly better than the control group as indicated by the following findings: compliance with psychiatric/substance abuse treatment on the unit was 75% in the treatment group vs. 20% in the control group, noncompliance or AMA discharge rate was 2% in the treatment group vs. 40% in the control group, acceptance of staffs discharge recommendations was 77% in the treatment group vs. 37% in the control group, and 58% of the treatment group patients remained in follow-up treatment for at least 4 months, vs. only 26% of the control group patients. Average inpatient length of stay was 22 days for the treatment group patients compared to 16 days for the control group patients. Side effects in the treated patients were negligible. Auricular acupuncture thus appears to be a safe and inexpensive treatment modality that is easily administered and produces significant results. Its wider application in substance abuse treatment appears warranted.

Countertransferential and attitudinal considerations in the treatment of drug abuse and addiction

Abstract This article explores countertransferential and attitudinal considerations in relation to their impact on the evaluation, diagnosis, and therapeutic management of drug-dependent individuals. Following a literature survey of the manner in which countertransference has been applied to the treatment of drug dependency, the authors discuss the status of the drug-dependent individual as a psychiatric patient and the resultant treatment implications when such a patient is viewed from within, rather than exclusive of, the mental health treatment delivery system. A number of examples are provided of patient-induced countertransferential reactions, in addition to specific attitudinal factors often present in the treatment of addiction.

The Sidney Cohen lectureship in drug abuse medicine

This is a very exciting period for basic discoveries in the field of neuroscience. We can begin to hope for the kinds of understanding that will give us medical insight into the causes and mechanisms of the addictions. Such knowledge may open the way for methods of prevention and treatment by means we can hardly imagine today. Tests for genetic vulnerability to addiction, so that prevention measures can be focused on those who would benefit most? Stimulation of the production of endogenous brain chemicals? Repair of genetic defects in peptide or receptor production? Immunizations? Long-term replacement therapies? Who knows? The next decade or two should see exciting developments leading to practical clinical applications in the field of addiction.