Sidney Schnoll

Prescription Medication Misuse among Persons with Spinal Cord Injuries

Use of prescription medication, alcohol, and illicit substances, and problems resulting from their use as well as depression and disability acceptance, were reported by 96 persons with long-term spinal cord injuries (SCI). Forty-three percent of the sample used prescription medications with misuse potential, and of these persons, 24% reported misusing one or more medications. Persons who used prescription medications were less accepting of their disability and were more depressed than persons who were not using prescription medications. Additionally, persons reporting problems resulting from prescription medication use were more depressed, and persons reporting problems resulting from nonprescription substance use were less accepting of their disability than were persons not reporting these problems. These results suggest that use of prescription and nonprescription substances by persons with SCI is associated with negative psychological outcomes.

Social support and anxiety in pregnant drug abusers and nonusers: unexpected findings of few differences

Drug-abusing (n = 25) and nonusing (n = 55) pregnant women from a publicly supported prenatal clinic were tested for level of social support and of pregnancy anxiety during the last half of pregnancy. Differences found between the groups were fewer than expected. Drug abusers did not differ from nonusers in overall level of social support or in Appraisal, Belonging, or Tangible subscales. Abusers were found to report lower levels of self esteem; lower self esteem was predicted by drug abuse, having more children and lower socioeconomic status. Drug abusers did not differ from nonusers in their overall feelings of pregnancy anxiety, but they did indicate higher fears for themselves and for the baby, and there was a tendency for higher depression and withdrawal.

Postgraduate Medical Fellowship Training in Alcoholism and Drug Abuse: National Consensus Standards

This paper describes the historical background of the Consensus Standards for Postgraduate Medical Fellowships in Alcoholism and Drug Abuse, developed for the American Academy of Psychiatrists in Alcoholism and Addictions and the Association for Medical Education and Research in Substance Abuse. These standards were prepared by a National Advisory Committee of the Center for Medical Fellowships in Alcoholism and Drug Abuse, which includes 23 leading figures in academic medical training in the addiction field. The standards define general information, facilities and resources, the educational program, and the specific knowledge and skills appropriate to fellowship training. The standards were designed to provide a model for optimal training for residency affiliated fellowships to be used by faculty, trainees, and organizations setting training standards.

Toxicology screening in acute spinal cord injury

The validity of self-reported intoxication at time of spinal cord injury (SCI) was examined for 88 cases at admission to an acute SCI center by comparing self-reports with serum and urine analyses. Serum ethanol greater than 50 mg/dl was the most frequently found substance (observed in 40% of the cases) followed by urine analysis evidence of cocaine (14%), cannabinoids (8%), benzodiazipines (5%), and opiates (4%). Evidence of substances with abuse potential was found in urine for 35% of the sample. While 62% of the sample had either serum ethanol greater than 50 mg/dl or a positive urine analysis, only 42% of the sample reported being under the influence of some substance at the time of SCI. Although the relationship between these two measures was statistically significant, self-report and toxicology analyses were discordant in 34% of the cases. These results suggest that routine drug testing at admission to an SCI center will produce both false-negative and false-positive results if substance presence alone is interpreted as evidence of intoxication.