Hi Bougainvillea,
No problem on the time lag - my spouse is also an attorney so I
understand that things come up suddenly. I've collected 14 articles
that I think will be of interest to you. They deal with either
amphetamine addiction in general or methamphetamine in specific, and
look at factors affecting treatment outcome and therapy success. Also
included are a few articles that assess gender differences indicating
recidivism when the offender uses drugs and/or alcohol. The articles
are in chronological order.
1: Journal of Psychoactive Drugs. 2000 Jan-Mar;32(1):95-105.
Adolescent amphetamine users in treatment: client profiles and treatment outcomes.
Hawke JM, Jainchill N, De Leon G.
This study compares client profiles of adolescent amphetamine users to
those of nonusers and examines the multivariate prediction of
posttreatment drug use, criminal, and HIV risk behavior outcomes in
the year following their separation from treatment. Data were
collected as part of a larger longitudinal study on a sample of 938
adolescents who were admitted to residential therapeutic community
drug treatment programs across the eastern United States and Canada
from April of 1992 through April of 1994. A subsample of 485
adolescents were reinterviewed one year after their separation from
treatment. Findings indicated that amphetamine users tended to be
white, older, and have parents with higher education and occupational
levels than nonusers. However, they also had more psychopathology,
more extensive drug use and criminal histories, and engaged in more
HIV-risk behaviors than nonusers. Additionally, amphetamine users tend
to come from homes where one or both parents used illicit drugs, drank
regularly, or had a mental illness, and they often reported histories
of childhood
maltreatment. Analyses of the one-year follow-up data indicated that
being an amphetamine user was not related to treatment outcome after
the client's demographic characteristics, overall drug use severity,
and treatment completion were taken into account. Therefore,
therapeutic community treatment appears to be an effective means of
treating adolescent amphetamine users.
2: Journal of Addictive Diseases. 2002;21(1):107-19.
Status of methamphetamine users 2-5 years after outpatient treatment.
Rawson RA, Huber A, Brethen P, Obert J, Gulati V, Shoptaw S, Ling W.
Increasing numbers of methamphetamine users sought treatment during
the decade of the 1990s. Little is known about the post treatment
status of methamphetamine users who enter treatment. The data
presented in this paper describe the outcome status of a group of a
convenience sample of 114 methamphetamine users from a total group of
500 methamphetamine users who were treated 2-5 years prior to a follow
up interview. Since the sample was not randomly selected, no specific
treatment outcome attribution is possible. Methamphetamine use and
other drug use of the follow up sample was substantially reduced from
pretreatment levels. In general, the follow up status of the sample
was much improved as compared to before treatment. However, headaches
and depression were reported at a similar rate at follow up as had
been reported at treatment admission.
3: Journal of Drug Education. 2000;30(4):423-33.
Methamphetamine use: hazards and social influences.
Wermuth L.
Use of methamphetamine, a potent central nervous system stimulant,
increased in the early- to mid-1990s in the United States,
concentrated in the west, midwest, and south. The use and trade of
methamphetamine was facilitated by a fairly simple production process
and the involvement of numerous small entrepreneurs as well as
drug-trafficking syndicates. National data from the 1994 Drug Abuse
Warning network revealed that for the period from 1991 to 1994
methamphetamine use among short-stay hospital patients more than
tripled, and methamphetamine-related deaths reported by medical
examiner offices nearly tripled. In addition, the Treatment Episode
Data Set revealed a 43 percent increase in treatment-program
admissions in which clients identified methamphetamine as the primary
drug of abuse. Nonetheless, methamphetamine use did not become
widespread in the U.S. population. Low-income and unemployed young
white men continue to be the group most likely to use methamphetamine,
but by the mid-1990s the drug had increased in popularity in more
diverse populations and regions. Economic and social pressures
experienced by a broad array of Americans may partially explain
expanded methamphetamine use; for example, depressed economic
conditions in rural and semi-rural areas have
contributed to methamphetamine's appeal as a source of income. A "war
against drugs" approach has characterized the policy response, with
increased criminal justice penalties. A public health approach is
recommended, including prevention campaigns, harm-reduction outreach
and treatment approaches, and pharmacologic and abstinence-based drug
treatment approaches.
4: Addictive Behaviors. 2004 Jan;29(1):89-106.
Methamphetamine use behaviors and gender differences.
Brecht ML, O'Brien A, von Mayrhauser C, Anglin MD.
This analysis describes methamphetamine (MA) use behaviors in a broad
cross-section of (N=350) former clients from a large publicly funded
treatment system and examines differences between males and females in
drug use history, MA initiation and motivators, MA-related problems,
acquisition, distribution, manufacture, and treatment characteristics.
Results show polydrug use, prolonged MA use before treatment,
initiation primarily through friends, common sensation-seeking
motivators (to have fun, get high, and experiment), numerous problems
related to MA use (including paranoia, violent behavior,
hallucinations, financial problems, and legal and work problems), and
a majority who have sold MA. Gender differences appear in selected
aspects of motivators and routes of initiation, access to MA, use
patterns, and MA-related problems. Such description of behaviors and
gender differences can provide a basis for development of treatment
strategies and points of departure for future research.
5: Journal of Addictive Diseases. 2002;21(1):45-60.
Use ecology and drug use motivations of methamphetamine users admitted
to substance abuse treatment facilities in Los Angeles: an emerging
profile.
von MC, Brecht ML, Anglin MD.
Who are methamphetamine (MA) users and what are the circumstances that
surround their drug use? This article provides a foundation for future
ethnographic studies and collaborative clinician-researcher
assessments of MA use by describing use ecology and drug use
motivation for 260 MA users admitted to treatment at public Los
Angeles County facilities in 1996. Use ecology data include MA
varieties and street names, first introductions to use, drug use
histories, access, selling and manufacturing, routes of
administration, unwanted results of use, and participants' use
behavior in the year before the 1996 treatment. Use motivation data
describe clients using MA as a substitute for other stimulants; to
cope with mental distress; to stay awake; to enhance sexual
experience; and to lose weight. Qualitative case studies illustrate
the findings and demonstrate the complex inter-relations of society,
culture, psyche and soma shaping MA use over time.
6: Journal of Psychoactive Drugs. 2000 Apr-Jun;32(2):211-20.
Predictors of relapse after treatment for methamphetamine use.
Brecht ML, von Mayrhauser C, Anglin MD.
The purpose of this study is to describe treatment utilization and
relapse and examine possible predictors of time to relapse after
treatment for methamphetamine (MA) use. This analysis is based on
natural history interview data from 98 subjects treated for MA use in
publicly-funded programs in Los Angeles County in 1995-97 and
interviewed two to three years following their treatment admission.
Results showed that half of the subjects had resumed MA use: 36%
within six months of the end of treatment, and 15% more within seven
to 19 months. Survival analysis methods showed significant predictors
of (shorter) time to relapse were shorter length of treatment, older
age of first substance use, and involvement in selling MA; ethnicity
(being Hispanic) and more previous time in treatment had weaker
effects.
7: Journal of Psychoactive Drugs. 2000 Apr-Jun;32(2):233-8.
Methamphetamine and cocaine users: differences in characteristics and
treatment retention.
Rawson R, Huber A, Brethen P, Obert J, Gulati V, Shoptaw S, Ling W.
The use of methamphetamine and cocaine have both produced significant
public health problems during the past two decades. Although these
powerful psychostimulants have many common acute and chronic effects,
there are some important differences in who uses these drugs and the
consequences of their use. This article reports on two large cohorts
of treatment-seeking cocaine and methamphetamine users who entered
treatment at the same facility over the same four-year period of time.
Patterns of use differed significantly. Cocaine users have more
episodic use patterns, spend more money on purchasing their drugs, and
use alcohol more heavily. Methamphetamine users include a higher
proportion of women, more frequently use on a daily basis, use
marijuana more often, and experience more severe medical and
psychiatric consequences. Despite the differences in the stimulant
drug effects and consequences, the treatment response to a
multicomponent, outpatient program is very similar.
8: American Journal of Drug and Alcohol Abuse. 1997 Feb;23(1):129-41.
Gender differences in the relationship of alcohol and drug use to
criminal behavior in a sample of arrestees.
Nunes-Dinis MC, Weisner C.
This paper examines differences between men and women in the
relationship of alcohol and drug use to criminal offenses, including
violent behavior. A probability sample of men (N = 959) and women (N =
188) arrestees were interviewed in a northern California county. No
significant differences were found between men and women in patterns
of drug use, but more men than women reported heavy drinking. A higher
proportion of men than women reported violence in the events related
to their arrest (p < or = .02). Logistic regression examined the
relationship of heavy drinking and violent offenses, controlling for
drug use and demographic variables. Frequent heavy drinking (OR =
1.47), white ethnicity (OR = .51), and being married (OR = 1.93) were
significant; gender was not significant. The results have implications
for future research on gender and violence.
9: Journal of Substance Abuse. 1996;8(4):379-402.
The relationships of substance abuse to illegal and violent behavior,
in a community sample of young adult African American men and women
(gender differences).
Friedman AS, Kramer S, Kreisher C, Granick S.
In a longitudinal study of an African American young adult community
sample (N = 380), prospective data on lifetime substance use/abuse
from childhood up to age 24 were used as control variables in analyses
to predict illegal and violent behavior during the ensuing 2 1/2-year
period. Frequent earlier use of drugs predicted subsequent violent
behavior for both men and women. Frequency of earlier use of alcohol
predicted subsequent violent behavior for men but not for women. A
weaker relationship was found between degree of psychopathology and
degree of engaging in either illegal or violent behavior than between
degree of psychopathology and degree of substance use/abuse.
Comorbidity (the combination of earlier use/abuse of drugs with
earlier psychopathology) was a stronger predictor, for women than for
men, of later illegal and violent behavior.
10: Journal of Substance Abuse. 2001;13(4):563-81.
Gender differences in the association of alcohol intoxication and
illicit drug abuse among persons arrested for violent and property
offenses.
Martin SE, Bryant K.
PURPOSE: To explore the associations between violent and other crimes,
and alcohol intoxication and recent use of cocaine, marijuana, and
other drugs among men and women arrestees and examine gender
differences in these relationships. METHODS: We conducted a secondary
analysis of 1998 using Arrestee Drug Abuse Monitoring (ADAM) system
data using a sample of 9242 male and 2594 women arrested for violent
and property offenses in 35 cities. Logistic regression was used to
predict arrest for a violent offense (rather than a property crime)
from drug- and alcohol-related, and other variables. RESULTS: Both
gender and alcohol intoxication are significantly related to arrest
for a violent offense. However, the intoxication effects (in the
absence of cocaine) are more than three times as great for female
(Exp(beta) = 5.59) as male arrestees (Exp(beta) = 1.74), while the
combined effects of alcohol and cocaine predict a property offense for
women but are insignificant for men. IMPLICATIONS: To achieve further
reductions in violent crime, intervention strategies need to focus on
reducing alcohol intoxication as well as illicit drug use. Research
on the role of alcohol on women's aggression and violence also is
suggested.
11: Journal of Psychoactive Drugs. 2000 Apr-Jun;32(2):221-8.
Correlates of outpatient drug treatment drop-out among methamphetamine users.
Maglione M, Chao B, Anglin MD.
This article explores correlates of retention among the 2.337
methamphetamine (MA) users entering public outpatient treatment
programs in California from January 1, 1994 through September 30,
1997. A secondary analysis of data from the California Alcohol and
Drug Data System (CADDS) was performed and predictors of drop-out
before treatment completion (as measured by a retention of 180 days or
more) were determined using logistic regression. Overall, 23.3% of MA
users
completed treatment, a rate similar to that for users of other drugs
throughout California. As expected, MA users who were older (40 years
or over), had less severe drug use patterns (used less than daily or
did not inject), or who were under coerced treatment were
significantly more likely to complete treatment that other MA users.
Surprisingly, men were significantly more likely than women to drop
out of treatment before 180 days. Until studies currently collecting
primary data on MA treatment are completed, the present secondary
analysis provides a useful foundation upon which future research and
intervention strategies may be based.
12: Journal of Psychoactive Drugs. 2000 Apr-Jun;32(2):183-91.
A descriptive analysis of participant characteristics and patterns of
substance use in the CSAT methamphetamine treatment project: the first
six months.
Reiber C, Galloway G, Cohen J, Hsu JC, Lord RH.
The CSAT Methamphetamine Treatment Project (MTP) is a multisite study
with a two-fold purpose: to assess the feasibility and outcomes
generated by a technology transfer of the Matrix treatment model for
methamphetamine (MA) abuse into several community-based treatment
programs, and specifically to compare outcomes of treatment as usual
at each site with outcomes of the Matrix model, as implemented in each
site. The study comprises seven sites, geographically situated in
Hawaii, Northern and Southern California, and Montana. This article
presents a demographic description of the cohort, and describes
patterns of drug use, abuse, and related problems among the 169
participants recruited in the first six months of the study, from
April through September 1999. Specific analyses presented include:
demographic composition of the sample with respect to gender, age,
ethnicity, education completed, employment status, and income; primary
drug used, and mean percent of days using various drugs including MA,
alcohol, and marijuana; and percent of sample reporting various routes
of drug administration. Mean baseline Addiction Severity Index
composite scores are presented that describe medical, employment,
alcohol, drug, legal, family/social, and psychiatric status for the
sample. Also presented here are comparisons of this preliminary
population to other populations reported in the literature. This early
subset of MTP participants is similar to other methamphetamine-abusing
populations described in the literature in age, years of education,
income, and mean years of use. However, because of its multisite
structure and the locations of its constituent sites, the MTP
population has greater variation in ethnic makeup than do populations
from other studies, offering an opportunity to provide useful new
information about drug use patterns and treatment responses in
populations not previously studied.
13: Substance Use & Misuse. 1998 Jun;33(7):1481-510.
Psychosocial, substance use, and delinquency differences among Anglo,
Hispanic White, and African-American male youths entering a juvenile
assessment center.
Dembo R, Schmeidler J, Sue CC, Borden P, Manning D, Rollie M.
Using data collected on nearly 4,000 Anglo, Hispanic White, and
African-American male youths processed at the Hillsborough County
Juvenile Assessment Center, we examine their psychosocial, substance
use, and other delinquent behavior differences. In extending the
results of previous research in a manner consistent with the concept
of relative deviance, significant differences in these variables are
found across the three groups. Implications of the findings for
theory, service delivery, and policy are also considered.
14: Substance Use & Misuse. 1998 May;33(6):1291-313.
Who drops out of drug-user treatment research on women?
Nishimoto RH.
Attrition or dropping out is an important methodological issue in
drug-user treatment research. The purpose of this study was to
describe and explain the degree of subject attrition-more
specifically, postinclusion attrition-within the context of a research
demonstration project which focused on a women's sensitive approach to
drug-user treatment. Demographic variables, psychosocial outcome
measures, and two treatment variables were examined as possible
predictors of attrition from research participation. Findings showed
attrition rates increased from admission, peaked at 3-month follow-up,
and then declined substantially by the 12-month follow-up period. A
logistic regression analysis showed only treatment discharge status to
significantly predict subject attrition.
I found these articles in the PubMed MEDLINE database
(www.pubmed.gov). I used a variety of search strategies, including
the following MeSH headings: "Amphetmine-related disorders"
"Methamphetamine" "Treatment Outcome" "Therapy" "Demography". The
most productive technique, however, was to find a good article and
then use PubMed's "related articles" tool. This tool finds articles
with similar keywords and subject headings, then ranks them in
relevancy order.
Here are some books your client may find helpful:
N.A. Text (Narcotics Anonymous) $11.55
Staying Clean: Living Without Drugs $9.95
I found these two in Amazon.com by doing a search for "methamphetamine
self-help". There are a number of others (including publications by NA
and books of meditations for addicts) that are available used via
Amazon.com. You might want to take a look at the "people who bought
this book also bought these..." for other recommendations.
Narcotics Anonymous (http://www.na.org/) has a number of inexpensive
books and pamphlets, many of which are available for order through
their website or through Amazon.com.
It looks like most of the successful treatment plans for meth are
in-person counseling. I've not been able to find good online plans
and groups. You might be interested in this article from the Office
of National Drug Control Policy, "Therepeutic Communities in
Correctional Settings: The Prison Based TC Standards Development
Project" (http://www.whitehousedrugpolicy.gov/national_assembly/publications/therap_comm/toc.html)
which talks about programs in prisons for drug counseling etc.
Good luck with your sentencing hearing. If there's anything else I can
do to help clarify this answer, please let me know. It's a good idea
to ask for clarification before rating the answer - you can only rate
the answer once, so make sure everything's done before doing so.
Thanks -
Librariankt |
