Human immunodeficiency virus seroprevalence and drug-using behavior in Milwaukee intravenous drug abusers.

We assessed human immunodeficiency virus (HIV) antibody prevalence and drug-using behaviors among intravenous drug abusers (IVDAs) enrolled in Milwaukee drug treatment programs. Six (2.3%) of 266 study participants were positive for HIV antibody by Western blot assay. A history of needlesharing was reported by 91% of participants, injection of drugs within the past 6 months by 76%, visits to a shooting gallery by 34%, and drug injection outside of Wisconsin by 41%. Nonwhite participants were more likely than white participants to share needles greater than 5 times per month (odds ratio of 2.0) and more likely to have visited a shooting gallery greater than 5 times (odds ratio of 2.7). The average frequency of injection did not differ significantly by race or gender. Pharmacies were the most frequently listed source of sterile needles, and the most common reason for sharing needles was convenience. We conclude that as of late 1987, HIV seroprevalence in Milwaukee IVDAs remained relatively low compared to that of IVDAs in the northeastern United States. There may be racial differences in drug-using behaviors that define distinct subpopulations of IVDAs. These differences should be assessed further, since they have important implications for the success of AIDS education efforts.

A method for evaluating anxiolytic sedatives.

Although anxiolytic sedatives are widely used in clinical practice, the methodology for assessing treatment effect of these compounds has not been well developed. The present double-blind study was designed to refine methodology for evaluating anxiolytics. Choice of rating scale, patient selection, maintenance of the double-blind status, the subjects' environment during the study, and the subjects' understanding of the study are discussed as considerations in reducing sources of variability and bias in the study of anxiolytics. After placebo prescreening, 14 subjects with diagnoses of anxiety recieved 3 to 6 mg lorazepam daily for four weeks, while 14 control subjects received placebo. The Hamilton Anxiety Rating Scale (HARS) and the Wang Anxiety Rating Scale (WARS), with its Anxiolytic Adjunct Scale (AAS), were used to assess changes in anxiety. The Wang and Hamilton ratings correlated well at both comparison periods. Lorazepam demonstrated significant superiority to placebo and produced no serious adverse effects. Anxiolytic efficacy did not differ significantly among the four weekly ratings.

The safety and value of naloxone as a therapeutic aid.

The safety and value of naloxone as a therapeutic aid was demonstrated in a large population of narcotic dependent persons over a two-year period. Naloxone was used to precipitate the narcotic withdrawal syndrome. This withdrawal syndrome was rated according to a previously developed scale. Retrospectively, naloxone rating scores were correlated with the patients' initial dose of methadone. With patients who received 0.8 mg naloxone, good correlation was obtained between the naloxone test score and the optimum methadone dose (mg), as indicated by the patients' physical status during the initial three days of methadone treatment. Three hundred and sixty-three tests were administered to 343 persons and no individuals developed any serious effects such as convulsions, syncope or cardiovascular collapse.

A brief anxiety rating scale in evaluating anxiolytics.

The Wang Anxiety Rating Scale (WARS) was designed to evaluate degrees of anxiety in patients receiving anxiolytic medication. WARS contains 12 pertinent symptoms of anxiety: nervousness, restlessness, excitability, irritability, worrying, disturbed concentration, palpitation, insomnia, hostility, tremors, smoking, and excessive perspiration. Frequently encountered side effects of anxiolytic medications are excluded. The validity of the WARS was determined by correlation with the Hamilton Anxiety Rating Scale (HARS) in a single-blind study in which 20 chronically anxious patients consecutively received placebo (three days), 15 mg clorazepate dipotassium (two weeks), and 22.5 mg clorazepate dipotassium (two weeks). Both anxiety scales, a side effect scale, and a global assessment were completed at regular intervals (periods 0-6). Results show (1) highly significant correlation (P less than 0.001) between WARS and HARS for periods 1-6; (2) greater correlation between HARS and side effect scale than between WARS and side effect scale; (3) greater correlation between WARS and global assessment than between HARS and global assessment; correlated changes in scores for WARS, HARS, and global assessment demonstrate efficacy of active medication.