Methamphetamine abuse: issues for special populations.

Methamphetamine (MA) abuse has been a problem in the western United States for decades. However, recently the incidence of MA abuse has risen to epidemic levels in some regions and among particular subgroups of the population. Recognizing the need to develop effective treatments for MA dependence, the Center for Substance Abuse Treatment (CSAT) established a multisite Methamphetamine Treatment Program (MTP) that compares the Matrix Model treatment program for MA to the treatments as usual at seven community-based clinics in California, Montana and Hawaii. Examination of the clients receiving services though this project provides an opportunity to explore particular issues of diverse special populations who are impacted by the problem of MA dependence. These groups include rural Americans, Native Americans, Hawaiians, gay and bisexual males and drug court participants. Specifically, this article examines cultural, geographic and situational barriers to accessing and completing treatment and presents strategies that have been used to overcome these barriers.

Sexual risk behavior and condom use among street youth in Hollywood.

A study of 610 street youth aged 13-23 who attended drop-in centers in Hollywood, Calif., reveals that 96% are sexually experienced. One-half of the young men and one-third of the young women have engaged in sex for food, money, shelter, drugs or other items needed. Twenty-five percent of the men and 15% of the women have injected drugs at some time in their life. Some 45% of the men and 30% of the women used condoms at last intercourse. A logistic regression analysis found that among men, those who have completed 10th grade or higher are nearly three times as likely to use condoms as are those who have less education. Young men who have been tested for the human immunodeficiency virus are nearly twice as likely to use condoms as are those who have not been tested. Among women, condom use declines with age, and young women who have engaged in sex for food, money or lodging are more likely to use condoms than those who have not.

High-risk behaviors among male street youth in Hollywood, California.

High-risk sex and drug use behaviors are examined among 446 male street youth 14 to 23 years old in Hollywood, California (the area in Los Angeles County with the highest number of AIDS cases). Comparisons are made based on whether the sex behaviors occurred in situations of "survival sex" ("sex you gotta do") and "recreational sex" ("sex you wanna do"). Ninety-seven percent of the males were sexually active, with 27.1% involved in prostitution in the last 3 months. Involvement in prostitution is most common among older, gay identified males. The most prevalent risk factors seen among this group include inconsistent condom use (which also varies by social situation), high-risk sexual behaviors during both survival and recreational sex, large numbers of sexual partners, intravenous drug use, and the use of drugs and alcohol during all sex.

Ontogeny of selective attention effects on event-related potentials in attention-deficit hyperactivity disorder and normal boys.

A longitudinal study of young attention-deficit hyperactivity disorder (ADHD) boys has found clear evidence for developmental abnormalities in event-related potential (ERP) waves that reflect cognitive processes associated with selective attentional tasks. Boys alternated attention to auditory or visual modalities in a train of stimuli, in an attempt to detect target stimuli in the attended modality. Results suggest that ADHD boys' attentional difficulties are due to insufficient facilitation of responses to the attended stimuli and not to an inability to block ignored stimuli. Abnormalities in ERPs reflecting cognitive processes associated with both interchannel selection mechanisms (processing negativity) and intrachannel selection mechanisms (P3b) were found. The degree of abnormality in the P3b responses to target stimuli in ADHD boys (lower than normal boys) was found to increase with age. It is suggested that the abnormally low P36 response to attended target stimuli found in ADHD boys may be due in part to insufficient LC noradrenergic activity normally triggered by attended task-relevant or novel stimuli.