Coping style of substance-abuse patients: effects of anxiety and mood disorders on coping change.

The authors studied the coping style of substance-abuse patients during clinical cognitive-behavioral group therapy, and the effects of mood and anxiety disorders on changes in coping style. Change in coping style was studied prospectively in a cohort of 132 residential-drug-abuse patients. In addition to pretreatment assessments, which included diagnosis of mood and anxiety disorders and addiction severity, repeated measurements of coping style were performed at predetoxification, pretreatment, and after three and six months of treatment. Considerable change in coping style between predetoxification and pretreatment was found, suggesting that coping assessment in a predetoxification phase is confounded by state factors surrounding treatment entry. Coping style of detoxified substance abusers is related to the presence of mood and anxiety disorders. Coping style was not found to be related to the severity of drug abuse. Furthermore, maladaptive coping styles decreased after three months of inpatient-substance-abuse treatment, and more-adaptive coping styles remained stable for another three months of inpatient treatment. Patients with an anxiety disorder improved less on coping style when compared to non-anxiety patients. Presence of a mood disorder had no impact on coping-style improvement. The results indicate that more attention should be focused on anxiety disorders during substance-abuse treatment in order to improve coping style. Furthermore, more studies are needed on the relation between substance abuse, coping style, and psychopathology.

Cue reactivity and effects of cue exposure in abstinent posttreatment drug users.

After 12 months of inpatient treatment, 16 opiate-addicted patients were exposed to drug-related stimuli. The results of this study indicate that cue reactivity in opiate-addicted subjects is still present after 12 months of intensive inpatient treatment. After exposing subjects to drug-related stimuli, there is an increase in craving, feelings of depression, and anger. Because posttreatment subjects are likely to be confronted with these stimuli following discharge, a reduction of this reactivity is desirable. In the present study, cue reactivity (feelings of depression, anger, tension, craving, and physical symptoms) reduced after protocolized cue exposure treatment. This effect maintained for at least 6 weeks after the last cue exposure session.

[Relatively low HIV prevalence among drug users in The Hague in spite of risky injection behavior]. / Relatief lage HIV-prevalentie onder druggebruikers in Den Haag ondanks riskant spuitgedrag.

Between September 1987 and January 1989 101 drug users in The Hague were studied for HIV seroprevalence and risky injecting behaviour. A comparison was made between this group and a group of 241 drug users who were studied in the same period in Amsterdam. All HIV-infected drug users, except for one homosexual man in Amsterdam, had a history of intravenous drug use. The HIV seroprevalence for 56 intravenous drug users in The Hague was 1.8% (95% CI: 0-5.3), and for 194 intravenous drug users in Amsterdam 26.8% (95% CI: 20.6-33.0). With regard to risky injecting behaviour no differences in frequency of borrowing or lending used needles and syringes were found between the two groups. Concluded is that further spread of HIV among intravenous drug users in The Hague (and Amsterdam) will be likely unless risk reduction in injecting behaviour will occur.