Volume 3, Number 2 - April 2007
A Note From NIDA's Director
[PDF - 64K]
Nora D. Volkow, M.D.
Change Is at Hand
[PDF - 48K]
David Anderson
Imaging the Addicted Human Brain
[PDF - 1.8MB]
Joanna S. Fowler, Ph.D., Nora D. Volkow, M.D., Cheryl A. Kassed, Ph.D., M.S.P.H., and Linda Chang, M.D.
Modern imaging techniques enable researchers to observe drug actions and consequences as they occur and persist in the brains of abusing and addicted individuals. This article presents the five most commonly used techniques, explains how each produces images, and describes how researchers interpret them. The authors give examples of key findings illustrating how each technique has extended and deepened our knowledge of the neurobiological bases of drug abuse and addiction, and they address potential clinical and therapeutic applications.
Assessing Organizational Functioning as a Step Toward Innovation
[PDF - 204K]
D. Dwayne Simpson, Ph.D., and Donald F. Dansereau, Ph.D.
Innovate and adapt are watchwords for substance abuse treatment programs in today's environment of legislative mandates, effective new interventions, and competition. Organizations are having to evolve—ready or not—and those that are ready have superior chances for success and survival. The Texas Christian University Organizational Readiness for Change (ORC) survey is a free instrument, with supporting materials, that substance abuse treatment programs use to assess organizational traits that can facilitate or hinder efforts at transition. This article presents organizational change as a three-stage process of adopting, implementing, and routinizing new procedures; describes the use of the ORC; and outlines a step-by-step procedure for clearing away potential obstacles before setting forth on the road to improved practices and outcomes.
One Program's Transition to Research-Based Strategies for Treating Methamphetamine Abuse
[PDF - 2.7MB]
Jay M. Hansen
Prairie Ridge Addiction Treatment Services turned to SAMHSA's Treatment Improvement Protocol (TIP) 33, "Treatment for Stimulant Use Disorders," to try to establish more effective practices for their fast-growing population of methamphetamine-addicted clients. Six years later, Prairie Ridge's executive director says that adopting the TIP's client-based treatment philosophy has enhanced the program's accessibility and results, not only for stimulant-abusing clients, but others as well. In this article he recounts how the TIP contents meshed with Prairie Ridge's preexisting treatment philosophy and practices; what they adopted and what they adapted from the TIP and why; counselors' responses during the transition; and outstanding issues.
Quality and Performance Improvement: What's a Program to Do?
[PDF - 136K]
Frank McCorry, Ph.D.
A confluence of forces is challenging traditional approaches to issues of quality in substance abuse care. The availability of effective, research-based interventions, the Federal emphasis on performance measurement and outcomes, and national initiatives to improve quality and data infrastructure are driving a transition from a static, compliance-oriented approach to a more dynamic performance improvement model. This new way of achieving and documenting quality will produce better outcomes for consumers and greater confidence in the value of substance abuse services, but first it will require new behaviors from all parties involved in the delivery of substance abuse prevention and treatment services. This article describes some of the shifts already under way and offers advice on how organizations can get ready for the coming changes.
Science and Practice in Action
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Attending to Emotional Cues for Drug Abuse: Bridging the Gap Between Clinic and Home Behaviors
[PDF - 136K]
Michael W. Otto, Ph.D., Conall M. O'Cleirigh, Ph.D., and Mark H. Pollack, M.D.
Classical conditioning models of addiction provide keys to understanding the vexing discrepancy between substance abuse patients' desire to abstain when they are in therapy sessions and their tendency to relapse. Experiments using these models demonstrate the power of environmental relapse cues and support clinical approaches, including active exposure, aimed at helping patients recognize and withstand them. Internal cues, including emotions and somatic states such as withdrawal, can trigger urges as powerfully as external cues such as people, places, and things associated with prior abuse. The authors describe a cognitive-behavioral therapy approach that focuses on identifying and actively inducing each patient's high-risk emotions, then helping him or her develop and practice healthy responses. Clinical trials support the approach for patients with panic disorder who have trouble discontinuing benzodiazepines, and early trials suggest it may be useful for patients addicted to other drugs as well.
This Issue's Authors and Respondents
[PDF - 60K]
Same Behaviors, Different HIV/STD Risks for Whites, African-Americans
[PDF - 52K]
Continuing Education Quiz for Counselors
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Substance abuse counselors can earn two nationally certified continuing education (CE) hours by reading the indicated articles and completing the multiple-choice quiz. This is an open-book exam. Complete the quiz by circling one or more of the multiple-choice answers. Be sure to answer all questions; unanswered questions will be scored as incorrect. You must score at least 70 percent to earn CE hours. Please note that we must receive your quiz by August 31, 2007.
[PDF - 184K]
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