DRUG ADDICTION TREATMENT RESEARCH German and American Perspectives

Transcription

1 DRUG ADDICTION TREATMENT RESEARCH German and American Perspectives Edited by GERHARD BUHRINGER and JEROME J. PLATT KRIEGER PUBLISHING COMPANY MALABAR, FLORIDA 1992

2 Table of Contents FOREWORD Bundesminister f'iir Gesumlheit PREFACE Gerhard Biihringer Jerome J. Plait Hahnemann University School of Medicine Division of Addiction Research and Treatment xiii xv LIST OF CONTRIBUTORS PART ONE EPIDEMIOLOGY OF DRUG ABUSE 1. THE EPIDEMIOLOGY OF DRUG USE IN GERMANY: BASIC DATA AND TRENDS 3 Karl-Heinz Reuband Zentralarchiv fur empirische Sozialforschung Universitat Koln 2. DRUG-RELATED DEATH 17 Klaus Piischel Institut fiir Rechtsmedizin, Universitat Hamburg

3 vi Contents 3. DRUG ABUSE AND AIDS IN NEW JERSEY: ISSUES AND INTERVENTIONS 35 Jerome J. Plan, Martin Y. lguchi, Victor Lidz, Donald A. Bux Hahnemann University School of Medicine Division of Addiction Research and Treatment PART TWO POLICY PERSPECTIVES 4. THE DRUG PROBLEM IN THE FEDERAL REPUBLIC OF GERMANY: MEASURES TAKEN BY THE GERMAN GOVERNMENT. WITH SPECIAL EMPHASIS ON PILOT PROJECTS AND THE AIDS PROBLEM 59 Michaela Schreiber Bundesministerium fur Gesundheit 5. THE TREATMENT OF DRUG ADDICTS: FLUCTUATIONS OF HEALTH POLICY OR A WELL-ORGANIZED. ADAPTIVE LEARNING SYSTEM? 67 Gerhard Biihringer 6. POLICY ISSUES PERTAINING TO THE TREATMENT OF HEROIN ADDICTS IN THE UNITED STATES, WITH PARTICULAR REFERENCE TO METHADONE MAINTENANCE THERAPY 91 John C. Ball, Eric Corty Addiction Research Center National Institute on Drug Abuse 7. METHADONE IN THE TREATMENT OF NARCOTIC ADDICTION 99 Robert G. Newman Beth Israel Medical Center PART THREE THE TREATMENT SERVICE SYSTEM 8. TREATMENT FACILITIES IN GERMANY: NUMBER AND TYPE OF SERVICES, ORGANIZATION. AND FUNDING 115

4 Contents vii Herbert Ziegler Sierra Tuscon Klinik 9. TREND ANALYSIS OF TREATMENT SERVICE DATA FROM THE EB1S INFORMATION SYSTEM 127 Roland Simon, Gerhard Biihrini>er. Michael Strohl 10. THE CHALLENGE OF COUNSELING AND CARE OF LONG-TERM DRUG ADDICTS: THE GERMAN EXPERIENCE WITH THE DEMONSTRATION PROJECT "SOCIAL WORK WITH LONG-TERM DRUG ADDICTS" (SLD) 139 Thomas Arnold Institut fur Sozialarbeit und Sozialpadagogik ISS PART FOUR ADDICTION CAREERS AND PROCESS OF TREATMENT 11. DEVELOPMENT OF DEPENDENCE AND DOPAMINERGIC MECHANISMS 163 Ursula Havemann-Reinecke Psychiatrische Klinik. Universitat Gottingen Klaus Kuschinsky Institut fur Pharmakologie und Toxikologie Universitat Marburg 12. RECOVERY FROM OPIATE ADDICTION: A LONGITUDINAL PROSPECTIVE STUDY 173 Richard Sickinger Jugendberatung und Jugendhilfe Walter Kindermann Hessisches Ministerium fur Jugend. Familic und Gesundheit 13. CLIENT CHARACTERISTICS AND THE THERAPEUTIC PROCESS IN RESIDENTIAL TREATMENT CENTERS FOR DRUG ADDICTS 187 Elke Hanel

5 viii Contents 14. CHANGES OF PERSONALITY AND DEPRESSION DURING TREATMENT OF DRUG ADDICTS 197 Heiner Ellgring Institut fur Psychologic Freie Universitat Berlin Heinz C. Vollmer Prop Alternative Aiglsdorf 15. VARIATIONS IN BEHAVIOR AMONG NARCOTIC ADDICTS 211 David N. Nurco Department of Psychiatry University of Maryland School of Medicine PART FIVE DROPOUT AND RELAPSE 16. THE DROPOUT RATE AMONG DRUG ADDICTS DURING THE FIRST NINETY DAYS OF RESIDENTIAL TREATMENT 227 Heinrich Kiifner, Andre Denis, Irene Roch, Michael Bohmer 17. FACTORS INFLUENCING DROPOUT FROM DRUG ABUSE TREATMENT PROGRAMS 241 Andre Denis, Heinrich Kiifner, Irene Roch, Michael Bohmer 18. PREDICTION OF PREMATURE TERMINATION OF THERAPY IN THE TREATMENT OF DRUG ADDICTS 253 Heinz C. Vollmer Prop Alternative Aiglsdorf Heiner Ellgring Institut fur Psychologic Freie Universitat Berlin Roman Ferstl Institut fur Psychologic Universitat Kiel 19. THERAPEUTIC ACCESSIBILITY OF DRUG ADDICTS DURING TREATMENT IN THERAPEUTIC COMMUNITIES 271 Dieter Kunz Therapiedorf "Villa Lilly"

6 Contents ix 20. PREDICTION OF DROPOUT AND RELAPSE 291 Klaus Herbst IFT Institut fiir Therapieforschung 21. FACTORS INFLUENCING RELAPSE AND TREATMENT DROPOUT 301 Helmut Kampe Fachhochschule Darmstadt. Fachbereich Sozialpiidagogik Dieter Kunz Therapiedorf "Villa Lilly" PART SIX TREATMENT AND OUTCOME 22. EVALUATION OF A DRUG-FREE OUTPATIENT TREATMENT PROGRAM FOR DRUG ADDICTS 323 Gabriele Spies, Michael Bohmer, Gerhard Biihringer IFT Institut fiir Therapieforschung 23. INDIVIDUALIZED BEHAVIOR THERAPY FOR DRUG ADDICTS 333 Heinz C. Vollmer Prop Alternative Aiglsdorf Roman Ferstl Institut fiir Psychologic Universitat Kiel Heiner Ellgring Institut fiir Psychologie, Freie Universitat Berlin 24. THE MUNICH MULTICENTER TREATMENT EVALUATION STUDY: RESULTS OF THE FIRST FOLLOW-UP Barbara Haderstorfer. Jutta Kiinzel-Bohmcr IFT Institut fiir Therapieforschung 25. THERAPEUTIC COMMUNITY RESEARCH: RECENT STUDIES OF PSYCHOPATHOLOGY AND RETENTION 367 Nancy Jainchill, George De Leon Narcotic and Drug Research, Inc. 26. PHARMACOLOGICAL TREATMENT OF OPIOID DEPENDENCY Mary Jeanne Kreek Rockefeller University

7 x Contents PART SEVEN DRUG ABUSE, DELINQUENCY, AND COMPULSORY TREATMENT 27. DRUGS AND DELINQUENCY: SOME RESULTS OF A CURRENT SELF-REPORT STUDY OF UNIVERSITY STUDENTS AND OF RECENT IN-DEPTH INTERVIEWS WITH DRUG ADDICTS 409 Arthur Kreuzer, Ruth Romer-Klees, Hans Schneider Institut fiir Kriminologie, Justus-Liebig-Universitiit GieBen 28. CRIMINAL LAW AND THE TREATMENT OF DRUG ADDICTS 433 Rudolf Egg Kriminologische Zentralstelle 29. COMPULSORY TREATMENT: RESULTS OF A FOLLOW-UP STUDY OF DRUG ADDICTS 449 Heiner Melchinger Institut fiir Entwicklungsplanung und Strukturforschung Universitat Hannover PART EIGHT DRUG ABUSE AND AIDS 30. HIV-INFECTION RATES IN INTRAVENOUS DRUG ABUSERS IN THE FEDERAL REPUBLIC OF GERMANY 465 Dieter Kleiber Freie Universitat Berlin 31. EVALUATION OF AN HIV-PREVENTION PROGRAM FOR DRUG ADDICTS: THE APP 483 Eva-Maria Fahrner, Ingolf von Tome IFT Institut fiir Therapieforschung Iris Bowman Heilpadagogische Tagesstatte 32. THE HARLEM AIDS PROJECT: DESCRIPTION OF AN AIDS OUTREACH PROJECT 499 Sherry Deren Narcotic and Drusi Research. Inc.

8 Contents xi 33. DRUG ABUSE AND AIDS: NIDAS CLINICAL MEDICINE BRANCH AND OPPORTUNITIES FOR GERMAN-AMERICAN RESEARCH COOPERATION 509 Peter I. Hartsock Clinical Medicine Branch National Institute on Drug Abuse 34. A REPORT ON THE NATIONAL AIDS DEMONSTRATION RESEARCH PROGRAM 519 Barrx S. Brown National Institute on Drug Abuse