Substance Abuse

This issue troubles me every time, even when I try not to think about it, and turn my mind away from it. Addiction is not what Just happened, it takes time, creep in slowly without you knowing you getting addicted to it. Most times people don't know they getting addicted to something, I believe everybody is addicted to something, I sometimes call love addiction because when you love somebody you will always want to be with that person. My immediate elder brother started smoking cigarette at age 17, and start smoking marijuana at age 19, and still smoke till this day.People always say â€Å"am not addicted to smoking or drinking†, and usually follow this sentence, I only take a glass of wine before going to bed, or I only smoke to relax myself. My community is drowning from substance abuse, drugs and alcohol. â€Å"People abuse substances such as drugs, alcohol, and tobacco for varied and complicated reasons, but it is clear that our society pays a significant cost. The toll f or this abuse can be seen in our hospitals and emergency departments through direct damage to health by substance abuse and its link to physical trauma.Jails and prisons tally daily the throng connection between crime and drug dependence and abuse. Although use of some drugs such as cocaine has declined, use of other drugs such as heroin and â€Å"club drugs† has increased†(Reilly, 1989). Drugs has become a big part of our society, I was a auto-technician for a big car company that work with Bentley and Aerosols. I have to go into customers car to fix or diagnose the problem, 60% of the time I find or smell marijuana in the car. That is the rate this country is going, 1 out of 2 people smoke, at least cigarette.Many marijuana users believes smoking pot has no negative effects, scientific research indicates that marijuana use can cause many different health problems. This always contribute to our society negatively, it make kids act up, make parents not function as paren ts, and eventually make the society slowdown. All this are happening without the drug being legalize, marijuana is always the focus point because it is the gate way drug to other substance. 2 Drugs are one of, and most epidemics in my community.Too months ago in my building, Just got home from school on a snowing, and cold day, I saw a lot of people adhered in from of the elevator, and was wondering why, I decided to ask somebody what's happening, she said mike was shot (14 year old boy on my floor) by somebody who he sold drugs for. This is the same boy the brother served 4 years in Jail, and just got home 4 months ago for possession of drugs. I see them every time, him and his friends. Age range from 12 to 16, smoking and drinking, and some of them don't go home for days, they skip school.Their parents don't talk to them thinking they can direct their own life. I see these things in my neighborhood every time, and wish I can urn it around in a day. They said Rome wasn't built in a day, and that's true. I plan to write an anonymous letter to some of the parents and the building manager concerning drugs, and how it affects the community, kids growing up around them, and the building it safe. After doing drugs they get wild and break things, my building has so many holes on the walls from their craziness.This is not fair to people in the building paying more expensive rent than them, they deserve clean and noise free environment. My hallway is packed with people all day for no reason, hey lay on the floor most times, and you have to walk across them. The elevator and stairways is full of graffiti, and gang sign on the wall, police is always in the building which is not good or fair to the tenants. I know is not going to be easy, everybody react to the same thing differently. I plan on being polite, positive.This are good kids, they Just need somebody to care about them, it don't really bother me because I grow up in a neighborhood like this, am only concern abo ut other tenants who are not used to it. I grow up in a big family, in a rough neighborhood. Almost 20 boys in and out of my house every day, most of them thugs, and they are all gang member. 3 They should be a program in poor neighborhood for kids and adult to tell them about them about their neighborhood, and the values.People won't respect or care for what they don't know, parent should learn to see their kids and as their kids and not their friends or buddies. Gang members claim neighborhoods saying is for the red or for blue side, because they don't know the real value of the neighborhood and nobody tell them. Illegal drugs have been around â€Å"since the 19th century when Americans iris discovered new wonder drugs like morphine, heroin, and cocaine, our society has confronted the problem of drug abuse and addiction.When the 20th century began, the United States–grappling with its first drug epidemic–gradually instituted effective restrictions: at home through d omestic law enforcement and overseas by spearheading a world movement to limit opium and coca crops. By World War II, American drug use had become so rare; it was seen as a marginal social problem. The first epidemic was forgotten. During the sass, drugs eke marijuana, amphetamines, and psychedelics came on the scene, and a new generation embraced drugs.With the drug culture exploding, our government developed new laws and agencies to address the problem. In 1973, the U. S. Drug Enforcement Administration was created to enforce federal drug laws. In the sass, cocaine reappeared. Then, a decade later, crack appeared, spreading addiction and violence at epidemic levels. Today, the Idea's biggest challenge is the dramatic change in organized crime. While American criminals once controlled drug trafficking on U. S. Soil, today sophisticated ND powerful criminal groups headquartered in foreign countries control the drug trade in the United States†. DEAD, 13) This is the American so ciety we life in now, the earlier we do something the better it will be for everybody. You don't want your teenage kid sneaking out to go drink, smoke or do drugs, and thinking it's cool Just because she see her friends 4 or even her parent doing it. Some people say smoking or drinking is not bad but how you do it, or what you do it for. Drinking more than two times in a week is Just as bad a smoking, that's what I think, because for twice a week you will want to hang-out ore with boys/girls and get some more drink. Substance Abuse Impact of Psychiatric Disorders on Treatment Outcomes for Patients with Substance Abuse Daniel Painter Raritan Valley Community College Table of Contents Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. page 3 Abstract 1†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. page 4-5 Critique 1†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. page 5 Abstract 2†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢ € ¦page 6 Critique 2†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. page 6-7 Abstract 3†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦page 8 Critique 3†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. page 8 Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. page 9 IntroductionFor this research I selected the articles that concentrated on treatment outcomes for clients with addictions who also had a mental illness diagnoses (depression, anxiety, antisocial personality disorder, phobias). The first two research studies were conducted at different times but by the same researcher, Drar Charney, MD, and concentrate on outcomes of addiction treatment in patients with co-occurring disorders of anxiety and depression, or both at the same time. The last article by Wilson Compton, MD, focuses on drug dependence treatment outcomes in patient with a variety of mental llnesses. All three studies show similar results in predicting outcomes. Study #1 Abstract The first study that I selected, â€Å"Association Between Concurrent Depression And Anxiety And Six Month Outcome Of Addiction Treatment† conducted by Dara Charney, MD, et al, focuses the common problem of depressive or anxiety symptoms appearing together with drug abuse. The study was conducted for 6 months, used a sample of 326 patients that were assessed through semi structured interviews, ASI, BDI, and Symptom Checkli st 90 and then reassessed after 6 months.The objectives of the study were to assess rates of depression and anxiety in patients seeking addiction treatment and examine how the existence of concurrent psychiatric symptoms will influence treatment outcomes. The sample included 326 patients which was mixed population of adults with substance abuse disorder, who were predominantly white (93%) and male (64%) with a mean age of 41 years old. The sample included patients who were recruited upon entering treatment at the MUHC addictions unit.All patients were eligible for study – there were no exclusion criteria. 63% of patients had significant psychiatric symptoms at intake: 15% had depressive symptoms, 16% had anxiety symptoms and 32% presented with combined depressive and anxiety symptoms. During the six-month follow-up study, participants were offered standard treatment: outpatient detoxification, one or two 90-minute group therapy sessions per week, at least four 50-minute indiv idual therapy sessions and random urine drug screens throughout treatment.Follow up included even those participants who dropped out of the treatment (154 patients dropped out of treatment before 6 months mark) and all participants were asked about the outcome of treatment (abstinence status and duration of continuous abstinence), psychological distress and depressive symptoms. Results of the study revealed that those patients who were presented with few psychiatric symptoms on intake or presented with either depressive or anxiety symptoms on intake fared better than those who presented with depressive and anxiety symptoms together: 73% were still abstinent at 6 months.Critique of study #1 The study supported studied done earlier on the same subject and came up with similar results: patients with co-occurring depressive, anxiety symptoms and addictions fare worse at the end of the addiction treatment than those who do not present with co-occurring symptoms. There are several drawbac ks in the means this study employed. The sample was not representative of the community at large, because the majority of the participants were white males.It was not a random sample as well, because patients were recruited at the same facility. Half of the patients dropped out of treatment before the 6 month period, and were still evaluated at the end of the study regarding its objectives, which is not representative of treatment outcomes since they did not receive treatment. However, on the positive side, the study did include a large sample of patients and the outcomes were consistent with the outcomes of the similar studies. Study #2 AbstractThe second study that I selected, â€Å"The impact of depression on the outcome of addictions treatment† conducted also by Dara Charney, MD, Antonios Paraherakis, BSc, et al, focused on prevalence of depression among men and women who entered the outpatient program for substance use disorder treatment. The objectives of the study were to find out whether it was primary depression or substance-induced depression, presentation of specific features of depression and the impact of depression on treatment out comes. The research sample included 75 patients of the MGH addictions unit. 97% of the sample population was Caucasian, 61. 3% were male and 38. % were female, all of mean age of 40. 5 years old. Subjects were consecutively recruited upon entering treatment and no exclusion criteria were applied. At intake 22. 4% of patients exhibited primary depressive disorder, 8. 4% had substance-induced depressions. At 3 months follow up 93. 3% of patients were reinterviewed. Participants who dropped out of the outpatient treatment were also invited to participate in the interview (35% of the sample). The study concluded that patients, who in the beginning of the study presented with primary depressive disorder, had longer duration of abstinence and greater decreases in symptomatology.Patients with substance-induced depressi on almost completely stopped using their primary substance. Critique of study #2 One of the drawbacks of this study is a small sample size: only 75 patients participated. Sample population was not diverse either: the majority of participants were white males. The duration of the study makes the validity of the outcomes questionable, based on the recurring nature of depressive disorder. However, the results were consistent with the results of similar studies. Study #3 AbstractThe third study I selected, â€Å"The role of psychiatric disorders in predicting drug dependence treatment outcomes† conducted by Wilson Compton, MD, et al, examined what role co morbid psychiatric disorders played in the outcomes of treatment of drug-dependent subjects. The researchers used a sample of 401 subjects from a variety of facilities in the St. Louis area: public outpatient methadone clinics, two drug-free outpatient programs, two drug-free inpatient programs, an outpatient program for drug-ab using prostitutes, and a residential recovery shelter for women. The sample was diverse in that 61% were African Americans and 66% were men.The majority had graduated from high school, were unemployed and had never married. Alcohol dependence was the most common co-occurring psychiatric disorder with a prevalence of 63%. The subjects were interviewed upon admission into the study and then re-interviewed at follow-up 12 months later to determine their drug abuse status. The results of the study showed that several psychiatric disorders predicted worse outcomes at the follow-up. For instance, subjects with major depressive disorder showed using a larger number of substances and having more drug dependence diagnoses and symptoms.Subjects with alcohol dependence showed more dependent diagnoses. Outcomes predicted better abstinence results for women then for men. Critique of study #3 This is a thorough study conducted over a fairly long period of time (12 months at follow-up) that involv ed a large population sample (401 subjects) and was diverse in the facilities involved and demographically. It shows solid outcomes consistent with other research that focused on similar topics. Overall, the study is well designed and its outcomes have a high probability of being accurate.Conclusion In conclusion, I would like to say that all three research studies focused on drug abuse treatment outcomes for patients who have co-occurring mental disorder. The first two were done by the same researcher and consistently did not have a varied population sample (the majority of patients were male and white in study #1 and study #2) and were done over a period of time that was not long enough in the duration to accept the findings as truly valid, although, the results of these two studies were consistent with the results of similar studies.The last research study, however, employed a large enough and diverse enough population sample as well as long enough duration to validate the result s that were achieved. Overall, study #3 was designed best out of the three and the validity of its findings can be accepted as accurate with a good amount of confidence. Works Cited Charney, Dora, MD; Palacios-Biox, Jorge, MD, et al (2005). Association Between Concurrent Depression And Anxiety And Six-Month Outcome Of Addiction Treatment.Psychiatric Services, 56, 8. Charney, Dora, MD; Paraherakis, Antonios, BSc, et al (1998). The Impact Of Depression On the Outcome Of Addictions Treatment. Journal of Substance Abuse Treatment, 15, 2, 123-130. Compton, Wilson, M; Cottler, Linda, Ph. D. et al (2003). The Role Of Psychiatric Disorders In Predicting Drug Dependence Treatment Outcomes. The Amercian Journal of Psychiatry, 160, 5. Substance Abuse Impact of Psychiatric Disorders on Treatment Outcomes for Patients with Substance Abuse Daniel Painter Raritan Valley Community College Table of Contents Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. page 3 Abstract 1†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. page 4-5 Critique 1†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. page 5 Abstract 2†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢ € ¦page 6 Critique 2†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. page 6-7 Abstract 3†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦page 8 Critique 3†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. page 8 Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. page 9 IntroductionFor this research I selected the articles that concentrated on treatment outcomes for clients with addictions who also had a mental illness diagnoses (depression, anxiety, antisocial personality disorder, phobias). The first two research studies were conducted at different times but by the same researcher, Drar Charney, MD, and concentrate on outcomes of addiction treatment in patients with co-occurring disorders of anxiety and depression, or both at the same time. The last article by Wilson Compton, MD, focuses on drug dependence treatment outcomes in patient with a variety of mental llnesses. All three studies show similar results in predicting outcomes. Study #1 Abstract The first study that I selected, â€Å"Association Between Concurrent Depression And Anxiety And Six Month Outcome Of Addiction Treatment† conducted by Dara Charney, MD, et al, focuses the common problem of depressive or anxiety symptoms appearing together with drug abuse. The study was conducted for 6 months, used a sample of 326 patients that were assessed through semi structured interviews, ASI, BDI, and Symptom Checkli st 90 and then reassessed after 6 months.The objectives of the study were to assess rates of depression and anxiety in patients seeking addiction treatment and examine how the existence of concurrent psychiatric symptoms will influence treatment outcomes. The sample included 326 patients which was mixed population of adults with substance abuse disorder, who were predominantly white (93%) and male (64%) with a mean age of 41 years old. The sample included patients who were recruited upon entering treatment at the MUHC addictions unit.All patients were eligible for study – there were no exclusion criteria. 63% of patients had significant psychiatric symptoms at intake: 15% had depressive symptoms, 16% had anxiety symptoms and 32% presented with combined depressive and anxiety symptoms. During the six-month follow-up study, participants were offered standard treatment: outpatient detoxification, one or two 90-minute group therapy sessions per week, at least four 50-minute indiv idual therapy sessions and random urine drug screens throughout treatment.Follow up included even those participants who dropped out of the treatment (154 patients dropped out of treatment before 6 months mark) and all participants were asked about the outcome of treatment (abstinence status and duration of continuous abstinence), psychological distress and depressive symptoms. Results of the study revealed that those patients who were presented with few psychiatric symptoms on intake or presented with either depressive or anxiety symptoms on intake fared better than those who presented with depressive and anxiety symptoms together: 73% were still abstinent at 6 months.Critique of study #1 The study supported studied done earlier on the same subject and came up with similar results: patients with co-occurring depressive, anxiety symptoms and addictions fare worse at the end of the addiction treatment than those who do not present with co-occurring symptoms. There are several drawbac ks in the means this study employed. The sample was not representative of the community at large, because the majority of the participants were white males.It was not a random sample as well, because patients were recruited at the same facility. Half of the patients dropped out of treatment before the 6 month period, and were still evaluated at the end of the study regarding its objectives, which is not representative of treatment outcomes since they did not receive treatment. However, on the positive side, the study did include a large sample of patients and the outcomes were consistent with the outcomes of the similar studies. Study #2 AbstractThe second study that I selected, â€Å"The impact of depression on the outcome of addictions treatment† conducted also by Dara Charney, MD, Antonios Paraherakis, BSc, et al, focused on prevalence of depression among men and women who entered the outpatient program for substance use disorder treatment. The objectives of the study were to find out whether it was primary depression or substance-induced depression, presentation of specific features of depression and the impact of depression on treatment out comes. The research sample included 75 patients of the MGH addictions unit. 97% of the sample population was Caucasian, 61. 3% were male and 38. % were female, all of mean age of 40. 5 years old. Subjects were consecutively recruited upon entering treatment and no exclusion criteria were applied. At intake 22. 4% of patients exhibited primary depressive disorder, 8. 4% had substance-induced depressions. At 3 months follow up 93. 3% of patients were reinterviewed. Participants who dropped out of the outpatient treatment were also invited to participate in the interview (35% of the sample). The study concluded that patients, who in the beginning of the study presented with primary depressive disorder, had longer duration of abstinence and greater decreases in symptomatology.Patients with substance-induced depressi on almost completely stopped using their primary substance. Critique of study #2 One of the drawbacks of this study is a small sample size: only 75 patients participated. Sample population was not diverse either: the majority of participants were white males. The duration of the study makes the validity of the outcomes questionable, based on the recurring nature of depressive disorder. However, the results were consistent with the results of similar studies. Study #3 AbstractThe third study I selected, â€Å"The role of psychiatric disorders in predicting drug dependence treatment outcomes† conducted by Wilson Compton, MD, et al, examined what role co morbid psychiatric disorders played in the outcomes of treatment of drug-dependent subjects. The researchers used a sample of 401 subjects from a variety of facilities in the St. Louis area: public outpatient methadone clinics, two drug-free outpatient programs, two drug-free inpatient programs, an outpatient program for drug-ab using prostitutes, and a residential recovery shelter for women. The sample was diverse in that 61% were African Americans and 66% were men.The majority had graduated from high school, were unemployed and had never married. Alcohol dependence was the most common co-occurring psychiatric disorder with a prevalence of 63%. The subjects were interviewed upon admission into the study and then re-interviewed at follow-up 12 months later to determine their drug abuse status. The results of the study showed that several psychiatric disorders predicted worse outcomes at the follow-up. For instance, subjects with major depressive disorder showed using a larger number of substances and having more drug dependence diagnoses and symptoms.Subjects with alcohol dependence showed more dependent diagnoses. Outcomes predicted better abstinence results for women then for men. Critique of study #3 This is a thorough study conducted over a fairly long period of time (12 months at follow-up) that involv ed a large population sample (401 subjects) and was diverse in the facilities involved and demographically. It shows solid outcomes consistent with other research that focused on similar topics. Overall, the study is well designed and its outcomes have a high probability of being accurate.Conclusion In conclusion, I would like to say that all three research studies focused on drug abuse treatment outcomes for patients who have co-occurring mental disorder. The first two were done by the same researcher and consistently did not have a varied population sample (the majority of patients were male and white in study #1 and study #2) and were done over a period of time that was not long enough in the duration to accept the findings as truly valid, although, the results of these two studies were consistent with the results of similar studies.The last research study, however, employed a large enough and diverse enough population sample as well as long enough duration to validate the result s that were achieved. Overall, study #3 was designed best out of the three and the validity of its findings can be accepted as accurate with a good amount of confidence. Works Cited Charney, Dora, MD; Palacios-Biox, Jorge, MD, et al (2005). Association Between Concurrent Depression And Anxiety And Six-Month Outcome Of Addiction Treatment.Psychiatric Services, 56, 8. Charney, Dora, MD; Paraherakis, Antonios, BSc, et al (1998). The Impact Of Depression On the Outcome Of Addictions Treatment. Journal of Substance Abuse Treatment, 15, 2, 123-130. Compton, Wilson, M; Cottler, Linda, Ph. D. et al (2003). The Role Of Psychiatric Disorders In Predicting Drug Dependence Treatment Outcomes. The Amercian Journal of Psychiatry, 160, 5.