Journal of Drug Issues

The study analyzes a rehabilitation program for skid-row alcoholics that utilizes lay volunteers as an integral component in the rehabilitation, reentry, process. Primary data were responses to a questionnaire by 15 of the 22 sponsor households (68%). The sponsor groups consist of two to six individuals recruited from local churches. We found that while the sponsors are significant in the recovery process, the middle-class values and life-style of the sponsors sometimes conflicts with the lower-class values of the clients. Sponsors are most effective when their primary role is friendship rather than the major responsibility for the recovery process. Primary motivation and reward for volunteering is helping others, with knowledge about alcoholism a significant factor. Sponsors felt they are significant in their client's recovery; sponsor-client contacts need to be made early in the rehabilitation process and much assistance is needed in the initial stages.

Extant studies relating alcohol abuse and alienation are reviewed. Questions are raised concerning the emphasis on the psychological traits of samples characterized by high degrees of powerlessness and low, socioeconomic status. Such studies are further questioned on the basis of their assumption that alienation is a set of consciously held attitudinal variables and on the basis of their neglect of a host of structural issues thought to contribute to alienation. The issues of affective responses to alienation, propertylessness, intrinsic and extrinsic needs, job/work involvement, trust and organizational deviance, and inauthenticity within bureaucratic settings are discussed and suggestions for future studies are offered.

Simplex and nonsimplex models containing personality and perceived environment variables as predictors of current use of alcohol, marijuana, and other drug use were compared in this reanalysis of data reported in a study by Potvin and Lee (1980). Contrary to the results given in the original study, we found that a nonsimplex pattern of relations among different forms of drug use allowed for a more adequate representation of the data than a simplex model for two of the three different age groups of adolescents sampled. Conformity-commitment and religiousness had consistent negative effects on drug use in each sample; parental support-affection and parental approval of friends tended to have small negative effects on drug use; self-esteem and alienation were unrelated to drug use. In general it appears that a nonsimplex model of current drug use provides a more adequate representation of the data than does a simplex model and that religiousness and conformity-commitment are constraining influences on adolescent involvement in drug use.

Theories on tobacco addiction divide into two camps, the exposure orientation and the adaptive orientation. The exposure orientation suggests that the use of tobacco is addictive because of the reinforcement properties of tobacco or because of tobacco's biochemical-altering effects. The adaptive orientation views tobacco addiction as a functional response to distress and, therefore, a form of sub-optimal adaptive behavior. Though the two views are not mutually exclusive, the case is made that the primary cause of addiction is explained by the adaptive orientation, and not the exposure orientation. Viewing not only tobacco addiction but all addictions from the adaptive orientation suggests different approaches to social policy and psychotherapy than those presently espoused by the exposure orientation.

A recent study examining how outreach agencies respond to addictions problems among the elderly uncovered a general dilemma for potential case-finders, namely, the conflict between the worker's concern about the client's substance use and the clients right to privacy. This paper describes how the agencies surveyed were resolving the issue and offers some suggestions as to how the general dilemma can be addressed.

Through in-depth interviews with 10(ten) male and 10(ten) female self-identified recovering alcoholics, this study examines the gender-related differences in pathways to alcoholism diagnosis and treatment. Respondents' stories suggest that while denial of the diagnosis delays appropriate treatment for both men and women, gender-related differences in the nature of the denial systems, such as who makes the diagnosis, who responds to it and how, keep women from such treatment more often than men. This applies irrespective of other gender differences in actual drinking behavior or rationale, symptoms (including psychopathology), time of onset or course of illness.

This article is a biographical sketch of Charles Edward Terry (1878–1945), a public health reformer who pioneered narcotic maintenance in early twentieth-century America. He also coauthored (with Mildred Pellens) The Opium Problem, a book that has been posthumously recognized as one of the most important works on the subject ever written. Terry's career and ideas are described against the background of the Harrison Act and the formation of American narcotic policy—a policy against which Terry vigorously, but unsuccessfully, dissented.

In the course of lengthy, confidential interviews conducted with 354 male narcotic addicts (195 Black, 159 White) living in the Baltimore metropolitan area, detailed information was obtained concerning their use of non-narcotic drugs during periods of active addiction to narcotics (principally heroin) as well as during periods of non-addiction to narcotics. A wide variety of non-narcotic substances were found to have a nonzero incidence of use; however, both the types and amounts of non-narcotic drugs used, as well as the combinations (patterns) in which they were used, were found to be a joint function of race (Black/White) and narcotic addiction status (actively addicted/not addicted to narcotics). Factor analysis revealed three major patterns among Blacks during periods of active narcotic addiction, and a different three patterns during periods of nonaddiction. Among Whites, four major patterns were identified during periods of active narcotic addiction, and five during periods of nonaddiction. Subsequent applications of cluster analysis revealed several different types of addicts based on patterns of non-narcotic drug use.

Therapists, counsellors and researchers looking into the alcohol and drug problems of homosexuals report that there have been inappropriate treatment and lack of facilities. This is slowly changing. The specific needs of gays were first recognized by Alcoholics Anonymous (A.A.), which by forming the splinter group of Gay A.A., provides the most support for gay alcoholics. The specific needs of gays with alcohol problems are discussed, as are intervention procedures and lack of knowledge—especially in the area of drugs other than alcohol.