Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-17T14:54:29.507Z Has data issue: false hasContentIssue false

Pathways to Opiate Addiction: An Evaluation of Differing Antecedents

Published online by Cambridge University Press:  29 January 2018

Bruce J. Rounsaville
Affiliation:
Yale University Department of Psychiatry and Director of Research, Substance Abuse Treatment Unit, Connecticut Mental Health Center, 100 Park St, New Haven, Connecticut 06511
Myrna M. Weissman
Affiliation:
Departments of Psychiatry and Epidemiology, Yale University School of Medicine; Director, Depression Research Unit, Connecticut Mental Health Center
Charles H. Wilber
Affiliation:
Substance Abuse Treatment Unit, Connecticut Mental Health Center
Herbert D. Kleber
Affiliation:
Yale University Department of Psychiatry and Director of Substance Abuse Treatment Unit, Connecticut Mental Health Center

Summary

This paper defines and tests a typology of addicts defined through assessment of the sequence of three types of key events: (a) traumatic childhood events such as death of a parent or child abuse; (b) onset of regular delinquent activity; and (c) initiation of illicit drug use. By evaluating the sequence of these events three groups are defined: (a) an initial childhood trauma group; (b) an early delinquency group; and (c) an initial drug use group. Data derived from a sample of treated opiate addicts are used to define and differentiate these three groups.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1982 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) DSM III: Diagnostic and Statistical Manual, Ed 3. Washington, DC: American Psychiatric Association.Google Scholar
Amsel, Z., Mandell, W., Matthias, L. et al (1976) Reliability and validity of self-reported illegal activities and drug use collected from narcotic addicts. International Journal of Addiction, 11, 325–36.CrossRefGoogle ScholarPubMed
Bale, R. N. (1979) The validity and reliability of self-reported data from heroin addicts: Mailed questionnaires compared with face-to-face interviews. International Journal of Addiction, 14, 9931000.Google Scholar
Ball, J. C. (1967) The reliability and validity of interview data obtained from 59 narcotic drug addicts. American Journal of Sociology, 72, 650–4.Google Scholar
Beck, A. T. & Beck, R. W. (1972) Screening depressed patients in family practices: A rapid technique. Post Graduate Medicine, 52, 1181–5.Google Scholar
Bejerot, N. (1972) Addiction: An Artificially Induced Drug. Springfield, Illinois: Charles C. Thomas.Google Scholar
Biernacki, P. L. (1973) The Social Careers of Heroin Addicts. Final Report R01 DA 00280. San Francisco, California: Scientific Analysis Corporation.Google Scholar
Bursten, B. (1973) The Manipulator: A Psychodynamic View. New Haven, Connecticut: Yale University Press.Google Scholar
Davis, W. N. (1970) The treatment of drug addicts: Some comparative observations. British Journal of Addiction, 65, 227–35.Google Scholar
Dole, V. P. & Nyswander, M. E. (1967) Addiction: A metabolic disease. Archives of Internal Medicine, 120, 1924.Google Scholar
Dupont, R. L. & Katon, R. N. (1971) Development of a heroin addiction treatment program: Effect on urban crime. Journal of the American Medical Association, 216, 1320–4.Google ScholarPubMed
Dupont, R. L. (1972) Heroin addiction treatment and crime reduction. American Journal of Psychiatry, 128, 856–60.Google Scholar
Endicott, J., Spitzer, R. L., Fliess, J. L. & Cohen, J. (1976) The global assessment scale: A procedure for measuring overall severity of psychiatric disorder. Archives of General Psychiatry, 33, 766–71.CrossRefGoogle Scholar
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview: The schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 37, 837–44.Google Scholar
Eysenck, H. J. (1959) The Manual for the Maudsley Personality Inventory. London: University of London Press.Google Scholar
Hawks, D. (1974) The epidemiology of narcotic addiction in the United Kingdom. In Drug Use: Epidemiological and Sociological Approaches, (eds. Josephson, E. and Carroll, E. E.). New York: Wiley.Google Scholar
Johnston, L. D., O'Malley, P. M. & Eveland, L. K. (1978) Drugs and delinquency: A search for causal connections. In Longitudinal Research on Drug Abuse: Empirical Findings and Methodological Issues, (ed. Kandel, D. B.), pp 137–56. Washington, DC: Hemisphere Publishing Corp.Google Scholar
Joseph, H. & Dole, V. P. (1970) Methadone patients on probation and parole. FED Probation, 34, 4255.Google Scholar
Kandel, D. B. (1978) Convergences in prospective longitudinal surveys of drug use in normal populations. In Longitudinal Research on Drug Use: Empirical Findings and Methodological Issues, (ed. Kandel, D. B.), pp 340. Washington, DC: Hemisphere Publishing.Google Scholar
Khantzian, E. J., Mack, J. E. & Schatzberg, A. F. (1974) Heroin use as an attempt to cope: Clinical observations. American Journal of Psychiatry, 131, 160–4.Google Scholar
Lukoff, I. F. (1974) Issues in the evaluation of heroin treatment. In Drug Use: Epidemiological and Sociological Approaches, (eds. Josephson, E. and Carroll, E. E.). New York: Wiley.Google Scholar
Maddux, J. F. & Desmond, D. P. (1975) Reliability and validity of information from chronic heroin users. Journal of Psychiatric Research, 12, 8795.CrossRefGoogle ScholarPubMed
Martin, W. R. (1980) Emerging concepts concerning drug abuse. In Theories on Drug Abuse: Selected Contemporary Perspectives, (eds. Lettieri, D. J., Sayers, M. and Pearson, H. W.), pp 278–85. Rockville, MD: NIDA Research Monograph Series # 30.Google Scholar
McLellan, A. T., Luborsky, L., O'Brien, C. P. & Woody, G. (1980) An improved diagnostic evaluation instrument for substance abuse patients: The addiction severity index. Journal of Nervous and Mental Disease, 168, 2633.CrossRefGoogle Scholar
Mirin, S. R., Meyer, R. E. & McNamee, B. (1976) Psychopathology and mood duration heroin use: Acute and chronic effects. Archives of General Psychiatry, 33, 1503–8.CrossRefGoogle Scholar
National Institute on Drug Abuse (1976) Client Oriented Data Acquisition Process (CODAP): Statistical Series Quarterly Reports, April–June, 1976. Rockville, MD: NIDA.Google Scholar
Paton, S., Kessler, R. & Kandel, D. (1977) Depressive mood and adolescent illicit drug use: A longitudinal analysis. Journal of Genetic Psychology, 131, 267–39.CrossRefGoogle ScholarPubMed
Pompi, K. F. (1979) The reliability of biographical information obtained from court-stipulated clients newly admitted to treatment. American Journal of Drug and Alcohol Abuse, 6, 7995.Google Scholar
Robins, L. N. (1966) Deviant Children Grown Up. Baltimore, MD: Williams and Wilkins.Google Scholar
Rounsaville, B. J., Weissman, M. M., Kleber, H. D. & Wilber, C. H. (1982) The heterogeneity of psychiatric disorders in treated opiate addicts. Archives of General Psychiatry, 39, 161–6.Google Scholar
Rounsaville, B. J., Cacciola, J., Weissman, M. M. & Kleber, H. D. (in press, a) Diagnostic concordance in a follow-up study of opiate addicts. Journal of Psychiatric Research, (in press).Google Scholar
Rounsaville, B. J., Weissman, M. M. & Kleber, H. D. (in press, b) The significance of alcoholism in treated opiate addicts. Journal of Nervous and Mental Disease, (in press).Google Scholar
Rounsaville, B. J., Weissman, M. M. & Kleber, H. D. (in press, c) An evaluation of depression in opiate addicts. Research in Community and Mental Health, Vol 3, (in press).Google Scholar
Rounsaville, B. J., Eyre, S., Weissman, M. M. & Kleber, H. D. (submitted for publication) The antisocial opiate addict.Google Scholar
SAS Institute (1979) SAS User's Guide. Raleigh, North Carolina: SAS Institute.Google Scholar
Schuckit, M. A. (1980) A theory of alcohol and drug abuse: A genetic approach. In Theories on Drug Abuse: Selected Contemporary Perspectives, (eds. Lettieri, D. J., Sayers, M. and Pearson, H. W.). NIDA Research Monograph Series # 30, pp 297302. Rockville, MD: NIDA.Google Scholar
Selzer, M. L. (1971) The Michigan alcohol screening test: The quest for a new diagnostic instrument. American Journal of Psychiatry, 127, 8894.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: Rationale and reliability. Archives of General Psychiatry, 35, 773–89.CrossRefGoogle ScholarPubMed
Stevens, R. (1972) The truthfulness of addict respondents in research projects. International Journal of Addiction, 7, 549–58.Google Scholar
Strauss, J. S., Carpenter, W. T. & Nasrallah, A. T. (1978) How reliable is the psychiatric history? Comprehensive Psychiatry, 19, 213–14.Google Scholar
Valliant, G. E. (1975) Sociopathy as a human process. Archives of General Psychiatry, 32, 178–83.Google Scholar
Wadsworth, M. E. J. (1980) Early life events and later behavioural outcome in a British longitudinal study. In Human Functioning in a Longitudinal Perspective: Studies of Normal and Psychopathic Populations, (ed. Sells, S. D.). Baltimore, MD: Williams and Wilkins.Google Scholar
Weissman, M. M. & Myers, J. K. (1978) Affective disorders in a US urban community: The use of research diagnostic criteria in an epidemiological study. Archives of General Psychiatry, 35, 1304–11.CrossRefGoogle Scholar
Weissman, M. M. & Paykel, E. (1974) The Depressed Woman: A Study of Social Relationships. Chicago: University of Chicago Press.Google Scholar
Wikler, A. (1973) Dynamics of drug dependence: Implications of a conditioning theory for research and treatment. Archives of General Psychiatry, 28, 611–16.Google Scholar
Woody, G. E. & Blaine, J. (1979) Depression in narcotic addicts: Quite possibly more than a chance association. In Handbook on Drug Abuse, (eds. Dupont, R. L., Goldstein, A. and O'Donnell, J.). Washington, DC: US Government Printing Office, NIDA.Google Scholar
Wurmser, L. (1978) The Hidden Dimension. Psycho-dynamics in Compulsive Drug Use. New York: Aronson.Google Scholar
York, C. (1970) A critical review of some psychoanalytic literature on drug addiction. British Journal of Medical Psychology, 43, 141–59.Google Scholar
Zinberg, N. E. (1975) Addiction and ego function. Psychoanalytic Study of the Child, 30, 567–88.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.