Polydrug abuse

In working with PCP and polydrug abusers who have impaired everyday functioning, counselors must be ultimately concerned with the individual s ability to recover. Objective prediction of recovery of function, using NP tests, involves a baseline evaluation and at least one repeated assessment. Patterns of NP strengths and deficits in the two or more assessments may then be compared. Clinical inferences can be made, describing skills that show relative permanence of deficit (with no change on repeated measurement), or... 

Historically, the HRB NP test, the most widely used and well-validated of all NP test batteries, takes from 6 to 8 hours for complete administration. Reducing an established test battery to a 2- to 3-hour structured assessment procedure requires the use of selected subtests those most sensitive to PCP-induced brain dysfunction. The development and validation of briefer screening batteries, which represent a reduction in the total number of subtests used, professional time, and expense is an emergent trend (Hartlage and Mains 1982, Reynolds et al. 1983). Based on our literature review and results of a pilot sample study of 30 PCP and polydrug abusers, the following subtests are recommended for inclusion in a brief NP assessment battery. 

Grant, I. Reed, R. Adams, K. and Carlin, A. Neuropsychological function in young alcoholics and polydrug abusers. J Clin Nenropsvchol 1 39-47, 1979. 

Schifano F, Di Furia L, Forza G, Minicuci N and Bricolo R (1998). MDMA ( ecstasy ) consumption in the context of polydrug abuse A report on 150 patients. Drug and Alcohol Dependence, 52, 85-90. 

Christensen, J. D., Kaufman, M. J., Levin, J. M. et al. Abnormal cerebral metabolism in polydrug abusers during early withdrawal a 31P MR spectroscopy study. Magn. Reson. Med. 35 658-663,1996 . 

Kaufman, M. J., Pollack, M. H., Villafuerte, R. A. et al Cerebral phosphorus metabolite abnormalities in opiate-dependent polydrug abusers in methadone maintenance. Psychiat. Res. 90 143-152,1999. 

Griffiths RR. Commentary on review by Woods and Winger. Benzodiazepines long-term use among patients is a concern and abuse among polydrug abusers is not trivial. 

The variety of drugs found in the urine of fifty consecutive heroin addicts attending the clinic in East Dorset in 1986 is displayed in Table 6.1. Amphetamines and barbiturates were found to be the drugs which were most often taken inadvertently. Polydrug abuse remains a problem, as shown in Table 6.2. This lists all of the drugs identified in the urine of fifty-two patients on their first attendance at the clinic in East Dorset. Only in 54 per cent of cases was just one drug present the rest had two or more. 

At the Haight Ashbury Free Clinics, it has been noted that some of the clients self-medicated their hallucinogenic-precipitated psychotic episodes with amphetamines. ° Often, this self-medication with amphetamines resulted in the development of amphetamine abuse, followed by secondary heroin, barbiturate, or alcohol abuse patterns, to ameliorate the side effects of the amphetamines. Thus, in certain patients, chronic psychological problems induced by LSD and other hallucinogenic drugs led to complicated patterns of polydrug abuse that required additional treatment approaches. ... 

So far we have simplified our discussion by considering only one drug at a time. The study of pharmacodynamics often involves the actions of two or more drugs, however. A person could take multiple drugs at the same time, or take one drug before another has totally cleared his or her body. The extremes are seen in polydrug abuse, which we illustrated in Chapter 1. 

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